A Letter to NIH and Dr. Anthony Fauci. Is Anybody Home?

Dr. David Chesler is knocking at the door of the mighty U.S. National Institutes of Health. He has something urgent to share.

Dr. Chesler is a geriatric specialist at seven Virginia nursing homes. Early in the pandemic, he read studies showing that Ivermectin, a drug he’s used to treat the scabies, was effective against the coronavirus. He started giving it in late April. So far, he has treated 191 infected patients.

In the United States, the COVID mortality rate among nursing home residents is 12 percent — 146,000 deaths in all. In Chesler’s small sample in Virginia, the mortality rate is 8 percent.

In other words, if nursing homes nationwide followed Chesler’s lead, one-third fewer deaths would have occurred. Further, excluding his earliest outbreak – in which an eight-day testing turnaround delayed treatment – Chesler’s mortality rate is 5 percent, less than half the U.S. rate.

This is no small thing. Nursing homes have been decimated by COVID, accounting for nearly 4 of 10 U.S. deaths from the illness.

The drug’s role in nursing home care is no secret. Similar reports have come from homes in France, Cali, Columbia, Toronto and Lajeado, Brazil. In the French outbreak, published in December in the Annals of Dermatology and Venereology, all 69 residents — average age 90 — and 52 staff survived a COVID-19 outbreak. In a bit of kismet, they had all taken Ivermectin for a scabies infestation. While it raged outside the home’s walls, COVID was prevented in all but seven residents and four staff, whose mild illness did not require oxygen or hospitalization.

Chesler told a similar story in a letter sent by FedEx on Jan. 10 to Dr. Anthony Fauci, the NIH’s COVID policy master. It seems logical that Chesler’s experience would attract the attention of the National Institutes of Health – might even excite officials at the suggestion that deaths could easily be avoided.

Chesler, an internist for more than 40 years, hasn’t heard back and cannot understand why. “It’s safe, and it’s inexpensive, and it seems to work,” he told me. “For the couple of doses you’re giving them, there’s almost no side effects.”

NIH: A Lack of Support

Failing to respond to reports like Chesler’s is just one of NIH’s impenetrable lapses on Ivermectin – an FDA-approved drug with a good safety profile — as a potential tool to turn COVID around.

Since the pandemic began, more than 50 studies have accumulated – including three meta-analyses — concluding that Ivermectin effectively prevents and treats early infection and improves survival in late-stage patients. Yet the U.S. National Institutes of Health has shown little interest in Ivermectin.

Despite promising studies, the agency has not funded a single trial on Ivermectin. Meantime, it has supported 113 other U.S. COVID-19 studies.

“When the government sees that a country like Slovakia is allowing Ivermectin as a prophylaxis and a treatment for COVID,” said Dr. Sabine Hazan Steinberg, who is conducting an Ivermectin trial, “the government of America needs to put some funds into Ivermectin to see if that’s legitimate or not.”

Beyond its lack of financial support, the NIH is continuing to post misinformation about Ivermectin. On Jan. 14, the agency upgraded its guidance to physicians to state that it was not “for or against” Ivermectin, a neutral stance shared with monoclonal antibodies and convalescent plasma. Nonetheless, on two key pages, where doctors go to seek information, NIH repeats the old advice: “The COVID-19 Treatment Guidelines Panel recommends against the use of Ivermectin for the treatment of COVID-19, except in a clinical trial.” (An easy-to-miss disclaimer tops one page, referring to the new neutral advisory.)

I attempted three times to get NIH to explain itself, asking specifically why outdated Ivermectin recommendations were still posted. In what amounted to a form letter, I was referred to the “the most up-to-date information” on the NIH website — including a page with the incorrect information. When I pressed the issue, a press spokesperson, Jennifer Routh, said in an email, “We have no further information to provide.”

Among the misinformation on the NIH website page on Ivermectin – beyond its outdated recommendation against it — is a description of a key Florida study that found a 40 percent decrease in deaths in critically ill patients treated with Ivermectin. “This study has not been peer-reviewed,” the NIH description states, incorrectly.

Dr. Jean Jacques Rajter, who conducted the study with his pulmonologist wife, Dr. Juliana Cepelowicz Rajter, calls this “perplexing” since their article was published in the medical journal Chest in October. “Now that it is peer-reviewed,” he said, “they don’t talk about it at all.”

These information lapses have consequences. As I wrote this, I was contacted by the family of a Canton, Texas, man, 67, in a COVID ICU whose request for Ivermectin had been denied. “Ivermectin does not work for COVID patients,” the man’s family was unequivocally told. In two recent New York cases, judges had to issue orders to give the drug after hospital administrators balked; both patients quickly left critical care. In the Texas case, the hospital relented after the family’s lawyer intervened. But days were lost in each case.

Unequal standards

When the history of COVID is written, the U.S. government’s promotion of remdesivir, which reaped $2.8 billion in sales but doesn’t save lives, shorten hospital stays or avoid the use of ventilators, will be contrasted with its failure to act on a cheap generic that does all that, Ivermectin.

NIH wouldn’t discuss its apparently different standard for each drug’s acceptance. I asked Dr. Andrew Hill, a Liverpool researcher whose analysis of Ivermectin trials found a stunning 75 percent improvement in survival.

“The FDA approved the drug [remdesivir] in a day and then a large study showed that it had no benefit either for survival or for hospitalization,” he told me in a Zoom interview from the United Kingdom.That, he noted, has made regulators wary: “I don’t think it’s a double standard. It’s reinforced the need for higher standards.”

But how high must those standards be in a pandemic emergency, especially for a drug that carries little risk?

The leading physician-researcher group advocating for Ivermectin, the Frontline COVID-19 Critical Care Alliance, put it this way in a letter to NIH: “We struggle to identify an explanation for this level of cautiousness in the setting of escalating and uncontrolled case counts, hospitalizations, and deaths from COVID-19.”

“If we put the safety and potential of Ivermectin against the ever-increasing impact of the virus,” it continued, “now is the time to more strongly support the adoption of this therapy.”

Dr. Pierre Kory, FLCCC president, is urging NIH to look at Peru’s experience – and reconsider its neutral stance. In a pre-print study, researchers reported COVID cases plummeting nationwide in tandem with state-by-state adoption of Ivermectin. “Any public health leader who gives this the attention it deserves,” he wrote to me, “CANNOT claim ignorance that there is a solution at hand.”

In the meantime, a handful of physicians – clearly not enough of them – is using Ivermectin.

Dr. Neil Chesen, a Pennsylvania internist and ophthalmologist, like Chesler, has seen “remarkable” improvement.

“It is the most mind-boggling thing I have seen in my 35-year medical career,” he wrote in an email, “that during what is clearly a crisis, we do not flood the zone with a benign, 100 percent safe treatment. It is clear to me if this were a hundred years ago, and all these other advanced and expensive treatments were not available, and Ivermectin was available, that it would be used everywhere.” 

Mary Beth Pfeiffer is an award-winning investigative journalist. Visit her website and follow her on Twitter: @marybethpf.

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