Even though ivermectin is not approved as a Covid-19 treatment, some hospitals and health care workers have faced threats of violence, harassment, and even political pressure after refusing to administer the drug, Matt Volz writes for Kaiser Health News.

Infographic: Strategies to stop workplace violence before it occurs

What we know about ivermectin in relation to Covid-19

Interest in ivermectin, a common antiparasitic drug, as a treatment for Covid-19 has surged in recent months, but several large studies indicate that its effect on the disease are either small or nonexistent. And while some clinical trials on the drug's effectiveness against the disease are ongoing, federal agencies and professional groups that develop treatment guidelines must review these results before the drug can be authorized for use.

Radio Advisory episode: Aaron Carroll on how clinicians can combat medical misinformation

Ultimately, based on the available research, ivermectin has not been approved for use to prevent or treat Covid-19 by FDA, the National Institutes of Health, or the World Health Organization. In addition, CDC in August advised health care professionals to steer patients away from the drug after usage of veterinary version of the drug led to a surge in calls to poison control centers.

Separately, speaking about patients' demands to receive ivermectin despite its unproven status, Rodney Hood, chair of the National Medical Association's Covid-19 Task Force on Vaccines and Therapeutics, said, "You don't get treated based upon what you feel or think." He added, "There are certain approved treatment regimens for certain diseases. If [what a patient is requesting] doesn't fit within that regimen, then you cannot treat them."

However, that has not stopped patients from seeking it out on their own, either through a doctor's prescription or other means. So far, many hospitals have refused to treat patients with ivermectin, leading to protests, lawsuits and, in some cases, even harassment and threats of violence.

Patients sue for ivermectin—and often harass hospital staff in the process

For instance, after one woman's relative was denied her request to be treated with ivermectin, she threatened violence, prompting one Montana hospital to call police and go into lockdown, Volz writes.

Similarly, a medical resident at an Idaho hospital had to call police after a Covid-19 patient's relative verbally abused her and threatened physical violence because she refused to prescribe ivermectin or hydroxychloroquine—another drug FDA has not authorized to treat Covid-19.

Workplace violence resource library

"My patient was struggling to breathe, but the family refused to allow me to provide care," wrote Ashley Carvalho, who is completing her medical residency training in Boise. "A call to the police was the only solution."

Hospitals have also faced backlash from public officials. For instance, officials in St. Peter's Health in Montana said public officials had been threatening and harassing their health care workers because they refused to treat a politically connected Covid-19 patient with both ivermectin and hydroxychloroquine, Volz writes.

"We stand by our assertion that the involvement of public officials in clinical care is inappropriate; that individuals leveraged their official positions in an attempt to influence clinical care; and that some of the exchanges that took place were threatening or harassing," said St. Peter's spokesperson Katie Gallagher. She added, "Further, we reviewed all medical and legal records related to this patient's care and verified that our teams provided care in accordance with clinical best practice, hospital policy, and patient rights."

According to Volz, these three conflicts underscore the pressure placed upon health care workers to provide unauthorized Covid-19 treatments—especially in areas of the country with low vaccination rates and high government skepticism. But while the demand for ivermectin and other unauthorized Covid-19 treatments have become a major dispute in some areas, Volz writes, reports of harassment and threats of violence like those recently seen in the Northern Rocky Mountains region are still relatively rare.

"You're going to have this from time to time, but it's not the norm," said Rich Rasmussen, president and CEO of the Montana Hospital Association. "The vast majority of patients are completely compliant and have good, robust conversations with their medical care team. But you're going to have these outliers." (Volz, Kaiser Health News, 12/2)