An Ohio judge’s decision last month to require a hospital to give a seriously ill man an unproven treatment for covid-19 has been set aside for the time being. Over Labour Day weekend, a second judge declined to maintain the temporary injunction that compelled the doctors to treat the patient with the drug ivermectin according to his wife’s wishes. Though ivermectin is widely used around the world as an antiparasitic, there is no strong evidence that it is an effective covid-19 treatment, and the U.S. has recently seen a modest spike in poison control calls related to its misuse by self-medicating patients.
51-year-old Jeffery Smith was first hospitalized and sent to the intensive care unit of West Chester Hospital on July 15, according to court documents. His condition worsened, and he was eventually placed on a ventilator. By late August, he had been put into a medically induced coma to improve his odds of recovery. On August 20, Smith’s wife, Julie Smith, filed for a court order on his behalf to approve the use of ivermectin as a three-week treatment, against the hospital’s recommendations. The drug was prescribed by another doctor, Fred Wagshul, an Ohio-based pulmonologist and a founding member of the Front Line COVID-19 Critical Care Alliance, a nonprofit group that has touted the use of ivermectin for treating covid-19.
Late last month, Butler County Judge Gregory Howard granted the original injunction, as the Cincinnati Enquirer reported. But the order was only meant to stay in place for 14 days. On Monday morning, Common Pleas Court Judge Michael Oster Jr. chose not to renew the injunction.
“Everyone involved wants Jeff Smith to get better. Simply stated, there are no bad actors in this case. Just the bad of a worldwide pandemic, covid-19,” Oster wrote in his decision, reports the Cincinnati Enquirer. However, Oster went on to correctly note that most public health experts and organisations do not endorse the use of the drug to treat covid-19 at this time. He also stated that he had to consider the rights of the hospital and its doctors and the potential harm of forcing doctors to prescribe a drug against their better judgment.
UC Health, the academic medical centre that oversees West Chester Hospital, applauded the decision.
“At UC Health, we respect the expertise of our clinicians and appreciate the scientific rigour used to develop treatments, medications and other therapies. We do not believe that hospitals or clinicians should be ordered to administer medications and/or therapies, especially unproven medications and/or therapies, against medical advice,” spokesperson Kelly Martin said in a statement to the Enquirer.
Ivermectin is a well-studied drug that is regularly used to treat a variety of parasitic infections in both animals and humans. Though there has been some evidence, especially early on, that it may help treat or prevent covid-19, the bulk of the research supporting its use is low quality, while some studies are suspected of being fraudulent and/or have been retracted. Larger and higher quality studies have not found compelling evidence for ivermectin’s benefits so far, though there are ongoing trials in the U.S. and UK. At least some supporters of ivermectin for covid-19 have been accused of misrepresenting the evidence behind ivermectin to make a profit, while social media groups have advocated people to self-medicate with ivermectin, either with help from doctors willing to prescribe it off-label or by acquiring the animal version of the drug. Often, support for the drug comes paired with a reluctance to get vaccinated against covid-19, an actually proven intervention for preventing and lessening the risk of serious illness.
These endorsements appear to have led to a substantial increase in prescriptions of ivermectin as well as overdoses in the U.S. this year, according to poison control call data. Most of these cases have reportedly been mild, and the absolute number of recent ivermectin-related poisonings still appears to be low (nor are these cases overwhelming ERs). But at least two people have been hospitalized with worrying neurological symptoms as a result of innapropriately taking ivermectin, according to the Centres for Disease Control and Prevention.
Though this particular court case may or may not have reached its end, there have been successful legal attempts in other states to force doctors to prescribe ivermectin for covid-19.