On August 23, Judge J. Gregory Howard of the Butler County, Ohio, Court of Common Pleas granted a motion filed by plaintiff Julie Smith on behalf of her husband, Jeff Smith, seeking as a matter of emergency relief an order compelling the West Chester Hospital to administer the drug Ivermectin to treat her husband, who remains in a medically-induced coma in that hospital’s ICU unit, suffering from complications due to COVID-19.  Judge’ Howard’s order on that date required the hospital to administer the drug, as recommended by the Smiths’ prescribing physician and medical witness, Fred Wagshul, despite the fact that no reliable medical evidence has shown it to be effective in treating the coronavirus.  Significantly, the Judge’s order did not state its reasoning or any findings of fact that would explain why the decision was made.

The hospital complied with Court’s order and began administering the drug over the past two weeks.This was done despite the objections of the hospital which had argued that the use of Ivermectin could interfere with the existing drugs that were helping to keep Mr. Smith alive.  In the interim, a full hearing on the plaintiff’s application for a preliminary injunction was scheduled before Judge Michael A. Oster, Jr. The case had originally been assigned to Oster, but the August 23 hearing had been handled by Gregory due to a conflict in Judge Oster’s schedule.

On Monday, after hearing testimony and reviewing evidence, Judge Oster reversed course and denied the plaintiff’s request for a preliminary injunction, essentially mooting his colleague’s prior order.

As reported by Andrea Salcedo, writing for the Washington Post:

On Monday, after Smith’s wife and the doctor who prescribed him the ivermectin failed to provide “convincing evidence” at a court hearing to show that the drug could significantly improve his condition, a different judge reversed course. Butler County Judge Michael A. Oster Jr. ordered the hospital to cease administering Smith, 51, the unproven treatment, arguing that “judges are not doctors or nurses.”

“Based on the current evidence, ivermectin is not effective as a treatment for COVID-19. … Even Plaintiff’s own doctor could not say [that] continued use of ivermectin would benefit [Jeffrey] Smith,” Oster wrote in an order filed on Monday.

Oster added: “After considering all of the evidence presented in this case, there can be no doubt that the medical and scientific communities do not support the use of ivermectin as a treatment for COVID-19.”

The Food and Drug Administration (FDA), the Centers for Disease Control (CDC) and the American Medical Association (AMA) are united in their opposition to the use of Ivermectin in treating COVID-19. Along with the American Pharmacists Association, all have issued advisories or guidelines against the use of the drug for purposes of such treatment.

In seeking the original order, Ms. Smith was represented by an attorney named Ralph Lorigo, the chairman of Erie County, New York’s Conservative Party. For his part, Wagshul is listed as a founder of the Front Line Covid-19 Critical Care Alliance (FLCCCA), an organization that touts the benefits of Ivermectin in preventing and treating COVID-19. Wagshul, interviewed last week by the Ohio Capital Journal, had this to say about the so-called effectiveness of the drug:

In an interview, Wagshul said the science behind Ivermectin’s use in COVID-19 patients is “irrefutable.” The CDC and FDA engaged in a “conspiracy,” he said, to block its use to protect the FDA’s emergency use authorization for COVID-19 vaccines. He said the mainstream media and social media companies have been engaging in “censorship” on Ivermectin’s merits, and that the U.S. government’s refusal to acknowledge its benefits amounts to genocide.

“If we were a country looking at another country allowing those [COVID-19] deaths daily … we would have been screaming, ‘Genocide!’” he said.

The website for Wagshul’s Critical Care Alliance includes articles that claim studies which recommended against the use of Ivermectin are part of a “hoax,” and that the pharmaceutical industry is actively engaged in efforts to “cover up” its effectiveness in order to profit from the vaccines. The FLCCCA site also contains inflammatory, conspiracy-driven videos and opinion-based articles from several purported experts on the subject.

Interviewed for the Capital Journal article, one physician with the Ohio University Heritage College of Osteopathic Medicine called the  FLCCCA a site for “snake oil salesmen,” and says that the studies relied upon by Ivermectin’s proponents are scientifically unreliable:

Dr. Leanne Chrisman-Khawam, a physician and professor at the Ohio University Heritage College of Osteopathic Medicine, called the FLCCCA “snake oil salesmen.” She reviewed the association’s research on the drug’s uses and said there are some serious problems with its cited studies: many of them don’t show positive results, and those that do bear design flaws like small control groups, unaccounted for variables, non-blinded studies, not accounting for mitigations like vaccines and masking practices, and others.

“Based on evidence-based medicine and my read on this large number of small studies, I would find this very suspect, even the positive outcomes,” she said

During Monday’s hearing, Judge Oster specifically asked Wagshul whether the administration of Ivermectin to Mr. Smith was improving his condition. Wagshul could only reply that it “seemed” to be, a conclusion that was rebutted by Smith’s actual treating physician.  Wagshul further testified that he simply did not know whether the continued administration of Ivermectin to Jeff Smith would benefit him in any way.

As noted by an article in the Capital Journal published directly after the hearing, several witnesses for the hospital expressed concerns about Wagshul’s credibility:

Several witnesses for the hospital cast doubt on Wagshul’s testimony and credibility as a physician. Dr. Ferhan Asghar, a surgeon and chief of staff at the hospital, said a physician who is not board certified would never be admitted to practice at West Chester, per hospital policy. He said it was also a “concern” that a physician would issue such a controversial prescription without seeing the patient or reviewing his information.

That fell far short of the “clear and convincing” standard of proof required to show “that there [was] a strong or substantial likelihood of success [of plaintiff Smith’s position] on the merits.”  Ultimately the Judge appears to have essentially weighed the overwhelming degree of evidence attesting to Ivermectin’s ineffectiveness in treating COVID-19 against the statements by Wagshul and his cronies at FLCCCA.

From Judge Oster’s Order:

The studies that tend to give support to ivermectin have had inconsistent results, limitations to the studies, were open label studies, were of low quality or low certainty, included small sample sizes, various dosing regimens, or have been so riddled with issues that the study was withdrawn. As such, based upon these limitations, the medical community does not support the use of ivermectin as a treatment for COVID-19 at this time.

[*]

While this court is sympathetic to the Plaintiff and understands the idea of wanting to do anything to help her loved one, public policy should not and does not support allowing a physician to try “any” type of treatment on human beings. Rather, public policy supports the safe and effective development of medications and medical practices. A clinical trial would be one such method of a developmental process. However, a clinical trial is not at issue in this case.

Judge Oster also ruled that plaintiff was free to transfer her husband to a hospital where Wagshul had privileges to treat.  But the overwhelming import of his ruling is that Courts should not be in the business of practicing medicine.

The Court’s order is about as clear a refutation of the utility of this horse deworming paste for treating COVID-19 as can be envisioned; however from a practical standpoint it is unlikely to change any minds. People in this country have been conditioned by Trump and the Republican Party to ignore fact-based and scientific-based evidence in favor of those conclusions they are comfortable with from a political standpoint, no matter how grievously inaccurate (or even ridiculous) those conclusions are. Seen in this perspective, believing in the curative abilities of Ivermectin is just a small step removed from believing that the 2020 election was somehow fraudulent or tainted.

This is particularly the case when the subject matter is not within the realm of knowledge of the average layperson. As evidenced by the overwhelming degree of interest in promoting this snake-oil cure for an epidemic it once characterized as a hoax, the right is simply doing what it has done for decades: pandering to people’s fears and ignorance. In touting the non-existent benefits of Ivermectin as some sort of “miracle cure” for an intractable pandemic it itself is largely responsible for aggravating and prolonging, the Republican party has simply exploited a readily available cadre of junk science purveyors, all eager and willing to assist that effort.

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This is a Creative Commons article. The original version of this article appeared here.

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