Livestock supply stores in the area have received numerous inquiries about the anti-parasitic deworming drug ivermectin in recent weeks, which has been heralded by some as a possible COVID-19 treatment medication despite being widely discredited by health officials.
Kenai Peninsula Borough Mayor Charlie Pierce has continued to defend the use of ivermectin — last week at an assembly meeting and again Monday when he made an appearance on Duane Bannock’s Sound Off radio show on KSRM.
“What I’m asking for is that the … world view of the various treatments that are being researched and looked at outside of and including vaccinations be looked at from a more open perspective,” he said on air. “Let the doctors experiment with perhaps some things that haven’t been signed off by the Food and Drug Administration.”
He backed the use of ivermectin, saying it is “a very inexpensive medication” and encouraged listeners to research the drug further.
The COVID-19 vaccines approved by the Food and Drug Administration are free to anyone eligible.
Pierce also claimed that ivermectin administered with other over-the-counter vitamins “has been very favorable” in treating the virus, which has been widely debunked by health agencies and officials.
Pierce also expressed interest in creating a research trial for the drug on the peninsula.
“I think the peninsula could be the first, maybe, medical establishment out of the box, maybe doing some experimental work, do some tests, maybe start their own research lab here and testing some of these medications on some of the patients that we have,” Pierce said on Sound Off. “Sign the disclaimer that says, you know, you won’t hold them responsible.”
The mayor did not respond to multiple requests for comment.
Pierce, who stated he is not a medical professional, said on the show that while he thinks health care professionals on the peninsula are responding to COVID patients well, he believes “our hospitals are missing a few items in their toolbox that perhaps could work.”
Sarah Donchi, the owner of Kenai Feed and Supply, said on Monday that she’s received a lot of interest in the types of ivermectin the store carries. Donchi said she tells people that the drug is supposed to be used for animal consumption only, but “people are buying it anyway.”
The label of the ivermectin paste in stock at Kenai Feed on Tuesday states that the dose is meant to treat a horse up to 1,250 pounds in weight. Another ivermectin and clorsulon cattle injection at the store Tuesday is meant to treat cows up to 550 pounds.
Employees at Cad-Re Feed in Soldotna are also getting inquiries about ivermectin “almost daily,” co-owner Shawn Taplin said Monday.
Taplin said he responds by telling customers the drug is a medication he orders from a veterinary supply company, but people still buy it.
“What they choose to do with it is up to them,” he said.
Studying ivermectin as a COVID-19 medication has also been mostly abandoned, according to Dr. Coleman Cutchins, a PhD pharmacist and infectious disease specialist with the state who has worked in the medical field for over 15 years.
“Really what it comes down to,” Cutchins said in an interview Monday, “vaccines are how we treat viruses.”
The pharmaceutical company Merck, which makes ivermectin, hasn’t found enough scientific evidence to recommend the drug as a COVID remedy.
In a statement from Merck in February, the company said its ivermectin analysis showed “no scientific basic for a potential therapeutic effect against COVID-19 from pre-clinical studies, no meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and a concerning lack of safety data in the majority of studies.”
Merck disregarding its own drug as a COVID medication, Cutchins said, “puts the nail in the coffin for me.”
Establishing clinical trials is a pretty long and laborious process as well, he said.
“He (Pierce) could theoretically do it but it would take a really long time,” Cutchins said. “(Any medical facility) can do drug trials but they’re very complex and take a very long time.”
In essence, to start a drug trial facilities first have to write a proposal and protocols and submit it to the Institutional Review Board for approval, which must show the trial design and background, endpoints, safety checkpoints and a plan for statistical analysis, according to Cutchins. The Board also assesses the ethics involved in treating drugs on humans.
To advance to an experimental study, Cutchins said the facility would then have to select patients to test on and make decisions about placebos and other technical aspects of the trial.
Cutchins also said most of the time clinical drug trials are done in large areas with diverse populations in order to be generalizable.
Dr. Kristin Mitchell, an internal medicine expert at Central Peninsula Hospital, said in an email Monday that she thinks conducting a trial might be difficult on the peninsula.
“The best trials are designed to be large enough that we can have high statistical confidence that the results could not have happened by chance,” she said. “Such a large trial would be difficult in an area with a small population, but subjects from many small areas might be studied as part of a larger trial.”
Even if a drug trial would be possible, many health officials are warning people against using unprescribed ivermectin.
According to a statement from the FDA titled “Why you should not use ivermectin to treat or prevent COVID-19,” the drug has not been approved as a remedy for the virus.
Additionally, the FDA stated it has received “multiple reports of patients who have required medical support and been hospitalized after self-medicating with ivermectin intended for horses.”
The Journal of the American Medical Association also published a peer-reviewed investigation analysis on ivermectin and COVID-19, and the conclusion reached was that the “findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand the effects of ivermectin on other clinically relevant outcomes.”
Cutchins said that ivermectin can actually be dangerous to humans if used incorrectly.
“The doses people are trying to recommend are really, really high,” Cutchins said.
If ivermectin is prescribed for people — usually for parasitic worms, head lice and skin conditions like rosacea according to the FDA — one dose of the drug is given at one time, Cutchins said. But, he said, if people are taking four times the dosage amount for days or weeks on end, the result could be damaging.
“We wouldn’t expect the safety profile to stay the same,” Cutchins said Monday.
Mitchell said that in her 20 years as a doctor on the peninsula she’s never used ivermectin.
“As a licensed MD, I take peer-reviewed scientific recommendations very seriously,” Mitchell said. “Ivermectin is not FDA approved… [or] recommended by the CDC, the NIH, or by the Infectious Diseases Society of America for COVID-19 outside of clinical trials.”
Mitchell also said she’s seen reports of Americans reacting negatively to the drug in other parts of the country.
In an official health alert from the Mississippi State Department of Health last Friday, medical professionals, hospitals and health care providers were informed that the state’s poison control line had received an increasing number of calls from people with potential ivermectin exposure.
“At least 70% of the recent calls have been related to ingestion of livestock or animal formulations of ivermectin purchased at livestock supply centers,” the alert reads. “Eighty-five percent of the callers had mild symptoms, but one individual was instructed to seek further evaluation due to the amount of ivermectin reportedly ingested.”
The alert also includes a disclaimer that states drugs approved for livestock are highly concentrated for large animals and can be toxic in humans.
“Medical decision-making is a complex process that involves synthesizing scientific, statistical, social and environmental data to develop recommendations in the best interest of a patient,” Mitchell said. “Many of us would be happy to volunteer our expertise to help elected officials at the borough or school board or city level make sound decisions in the interest of public health.”