It has been an interesting couple of months.
The minor firestorm began when the media began reporting stories of people using veterinary formulations of ivermectin to treat or prevent COVID. It was possible to buy it at farm feed stores or places like Tractor Supply. Some overdoses occurred. The media over-represented how many overdoses took place, and the FDA issued a warning.
Then something magical happened. Overdoses associated with use of a veterinary product somehow became conflated with medically supervised use of prescription ivermectin at appropriate dosage levels. All of a sudden, it became unsafe and unwise to use prescription ivermectin. The FDA even issued an infamous tweet. And the media began to mock the idea of taking ivermectin for COVID-related issues.
Very quickly, the Deep State mobilized against ivermectin as the Delta Surge hit. Messages were put out to the states. HHS stopped payments for ivermectin for Medicare beneficiaries.
And of course, North Carolina gleefully jumped aboard. NC Health and Human Services got involved. The North Carolina Board of Pharmacy put out an initial message to pharmacists and pharmacies that later got expanded. All of a sudden, pharmacists statewide were less willing to fill prescriptions; and patients had to scramble to get them filled. You can view the Board of Pharmacy's message on the home page of its website. It is wildly inappropriate. Here is the most important part of their message:
Pharmacists are reminded that they have a right to refuse to fill or refill any prescription order if doing so would be contrary to their professional judgment. Moreover, a pharmacist shall not fill or refill a prescription order if, in the exercise of the pharmacist’s professional judgement, there is a question as to its safety for the patient. 21 NCAC 46.1801. As well, pharmacists have an obligation to engage in neither negligent nor unprofessional conduct in the practice of pharmacy. G.S. 90-85.38(a)(9) and (a)(10).
That message had a chilling effect. And yet, there is a rapidly developing literature suggesting that ivermectin can be helpful for both prevention and treatment of COVID-19-related complications.
Moreover, ivermectin has been used safely in humans for many years for such conditions as scabies, lice, onchocerciasis, and strongyloidiasis. It is widely suspected that its widespread use in certain foreign countries aided the response to COVID-19 dramatically; and accounted for the fact that some of these countries had much less problems with the pandemic than the United States did.
And physicians have had the prerogative to prescribe "off-label" for many years. That is nothing new. It contributes to medical innovation, which ought to be regarded as desirable.
The premise that pharmacists wield a discretionary veto over prescriptions written by physicians is highly problematic. While they can play a vital role in assuring that prescriptions are safely dispensed, and that errors are caught, this grants them a form of unchecked power that can harm patients.
One phenomenon that is not widely known is that pharmacists over the last couple of decades now earn a doctorate-level degree when they graduate from school. That was not always the case. This naturally makes them feel that they are on par with physicians; but they do not carry the same responsibility to patients to offer them therapies that might be helpful, and to help solve their predicament.
But what was even more worrisome? Some pharmacists have been telling patients outright lies. They represented that they could not get the drug from suppliers-- even though any pharmacy can order it and wait. A couple of pharmacists tried to tell me that the State Board of Pharmacy or the FDA was prohibiting them from dispensing it-- which was untrue.
Then there are dynamics I had previously discussed. The vast majority of primary care physicians in the state were not offering early treatment or preventive treatment. Hospital systems were actively discouraging it. At least one in North Carolina took ivermectin off their formulary. (Indeed, the unavailability of preventive and early treatment was the key factor that led to many folks buying veterinary ivermectin out of desperation.)
The federal and state governments sent an unmistakable signal that using ivermectin was an unwise approach, and the unthinking sheep were easily herded. Moreover, the "establishment" organizations that provide continuing education to physicians punted on the issues of early or preventive treatment.
Recall also that last year, the state of North Carolina had hit the brakes on the concept of preventively prescribing hydroxycholoroquine-- and made it illegal.
And as a result, North Carolina patients have been poorly served. Too many have died unnecessarily; and too few had access to these therapies. And the governmental entities that primp around and pretend they are protecting the public instead are doing the exact opposite.
I had posted here Dr. Peter McCullough's talk a few days ago. And toward the end of his talk, he pointed out that our struggles are not ultimately about the numerous micro-issues associated with the pandemic such as the ability to prescribe and fill a prescription for ivermectin or hydroxychloroquine. Instead, he said, there is something very big going on that was planned a couple of years ago. He implied there is a larger agenda; and we now see that the agenda was not just getting rid of Trump.
And in fact, McCullough offers the only plausible explanation. Because there has been so much illogic and irrationality since the very beginning and applied consistently over the last 19 months-- wielded by otherwise intelligent people-- it is not possible to ascribe these issues to mere stupidity or intransigence or obstinacy.
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