Doctors Can Prescribe Ivermectin, Hydroxychloroquine Off-Label For COVID-19: Nebraska AG
Nebraska Attorney General Doug Peterson issued a legal opinion saying that his office won’t seek disciplinary action against doctors who prescribe hydroxychloroquine or ivermectin as off-label medicines to treat or prevent COVID-19, as long as they are not engaging in any misconduct.
The opinion (pdf), issued on Oct. 15, was in response to a request from Dannette Smith, CEO of the state’s Department of Health, which licenses and disciplines doctors. Smith asked whether it would be “deemed unlawful or otherwise subject to discipline” for doctors to prescribe ivermectin, hydroxychloroquine, or other “off label use” medications to treat or prevent COVID-19.
The Republican attorney general said in the opinion that his office finds “the available data does not justify filing disciplinary actions against physicians simply because they prescribe ivermectin or hydroxychloroquine to prevent or treat COVID-19.”
Health care providers in general may be subject to discipline if they “neglect to obtain informed consent, deceive their patients, prescribe excessively high doses, fail to check for contraindications, or engage in other misconduct,” wrote Peterson.
He said his office is not recommending any particular treatment options for COVID-19, but only the off-label early treatment options as raised by the health department “and conclude that the available evidence suggests that they might work for some people.”
The opinion continues, “Allowing physicians to consider these early treatments will free them to evaluate additional tools that could save lives, keep patients out of the hospital, and provide relief for our already strained health care system.”
The legal opinion also noted that there may be other promising off-label medicines to tackle the CCP (Chinese Communist Party) virus, which causes COVID-19.
Hydroxychloroquine, an anti-inflammatory and anti-malarial medication, gained prominence and heavy scrutiny after former President Donald Trump said he was taking it as a prophylactic.
Facebook, Twitter, and YouTube in July 2020 removed videos of a group of doctors who advocated for its use as early treatment and prophylaxis amid the pandemic.
A study published in the American Journal of Medicine on Jan. 1 found that hydroxychloroquine helped lower mortality in the early treatment of COVID-19.
The World Health Organization in March advised against the use of hydroxychloroquine for COVID-19.
Ivermectin, a generic medicine widely used against some parasitic worms as well as to treat scabies, lice, and rosacea in humans, has been praised by some doctors as a life-saving early treatment for COVID-19.
Two groups, the Front Line COVID-19 Critical Care Alliance and the British Ivermectin Recommendation Development Group, have urged for the off-label use of ivermectin for COVID-19. There are at least 63 studies, of which 45 are peer-reviewed, on the treatment of COVID-19 with ivermectin.
The American Medical Association, the American Pharmacists Association, and the American Society of Health-System Pharmacists, said in a joint statement in September they were against its use outside of a clinical trial as a COVID-19 drug.
In Australia, the therapeutics regulator has restricted the prescription of ivermectin for COVID-19 and other off-label use only for certain specialists, including infectious disease physicians, dermatologists, gastroenterologists, and hepatologists.
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Jarrad Winter, via AmericanThinker.com, has broken down a few key sections from the AG’s lengthy opinion.
As to the question of ivermectin as a treatment option:
The Mahmud study–a CRT that explored ivermectin as an early treatment for 363 individuals–concluded that “patients with mild-to-moderate COVID-19 infection treated with ivermectin plus doxycycline recovered earlier, were less likely to progress to more serious disease, and were more likely to be COVID-19 negative on day 14. And Niaee’s research team found that ivermectin can help even hospitalized patients. That group conducted a “randomized, double-blind, placebo-controlled, multicenter clinical trial” with 180 hospitalized patients diagnosed with COVID-19. They concluded that ivermectin “reduces the rate of mortality and duration of hospitalization in adult COVID-19 patients,” and the improvement of other clinical parameters showed that the ivermectin, with a wide margin of safety, had a high therapeutic effect on COVID-19.
What initially made ivermectin a target for all the inexplicable slander?
Why would ivermectin’s original patent holder go out of its way to question this medicine by creating the impression that it might not be safe? There are at least two plausible reasons. First, ivermectin is no longer under patent, so Merck does not profit from it anymore. That likely explains why Merck declined to “conduct clinical trials” on ivermectin and COVID-19 when given the chance. Second, Merck has a significant financial interest in the medical profession rejecting ivermectin as an early treatment for COVID-19.
As to the question of hydroxychloroquine as a treatment option:
In 2004, long before the COVID-19 pandemic began, a lab study revealed that chloroquine “is an effective inhibitor of the replication of the severe acute respiratory syndrome coronavirus (SARS-CoV) in vitro” and thus that it should be “considered for immediate use in the prevention and treatment of SARS-CoV infections”. The following year, another paper explained that “chloroquine has strong antiviral effects on SARS-CoV” and “is effective in preventing the spread of SARS[-]CoV in cell culture.”
It is widely recognized in the medical community that hydroxychloroquine is generally safe, so safe in fact that it may be prescribed to pregnant women and “children of all ages.”
What made hydroxychloroquine controversial in the first place?
A striking example features one of the world’s most prestigious medical journals–the Lancet. In the middle of the COVID-19 pandemic, the Lancet published a paper denouncing hydroxychloroquine as dangerous. Yet the reported statistics were so flawed that journalists and outside researchers immediately began raising concerns. Then after one of the authors refused to provide the analyzed data, the paper was retracted, but not before many countries stopped using hydroxychloroquine and trials were cancelled or interrupted. The Lancet’s own editor in chief admitted that the paper was a “fabrication, a monumental fraud,” and “a shocking example of research misconduct in the middle of a global health emergency.”
Interesting note about ivermectin and hydroxychloroquine hesitancy:
As for professional associations’ and physician groups’ views on hydroxychloroquine, it appears they generally adopt the same position they did on ivermectin. Those like the AAPS who support ivermectin as an option for early COVID-19 treatment generally support hydroxychloroquine too, while those like the AMA, APhA, and ASHP that oppose one typically resist the other.
The AG’s conclusion:
Allowing physicians to consider these early treatments will free them to evaluate additional tools that could save lives, keep patients out of the hospital, and provide relief for our already strained healthcare system.
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Read the full opinion below:
Tue, 10/19/2021 – 08:45