OPINION

The Nebraska AG Has Gone Where No Man Has Gone Before

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…by actually looking at data. Imagine that. And on October 14, he issued a lengthy advisory letter indicating that the use of Hydroxychloroquine or Ivermectin in the early treatment of COVID-19 was just fine, as long as ordinary informed consent was given. In plain English, doctors and patients are free to do what doctors and patients are supposed to do – discuss treatment options and proceed when they agree. The Governator and Howard Stern be damned!

The short story is that AG Peterson was asked by Dannette Smith, the CEO of the Nebraska Department of Health and Human Services if it was “unlawful” for doctors to prescribe HCQ or Ivermectin as early treatment or prophylaxis for COVID-19. Ultimately the AG said, “No.” He could have told her it was a stupid question and been completely correct. After all, physicians are supposed to make decisions in the best interest of their patients. It’s not up to bureaucrats.

A lot of prescriptions are for “off-label” uses for drugs. As an anesthesiologist/intensivist, I can point to dozens, if not hundreds, of times I used a medication outside of the list of things the FDA approved it for. And that’s just because my memory of thirty-six years in the trade isn’t that detailed.

Drug companies spend megabucks to get drugs approved for use for “something.” Once they’re approved, lots of other uses are discovered. If there appears to be enough money in them, the drug company will sponsor new studies. Otherwise, doctors will simply find new ways to use the drugs because of what has been observed. These are called “off-label” uses and often become more important than the original uses. Drug companies can’t legally advertise them to doctors, but docs can happily tell each other or do studies to show the benefit. But because a study isn’t sent through the drug company to the Federal Delay Administration, it won’t appear on the FDA-approved label. That means drug reps aren’t allowed to talk about it. Patients are harmed because the word doesn’t get out quickly. 

AG Peterson does an excellent job of reviewing the key literature, both pro and con. In short, he acts like a scientist, not a politician. And scientific knowledge progresses by two sides arguing with each other. That’s right! Think back to Copernicus and Galileo. Before they pushed, using actual observations, the idea that the earth orbited around the sun, the scientific consensus – Have we heard that before??? – was that the sun orbited around the earth. But two scientists “argued” with the consensus and ultimately proved what we now accept as true. The same thing should be happening with COVID, but isn’t.

All of us are familiar with the FDA’s Ivermectin “horse dewormer” tweet. The FDA is supposed to be the final authority on all things drug. CNNLSD and PMSNBC flat-out demand that we accept that orthodoxy as “settled science” even while CNN’s Dr. Sanjay Gupta is being forced by Joe Rogan to admit that his network and the FDA lie about this. But AG Peterson didn’t buy the FDA spin. He looked at the scientific literature. And he found what any of us could find, given the time. Unfortunately, most people don’t have the time to sort out the spin from the truth.

India proved beyond a shadow of a doubt that Ivermectin stops COVID in its tracks. Its state of Uttar Pradesh, with 241 million people, gave everyone a course of Ivermectin, at a cost under ten dollars each. Its hospitalization and death rates are vanishingly small. The state of Delhi did just as well. But Kerala, a state that emphasizes vaccines, saw its COVID problems magnified when they abandoned Ivermectin. Data from Peru tells the same story. 

We should make no mistake, this human drug is extremely safe. When compared to Remdesivir, Anthony Fauci’s baby, Ivermectin has had fewer side effects reported in forty years of use than the “wonder drug” has had in one year. And, by the way, Ivermectin’s side effects are usually mild and self-limited, while Remdesivir’s are quite severe. But that didn’t keep Newsweek from falsely claiming that Ivermectin overdoses were clogging up Oklahoma ERs. As it turns out, they were quite happy to quote a doctor who wasn’t even associated with the hospitals in question.

The AG goes on to note that the FDA claims Ivermectin is not an antiviral while citing on another page a study showing its “broad-spectrum anti-viral activity.” He carefully shows how multiple studies support Ivermectin, contrary to the FDA’s blanket opprobrium. The AG doesn’t let the CDC off the hook, either. And as a final coup-de-grace, several professional societies and drug manufacturers are included in his broadside. Space does not permit a review of his equally blistering condemnation (using careful and polite wording) of the mistreatment of Hydroxychloroquine.

All of this shows that it’s not necessary to be a physician to understand medical papers. While there may be some language that requires a layman to use a dictionary, most of any medical study is actually in pretty straightforward English. My Governor, Ron DeSantis, proved this when he invited John Iaonnidis and Scott Atlas from Stanford University to Florida to discuss COVID responses last year. They arrived with a thick binder full of studies. DeSantis basically quoted all of them without opening the binder and added a few more. Not only had he read them, he understood them and understood their implications. That meant he could open Florida for business, a move that has proven to be highly beneficial.

No one can even read all the quarter-million or more scientific papers on COVID. And not all of those agree. But when governmental bodies write talking points for professional societies, our antennae should go up. If they universally condemn something, we ought to do some searches for ourselves, but not on Google. Go to Bing, DuckDuckGo, or StartPage. Then you’ll have a chance to see the truth. 

AG Peterson discovered that early treatment is highly effective. You don’t have to just wait until you’re too sick to stay home. Having made that discovery, he stood up for the right of physicians and patients to determine their own choices. Nebraskans no longer have to be beholden to those who think they are better than us. Other states AGs should simply copy his letter and issue it for their states. 

Engage!

Ted Noel MD is a retired Anesthesiologist/Intensivist who posts on social media as DoctorTed and @vidzette.