An outspoken UCLA Health physician Joseph A. Ladapo recently made some waves with a cutting Wall Street Journal editorial declaring that the medical establishment of the United States during this pandemic is failing to follow evidence-based medicine, and consequently, America, the world’s biggest GDP and most formidable health-based economy, continues to be battered into submission by the ongoing COVID-19 pandemic. Dr. Ladapo calls out for what many physicians that visit TrialSite recommend: why not treat the majority of COVID-19 patients before they are ever hospitalized with low cost and available treatments that are in fact working? Dr. Ladapo brought up the recent Nov 19 hearing before the Senate Homeland Security and Governmental Affairs Committee for just such evidence. In fact, some of the presenters have made their case directly on the TrialSite News Podcast platform, such as Baylor’s Dr. Peter McCullough. But what evidence does this recent Wall Street Journal editorial author point to for early onset COVID-19? How about the trove of case series, observational study and randomized controlled trial results evidencing the benefits of ivermectin for early use in COVID-19 cases? TrialSite has spent several months chronicling ivermectin studies from India, Bangladesh, Columbia, Egypt, Brazil and Iraq, Mexico and the United States. We even made a documentary about the use of ivermectin in Peru. Not all of these studies were randomized controlled studies but several were—and in fact now at least a handful of randomized controlled study results point to clear efficacy and safety of Ivermectin for early stage use in SARS-CoV-2 infections. Even in the U.S., a well-respected physician husband and wife team published the results of their well-designed case series in peer reviewed journal Chest. The evidence for a substantial benefit has accumulated by the month but for some reason, powerful people in healthcare, government and research agencies appear to look the other way with a focus on the development of expensive monoclonal antibodies for treatment in the hospital and of course vaccines. In addition to ensuring that high quality vaccines are available to the public as soon as possible—and on this topic the biopharmaceutical industry appears to be delivering in a big way—it’s critical also to open up, understand and embrace public health approaches that can serve to treat COVID-19 patients early on, in an economical way. This public health pivot emphasizes early treatment to keep as many mild to moderate COVID-19 patients as possible away from the need for hospitalization.
Dr. Ladapo steps up in a noble and courageous way to cut against the dominant grain in this case. United States healthcare is not built on a fear-driven, top down, command and control national-style model. Rather, it’s a fundamentally doctor-driven and decentralized, dynamic and diverse competitive system that looks at a myriad of material evidence and real world data, to support progressive and incremental advancement of human health: progress is here, it’s in reach. In addition to incredible work of vaccine and therapy development to date, TrialSite celebrates a courageous medical spokesperson that puts overall public health over fear, control and concern for what others might think.
Call to Action: Read Dr. Ladapo’s editorial and consider the pros and cons of his argument. What are your thoughts?