The health chief of Misamis Oriental has authorized the use of anti-parasitic drug ivermectin on COVID-19 patients in the province, based on President Rodrigo Duterte’s recent statement that he has left the use of the drug to the discernment of patients and their doctors.

Dr. Jerie Calingasan, Misamis Oriental provincial health officer, issued a September 15 health advisory and guidance, directing public hospitals under the capitol to add ivermectin to their COVID-19 treatment protocols.

There are eight public hospitals spread across Misamis Oriental under the capitol.

Calingasan based his instruction on the September 11 Philippine News Agency (PNA) report, “PRRD leaves Ivermectin use to doctor, patient discernment.”

During his “Talk to the People” broadcast recorded on September 10 but aired on September 11, Duterte said that while there was still no definitive study on the benefits of using ivermectin for COVID-19 treatment, “testimonies abound” that the drug supposedly helps.

Referrring to Ivermectin, the President said: “I leave it really to the doctor-patient relationship. If the doctor believes in good faith that it can help, and the patient also believes in his heart that he will get well, we’ll leave it up to you to decide kasi mahirap naman masisi na eh kung totoo talagang effective tapos pipigilan mo (because it’s difficult to get blamed if this really turns out to be effective and then you try to stop it).”

Misamis Oriental Governor Yevgeny Vincente Emano said he discussed the matter with Calingasan, and the latter told him that he would allow Ivermectin use “if the admitting doctor and the patient agree.”

Emano confirmed in a text message to Rappler that Calingasan based his decision on Duterte’s pronouncement, and that the capitol would support the provincial health officer as he makes the call on medical matters.

Calingasan’s advisory detailed how the provincial hospitals are to use the anti-parasitic drug on COVID-19 patients.

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Calingasan asserted that there were studies that showed that ivermectin supposedly inhibits the replication of many viruses, including COVID-19, and that the drug reportedly has potent anti-inflammatory properties with multiple mechanisms of inhibition and prevents viral entry into host cells and cytokine storms.

Calingasan also said that the drug had supposedly been found to hasten recovery, decrease hospitalization and mortality, “has a remarkable safety record,” and can be given in pre- and post-exposure prophylaxis.

“Read and study more on ivermectin,” Calingasan concluded in his advisory.

DOH regional chief: Not recommended to prevent, treat COVID-19

The Department of Health (DOH) in Northern Mindanao issued an advisory against the use of ivermectin a day after Calingasan’s advisory. It is addressed to all governors, mayors, health officers, hospital chiefs, and healthcare workers in the region.

In his advisory issued on Thursday, September 16, DOH regional director Dr. Jose Llacuna said that the DOH-Center for Health Development Northern Mindanao “strongly believes in evidence-based medicine which uses high-quality research to guide clinical decision-making and come up with a conscientious and reasonable treatment recommendation.”

“Ivermectin is not recommended for prevention or treatment of COVID-19,” he said.

He reiterated a statement issued by health experts in March, which was based on a “systematic review of six randomized controlled trials of good methodological quality,” that did not support the use of Ivermectin for COVID-19 prevention or treatment.

He also cited a more recent review published in late July, this time on 14 randomized  controlled trials on prevention and/or treatment of COVID-19 which belied anecdotal claims that ivermectin is effective in COVID-19 prevention or treatment.

Llacuna said the consensus was that ivermectin did not significantly reduce the risk of death among COVID-19 patients with mild to severe conditions and neither did it lower the need for mechanical ventilation or supplemental oxygen.

He said ivermectin neither increased nor reduced negative COVID-19 tests nor did it make a difference in the length of hospital confinements.

“Ivermectin did not improve outpatients’ condition. Ivermectin did not prevent confirmed COVID-19,” he said.

Llacuna added, “Ivermectin may only be used for its indication as an anti-parasitic or off-label only in strict clinical trial settings.”

Llacuna also called on stakeholders to continue strengthening the COVID-19 response through evidence-based prevention, detection, isolation, treatment, and reintegration strategies, including the government’s mass vaccination rollout.

The Philippines’ Food and Drug Administration (FDA) ha earlier issued a certificate of product registration (CPR) to a local company to register ivermectin but only for human anti-parasitic treatment.– Rappler.com