Doctors claim Brazilian hospitals had shady COVID-19 treatment
BRASILIA, Brazil (AP) – Irene Castilho, 71, didn’t even have a day to mourn after her husband died of COVID-19. She too was sick, coughing, and having trouble breathing; he was hardly gone when she started using his oxygen mask. On the same day, March 22nd, she was admitted to a hospital in Sao Paulo.
She had followed the doctors’ instructions to the letter – dutifully taking her doses of hydroxychloroquine. She also took ivermectin and a battery of anti-inflammatories and vitamins in the so-called “COVID kit” that her health company Prevent Senior mailed home.
Even so, her condition had worsened.
At the hospital, doctors advised Castilho’s daughters to give her flutamide – a drug typically used for prostate cancer – but they declined because they were concerned about possible side effects for their mother, who recently had liver cancer.
They later saw a nurse administering flutamide; she told them it was prescribed despite their objection.
Castilho died in late April, 33 days after her husband.
Castilho’s case is one of a number of examples that have led to explosive allegations against Prevent Senior, who runs 10 hospitals in Sao Paulo and makes Brazil scandalous.
Whistleblowing doctors testified before the Senate last week through their attorney that Prevent Senior tested drugs without proper consent, forcing doctors to prescribe unproven drugs touted by President Jair Bolsonaro.
Some senators have said it appears to prevent fake senior death certificates from leaving out COVID-19 as a cause of death. The authorities are also investigating complaints made by the company without proper authorization.
Two weeks ago, Pedro Batista Júnior, executive director of Prevent Senior, testified to senators that doctors are free to prescribe their own prescriptions for the treatment of COVID-19, saying that patients have voluntarily consented to their COVID kits gain weight.
In response to questions from the AP, Prevent Senior denied any wrongdoing, irregularities in its facilities, or conducting unapproved processes. It was said that all patients or family members had consented prior to treatment.
The supply in the Brazilian public health system is often below average. Many middle-class Brazilians have private plans, but the costs for the elderly are high.
Prevent Senior appeared to be helping to fill that void. It was founded in 1997 and grew among those who couldn’t afford premium care; The monthly cost is around $ 300, half that of some competitors. The company has more than 500,000 customers, with an average age of 68 years.
Hydroxychloroquine was promoted by Bolsonaro and his allies. While some studies at the beginning of the pandemic suggested that this could hold promise, for the most part they were done in laboratory courts. Extensive global research has long found that it is ineffective and potentially dangerous for COVID-19.
Doctors also said they were told to prescribe ivermectin, an anti-parasite drug that has yet to be proven effective in COVID-19. The American Medical Association does not recommend prescribing it outside of formal studies.
The pressure to prescribe hydroxychloroquine and ivermectin is confirmed by internal Prevent senior chat groups on WhatsApp obtained from The Associated Press, previously notified to the Senate committee to investigate the country’s COVID-19 response.
This includes messages from Benedito Júnior and another senior executive, two current clinic directors, a former clinic director and an unnamed doctor.
Attorney Bruna Morato, who represents 12 doctors currently or previously employed by Prevent Senior, told senators on Sept. 28 that her clients have been repeatedly told to choose between prescribing dubious drugs or losing their jobs.
Prevent Senior insisted that doctors were free to prescribe the COVID kit or not.
Prevent Senior told the AP that flutamide will not be officially tested, but doctors have been allowed to administer it. The company claimed the drug may be helpful in treating COVID-19.
Jorge Venâncio, commissioner of Brazil’s National Research Ethics Commission, told the AP that Prevent Senior’s only application for COVID-19 research was for hydroxychloroquine and azithromycin, an anti-inflammatory agent that has also not proven helpful.
He said the council approved this request to start studies in April 2020 and the hospital released its results just three days later, indicating that the study had already been conducted.
Prevent Senior told the AP it was not a scientific study, but rather an “observational report” comparing patients who received hydroxychloroquine and azithromycin with others who were not taking them and therefore would not need registration.
“Even if it were observational research, as you are now saying, it would have to be registered,” said Venâncio.
Prosecutors in Sao Paulo investigating the health care provider received this information from the Research Council as well as complaints from doctors and patients.
Legislators are also investigating possible death certificate fraud. In May 2020, the Ministry of Health issued guidelines that a death caused by COVID-19 should be classified as such on a death certificate, even if the patient no longer tested positive for the virus.
But that didn’t always happen. Luciano Hang, a department store tycoon who is an ardent Bolsonaro supporter, told senators his mother was admitted to a Prevent Senior facility in Sao Paulo with COVID-19. However, the disease does not appear on her death certificate, the copy of which the AP verified.
It remains unclear whether this means patient deaths were not included in the state and national counts of COVID-19 deaths. Prevent Senior told the AP that this will not affect mandatory notification to authorities.
Neither Sao Paulo nor federal health officials said whether patients who died of COVID-19 at Prevent Senior facilities were included in the country’s death toll, which is the second highest in the world at more than 600,000.
Many say the Prevent Senior revelations reflect what is going on elsewhere. The state regulator for private health plans said in a statement to the AP that it is investigating Hapvida, Prevent Senior and another provider, Unimed Fortaleza. The Sao Paulo Medical Council is also investigating Prevent Senior.
The Senate Committee wants to publish its final report within two weeks and some legislators have already signaled that they want to set an example for Prevent Senior.
Senator Renan Calheiros, who is due to write the report, told the AP, “Prevent Senior is the most shocking case this committee is investigating from a humanitarian and civilizational perspective.” ___
AP journalists Tatiana Pollastri and Mauricio Savarese carried from Sao Paulo. at