Two years ago, ivermectin was an obscure drug consigned only to those who had the rare displeasure of contracting parasites like scabies or river blindness. American doctors wrote a mere 150,000 prescriptions for the drug in 2019 – roughly 0.1% of the prescriptions written for Lipitor, a widely used atorvastatin designed to lower cholesterol.
Last year, however, as the pandemic raged on and conservatives stood their ground against common sense public health measures like masks and vaccines, ivermectin became a household name. Despite lacking proper consensus from the scientific community, the drug has been widely touted by right-wing pundits, politicians, and entrepreneurs as the unofficial magic bullet for COVID-19.
In many ways, the right-wing frenzy around ivermectin can be traced back to that of hydroxychloroquine, which was last year baselessly extolled by Donald Trump and many of his supporters in media and congress. However, ivermectin appears to have taken a much stronger hold over Trump's following (and beyond), benefiting from a robust network of profit-seeking providers continuously selling it to thousands of Americans.
Over the last several months, much of the battle to normalize ivermectin as a legitimate COVID treatment has played out in courts, which have seen a sudden surge in lawsuits filed against hospitals unwilling to administer the drug. Such offensives have arisen in states like Louisiana, Illinois, California, Kentucky, Delaware, Texas, and more.
"I've never encountered this and I've been in practice over 40 years," Dr. Rodney Hood, who serves on the National Medical Association's COVID-19 Task Force on Vaccines and Therapeutics, told FiveThirtyEight. "You don't get treated based upon what you feel or think," Hood said. "There are certain approved treatment regimens for certain diseases. If [what a patient is demanding] doesn't fit within that regimen, then you cannot treat them."
In one of the most widely publicized cases from August, Julie Smith, the wife of a 51-year-old coronavirus COVID patient in Ohio, sued a Cincinnati-based hospital network for not administering the ivermectin to her husband, demanding that the hospital deliver a three-week course of the drug. That month, Smith saw a favorable ruling from Butler County Judge Gregory Howard, who formally ordered the hospital to administer the drug to her husband despite warnings from the Centers for Diseases Control that its use could be unsafe. In September, the decision was reversed by a different Ohio judge, who noted that "medical and scientific communities do not support the use of ivermectin as a treatment for COVID-19."
In May, Desareta Fype, the daughter of a 61-year-old woman with COVID-19, similarly sued an Illinois hospital after all of its affiliated doctors refused to administer ivermectin to her mother. A judge later told the hospital to "get out of the way" and allow any board-certified doctor to give Fype's mother the drug, according to The Daily Herald. The hospital's attorney, Daniel Monahan, said that 20 physicians and 19 other health care workers at the hospital all refused to deliver the medicine despite the ruling, ultimately prompting Fype to hire an outside doctor to administer the drug.
While many of the ivermectin suits have been filed by seemingly unconnected individuals throughout the country, there do appear to be several common threads.
One of these threads is Ralph Lorigo, who this year became the most "in-demand" attorney for plaintiffs looking to compel the use of ivermectin in hospital systems for their loved ones, according to The Daily Beast. Lorigo helms a general practice law firm in West Seneca, New York, and has reportedly worked on at least 60 ivermectin cases, per a Journal News report. The attorney, who represented both Julie Smith and Desareta Fype, claims to be "largely successful" in delivering wins, allowing patients to force ivermectin's use.
Citing an array of dubious studies, Lorigo told the Beast that his legal actions are aimed at delivering "last-ditch" treatment for patients that have exhausted every option. But many medical professionals argue that the suits put unnecessary strain on hospitals that are already buckling under the weight of a pandemic.
"Hospitals are dealing with the unvaccinated COVID-19 patients at a very high pace," Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security, told the Beast. "And then you're going to burden them by filing a lawsuit or creating legal problems over them trying to provide the best care for these people who chose not to be vaccinated and who are now crushing their hospitals?"
Timothy Brewer, an epidemiology professor at UCLA, added that Lorigo's "why not?" approach is far from justified, largely because the studies proffered by Lorigo are hardly conclusive, potentially adding complications to drugs patients are already being given. For instance, many of the studies use statistically insignificant sample sizes, deliver unsafe doses of the drug, or were written by doctors with clear conflicts of interest.
In recent months, Lorigo, the chairman of New York's Erie County Conservative Party, has said that his business has become effectively consumed by ivermectin suits, telling SpectrumNews1 that he receives "somewhere between 80 and 150 emails and requests for information and help" on a daily basis.
"We freely give the information. I've been here seven days a week for the last seven weeks without a day off, trying to get people the information that they so desperately need," he added.
It remains unclear how much the attorney profits from each suit – or how the suits are structured. Asked who fronts the money, Lorigo refused to answer. According to Bloomberg Law, he alleges that he offers his services at a "reduced rate."
Aside from Lorigo, another common thread in the ecosystem of ivermectin litigation is America's Frontline Doctors (AFLD), a conservative political group founded by Dr. Simone Gold in 2019.
AFLD is arguably the most dominant force currently working to legitimize ivermectin as a valid COVID treatment, connecting hundreds of patients with drug providers happy to fuel what's become a multimillion-dollar industry in ivermectin sales, Time reported. The Intercept estimated that, between mid-July to mid-September of this year, AFLD and its partners raked in roughly $6.7 million in revenue by coordinating telehealth consultations for the drug. But in the process, the group reportedly bilked hundreds of unsuspecting customers out of thousands in consultation fees by, in many cases, failing to deliver the drug at all.
Irwin Redlener, who directs the National Center for Disaster Preparedness at Columbia University said that the group AFLD is "the 21st century, digital version of snake-oil salesmen."
"And in the case of ivermectin, it's extremely dangerous," he added.
Throughout the pandemic, AFLD waged a whole host of right-wing disinformation campaigns. It advocated for the use of hydroxychloroquine, called lockdowns "mass casualty events," disputed the efficacy of mask-wearing, and alleged that death certificates were being forged to artificially inflate the pandemic death toll.
While Gold has reportedly labeled the group "grassroots," AFLD is led by a cavalcade of high-brass conservatives with roots in think tanks and advocacy groups like the Heritage Foundation, the American Legislative Exchange Council, and FreedomWorks. Its founding director, Jenny Beth Martin, is the co-founder of the Tea Party Patriots, a right-wing group started in opposition to President Obama's domestic agenda before becoming a pro-Trump outfit.
On top of AFLD's connection to the Tea Party Patriots, the group is also affiliated with the Council for National Policy (CNP), a "shadowy coalition" founded in 1981 "that coordinates initiatives among conservative megadonors, political operatives, and media owners, many of them Christian fundamentalists," the Washington Examiner reported. Conservative businessman Richard Uihlein gave the group $4.3 million over a five-year period through 2020.
The Jefferson Parish Sheriff's Office is investigating a deputy accused of holding a Black woman by her hair and slamming her head repeatedly into the pavement with such force that a witness to the Sept. 20 incident said it ripped several of Shantel Arnold's braids from her scalp. A 14-second video captured the incident in the New Orleans suburb where, for decades, Black residents have accused the Sheriff's Office of targeting them.
It was the second time that hour that Arnold had been assaulted. By the time the deputies arrived, she said she had already fended off an attack by some local boys.
In an interview, the 34-year-old Arnold, who has not been previously identified, told the news organizations she had needed the police's protection. But protection is not what she got.
The video begins with a sheriff's deputy seen holding the wrist of Arnold, who is lying on her back on the sidewalk. The deputy appears to be dragging her along the pavement. The deputy then grabs Arnold's arm with his other hand and jerks her upward, lifting her body off the ground. They briefly disappear behind a parked white vehicle. When they come back into view, the deputy is holding Arnold by her braids, slamming her repeatedly onto the cement. At one point, he whips her down so violently her body spins around and flips over.
The footage ends as the deputy crouches down and places a knee onto Arnold's back.
In this case, the Sheriff's Office is conducting an internal affairs investigation into the incident, something it has not done in some similar cases, according to court records. ProPublica and WWNO/WRKF were able to confirm the probe because Arnold, who did not file an official complaint, and her relatives have transcripts of their interviews with investigators. But Sheriff Joe Lopinto did not immediately respond to requests for comment on the incident itself or his department's response to it.
For decades, members of the Black community have accused the Sheriff's Office of using excessive force against them, making false arrests and failing to rein in abusive deputies. Last month, a story published by WWNO/WRKF and ProPublica revealed stark racial disparities in shootings by deputies and systemic problems with transparency and accountability.
The investigation found that more than 70% of the people deputies shot at during the past eight years were Black, more than double the parish's Black population. In addition, 12 of the 16 people who died after being shot or restrained by deputies during that time were Black men. The investigation also found that the Sheriff's Office could not account for how often its deputies use force or how many complaints civilians lodged against its employees.
Lopinto previously declined to be interviewed about the news organizations' findings, saying only that when his deputies commit serious misconduct, they are arrested; he also noted that at least nine deputies, in a department of about 760 deputies, had been booked since he became sheriff in 2017.
Following the story, the ACLU of Louisiana called on federal prosecutors to launch an investigation into the Sheriff's Office.
Arnold's case raises many of those same issues. The evidence — based on interviews with the victim and the two witnesses, statements they provided to the sheriff's internal affairs division and the video — makes clear that something went very wrong when a citizen of Jefferson Parish needed help.
The incident started around 2 p.m. on Sept. 20 when Arnold was attacked by three boys as she was walking down the street near her family's trailer home. At 4-foot-8 and about 100 pounds, her left eye missing from a car accident years earlier, Arnold regularly made an easy target for the neighborhood bullies, her family said.
During the attack, which lasted several minutes and was captured in a cellphone video, the boys slammed Arnold to the ground and beat her while a crowd watched and laughed. She tried to defend herself with a stick, which is visible in the video. The assault ended only after 71-year-old Lionel Gray, whom Arnold considers her stepfather, chased the boys away.
Disheveled and covered in dirt, Arnold stumbled down the road toward her home when an unidentified sheriff's deputy rolled up beside her in his patrol car.
In the transcript of her interview with an internal affairs investigator, Arnold says: “I'm on my way home. I ain't make it all the way to the block, the police come out of nowhere, swarming, getting me like, 'Come here.' I'm like, 'What's going on? I just got beat up by two children, what ya'll doing?'"
Arnold said the deputy demanded she stop and talk to him. She told him that she had just been assaulted and wanted to go home, and she continued walking.
According to Gray and another witness, Arnold's 55-year-old uncle, Tony Givens, the officer jumped out of his vehicle, grabbed Arnold and threw her to the ground, unprovoked. Gray and Givens were standing at the foot of the family's driveway, about 20 feet away.
In an interview with the internal affairs investigator, Gray said that Arnold didn't pull away. “She didn't have a chance to pull away because, you know, this guy was strong. He grabbed her arm, and some kind of move he made, and she went down to the ground. ... So I was walking up to him and he told me, 'If you come any closer I'm going to kick everybody's ass out here.' So, I said ... 'you don't have to use that type of force on that little woman right there, she's a midget.'"
What happened next was picked up on a video shared on social media and viewed more than 130,000 times. It is unclear who took the video, which is the only footage of the incident to have surfaced; the Sheriff's Office remains one of the few large law enforcement agencies across the country that does not use body cameras. This week, however, the Sheriff's Office announced that it had signed an $8.7 million contract for 500 body cameras that would be deployed by December.
Lopinto said that the contract had been signed in June, “well before any of these articles that were written," and that he didn't say anything publicly because “really nobody has asked me. It's not like I denied it," he said.
WWNO/WRKF and ProPublica sent the Sheriff's Office an email on July 29 specifically asking about the fact that the office had not yet adopted body cameras. The Sheriff's Office did not respond to that email, five follow-up emails and multiple voicemail messages, texts and a certified letter.
Arnold told investigators with the Sheriff's Office that it was not the boys but the deputy who caused her injuries, which included bruises and scratches across her body, a busted lip and recurring headaches. Deputies on the scene called an ambulance, which took Arnold to a local hospital. She was not charged with a crime.
Alanah Odoms, executive director of the ACLU of Louisiana, said the video of Arnold and the deputy was “yet another testament to the shocking frequency that JPSO targets and brutalizes innocent, unarmed members of the Black community."
Sam Walker, emeritus professor of criminal justice at the University of Nebraska at Omaha, called the deputy's actions in the video “outrageous" and questioned whether the Sheriff's Office properly trains its deputies in control tactics or de-escalation techniques.
“There are essentially two answers here. One is they do, and he ignored his training," Walker said. “Or answer No. 2 is no, they don't, which is to say their training program is completely unacceptable. So, it's either him or the organization."
The video of Arnold and the deputy also raises new questions about the Sheriff's Office use-of-force policy, which activists and critics have assailed as vague and insufficient.
They have also said that the department lacks transparency around use-of-force incidents. According to the news investigation published last month, the Jefferson Parish Sheriff's Office was unable to produce any documents related to non-shooting use-of-force incidents. The research organization Police Scorecard Project made a similar request for data on use-of-force incidents; the Sheriff's Office responded by saying those records don't exist.
Shortly after Arnold had been taken to a hospital by ambulance, her sister, Mercedes, arrived on the scene. Mercedes, 32, said the deputy accused of attacking her sister was still present and tried to convince her to call the coroner to have Arnold committed to a hospital for mental health problems. She refused.
“He was just trying to cover up what he did by saying my sister is crazy," she said.
In the following days and weeks, Mercedes and multiple family members said, the same deputy has rolled by their house multiple times in what she believes to be an attempt to intimidate them. But she said she and her family are not afraid and will continue to speak up until the Sheriff's Office holds its deputies accountable.
Apparently, the Republican argument suggests, we should just forget about the coronavirus and ignore a disease that has killed 700,000 Americans, variously overrun our hospitals, interrupted jobs, businesses, and lives, and has spurred a strong political resistance movement.
Even as some courts have already endorsed the idea of government mandates for masks and protections against contagion, Texas Gov. Greg Abbott is challenging the right of President Joe Biden to act for public health as "yet another instance of federal overreach."
It's apparently okay for Abbott to mandate against mandates not only for the state's employees but for its private businesses as well. But, by contrast, it's not okay for the federal government to tell Texas, Florida, or any state what to do about a pandemic that knows no bounds, or for companies with more than 100 employees.
That Texas is only now beginning to emerge from two months or more of spiraling covid cases, hospitalizations and deaths is not the focus of this dust-up over the rules. Rather, it's a bald political showdown.
Frankly, it's disgusting, no matter what one's politics are. No, this drawdown borders on insanity. Why do we have time, energy, and money available for endless court battles over who's really in charge?
Has Abbott not heard of the telephone, to simply call Biden and engage in some debate if they disagree?
In any event, airlines based in Texas are moving ahead with mandates anyway, guaranteeing more tumult, not less.
Why It's Strange
It is such a strange battlefield that we need to look at it for what underscores this continuing Texas rebellion, especially since it spreads so quickly to other Republican-led states. Several things that question our general understanding are coming to the surface simultaneously.
- Discussion about countering a pandemic seems futile. Whenever one side of our cultural divide talks about medicine, the other is talking about rights, including the right to be as sick as one chooses and the right to infect others. We've passed the time of legitimate discussion about immediate health effects of vaccines; that is not even on the table in these moves by Abbott, who has been vaccinated and who has undergone a mild form of covid. The anti-vax position has become nearly fully a political one. By all medical standards, having had covid is no guarantee about carrying the contagion further or even to protection beyond some undetermined but finite time.
- Blame for covid under anti-vax is limited now only to the also endless debate over its origin from nature or from a man-made process in a China laboratory, either as the result or by-product of some National Health Institute grant over a study of interspecies transmission. There is no acknowledgment that keeping more than 30% of adult Americans unvaccinated is a problem that manifests as a continuing public petri dish of mutation. Meanwhile, the Right is actively blaming Biden for high gas taxes, for a messy withdrawal from Afghanistan, clogged supply lines and sagging international dominance—because they all are happening on Biden's watch.
- Spending zillions of dollars on treatments for those who already have covid may blunt hospitalizations but does nothing to halt the spread of an airborne contagion. Yet, we're seeing tons of support across the political spectrum to spend $2,000 a dose for antibody treatments now emerging, even in pill form, rather than a $20 vaccine. For those who also argue against Biden's big-spending proposals as wasteful, this position seems, well, incongruous.
- The legal arguments here are arcane, as well as, frankly, ludicrous to you and me and our jobs. Is this more about state power versus federal power in a constitutional republic than about a chance to jack up Biden and ignore a public health menace? The force of law seems to favor the federal government acting in an emergency. The practical concerns for businesses like American Airlines based in Dallas pulled among conflicting mandates from the feds, the state and demands of consumers are simply not as important to this governor as a political principle.
By all accounts from all political viewpoints, telling businesses what they cannot do is seen as antithetical to a "conservative" view that wants government restraint.
If It Quacks. . .
It is much more understandable to see the Texas challenge over covid mandates right alongside the Texas challenge over abortion, over voting rights, over the environment and even over issues of immigration.
That is, Texas politics demand that Abbott, running at least for reelection if not for president, must protect himself from absolutists even more right-wing than he himself believes. This week, we saw hardliner Republican candidate Allen West continuing to tweet from his covid hospital bed against vaccine mandates and for expensive alternative treatments. Don Huffines, a former Texas state senator who is challenging Abbott, tweeted that "Greg Abbott is a political windsock and today proves it, He knows conservative Republican voters are tired of the vaccine mandates and tired of him being a failed leader." Apparently, in response to a Huffines criticism that a state website to help teen suicide might be fostering trans discussions, Abbott had the site pulled.
About 15 million Texans have been fully vaccinated, or just over half, lagging the national average.
Why kowtowing to a minority of voters in hopes of reelection is a bit of a mystery to me. But the reason for anyone to run for governor or president should be to solve problems.
It's hard to see what problem this governor is solving other than his own political dreams.
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