Tulare County medical providers prescribing controversial ivermectin treatment


Ivermectin can be prescribed by doctors, but some have taken to livestock stores to get the drug without a prescription.

Dr. Daria Majzoubi, MD who owns Maj Medical Clinic in Visalia is currently prescribing Ivermectin to his patients. He refers to it as “an anecdotal treatment method.”

“I want to be completely clear, this treatment is not something someone should consider a cure, but they shouldn’t write it off completely. Getting the vaccine is still the best way to prevent death from the COVID-19 virus,” Dr. Majzoubi said.

Like many other physicians, Majzoubi uses what he calls “off label treatment” methods. This means he might prescribe a medication meant for one illness as a treatment for another.

“This happens all the time in doctors’ offices,” Majzoubi said.

Though more widely known as a medication for livestock, ivermectin is available by prescription in human dosages. The FDA warns physicians against prescribing the medication for COVID-19 but some doctors in the Central Valley praise it as a successful treatment method.

Majzoubi heard about other physicians prescribing the drug last fall, but remained skeptical due to the lack of research.

It wasn’t until an elderly patient took ivermectin and recovered from COVID that he considered adding it to his treatment method.

“I didn’t think he was going to recover in his condition, I was worried,” he said. The patient found ivermectin at a feed store and managed to doll out the proper dosage.

“That’s when I started doing research on the drug,” he said.

The medication is only useful within 48 hours of symptoms, Majzoubi said. He cited a study done by the Monash Biomedicine Discovery Institute, “ivermectin produced a 99.8% reduction in cell-associated viral RNA in cells infected with SARS-CoV-2 after 48 hours,” the study read.

“As long as my patients are safe, I’m going to do what I can. Prescribing this medication hasn’t harmed anyone. But, it hasn’t been completely effective either,” he said.

Depending on the circumstances when a patient with COVID comes to him, he might prescribe ivermectin, zinc, and sometimes a Z-Pack–which is used to treat a variety of  bacterial infections.

Majzoubi gave the same treatment of ivermectin, zinc, and a z-pack to two patients. One patient started the treatment within 48 hours of showing symptoms and fully recovered. The other had been experiencing symptoms for longer, and the treatment didn’t help him.

“When you have a pandemic running wild, you reach for whatever you can use, as long as it is safe,” he said.

But, about two months ago, he started receiving pushback from pharmacists, “they refused to fill the prescriptions I was writing on the basis that it was unsafe,” he said.

Sometimes this regimen works, sometimes it doesn’t, he said. He humbly admits that not all of his patients have stayed out of the hospital.

Majzoubi said ivermectin has been less effective when treating the delta variant. He doesn’t claim it as the best treatment for COVID-19 either.

 

“I came across it on the internet,” an anonymous Nurse Practitioner

A nurse practitioner in Visalia, who prefers to remain anonymous, has also seen full recovery from COVID patients who have taken ivermectin within the first 48 hours of showing coronavirus symptoms.

“I tell people 48 hours because once the second phase of COVID sets in, it can be deadly,” he said.

He learned about ivermectin while doing online research to see what treatment methods other doctors are using.

“Somebody in Australia figured out that ivermectin worked… among doctors and researchers it’s been known for a long time to work well on tropical viruses.”

He came across a treatment method from the Front Line Critical Care Alliance (FLCCC).

The FLCCC is a consortium of highly published critical care physicians and scholars — “they had a 60 page report with references,” he said.

The report laid the groundwork for how to treat COVID-19 with ivermectin, what to do and when to do it.

Like many physicians, this Nurse Practitioner is frustrated with how politicized the pandemic has become.

“I tell people, you can treat COVID with this if you catch it early on. And they say ‘well that’s your opinion,’” he said. “I say, no, that’s my experience since last year.”

This physician also commonly uses drugs off label. Ivermectin is not classified as an antiviral, “But we use lots of drugs off label. It is designed and approved to do this, but you know it’ll also have a good effect over here.

As long as the patient knows they will be taking an “off label” medication, there is nothing unethical about it, he said.

 

Self medicating

Over the last few months, ivermectin has built up more internet fame than the proven treatment of monoclonal antibody therapy.

It gained popularity among people looking for a home remedy and was promoted by conservative figures like Fox News anchor Tucker Carlson and Sen. Ron Johnson from Wisconsin.

Popular podcast host Joe Rogan, who has come out against the COVID vaccines, said that he is taking ivermectin — among other medications — after being infected with the virus.

The HuffPost reported, “The groups [promoting ivermectin] are largely used to share tips for how to procure ivermectin, often referring people to SpeakWithAnMD.com, a telemedicine platform propped up by right-wing, anti-vax group America’s Frontline Doctors.”

After seeing it online, people in the Central Valley started baking ivermectin paste into their favorite muffin recipes to test its efficacy.

One clerk at Tractor Supply in Tulare said ivermectin was “flying off the shelves.”

Other feed store clerks in Farmersville, Woodlake, and Strathmore said they noticed more people coming in to buy the medication, but weren’t sure if it was for personal or livestock use.

One clerk working at Strathmore Feed said some of his customers told him they were buying it for personal use, “we tell them it’s meant for horses,” he said.

On August 27, Tulare County Public Health Officials released a statement saying that self-administering “ivermectin meant for veterinary use can be especially dangerous.”

“It’s important to note, public health officials are receiving reports of people being admitted to the hospital that have been taking ivermectin prescribed by physicians, and they still end up in critical care,” Carrie Monterio, the public information officer for Tulare County Health and Human Services Agency said.

 

The perfect storm for a treatment method like ivermectin

The Central Valley provides fertile ground for doctors to prescribe ivermectin. With rising case counts and a large population of unvaccinated hosts, ivermectin gained popularity.

According to the Visalia Times Delta, Tulare County reported 1701 cases and 13 deaths in the latest week and 1094 cases and 13 deaths the week before.

This is in contrast to Marin County, in Northern California, which experienced a seven day average of 46 cases, according to the New York Times.

For some health care workers, this feels like the early days of the pandemic when they were scrambling to find treatment methods for the virus.

Dr. Majzoubi said he is constantly trying to refine his treatment method for coronavirus.

“I think part of the problem is that there is no treatment. Doctors are just trying to find something… you have to stay open minded,” he said.

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