ICU doctor let go over vaccine mandate pushes for early outpatient treatment

By Caroline Hecker

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    ST. LOUIS (KMOV) — A local ICU physician – who fought the COVID-19 pandemic on the front lines for 18 months – is out of a job after refusing to get the COVID-19 vaccine.

Dr. Mollie James, D.O., said she was employed at two health systems in the Midwest, including in St. Louis, for much of the pandemic. She was also splitting her time between local hospitals and one in New York.

James said she has worked as a trauma and acute care surgeon and intensivist for 11 years, four of which were spent in St. Louis.

“When the pandemic hit I just felt a calling to go to New York when they called for volunteers,” she said. “So I went there in April of 2020 and I liked being in the midst of it. My purpose for going was to help them out, but also to see what they were doing in real time and what was the most effective for patients so I could bring that back to the community.”

For most of the last year and a half, James said she traveled between New York and St. Louis, working with critical ICU patients infected with COVID-19 in multiple hospitals.

“I was scared, so I have a lot of empathy for the people who live in fear, because we didn’t know,” she said. “About that time nurses were dying. Doctors were dying. And so I didn’t know what we were getting into.”

James said she tested positive for COVID-19 in March of 2020, about a month before volunteering to go to New York. Still, she said she was nervous.

“We had freezer trucks serving as morgues outside my hospital so it was a very real reminder to wear all of the personal protective gear,” she said.

During her time treating patients at the height of the pandemic, James said one of the first big improvements in treatment she witnessed was the addition of steroids and blood thinners to treatment protocols.

In December of 2020, James said the Senate committee testimony of Dr. Pierre Kory, a fellow ICU physician, caught her eye.

“He started talking about Ivermectin,” she said. “At the time, I wasn’t familiar with that medication, so I started looking into it and the dosing protocols and the side effects and the downsides to it. We started slowly using it in a few patients, then the pandemic numbers went down and I didn’t really see a big difference at that time.”

When a surge of COVID-19 cases hit southwest Missouri, James said she started doing additional research on the drug and the concept of early outpatient treatment.

“There’s an entire protocol and Ivermectin is a key part of it,” James said. “We use blood thinners and different vitamins along with a stronger steroids than most people use, called Methylprednisolone. We combine that with Ivermectin and that combination seems to be extremely effective.”

According to the FDA, Ivermectin tablets are approved for use in humans at very specific doses to treat some parasitic worms. But James believes it’s an effective way to treat COVID-19.

“I had two patient successes at the hospital that was offering it and they pulled it off the shelf a week later,” James said. “I was told it wasn’t approved by the COVID committee so doctors who were not involved in the patient’s care, my patient’s care, were making decisions about what I could use.”

Dr. Clay Dunagan, the head of the St. Louis Metropolitan Pandemic Task Force, looked into James’ claims but said there are better treatment options available.

“It’s conceivable that Ivermectin has some impact early in the disease but it’s not really something we should be using. We have other drugs that are more effective,” he said.

Dunagan said early data shows Ivermectin doesn’t make much of a difference and he believes Remdesivir, an anti-viral drug, along with other steroids benefit patients more.

James said the decision should be between a patient and their doctor.

“When I was able to properly dose and use Ivermectin in an ICU patient, I saw the fastest turnaround of any patient out of probably a couple thousand that I’ve treated,” James said. “When you have administrators telling physicians what medications they can prescribe, or how to counsel patients regarding interventions or telling them not to do something they believe is in the patient’s best interest, I think doctors have an obligation to leave those situations.”

Dunagan said many hospitals do have COVID-19 committees that are often comprised of doctors and pharmacists who make decisions on treatment protocols.

“Those groups are invaluable and provide an objective look and what works and what doesn’t,” he said.

Because James recovered from COVID-19, she believes her natural immunity outweighs any medical need for a vaccine. She said she doesn’t actively encourage her patients to get vaccinated, but did add she believes it’s a decision that should ultimately be left up to a patient and their doctor.

James cites an early Pfizer study, that found 95 percent efficacy in the vaccine two months after the second dose. The same study ultimately led Pfizer to being granted Emergency Use Authorization from the FDA. However, she said the two-month time frame is too short to judge effectiveness and said the study found antibodies began dropping off after that time period.

The Pandemic Task Force refutes that claim and said more data has since been collected showing the vaccine grants long-term protection.

“The benefits of vaccination are dramatic in terms of preventing bad things that can happen from COVID,” said Dunagan. “The treatments that we use after people have been infected, they do provide some benefit, but they’re certainly not silver bullets.”

James admits her position on the use of Ivermectin and vaccination status places her in the minority of healthcare workers. Still, she said she’s speaking out based on the tragedy she’s witnessed firsthand.

“I think there are a lot of people living in fear, they’ve been sold fear for a long time. They don’t need to be afraid, they just need to be informed,” James said. “They need to arm themselves with the knowledge and potentially the medications so they know what to do and get back to life.”

Dunagan said the vast majority of healthcare workers agree with the current treatment course and vaccine mandate.

“Getting through medical school doesn’t always mean you’re able to interpret and use science in the proper way,” he said. “We’ve got people who are mounting the counter narrative but I think the vast majority is pre-aligned on these things.”

James is in private practice now, seeing patients virtually from across the country. She said she will prescribe several medications, including Ivermectin, to patients who have tested positive, or are worried about contracting COVID-19.

“Everyone is a candidate for early treatment,” she said. “I believe its 85 percent effective in keeping people out of the hospital.”

She adds she’s run into roadblocks at pharmacies, with pharmacists unwilling to fill prescriptions for Ivermectin. Insurance companies don’t cover it either, leaving patients to pay out-of-pocket.

Dr. Dunagan said he is confident in the current treatment regiment offered to patients in task force hospitals and said decreasing hospitalization numbers are evidence of its effectiveness.

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