Following the death of a Chicago COVID patient at the center of a debate surrounding the use of the drug ivermectin, NBC 5 is looking into treatment methods currently being used in local hospitals.
At Northwestern Medicine, Dr. Benjamin Singer says treatment is decided between the treating physician, the patient and their family.
"At Northwestern, we have a very high bar for giving medications that may be harmful," said Singer, who is the attending physician in the medical and COVID ICU at Northwestern Memorial. "Ivermectin falls very much into the category where there is no evidence that it helps people with COVID-19. Simultaneously, there is insufficient evidence that the doses that might be required are safe to use, particularly in people who are sick in the ICU."
Ivermectin is FDA approved to treat some infections caused by parasites but has not been approved for use in preventing or treating COVID-19, which is a virus caused by SARS-CoV-2.
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"Just because a drug works for one condition, and may be safe in one condition, is insufficient evidence for us to use it broadly in another condition in patients who are much, much sicker with a very different disease," said Singer.
Northwestern Medicine does offer the use of monoclonal antibodies, which are laboratory-made molecules that act as substitute antibodies, under the FDA's Emergency Use Authorization.
Chicago's commissioner of public health Dr. Allsion Arwady said monoclonal antibodies are one of the best treatments available to those who qualify.
"Monoclonal antibodies are a treatment that is available very early on if someone has been infected with COVID and they’re at really severe risk for getting very sick, getting hospitalized, or even dying from COVID," Arwady said.
Rush University Medical Center, Cook County Health, Advocate Aurora Health and UI Health also currently use monoclonal antibodies to treat early illness.
All five health systems, including Northwestern, also use Remdesivir, an anti-viral medication that has been fully approved by the FDA, for patients who are hospitalized but not on life support. Steroids like Dexamethasone are used on the most severely ill patients who require a ventilator or ECMO.
"A lot of this is determined by where they are in their course of illness," said Dr. Singer.
In response to an NBC 5 request regarding the use of ivermectin and other treatment for COVID-19, Rush said it has "been developing and updating treatment guidelines since March 2020."
"When we make changes, it’s based on new research, data and literature search. We also use the NIH guidelines which are updated regularly," Rush continued in a statement.
Cook County Health tells NBC 5, "Ivermectin is not part of, nor has it ever been within, Cook County Health’s COVID-19 treatment guidelines. Currently, there is not enough data proving it as an effective treatment option, and it has not been approved for use by the Food and Drug Administration."
Advocate Aurora Health says in part, it has "issued a prescribing alert to all physicians that reinforced the FDA, CDC, National Institutes of Health and Infectious Diseases Society of America’s recommendation against the use of ivermectin in humans for the treatment of COVID-19 infection as well as our support for physicians in denying all patient requests for ivermectin for COVID-19 infection based on evidenced-based prescribing practices."
Dr. Singer acknowledges more treatment options are needed and says current drugs may be repurposed in the future but emphasizes the need for more testing.
"In order to use them we need evidence, we need strong data they are both safe and effective," said Singer.
Many health officials agree the best treatment is still prevention.
"The best way to reduce your risk of severe disease is by getting vaccinated," said Dr. Isaac Ghinai, the Medical Director of Testing at the Chicago Department of Public Health.