Fresno doctors baffled by patients’ COVID skepticism, belief in unproven ‘cures’ amid surge
A whirlpool of skepticism related to the COVID-19 pandemic — from people seeking out livestock deworming medicine as a cure for the virus, to vaccine resistance, to doubts over the severity of the crisis that hospitals and doctors say they’re facing — is fueling growing concern among doctors and emergency medical service leaders in Fresno and the central San Joaquin Valley.
Dr. Rais Vohra, Fresno County’s interim health officer, and Fresno County emergency medical services coordinator Dan Lynch gave voice to those worries recently, describing what he called an “information pandemic” that is helping to drive the spread of the coronavirus in a region in which more than half of residents have yet to be vaccinated and where pleas to wear face masks meet resistance based on prioritizing personal freedom over public health.
“It’s just another symptom of the ‘infodemic,’” Vohra said late last week in a briefing with reporters, doctors and hospital leaders late last week. “In the very same way that COVID presents with a constellation of symptoms, this information pandemic that we’re struggling with also presents us with a constellation of symptoms.”
“People doubt the layers of protection” including face masks and social distancing to limit transmission of the virus, he said. “They doubt the efficacy of the vaccines, they seek out alternative and unproven cures, and they express skepticism whenever the leaders of the hospitals are telling them that the hospitals are at or over capacity.”
“That constellation of symptoms is a sign that someone has been infected by viral misinformation,” Vohra added. “I feel sorry for them. I wish I had a vaccine for that and a cure for that. But really it’s up to everyone to protect themselves and inoculate themselves with the truth.”
Livestock dewormer for COVID?
In Fresno and Tulare counties, doctors and health officials are getting local reports of people using a veterinary medication called Ivermectin, generally used to treat worms and parasites in horses and other livestock, to treat their own symptoms of COVID-19.
Vohra said that in addition to not being proven or approved to treat coronavirus in humans, such self-medication can have dangerous side effects.
“They may actually delay people from seeking care that could actually help them, like monoclonal antibody treatment that can neutralize the virus,” he said.
In Tulare County, public health officer Dr. Karen Haught issued a public health advisory on Friday warning people against using Ivermectin, based on “concerning reports from local hospitals” about people self-medicating with the drug.
Because veterinary forms of Ivermectin is formulated for large animals, “it can be especially dangerous” for humans and “and may contain doses that are much higher than what’s safe for people,” Haught said.
At Kaweah Health in Visalia, chief nursing officer Keri Noeske said the hospital has had to admit COVID-19 patients who required hospitalization despite self-medicating with Ivermectin.
“If a doctor decides to prescribe Ivermectin, they will have the knowledge to dose it accurately and know if it will adversely interact with other medications or conditions for a patient,” she said.
But Noeski said Kaweah Health “is not using Ivermectin here because it is not supported by rigorous research and medical societies at this time.”
The U.S. Food & Drug Administration was pointed in its caution against using the livestock medication: ““You are not a horse. You are not a cow. Seriously, y’all. Stop it,” the agency said on Twitter on Aug. 21.
An overblown hospital crisis?
Lynch, who oversees regional emergency medical services such as ambulance transportation across Fresno, Kings, Madera and Tulare counties, decried the assertions made by some pandemic skeptics that hospitals and medical leaders are exaggerating the impact that COVID-19 is having on the health care system.
“I think the evidence is extraordinarily clear,” Lynch said. “We’re doing things that are unprecedented for our area. We’re shutting down people’s ability to go to an emergency department by ambulance with non-emergency conditions. We have such full hospitals that we’re moving the most critical patients outside of our county and region to other areas of the state to make room.”
“I don’t understand where somebody could say this is all a facade, that this is blown out of proportion,” he added. “We are in worse condition today, we are in a more dire situation today in our health care system in these counties than we were in the highest point of December (and) January.”
Over the past weekend in Fresno County, more than 400 people were being treated in hospitals for confirmed and suspected COVID-19 infections, including almost 90 critically ill patients in intensive-care units. Valleywide, hospitals in Fresno, Kings, Madera, Mariposa, Merced and Tulare counties were treating 725 coronavirus patients, of whom more than 130 were in ICU beds.
That’s a smaller number of patients than the peak of a winter surge. But the difference is that during that zenith of the hospital burden, the state and the U.S. Department of Defense were able to deploy medical teams to help local hospital staff. Now, Lynch said, that extra help is not available, and more local hospital nurses and doctors are being forced to miss work because they’ve been exposed to or tested positive for COVID-19 and are in isolation or quarantine.
“It’s very evident if people just open up their eyeballs and look at what the evidence is showing them in our system,” Lynch said.
Resistance to vaccine efforts
Since the first vaccines for COVID-19 received emergency use authorization from the U.S. Food & Drug Administration in December, more than 55% of all California residents are now “fully vaccinated” for the virus, meaning they’ve received both doses of the two-shot regimens from either Pfizer or Moderna or one shot of the single-dose Johnson & Johnson vaccine. The Pfizer vaccine received full approval from the FDA last week for people ages 16 and older.
In Fresno County and neighboring Valley counties, however, people have been slower to accept the vaccines. Almost 494,000 residents in Fresno County, or 47.8%, have not received even one shot and are completely unvaccinated, compared to just under 452,000 or 43.8% who are fully vaccinated.
In other Valley counties, vaccination rates are:
- Kings: 30.7% fully vaccinated (47,963 people), 62.6% unvaccinated (97,976 people).
- Madera: 39.3% fully vaccinated (62,939 people), 53.0% unvaccinated (84,780 people).
- Mariposa: 31.7% fully vaccinated (5,649 people), 51.4% unvaccinated (9,145 people).
- Merced: 34.5% fully vaccinated (99,223 people), 53.3% unvaccinated (153,322 people).
- Tulare: 37.3% fully vaccinated (180,820 people), 55.4% unvaccinated (268,405 people).
In addition to his role as Fresno County’s interim health officer, Vohra is a physician with the UCSF Fresno Medical Education program who works occasional shifts in the emergency room at Community Regional Medical Center in downtown Fresno.
“Patients in the critical care area … are coming in to get intubated and put on ventilators” with severe coronavirus cases, he said. “And some of the last words they say before they get intubated are, ‘I really wish I’d gotten that vaccine. I don’t wish this on anyone.’”
“Every family that’s watching over a patient in the ICU today is thinking the same thing as well: ‘If only we could take back the last two weeks, if only we could take back the last three months, we would have done things so much differently,’” Vohra added. Those families, he said, tell him “We would have gotten the vaccine, we would have stayed inside instead of gone out …or we would have worn our masks.”
“There’s so much we can do to protect ourselves if only we’re willing to learn from the mistakes of others,” Vohra said. “I’m not saying that to be petty or mean, but there are a lot of grieving families in our hospitals right now and we need to learn from them or we’re doing to be part of that unfortunate population.”
This story was originally published August 31, 2021 at 5:00 AM.
