Doctors claim Brazil hospitals gave dodgy COVID-19 care

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Irene Castilho, 71, did not have a day to grieve after the death of her husband from COVID-19. She was also sick, coughing and struggling to breathe; He was barely gone when he started using his oxygen mask. On the same day on March 22, he was admitted to a hospital in Sao Paulo.

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She had followed the doctors’ instructions to the letter – dutifully taking hydroxychloroquine supplements. She also took ivermectin and a battery of anti-inflammatories and vitamins in a so-called “COVID kit” that her health care company, Prevent Senior, sent to her home.

Still his condition kept on deteriorating.


At the hospital, physicians advised Castillo’s daughters about giving flutamide – a drug commonly used for prostate cancer – but they declined, concerned about possible side effects for their mother, who had recently been diagnosed with liver cancer. had cancer.

He later saw a nurse giving flutamide; He told them that it was determined despite their objection.

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Castillo died in late April, 33 days after her husband.

Castillo’s case follows a series of examples that have brought explosive charges against Pravent senior, who operates 10 hospitals in So Paulo, that have defamed Brazil.

Whistleblowing doctors testified in the Senate last week through their lawyers to stop senior tested drugs without proper consent and force doctors to prescribe unproven drugs prescribed by President Jair Bolsonaro.

Some senators have said it appears to have stopped senior fake death certificates leaving COVID-19 as the cause of death. Officials are also investigating complaints that the company researched without proper authorization.

Two weeks ago, Pedro Batista Jr., executive director of Prevent Senior, testified to senators that doctors were free to create their own prescriptions to treat COVID-19 and that patients freely agreed to take their own COVID kits. Were.

Responding to questions from the AP, Prevent Senior denied all wrongdoing, irregularities or unapproved tests were conducted at its facilities. It said that all patients or family members gave consent before receiving treatment.

Care is often underfunded in Brazil’s public health care system. Many middle-class Brazilians have private plans, but the cost is higher for the elderly.

Prevent Senior seemed to be helping fill that gap. It was established in 1997 and has grown among those who cannot afford premium care; Its monthly cost is around $300, which is half as much as some competitors. The company has over 500,000 customers with an average age of 68 years.

Hydroxychloroquine has been promoted by Bolsonaro and his colleagues. While some studies at the start of the pandemic suggested this might be promising, they were largely conducted in laboratory recipes. Extensive research around the world has long found it to be ineffective and potentially dangerous for COVID-19.

Doctors also said they were asked to prescribe ivermectin, an anti-parasitic drug whose effectiveness for COVID-19 is unproven. The American Medical Association recommends against prescribing it outside of formal tests.

The pressure to prescribe hydroxychloroquine and ivermectin is confirmed by internal Prevent senior chat groups on WhatsApp obtained by The Associated Press, and which were previously shared with the Senate committee investigating the nation’s COVID-19 response.

They include messages sent by Benedito Jr. and another executive, two current clinic directors, a former clinic director and an unidentified physician.

Lawyer Bruna Morato, who represents 12 doctors currently or previously employed by Prevent Sr., told senators on September 28 that her clients were repeatedly told that they were between prescribing questionable drugs or losing their jobs. Choose.

Prevent senior insisted that doctors are free to prescribe COVID kits or not.

Prevent Sr. told the AP it was not formally testing flutamide, but said doctors were allowed to administer it. The company said that this drug can be helpful in the treatment of COVID-19.

Jorge Venicio, commissioner of Brazil’s National Research Ethics Commission, told the AP that the only applications filed for COVID-19 research were related to Prevent Senior hydroxychloroquine and azithromycin, an anti-inflammatory that has not been shown to be helpful.

He said the council approved the request to start the trial in April 2020 and the hospital published its results three days later, indicating that the study had already taken place.

Prevent Sr. told the AP that this was not a scientific study, but an “observational report” that compared patients who received hydroxychloroquine and azithromycin with those who did not, and therefore registered them. will not be required.

“Even if it was observational research, as they are saying now, it would have to be registered,” Vencio said.

So Paulo prosecutors, who are investigating the healthcare provider, received information from the research council, as well as complaints from doctors and patients.

The legislators are also probing possible fraud in death certificates. In May 2020, the Health Ministry issued guidelines stating that a death from COVID-19 should be classified as a death certificate, even if the patient has stopped testing positive for the virus.

But that doesn’t always happen. Luciano Hang, a department store magnate who is an ardent Bolsonaro supporter, told senators that his mother was admitted with COVID-19 at a Prevent senior facility in So Paulo. Yet the disease does not appear on his death certificate, a copy of which the AP reviewed.

It is not clear whether this means that patients’ deaths were omitted from COVID-19 deaths at the state and national levels. Prevent Sr. told the AP that it does not interfere with the mandatory notification to officials.

Neither So Paulo nor federal health officials said whether patients who died of COVID-19 exceeded the country’s death toll, the country’s second-highest figure of 600,000. More than.

Many say that Prevent Senior’s revelations reveal what is happening elsewhere. The government regulator for private health care plans said in a statement to the AP that it is investigating Hapvida, Prevent Senior, and another provider, Unimed Fortaleza. The Medical Council of Sao Paulo is also investigating Prevent Senior.

The Senate committee aims to issue its final report within two weeks, and some lawmakers have already indicated they want to set an example of Prevent Senior.

Sen. Renan Calheiros, appointed to write the report, told the AP: “Stop Sr. is the most shocking case to be investigated by this committee from a humanitarian and civilizational point of view.”

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