General medical practitioners have lobbied the government to allow and facilitate the ongoing use of Ivermectin for treatment of Covid-19 patients, setting themselves on a collision course with Public Health Physicians who warned the drug was not certified locally to be used against the new coronavirus.
Early this week, the Zimbabwe College of Public Health Physicians (ZCPHP) warned that hype over Ivermectin is irresponsible, as more evidence on its effectiveness was needed.
Read: https://cite.org.zw/health-experts-warn-against-use-of-ivermectin-to-treat-covid-19/
But in a letter addressed to the Ministry of Health and Child Care permanent secretary, Dr Jasper Chimedza, the GPs argued that working 18 hour days over weekends and holidays, they “had come to understand what does and doesn’t work in the treatment and prevention of Covid-19.”
“We have followed medical evidence rigorously and practiced standard care managing their patients in the early stages as with the national guidelines… but retaining patients with these standard guidelines has not worked or helped those who are not part of the 85 percent that recover,” the GPs said.
“We feel comfortable using Ivermectin which has been around for 40 years, is on the World Health Organisation essential drug list and has an excellent safety profile.”
The doctors also noted the use of Nanoparticulate silver was helpful to Covid-19 patients and were engaged in studies collaborating with scientists elsewhere in the world to make sense why the drug worked so well.
“Research academics and institutions have been approached for help in trying to do clinical trials on this but the actual performing of the trial has been delayed by the fact that the very clinicians who are working 18 hour clinical days with very little pay, are the same ones expected to perform these trials. We as GPs can testify to the safety and effectiveness of using nano silver from April 2020 to date although we have still lost patients who have presented late in the disease.
“Since August 2020 we have adopted the use of both Ivermectin and nanosilver solution and have found this combination to be a game changer in terms of the management of our patients,” said the GPs who have been using the drugs either separately or together for the past five months.
“After the first wave when numbers were low it was less obvious just how successful this regimen can be but when the second wave hit in mind December we found that using this protocol was extremely effective. We use far less oxygen, far fewer patients progress and in fact some practitioners estimate that they have less than 1.5 percent mortality using this combination. We believe that Zimbabwe’s case fatality rate would be significantly higher over the last month if we had been unable to use it.”
But some public health physicians who preferred anonymity said this argument was “appalling” and accused the GPs of exploiting the vulnerable.
“This should be a call by physicians and not GPs. GPs treat mild to moderate diseases which does recover on its own. So what are they talking about? If these really worked like they allege why is number of deaths on the rise. We know they are using these medications illegally,” said the health expert.
Apparently, a Covid-19 prevention pack (consisting of 2 x 12 mg Ivermectin tablets: dosage once weekly and 4 Doxycycline 100mg tablets: dosage daily x 4 days) is US$30 while a treatment pack (consisting of Ivermectin 12mg tablets x 4: dosage 1 daily x 4 days and Doxycycline 100mg tablets x 10: dosage twice daily x 5 days) is US$40, meaning one needs US$70 for both.
Another physician quizzed why the doctors were asking for permission from the Permanent Secretary yet they were already using these two drugs.
“It’s this sort of unprofessional behaviour that brings our profession into disrepute, a GP or any medial professional for that matter standing up to say this works from my experience is not evidence. It’s also not good enough to say there’s no one to conduct trial because everyone is busy treating Covid-19,” they said.
The GPs acknowledged the sentiments raised by public health physicians but they strongly objected to them going into the public domain without consulting them yet are the ones ‘on the ground actually treating these patients.’
“We respectfully request however that we be allowed to fulfill our mandate to treat our patients ethically, safely and effectively with the best evidence that we have and to save our patients lives,” said the GPs who asked the health ministry to facilitate the importation of Ivermectin for those clinicians who wish to use it.
They also asked the ministry to regularise the use of nano silver as a complementary medicine so they could direct their energies to the treating of patients “instead of constant anxiety about staying within the regulatory framework and law…”
If trials data showed they were wrong and the regimen was ineffective, the GPs said they would be the first to apologise but claimed if the drugs were withdrawn, it would be “the patients who will most certainly die in the next 12 weeks and no amount of apologies from the public health physicians will bring them back for their families. We as doctors believe this to be against everything we stand for and do not want this on our conscience.”
