Author: Dr. Craig DeLisi, Family Care Center Mt. Pleasant, TX

As COVID-19 drags on and cases continue to rise around the state of Texas, we are all searching for a ray of hope in the dismal news reports we hear every day.  But while a “silver bullet” cure would be great, we have to understand that it takes medical studies and scientific data to substantiate these claims.  We must continue to beware of anecdotal claims, even from physicians.

I’ve received some emails, calls and texts this week about an interview with a physician from west Texas who claims he has found a “silver bullet” for COVID.  He touts a commonly prescribed inhaled medication called budesonide that treats inflammation and is used for asthma prevention. I’d like to offer a local, medical opinion on the matter.

I watched the interview in its entirety.  What I can NOT do is affirm or refute the efficacy of budesonide at this point.  To date there have been no studies done that I am aware of testing inhaled steroids in patients with COVID-19.  Budesonide does treat inflammation, and I’ve personally used it countless times to prevent asthma/allergy inflammation in the lungs.  Well-designed studies have shown that steroids given intravenously in hospitalized, ventilated patients with COVID have been shown to improve mortality.  But giving them earlier in the course of illness has NOT shown to be as effective.  He states (I can’t confirm) that there are currently some studies evaluating inhaled steroid use.  So it sounds like we will know soon enough whether or not his claims are true.

While I can’t argue against the medication itself, I can argue against many of the other statements he makes in the interview.  I won’t do that exhaustively here for the sake of time.  But there are many things that make me suspicious that his information is suspect at best and fraudulent at worst.  As we all look at social media and the news in these times it’s important to beware of false claims and unsubstantiated “research”.

A few things to beware of in COVID “news”:

• Evidence that is ANECDOTAL – testimonial – no numbers, data, study. (Always be concerned when this is the primary evidence that is given. It is one of the hallmarks of medical quackery.)
• Lacking specific numbers or data to back up the claims.  The doctor we are discussing today won’t tell how many patients he’s treated, just that he’s been “doing it since March” and that “they’re all alive”. (So have I and mine are too…maybe I should go on TV!)
• Bashing all of the major national and international health care authorities (CDC, WHO, NIH), suggesting they are missing something very basic. (“All the experts are wrong” is usually a suspect position)
• Consider the Source – Credentials Matter.  Physicians should share their specialty, medical school training, etc. rather than mentioning TV appearances or political appointments.   When a physician speaks, he should have a specialty that would be tied to the topic as well.  For instance, this doctor mentions being a surgeon.  That carries a bit less weight than a pulmonologist or infectious disease specialist or even an emergency physician or family physician who are on the front lines.
• Over-simplification of statistics can be suspect as well.  These claims of why ENTIRE COUNTRIES are seeing such low numbers, claiming it MUST be because of this treatment and not because of effective prevention because of masks, tracking, etc.  (Beware of oversimplification of something this complex)
• Consider Motives.  This is most obvious when someone is trying to peddle a product – medication, therapy, book, etc.  But occasionally it might be for other reasons, like notoriety.  I see no clear red flags in this case, but this is often the most obvious warning sign that something is amiss.

A few additional things here that cause me to pause and consider the validity of his claims are:

• He minimizes the importance of a coming vaccine, calling it “unnecessary”.  (I could not more strongly disagree with this sentiment)
• He elevates the statistics of influenza – 80,000 deaths a year happened ONCE in the last 40 years (3 years ago), NOT yearly.  Influenza typically kills 10,000-40,000 in the US per year.
• He downplays the well-established benefits of mask wearing and social distancing. (So not-helpful…🤦🏻‍♂️)

Budesonide might be the “game changer” we’ve been waiting for. But all of the above (and more) make me dismissive of his claim.  I’m as anxious (probably more so) as many of you for us to find an effective outpatient treatment that will help prevent bad outcomes (hospitalization, intubation, death).  Physicians and scientists around the ENTIRE WORLD are tirelessly thinking and looking for something to change our world back towards normal.  But if Singapore, Taiwan, Japan and Iceland were all so successful because of his treatment, don’t you think the world would’ve caught on by now?  Of course it would have. The only way it would not is if either (a) he is wrong or (b) there was a conspiracy by the U.S government/media/entire medical community (and the rest of the world) to wilfully ignore or conceal it.  My money is on choice (a).

Incidentally, I’m a Christian, too.  I certainly believe that the Lord can give knowledge and insight to His people.  He has for me within my practice of medicine numerous times.  But I also believe that science matters.  Hypothesis are based on rational theories.  And then they are tested in the crucible of trial/experiment, which either proves or disproves them.  This physician’s hypothesis is rational.  And time and testing might bear it out as being correct.  But the reason we do well designed, non-biased studies is to see if what works in theory actually works in practice.  In medicine, it is very often the case that it does not.