Is there a conspiracy against Covid treatments?

BEFORE anything else, a couple of corrections on our October 16 column. In editing the following facts were obscured: This writer was moderator of future Justice secretary Crispin “Boying” Remulla’s third year Ateneo High School class, and the latter was class president. And Gloria Macapagal Arroyo was no longer president in 2011 when she was detained for eight months over election fraud accusations later dismissed in court.

Turning to the headline question, it’s rhetorical, not accusing. One is just puzzled that through the pandemic years, even after at least three remedies for coronavirus disease 2019 (Covid-19) were approved by the United States or Europe, medical authorities at the Department of Health (DoH), the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID) and other entities addressing the contagion have said little about Covid-19 treatments proven to prevent deaths.

The loudest the DoH and the IATF statements about treatments disparaged ivermectin, hydroxychloroquine and other medication continually prescribed by many doctors with good results. And nearly the only positive remark about Covid cures came not from a physician or medical scientist, but from former entrepreneurship adviser Jose Concepcion 3rd. The Go Negosyo founding head recently urged health authorities to stockpile remedies like Pfizer’s Paxlovid, which slashes risk of serious or fatal illness by 89 percent.

Comparing DoH and US CDC

How does the DoH compare with national health agencies elsewhere in presenting Covid-19 treatment?

The DoH Covid-19 frequently asked questions, last updated in May last year, makes no mention of medication (https://doh.gov.ph/COVID-19/FAQs). The department’s Cordillera Administrative Region office raises the question: Is there a cure for Covid-19? It replies:

“There is currently no licensed medication to cure Covid-19. However, there are ongoing clinical trials that investigate the effectiveness of certain drugs for Covid-19. That is why our best intervention at the moment is protection from the virus through our minimum public health standards and Covid-19 vaccination.”

What about America’s Centers for Disease Control and Prevention (CDC), the lead agency in the country fighting Covid-19? It has a graphic urging Americans: “Don’t delay” Test soon and treat early.”

How? The NIH, which coordinates and supports medical research institutions across the United States, provides “Covid-19 Treatment Guidelines,” updated in April this year (https://www.covid19treatmentguidelines.nih.gov/therapies/antiviral-therapy/ivermectin/). Plus: an Oct. 19, 2022 “Statement on Omicron Subvariants and Anti-SARS-CoV-2 Monoclonal Antibodies” which explains:

“The Covid-19 Treatment Guidelines Panel continues to recommend bebtelovimab for the treatment of Covid-19 only when ritonavir-boosted nirmatrelvir (Paxlovid) or remdesivir cannot be used in non-hospitalized adults who are at high risk of progressing to severe Covid-19 (see Therapeutic Management of Nonhospitalized Adults With Covid-19). Ritonavir-boosted nirmatrelvir, remdesivir and molnupiravir are expected to be active against these sub-variants.”

In fact, there are five antivirals approved for use against Covid-19, including Paxlovid, AstraZenica’s Evusheld and Merck’s molnupiravir. The US Health and Housing Services Department has published a “Side-by-Side Overview of Therapeutics Authorized or Approved for the Prevention of Covid-19 Infection or Treatment of Mild to Moderate Covid-19” (https://aspr.hhs.gov/COVID-19/Therapeutics/Documents/side-by-side-overview.pdf).

Why can’t the DoH and the FDA do that?

Stopping ivermectin research

What’s worse, when the Department of Science and Technology (DoST) sought clearance from the Food and Drug Administration, a DoH attached agency, for clearance for ivermectin clinical trials, the FDA never gave it and the DoH argued against trials. So in May this year, the DoST dropped the idea.

Among reasons given: “recommendations from various international and local organizations against the use of ivermectin, lack of clinical trial benefits … and the availability of effective therapeutics for the early phases of Covid-19.”

Two points the IATF, the DoH and the FDA should consider. First, leading research institutions including Oxford University and America’s National Institutes of Health have done ivermectin clinical trials. Even the World Health Organization said ivermectin could be administered in such studies. If the DoST was willing to test the drug and settle debates even in Congress about its efficacy, why not?

Second, there are reports that point to ivermectin’s effectiveness, even as others say many studies are inconclusive or badly done. Here are some recent articles that the DoH and the FDA experts may wish to read, among many other studies all online:

“Moderate-certainty evidence finds that large reductions in Covid-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.” (from American Journal of Therapeutics, 2021: https://tinyurl.com/8e6djky7).

“This study suggested that ivermectin/doxycycline, C-IVIG, methylprednisolone, interferon-beta/SOC … [and other antivirals] were efficacious for treating severe Covid-19 patients.” (Medicine journal, Oct. 14, 2022: https://bit.ly/3StKzOO).

“Statistically significant improvements are seen for mortality, ventilation, ICU admission, hospitalization, recovery, cases and viral clearance. All remain significant after exclusions. 58 studies from 52 independent teams in 22 different countries show statistically significant improvements in isolation (40 primary outcome, 38 most serious outcome).” (Ivermectin for Covid-19: real-time meta analysis of 92 studies, Oct. 21, 2022: https://ivmmeta.com/).

As this column has repeatedly argued, the government must harness not just vaccines and health protocols in the battle against the contagion, but proven remedies. With Covid deaths having trebled from one a day in June to multiple casualties today, it is criminal not to promote and deploy proven remedies that can reduce deaths by as much as 89 percent.

Congress would also do well to investigate this apparent neglect, which may be allowing Filipinos to become gravely or fatally ill unnecessarily. That may be the only way to get our health authorities harnessing Covid-19 medicines to save Filipinos.