Doctors with Evergreen Family Medicine in Roseburg use the clinic’s blog to share false or misleading information about herd immunity, vaccines, and face masks. They also say they’re prescribing ivermectin, a controversial drug that most public health agencies advise against taking to treat or prevent COVID-19.
Even so, local hospitals and the county’s public health agency have steered away from criticizing the clinic because it’s a major medical provider in a region that’s desperate for health care.
“Ivermectin is not public health’s battle,” says Douglas County’s public health director Bob Dannenhoffer, noting that Evergreen is one of Roseburg’s main vaccine providers. “What doctors prescribe or what doctors don't prescribe in their office is not the job of public health.”
Evergreen Family Medicine declined an interview. Chief Operations Officer Kim Tyree provided this statement:
"At this time, our physicians and staff are busy delivering care to our community. Evergreen’s response to this surge and the pandemic in general is broad and complex. We have found the best way to communicate to our community is through our website. The subject does not lend itself to a feature column or 2 minute media spot. We will provide some context to everything that our medical professionals are doing to combat this disease in our community."
Ivermectin has no proven impacts against the coronavirus. It’s more commonly used to treat worms in livestock. It’s also approved by the Food and Drug Administration for use in some rare health conditions in humans, but it's not currently authorized or approved by FDA for treatment of COVID-19. TheFDA urges people not to take ivermectin for the coronavirusbecause it can have some serious side effects, including vomiting, diarrhea, seizures, coma and death.
Other agencies that have advised people against using ivermectin for COVID-19 outside clinical trials include the Centers for Disease Control and Prevention and the World Health Organization.
The Oregon Poison Center received a record number of calls related to ivermectin use in August, when it had 21 cases of people intentionally misusing the drug. By comparison, it had three such cases in all of 2020.
Officials with the center say most of the calls in August were related to people taking the veterinary version of the drug, but some calls came from people who got prescriptions from doctors.
Representatives with the Oregon Board of Pharmacy say the ivermectin prescriptions are coming from local clinics as well as online “pill mills” — websites where people can find providers that are licensed to prescribe medicines in the state of Oregon. There aren’t any laws against prescribing ivermectin for COVID-19, but pharmacists can decline a prescription or report it to Oregon’s medical boards.
“We do have rules around the responsibility of pharmacists when filling prescriptions, which include evaluating the prescription’s authenticity and whether the provider-patient relationship is a valid relationship and it’s not just an internet-based prescription drug or something done fairly carelessly,” says Executive Director Joe Schnabel.
Oregon Poison Center Medical Director Rob Hendrickson says the trend of people taking experimental drugs to treat or prevent the coronavirus harkens back to the beginning of the pandemic, when researchers sought an FDA-approved treatment in order to forgo the lengthy drug-approval process.
“With ivermectin, there was some evidence with other viruses that it might inhibit [the coronavirus's] entry into cells,” Hendrickson says.
Preliminary studies followed, including a small study that suggested it could prevent the coronavirus from getting into cells.
“Obviously that was very encouraging.” Hendrickson says. “Unfortunately that was followed up with several well-designed studies, and despite the earlier clearance of the virus, there doesn't seem to be any change in the amount of time people feel symptoms, the percentage of people who get admitted to the hospital who need a ventilator, or the people who survive or die. There are no clinically meaningful outcomes at all, despite this evidence that it may allow the virus to clear quicker.”
Nonetheless, people continue to cite the initial studies as reason to experiment with the drug. Hendrickson says throughout the pandemic, the Oregon Poison Center has received calls about people trying drugs that have no benefit against the coronavirus, including hydroxychloroquine, colloidal silver, hydrogen peroxide, and various supplements.
“And that type of use is concerning because those things can have toxicities,” Hendrickson says. “When something doesn't work, taking the risk of the adverse effects or the toxicity isn't really worth it, ever. The list of things that have been tried for COVID is pretty long, but at this point, most of these have been pretty well studied and they simply don't work.”
Schnabel, of Oregon’s pharmacy board, says these experimental treatments can have another side effect: giving people a false sense of security against the coronavirus.
“We really would like people to use proven methods of virus prevention, of which, this really isn't,” Schnabel says.
Most doctors and major health agencies agree that the most beneficial and proven methods of preventing the spread of the coronavirus include wearing face masks, physically distancing, and getting vaccinated.
