In its warning about the drug ivermectin, Louisiana’s Department of Health both potentially helped protect people and put lives at risk.
Echoing a recent reminder distributed by the national Food and Drug Administration, LDH “strongly” advised not to use this drug, authorized by the FDA for use in humans and animals to battle parasites, for prevention and treatment of the Wuhan coronavirus. Several states have done the same, and reports of increased volumes of calls to a few states’ poison control centers have emerged logging incidents from taking the drug for this purpose and a few precautionary hospitalizations have occurred from this, although no reports of medical intervention have surfaced as a result.
The LDH news release notes that dosage for animals and human differs, that “[u]sing any treatment for COVID-19 that is not approved or authorized by the FDA, unless part of a clinical trial, can cause serious harm,” and urges “do not take ivermectin unless you have a prescription for an FDA-approved use, get it from a legitimate source and take it exactly as prescribed for the condition it was prescribed for.” These kinds of uses ensure a correct dosage and unadulterated product, such as through a compounding pharmacy.
Cautioning in this fashion does alert people not to self-medicate dangerously. Unfortunately, it also ignores mounting evidence of the drug’s effectiveness and may cost lives by discouraging its use especially upon contracting the virus.
While the FDA may largely agree with the LDH pronouncement, also made by several other states’ health agencies, most states have yet to announce this as their official word on the subject and use of ivermectin in this fashion isn’t illegal. Medical professionals legally may prescribe it for use against the virus (colloquially called “off-label” use) and some do.
The World Health Organization isn’t in the business of regulating drug use, and on this subject provides a more objective view. At the end of March, it called evidence of effectiveness in use of ivermectin either as prophylactic or treatment “inconclusive,” which hasn’t changed since.
However, since then, controlled trial data have pointed towards effectiveness, at particular dosages in specific regimes. Three weeks after WHO’s statement, a meta-study (essentially, a summary of studies) of controlled trials published that determined on the whole ivermectin did convey prophylactic and treatment benefits. Last month, another meta-study found the same (although one study in its portfolio has come under question).
These studies indicate taking one or more certain number of dosages of ivermectin can prevent contracting the virus, but not nearly at the effectiveness level of current vaccines approved in America. Yet these also report that taking it at the onset of virus symptoms also significantly reduces the harmfulness of the bug (this feature widely anecdotally noted through personal experiences posted on social media).
From a political perspective, the LDH discouragement in spite of this science seems understandable in a state in the bottom half-dozen in proportion of vaccinated individuals. Not speaking against ivermectin makes it easier to promote it as a vaccine alternative, even though it appears less impactful.
But it also throws the baby out with the bathwater, creating less incentive for people to have ivermectin on hand or request it if contracting the virus – whether they are vaccinated, for breakthrough cases of vaccinated individuals on the rise indicate waning effectiveness as time passes. As such, the LDH news release has performed a public disservice.
Fighting the pandemic, especially as it undergoes its current transition into an endemic fact of life, requires every pharmaceutical edge be on the table. LDH should issue a postscript to its statement, summarizing the actual science behind ivermectin research, as well as reports of the drug’s misuse and its consequences, and let people and health care providers draw their own conclusions about its use against the virus. Anything less violates its duty to protect the health of Louisianans.