It’s been in the news that several telehealth companies are offering patients access to the anti-parasite drug ivermectin, which while rumored by some to be an effective treatment for COVID-19 is unproven. As coronavirus deaths in the United States continue to rise, tracking at over 650,000 deaths to date and hovering around 1,500 each day, we need to remain hopeful, of sound mind. Most importantly, we need caregiving and doctoring guided by science and evidence.
While ivermectin is an FDA-approved drug used to treat several diseases including scabies and certain tropical diseases, it is not approved by the FDA for treatment of any viral infection and there have been no methodologically sound clinical trials that have shown clinical benefit from ivermectin in the treatment of COVID-19.
As a new(er) encounter than the more familiar in-office doctor visit, all eyes are often on telehealth for what could go wrong; what corners might be cut. Unfortunately, it appears true that some bad actors have been identified, but likely no more in the virtual than the physical world.
As online doctors, we know we are still working to disprove those misperceptions and validate the medium is, in most cases, fully capable of facilitating the same quality of care as in face-to-face interactions. Ivermectin is just the latest litmus test of this parity. Past misperception that the virtual world is a ripe place to find opioids, hydroxychloroquine, and liberal prescriptions for antibiotics have since been disproven.
In a time full of unknowns, ivermectin treatment is another unknown in the COVID-19 conversation. This medication, along with others, may offer benefit to treating the virus, but today we have no good evidence to support that.
As consumers continue to become more comfortable accessing care online, it’s critical that the quality of the care being delivered is of the highest standard. As doctors working in a still-young industry, let’s be hopeful but let’s commit to follow the evidence and science as we do in traditional care settings. Telehealth is a powerful tool to expand our reach and impact. It’s also a delicate tool to use with caution and care. Looking ahead, we’ll watch for results from adequately powered, well-designed, and well-conducted clinical trials that may or may not provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19. Until then, we carry on with proven treatments out of a deep respect for those who have entrusted us with their care.
Mia Finkelston and Cynthia Horner are family physicians.
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