There are four pillars of combatting a pandemic but state and federal officials are ignoring an important one — early COVID treatments — and that may be causing some patients to have more severe consequences and putting unnecessary strain on hospitals and their staff.
According to Dr. Mark Steffen, a medical doctor and Kansas senator-elect from Reno County, the pillars of fighting a pandemic include contagion control, early disease treatment, hospital capacity, and vaccination. Maintaining distance, business capacity limits, masking, and temporarily closing businesses are designed to slow the spread of the illness.
To date, that’s been the primary focus of state and local officials, but they’ve largely ignored the early COVID treatment pillar, including the use of hydroxychloroquine and nebulized steroids.
“We in Kansas are totally devoid of early treatments,” Steffen said.
FDA revokes Emergency Use Authorization
The challenge isn’t unique to Kansas.
Dr. Harvey Risch, a medical doctor and professor of epidemiology at Yale University, told a U.S. Senate committee last month that the federal government spent vast sums of taxpayer money on curbing contagion and vaccines. Officials ignored potential early outpatient treatments to limit the number of COVID deaths and alleviate hospital capacity issues.
“Our government research institutions have spent billions of dollars on expensive patent medications and vaccine development and almost nothing in outpatient treatments, the first line of defense,” Risch told the Senate Homeland Security Committee on Nov. 19.
The sparsely attended Senate hearing included testimony from a handful of doctors. The majority spoke about the efficacy of some medications prescribed off-label to treat COVID on an outpatient basis. The most famous is hydroxychloroquine. Used for decades as a prophylactic to prevent malaria and as a treatment for rheumatoid arthritis and lupus, the Federal Drug Administration provided hydroxychloroquine emergency use authorization for COVID.
Government officials maligned potential off-label treatments as COVID was politicized, according to Sen. Ron Johnson, a Wisconsin Republican and chair of the Senate Homeland Security committee.
The FDA revoked emergency use authorization for hydroxychloroquine to treat COVID in June. The Kansas Board of Pharmacy discourages pharmacists from supplying the drug without verifying with a doctor the intended patient’s diagnosis.
“And (Kansas officials) shut down the use of a nebulized steroid on this nonsensical theory that to use a nebulizer would just spread the virus,” Steffen said. “They’re screaming that the sky is falling and they’re shutting down treatments based on theory.”
According to Steffen, the only approved COVID treatments require doctors to send sick patients home to wait to get better or get worse. To prescribe FDA-approved treatments for COVID, like Remdesivir and monoclonal antibody treatments like Regeneron, patients must be hospitalized.
Hospitals report bed usage
As of Friday, Dec. 4, Kansas hospitals reported 626 out of 1,075 staffed intensive care unit beds in use. Of those, COVID patients used 306, leaving 42% of all staffed ICU beds available. Officials reported 1,178 people hospitalized for COVID and 3,181 hospital beds available.
“Never before have we said ‘stay home until you’re about to die and then we’ll take care of you’,” Steffen said. “We don’t say with breast cancer, you’re at stage one, come back and we’ll help you fight it when you get to stage four.”
Johnson called the federal government’s sole focus on contagion and vaccines a “glaring blunder that probably cost lives.
“To me, it is obvious we should robustly explore every possible treatment to combat this pandemic at every stage of the disease.”
COVID progresses in stages
Dr. Peter McCollough is a professor of medicine and vice chief of internal medicine at Baylor University Medical Center in Dallas. COVID progresses in stages, he said. The first is viral reproduction, the second is cytokine storm, and the third is microthrombosis or clotting.
THE FDA doesn’t approve any treatments for the first stage.
“I’m asking for your help,” McCollough told the Senate committee. “I’m asking for the government to organize all government agencies that are related to this to rapidly assist doctors with their innovation and their compassionate care of patients with COVID-19 at home. We can prevent hospitalizations and death, and right now, it’s the only option.”
Johnson said international, federal, and state institutions let us down.
“We are all aware that Tamiflu is only effective when prescribed early enough to stop the flu virus from replicating and before the patient becomes too sick,” Johnson said. “Why haven’t federal agencies and the medical community applied the same logic and approach to the Coronavirus? This question has baffled me since March, and there probably is not a single explanation.”