From comments in Nakedcapitalism.com (your mileage may vary):
urblintz Thank you IM Doc.
Your patients are in the best of hands.
Respect.
Carolinian Perhaps you can link to official sources that those of us could point our physician to should we unfortunately get Covid. I have no idea whether Ivermectin is allowed in my state but it would be helpful to at least have some ammunition to request a second opinion or access to someone who could write a prescription. I find your personal witness on this compelling but what are people to do when the medical establishment, or at least some of it, is trying to stymie a medication that is both legal and safe? Do patients have any right or say in the manner?
Yves Smith The problem is physicians are receptive or they aren’t, so medical literature won’t persuade someone whose mind is made up. My MD was willing to prescribe me some initially but the anti-Ivermectin view is particularly strong in NYC so she’s backed off.
Orca You can find information about (IVM) treatment protocols and obtain prescriptions at the Front Line COVID-19 Critical Care Alliance website (look for Quick Links) –
https://covid19criticalcare.com/
Dr. Pierre Kory, former Chief of the Critical Care Service and Medical Director of the Trauma and Life
Support Center at the University of Wisconsin and a Master Educator, tweeted that his colleagues have prescribed hundreds of IVM treatments to congressional staff.
There have been a few links on this site this week about ivermectin. Including a very well done discussion of the most important extant trials.
I would like to add a few things from my own experience about this drug. And where we are right now. In my area, we are again having what appears to be the early stages of yet another surge of COVID. This time, it is clearly involving many fully vaccinated and even boostered patients. And they are very ill. This is not a joke. In these patients, the vaccines have clearly failed in their mission. Seeing the tide coming in, even Dr. Fauci had to admit as such this week.
We supposedly have the new Pfizer drug (more on that in a second) and we now have the monoclonal antibody therapy. Unfortunately, the supply of the Pfizer drug is non-existent. And we have very limited supplies of the antibody drug. That drug is reserved for only patients that are high-risk and already very ill. Just so you can understand the magnitude of this issue – 68% of the patients who received the antibodies this week in my area were fully vaccinated, many boostered (I do not have that exact %). The other 32% were the unvaccinated. Again – the vaccinated patients are now getting sick enough to be in the “high-risk” group to get antibodies.
I do not believe anyone anticipated we would be in this situation with a fairly significant majority of the population vaccinated – but here we are. And now because of the severe staffing shortages and other issues, it is very important to do all we can to keep people out of the hospital safely.
As I have stated repeatedly, my experience in previous surges with this infection have demonstrated to my own eyes that Ivermectin is very capable of doing this. That is pretty much the only area in which I use it – patients who are positive whether ill or not get started on it immediately in addition to all of their primary contacts. Despite the months of propaganda from MSNBC and the CDC ( don’t take the horse dewormer y’all) , I have yet to have a single person have one issue with this medication. The same cannot be said for the vaccines. However, as is the case in every single viral infection in human medicine, once people are sick enough to be in the hospital, almost nothing works well. One of the agents we have been using, remdesevir, seems to do absolutely nothing beneficial that I can tell and often damages the patients. To be brief at that point of hospital admission – it is 100% support. It is critical to deal with patients early and strong in their illness.
I will say again – I was a very young doctor in the AIDS crisis working in an inner city hospital surrounded by dying AIDS patients at every turn. A very similar story was playing out at the time – and I guess WISDOM is the ability to learn from the mistakes of the past and never let them fool you again.
Pneumocystis carinii – the scourge of AIDS before we had effective anti-virals is the agent that killed the vast majority of my patients back then. Often abbreviated PCP. It causes a severe pneumonia. This bug is most definitely NOT a bacteria. In the 1980s it was thought to be a protozoa like ameba – however now we consider it more like a fungus ( I am not going into that here – suffice it to say it is NOT a bacteria). Interestingly, there were all kinds of agents in the 80s and early 90s for this agent that were actually doing far more damage than good to people – IV and inhaled pentamidine is the most common. And this drug was making mountains of cash for Big Pharma. From the front lines, various docs across the country started using a very old patent-expired ANTI-BACTERIAL called BACTRIM. 2 cents a pill. This had been used for decades at the time mainly in the treatment of urine infections. And docs all over America noticed how well it was working for PCP. All anecdotal – but vigorously shared. We had all had one too many cardiac arrests with the pentamidine. Some papers here and there appeared. All minimal studies because that is all you could really do as a lone wolf at the time. But overwhelming efficacy and minimal safety issues were noted. And then Dr. Fauci sent out the wolves. He and others were very busy promoting vaccine research, and antivirals that were very toxic, and keeping the pentamidine money train going. I sat through one conference after another deriding the use of BACTRIM as a pee pill by NIH experts sent to quell the rebellion. “How dare you use a bacterial agent against this protozoan fungus – the drug is not even in the right class”. The ridicule coming from these people at times was overwhelming. All kinds of papers and statistical manipulation was belched forth to try to subvert the evildoers. But the drug actually worked. And the doctors using it noted it. And persisted. And over the next few years, despite the NIH, Bactrim became the drug of choice for PCP – and still is to this day. I have not written a prescription for pentamidine in decades. Not even sure they still make it.
Therefore, was born an innate skepticism of Big Pharma and indeed of Dr. Fauci, in an entire generation of young doctors in this country.
One huge difference back then is we did not have the odious presence of the pathological liar Rachel Maddow and the morons at the NYT to poison the medical discourse. We did not have Big Pharma owning our entire media landscape with their ad dollars ( that did not start until the mid 1990s hat tip to the assholes Newt Gingrich and Bill Clinton). We did not have facebook and twitter and youtube to censor anything that was said about bactrim or pentamidine. We had ourselves, our colleagues, our wits, and our experience and our intellect. It was a much better world.
Unlike so many on both sides of the ivermectin issue which appear to be religious zealots, I came by my usage of this drug by doing a deep dive into the actual science. I was initially quite skeptical. But reading the basic science and some of these clinical trials made me feel very comfortable in trying it. The safety profile is so good that using it in this kind of crisis would be unethical. I am not alone in that assumption. Despite what the talking heads say on TV, every medical ethics conference I have been to about this topic, EVERY SINGLE ONE, to this day continue to state it is UNETHICAL not to use it.
Earlier this year, I attended a few conferences where the pharmacodynamics were discussed and the clinical trials discussed. It was there I learned from a PharmD that I know and trust that Big Pharma was starting their anti viral trials for COVID. And the candidates he had seen HAD EXACTLY THE SAME COURSE OF EFFECT ON COVID AS THE BASIC MEDICINE TRIALS WERE TELLING US ABOUT IVERMECTIN. Let me say that again – at least some of the Big Pharma agents being evaluated had the exact same effect on COVID as Ivermectin. I could not believe that at the time. Because this research is proprietary, it was unavailable to be looked at. But I did share this with the COVID brain trust back then. But here we are – on the verge of having this released – and indeed – THE PFIZER DRUG INHIBITS EXACTLY THE SAME PROTEASE INHIBITOR AS IVERMECTIN. The only difference is that ivermectin seems to be active against multiple other parts of COVID that this new Pfizer drug does not touch.
And where do the American people get to learn this? From Rachel Maddow? Sean Hannity? Chris Cuomo? The Paper of Record the NYT? The New Yorker? – Our elected officials? NO TO ALL – We get to learn this from a retired nurse in Great Britain and a comedian in his garage studio – https://www.youtube.com/watch?v=xROICA8Hr7I
Please note – the discussion that the nurse gives is the Cliffs note version of what I have been hearing for months. He makes it very easy to understand.
We are a corrupt and unserious nation. That includes my profession. They have managed to propagandize this issue for long enough now that the very word ivermectin is now radioactive. And just in time for the new 800 dollar a course Pfizer drug to hit the market – and there are others from other companies right behind them. Pigs feeding at the trough.
Where are the promised trials? I have been waiting all year. As a non-zealot, I would love to know one way or the other what the efficacy of ivermectin is……Will likely never know at this point. The cash register is just 2 steps away.
If you are high risk, get vaccinated. If you feel you are sick with COVID or are newly positive – get in touch with your doc. At my practice, we are now hitting it with all we have. I now have many patients demanding this approach. The Joe Rogan and Aaron Rodgers screeds from the MSM have done nothing but profoundly increase this desire. Antibodies if available. Ivermectin and fluvoxamine. And all the usual OTC. If you are vaccinated, do not assume there is a halo of protection – there most certainly is not. Continue to be diligent. Lose weight, sleep well, do all you can to decrease your stress level. Protect your vulnerable.