Dr Josh Septimus, a primary care physician at Houston Methodist who manages all six of the hospital’s same-day clinics, said some COVID patients become irritated when his staff refuses to treat them with ivermectin. The medicine is only approved for parasitic illnesses, such as river blindness or scabies, and not for viral infections.
Patients are flooding his clinics with requests for the drug, he said, leading to hostility toward physicians assistants and nurse practitioners who by policy cannot prescribe it.
“We have had patients threatening us if we decline to prescribe ivermectin,” he said.
“There are people who have just completely lost faith in mainstream medicine. And in those communities, there’s anger at the public health establishment.”
Ivermectin is at the center of the latest craze over unproven COVID treatments that so far do not show any meaningful benefits for patients battling the virus. Researchers are still studying whether the drug can help COVID patients in the future. But right now, the U.S. Food and Drug Administration and Centers for Disease Control and Prevention warn against using it, citing the risk of severe side effects.
Outpatient ivermectin prescriptions have soared since mid-July, with a simultaneous increase in calls to poison control centers about ivermectin exposure, according to the CDC. Some people who ingested the drug reported serious damage to their nervous system.
Ivermectin has “become part of the canon of anti-science disinformation that we’re seeing from the political right,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. “There is no strong evidence that it works either as a treatment or preventative measure for COVID.”
Dr Faisal Masud, the medical director for critical care at Houston Methodist, said families have been demanding the drug for their loved ones fighting COVID in the ICU. Before the drug became popular, demands for specific medications were “very rare,” he said.
“That is baffling and it’s disappointing,” he said. “It creates a rift between the medical team and the family. And you don’t want that. You want everybody on the same page.”
The desire for ivermectin led one family last week to file a lawsuit against Memorial Hermann. A 74-year-old man, described as the backbone of his family, obtained a prescription for the drug at Houston’s VA Medical Center following a positive COVID test, a family member said. He was later admitted to Memorial Hermann Sugar Land.
A Fort Bend County judge on Sept. 3 issued a court order to force the hospital to administer the drug, but doctors refused, the family said. The man died three days later. The VA said it is reviewing the case but could not comment on the prescription. Memorial Hermann could not comment on specifics of the case.
Experts point to multiple factors that trigger people’s desire to resort to drugs like ivermectin. The increased reliance on the internet in lieu of medical doctors is one issue, said Dr Eric Storch, professor and vice-chair of psychology in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine.
The level of political divisiveness also plays a role, he said.
“There’s become this suspiciousness within our system that oftentimes is sort of falling on partisan lines,” he said. “Another thing is people are really reaching out for answers especially when there’s this fear and anxiety in the air.”
High-profile conservative media figures such as Laura Ingraham and Tucker Carlson have touted the drug as a possible COVID treatment. Well-known podcaster Joe Rogan, who attracts a massive audience, recently said he used ivermectin with a number of steroids to treat COVID.
Masud said some COVID patient family members refer to celebrities they see using it. But they “are demanding something that no reasonable doctor would ever be comfortable prescribing,” he said.
That creates a trust issue between doctors and patients at a time when that connection is paramount, he said. Families cannot see their loved ones who have COVID and therefore must rely more heavily on the doctor’s decisions, he said.
What starts as skepticism evolves into paranoia. Then it turns into aggression.
“The verbal, the psychological, and in some cases physical threats is unprecedented,” Masud said. “And you need to remember that all of my doctors — including the physical therapists, respiratory therapists — are exhausted.”
Septimus said the patients in his primary care practice do not display the level of hostility as patients in same-day clinics, where doctors often see people for the first time.
His patients usually respond with a “thank you” when he explains why he will not treat them with ivermectin, he said. “But that is not the experience of many of my younger colleagues who do not have that long trust built up, where those patients get very angry and demand and complain.”
Experts say some ivermectin advocates misunderstand early lab studies that showed some benefits against COVID. More recent, comprehensive tests on humans have not been promising.
“There is a ton of stuff you can put in a test tube with the virus that inhibits viral growth,” said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine.
McDeavitt and other researchers acknowledge that further study of ivermectin is warranted. But Masud and Septimus view the level of misinformation as an urgent problem.
“We are also people,” Masud said.
“We are scared. We are frustrated. We also want this to end. Threatening doesn’t do any good. If doctors don’t show up, who is going to suffer?”