AMA to doctors: Stop prescribing ivermectin to treat COVID, damn it

(AP Photo/Andrew Harnik, File)

There’s a running debate on Twitter today over what’s more newsworthy, people taking an anti-parasitic drug to treat COVID or the media dunking on them for it by falsely describing ivermectin as a medication for livestock. It isn’t — at least, not exclusively. There’s an FDA-approved version for human beings and there’s also a more concentrated version for horses and cattle, and some unknown number of people have taken the latter in their desperation to gain access to the drug. Snarking that Joe Rogan is taking a “horse dewormer” for his coronavirus infection may well be (and probably is) inaccurate. In its haste to goof on Rogan for having flirted with anti-vaxxism in the past, the press is being irresponsible. And they should be called on it.

But the bigger story is that seemingly many thousands of Americans are hunting around for a drug which at least 14 different studies have shown doesn’t work on COVID, right? To read some righty commentary today, you’d think the true scandal with ivermectin is that our feckless press has besmirched the good name of a perfectly respectable deworming medication. Virtually every take about it makes a point of noting that it was created by a Nobel Prize winner.

I’d say the bigger scandal is that some meaningful number of our fellow citizens are either so allergic to medical consensus or so dug in on their antipathy to the vaccines that they’re willing to dose themselves with an unproven drug in the expectation that they’ll eventually own the smarmy pro-vax eggheads when ivermectin ends up curing their COVID. And some of them have taken that spiteful logic to the point that they’re willing to obtain that drug in animal-sized doses from pet stores.

If this is a media bias story, it’s a media bias story secondarily. Primarily it’s a story about people doing everything they can during a raging pandemic to avoid following conventional medical advice to protect themselves.

Some responded to that by saying, “If the media lies about the drug by saying it’s for horses, and the people taking it know that’s a lie, why would they believe anything else the media says?” Agreed, the media should be accurate because that’s its most basic ethical duty. But do we really think the press being scrupulously accurate about ivermectin’s dual human/animal use would matter to people who’ve come this far ignoring the data in favor of vaccination? Because that’s who’s mostly taking ivermectin, I assume. If you’ve reached the point where an anti-parasitic drug is your go-to prophylactic or therapeutic against COVID, you gave up on listening to medical advice from “the establishment” awhile ago.

All of this is a prelude to the AMA stepping in today to urge doctors to stop prescribing this drug for COVID, for God’s sake. It’s not just that there’s no evidence that it’s effective against the disease. It’s that many people clamoring for ivermectin are surely doing so as an alternative to getting vaccinated. It’s true that taking normal doses of the drug won’t harm a person, but that’s not the point. What’ll harm them is encouraging or enabling their foolish decision to rely on an unproven prophylactic/treatment in lieu of getting the vaccine.

Ivermectin is approved by the U.S. Food and Drug Administration (FDA) for human use to treat infections caused by internal and external parasites. It is not approved to prevent or treat COVID-19. Ivermectin is also available to treat certain veterinary conditions; medications formulated or intended for use in animals should not be used by humans. We are alarmed by reports that outpatient prescribing for and dispensing of ivermectin have increased 24-fold since before the pandemic and increased exponentially over the past few months. As such, we are calling for an immediate end to the prescribing, dispensing, and use of ivermectin for the prevention and treatment of COVID-19 outside of a clinical trial. In addition, we are urging physicians, pharmacists, and other prescribers—trusted health care professionals in their communities—to warn patients against the use of ivermectin outside of FDA-approved indications and guidance, whether intended for use in humans or animals, as well as purchasing ivermectin from online stores. Veterinary forms of this medication are highly concentrated for large animals and pose a significant toxicity risk for humans.

“[T]he media have convinced themselves that they know better than the doctors prescribing ivermectin to their coronavirus patients,” wrote Kaylee McGhee White today in another piece refocusing the ivermectin saga on media bias. Well, now here’s the AMA telling doctors to stop prescribing it. What kind of doctor would dose out an unproven treatment knowing that an actually effective one is free and widely available, anyway?

Where does the impulse come from to excuse people’s decision to take this drug knowing that it likely means they’ll skip getting vaxxed and go on putting themselves and those around them at higher risk of infection, transmission, and serious illness from COVID?

“Use of ivermectin for the prevention and treatment of COVID-19 has been demonstrated to be harmful to patients. Calls to poison control centers due to ivermectin ingestion have increased five-fold from their pre-pandemic baseline,” the AMA goes on to note. Right, the uptick in documented poisonings has been widely covered, and of course no one knows how many cases there have been where someone overdosed but didn’t call poison control (possibly out of embarrassment if they took the animal version). It’s unclear how common ODs are but this story from Oklahoma is hair-raising:

Dr. McElyea said patients are packing his eastern and southeastern Oklahoma hospitals after taking ivermectin doses meant for a full-sized horse, because they believed false claims the horse de-wormer could fight COVID-19.

“The ERs are so backed up that gunshot victims were having hard times getting to facilities where they can get definitive care and be treated,” he said.

That’s something McElyea said is now backing up ambulance systems as well.

“All of their ambulances are stuck at the hospital waiting for a bed to open so they can take the patient in and they don’t have any, that’s it,” said Dr. McElyea. “If there’s no ambulance to take the call, there’s no ambulance to come to the call.”

Some people who live in rural areas may have ivermectin already on hand for their livestock and are accessing that supply rather than going to see a doctor for a prescription, maybe because they’re not sure if the doctor would write one for them. In that sense, the AMA’s recommendation may end up backfiring in the same way that cutting off legal access to a drug in high demand ends up backfiring. People desperate for ivermectin and now newly unable to get an Rx may resort to the animal version, increasing the risk of an overdose. That’s a tough position for the AMA since they’re trying to steer doctors and patients into embracing vaccination as the only effective hedge against COVID, but cutting off the ivermectin supply likely isn’t going to do that. People with a ravenous appetite for snake oil will try to get it one way or another. That’s the story here, not the media snickering about “horse dewormer.”