How misinformation about COVID-19 fuels a run on veterinary drugs (published in 2021) (2023)

How misinformation about COVID-19 fuels a run on veterinary drugs (published in 2021) (1)

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Veterinarians, ranchers and ranchers say they are grappling with the impact of a surge in demand for the wormer ivermectin.

Dr. Karen Emerson, a veterinarian in West Point, Mississippi, uses the dewormer ivermectin to treat snakes, chickens, and rabbits.Credit...Houston Cofield voor The New York Times

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The last 10 ml of ivermectin at Emerson Veterinary Hospital.

The Veterinary Center in West Point, Mississippi, has been short of medicines for months. Hospital owner Dr. Karen Emerson kicked off the new year with a 500ml bottle of ivermectin, which she uses to kill parasites in dogs, chickens and other patients. But when the bottle emptied, her staff tried to find more, but all they found was a small 50ml bottle. Everyone told them: none available.

So started Dr. Emerson to dose the drug to snakes and other exotic animals because she had no other deworming treatment. She told dog owners to pay for a more available alternative drug, but it could cost seven times as much.

Dr. Emerson was surprised by the scarcity of ivermectin, as it was always available in abundance. But when people poured into her clinic asking about treatment with the drug, she put two and two togetherCoronavirus disease

"I really think that's why we're so short, because a lot of people are using it," she said.

For more than a year, misinformation about the effectiveness of ivermectin in treating or preventing the coronavirus has circulated on social media, podcasts, and talk radio. Although the US Food and Drug Administration says the drug is not approved to treat COVID-19 and haswarn people not to take it, media personalities expressing skepticism about a coronavirus vaccine, such aspodcast Joe Rogan, popularized ivermectin for this purpose.

The inaccurate information led some people to overdose on certain formulations of the drug, stretching thin on doctors and hospitals. But at the extreme end of misinformation are people like Dr. Emerson, who routinely use the drug for drugs already approved for animal therapy.

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How misinformation about COVID-19 fuels a run on veterinary drugs (published in 2021) (3)

While some versions of ivermectin can treat head lice and other conditions in humans, other preparations (in the form of liquids and pastes, etc.) are common in horses and livestock as a way to destroy worms and parasites. Farmers, ranchers and suppliers say people are increasingly trying to buy these animal products to ward off or fight the coronavirus.

itRequirePutting pressure on the horse and livestock world. Jeffers, the national pet supply retailer, recently raised the price of ivermectin paste from $2.99 ​​to $6.99 per tube. Due to over-ordering, a Las Vegas farm store began selling the drug only to customers who could prove they had it.horse. In California, a farmer was told the backlog was so large that she was 600th in line for the next order.

With scarce resources, some farmers, ranchers and veterinarians are turning to ordinary or more expensive alternatives to feed their animals. Others switched to expired ivermectin, or kept the drug quietly when possible. Many people were shocked.

"I'm very concerned," said Marc Filion, owner of Keegan-Filion Farms in Walterboro, South Carolina, who has been feeding the drug to his 400 pigs and 25 cattle. If he doesn't treat the pigs with the drug when they are five weeks old, they could develop diarrhea and may need to be slaughtered, he said.

Colina Corte, a University of Washington researcher who studies online conspiracy theories, said the experiences highlight the real impact of misinformation and how far it can spread.

"This doesn't just affect communities that believe in disinformation," she said. "It even affects people who have no part in the vaccine — it affects the horses."

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(Video) Covid Vaccines: Last Week Tonight with John Oliver (HBO)

According to statistics, the number of prescriptions for human ivermectin preparations has increased from a pre-pandemic baseline of 3,600 per week to more than 88,000 last month.Center for Disease Control and Prevention. There is no data on people purchasing ivermectin for animals.

The FDA in a statement. Said it had not received reports of ivermectin deficiencies, but "recognized that access to animal ivermectin is important for ranchers, ranchers and horse owners to maintain herd and animal health."

The agency tweeted last month that people shouldn't be using the drug to treat COVID-19, writing, "Seriously, y'all. STOP."

Misinformation about ivermectin as a possible treatment for the new coronavirus began to spread just weeks after the pandemic. In April 2020, scientists at Monash University in Melbourne, Australia,publishedPreliminary findings suggest the drug can kill the coronavirus within 48 hours when used in a laboratory setting. Monash University warns that the results are premature and that the investigation continues.

"Do not self-medicate ivermectin or administer ivermectin to animals," the company says on its website.

A week later, the FDA issued a warning against the use of animal preparations to treat the novel coronavirus. Despite. Findings quickly spread online, with support from othersstudyThe results showed that the drug had a beneficial effect on coronavirus patients. at least one study showedpull back

Since then incorrect informationThrive on social media sitesExamples are Reddit and Facebook. In the Facebook group 'Ivermectin Covid-19 Testimonials', 4,200 members exchanged advice about possible side effects of taking the drug and how to calculate the dosage of ointment for horses. These discussions are often repeated on podcasts and elsewhere.

"Is ivermectin paste taken orally or rubbed on the skin?" reads a recent post in the Facebook group.

"Put it on a cookie and smear a little peanut butter on the same cookie," one commenter replied.

Facebook said it removed references to a potential deal for ivermectin, as well as any suggestion the drug could be a cure. Reddit says it encourages open discussion as long as it doesn't violate its policies.

(Video) COVID 19: Updates on Testing, Pharmacology & Misinformation Confirmation

As the drug becomes more popular, some vets are bracing for shortages. Last year, Dr. Juliana Sorem, a veterinarian at WildCare, a wildlife research center in San Rafael, California, that treats injured wild animals, has a two-year supply of the drug. Her supervisor told her to take action as soon as she learned that people were using it to fight the coronavirus.

"We tried to be proactive," said Dr. Solem. WildCare now stocks six of the precious bottles.

Others were not so quick to act and regretted it. Judi Martin, manager of Skyline Ranch Equestrian Center in Oakland, California, said her brother warned her to stock up on ivermectin earlier this year after taking it to prevent COVID-19. Mrs. Martin said she didn't take him seriously.

Nine months later, Ms. Martin's supplier has sold out. She said the supplier called the drug "liquid gold" and told her she was number 600 for the next shipment.

Some dealers have adapted to the rising demand. Word spread quickly about the V&V Tack & Feed pet store in Las Vegas last month.put up a signSaid customers had to show a picture of themselves and the horse to buy ivermectin.

"I leave it to my horse breeders because they need it," Shelley Smith, the clerk who put up the sign, said in an interview. "This is the person I want to protect."

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Ruth Jeffers, owner of Jeffers pet store, said the ivermectin paste on her website is sold out this year. The tubes also sold out after they added more expensive versions.

So this spring she limited the number of new customers to five tubes. Driven by demand, she raised the price of Jeffers brand ivermectin, her cheapest option, from $2.99 ​​to $4.99 per tube and then to $6.99.

"It's hard to turn your first product into a circus," Ms. Jeffers said.

At Horsey Haven Retirement Home in New Castle, California, a stable that houses boarding horses, a lack of affordable ivermectin recently led to a discussion about cost. Laura Beeman, owner of Horsey Haven, said she had long used the drug to kill the parasite in her stable of 28 horses. These treatments are performed four times a year at no cost to the horse owner.

But with drug prices rising, Ms Beeman isn't sure she can continue to provide the service for free. She said she might start asking owners what is now $7.99 for a tube of cream, up from $1.99 before.

"Right now I have nothing left," she said.

Dr. Emerson said her animal hospital typically uses up to two 500ml bottles of ivermectin per year. She added that since the 3,500-square-foot hospital opened seven years ago, she has "never" had a problem obtaining medication.

Her first clue came two months ago, when pet owners began asking about coronavirus medications. Last month, her housekeeper said her sister drank ivermectin in her coffee.

(Video) Dr. Gregory Poland discusses COVID-19 Vaccines: Myths, Mysteries, Misinformation, Myopia & Miracles

Dr. Emerson had tried to refill the medication, but could only find 50 ml bottles. Now she says she understands why.

She said she has since done her best to slow the use of the drug in the community. in an AugustInterview with local TV channelShe warned people about the dangers of taking ivermectin and the consequences a deficiency could have for animals. She also explains the dangers of off-label use when people come in and ask about the drug, she said.

There's only 10 milliliters left and Dr. Emerson thinks she'll use it up over the next month.

"If my other herd had seed mites, I wouldn't be able to help them," she says. "And then I don't know what we're going to do."

Erin Woo is a reporting researcher in the technology department. She is a graduate of Stanford University. @erin kwo

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FAQs

Are veterinary drugs FDA approved? ›

An approved animal drug has gone through the New Animal Drug Application (NADA) process, or for an approved generic animal drug, the Abbreviated New Animal Drug Application (ANADA) process. If the information in the application meets the requirements for approval, FDA approves the animal drug.

Is it possible to get drugs from animals? ›

Medications such as conjugated estrogens (Premarin), desiccated thyroid hormone (Armour Thyroid), and heparin come from various animals.

How are veterinary medicines regulated? ›

Animal pharmaceuticals are reviewed and approved by the FDA's Center for Veterinary Medicine (CVM) as governed by the Federal Food, Drug and Cosmetic Act (FFDCA). The standards and processes for reviewing animal pharmaceuticals are very similar to those used for pharmaceuticals intended for humans.

What is a medically necessary veterinary product? ›

What is a Medically Necessary Veterinary Product? A Medically Necessary Veterinary Product (MNVP) is a product that is: Used to treat or prevent a serious animal disease or condition, or. Is needed to assure the availability of safe food products of animal origin, and.

Can a doctor prescribe a drug that is not FDA approved? ›

From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient.

Does the FDA actually approve drugs? ›

A team of CDER physicians, statisticians, chemists, pharmacologists, and other scientists reviews the company's data and proposed labeling. If this independent and unbiased review establishes that a drug's health benefits outweigh its known risks, the drug is approved for sale.

How many medications are made with snake venom? ›

Approved Drugs

Among the 11 approved toxin-based molecules marketed, one molecule (ziconotide) is obtained from cone snails, two from lizards (exenatide and lixisenatide), two from leeches (bivalirudin and desirudin), and six from snakes (captopril, enalapril, tirofiban, eptifibatide, batroxobin, and cobratide).

What medicine has snake venom in it? ›

Drugs from snake venom toxins
  • Captopril. The antihypertensive drug captopril was the first drug based on a bioactive component from snake venom that was approved in the US by the FDA in 1981 and in European countries from 1984 onwards. ...
  • Tirofiban. ...
  • Eptifibatide. ...
  • Batroxobin. ...
  • Haemocoagulase. ...
  • α-Cobrotoxin. ...
  • Anfibatide. ...
  • Crotamine.
Jun 10, 2022

How many drugs fail after animal testing? ›

3. NIH admits that 95% of all drugs that are shown to be safe and effective in tests on animals fail in human trials because they don't work or are dangerous.

What drugs are used for both humans and animals? ›

Medications commonly prescribed to both humans and pets include antibiotics like amoxicillin, antidepressants such as Prozac, pain medication like tramadol, various chemotherapy drugs, certain thyroid-control medications, and prednisone.

Can humans take veterinary medicine? ›

Although some animal medicines may share the same or similar ingredients as human medicines, they are not safe for human use and shouldn't be taken.

Do animals and humans use the same drugs? ›

It is dangerous to take drugs meant for animals. Animal drugs don't go through the same safety testing and can contain impurities.

Is there a shortage in veterinary medicine? ›

Pet ownership is increasing steadily. Researchers expect a 33% increase in pet healthcare spending over the next 10 years. 41,000 new veterinarians are needed to meet this demand. Despite a regular pipeline of veterinary graduates, there will still be a shortage of about 15,000 veterinarians by 2030.

Why do vets charge for prescriptions? ›

There are restrictions on what medicines vets can provide due to strict rules around animal prescriptions. They can't simply prescribe the cheapest human version of a medicine. Instead, they're obliged to provide veterinary-licensed medicine, which can be many times more expensive than their human counterpart.

Is it normal for a vet to charge for a prescription? ›

A: There is no federal law preventing your veterinarian from charging you a fee for their services and time invested in writing a prescription. Some veterinarians charge a nominal fee for writing prescriptions, but others don't. Individual states might have specific guidance for veterinarians on prescription fees.

What is the off-label use of ivermectin? ›

Numerous studies report low rates of adverse events, as an oral treatment for parasitic infections, scabies and head lice. Ivermectin has been used off-label to treat diseases associated with Demodex mites, such as blepharitis and demodicidosis.

How many drugs fail FDA approval? ›

1. Why 90% of clinical drug development fails? Drug discovery and development is a long, costly, and high-risk process that takes over 10–15 years with an average cost of over $1–2 billion for each new drug to be approved for clinical use1.

Do doctors get anything for prescribing drugs? ›

Under this statute, it is illegal for a physician to receive remuneration for referring a patient for a service that will be paid in whole or in part by a federal health care program or for prescribing or recommending the purchase of a drug that will be paid in whole or in part by a federal health care program.

What are the criticism of the FDA drug approval process? ›

Some critics argue that the pre-FDA process of drug development and testing—including the various stages of clinical trials—takes too long and costs too much, thus stifling innovation. It is true that bringing a new prescription drug to market is a time-consuming, expensive, and risky process for drug manufacturers.

What is most commonly prescribed drug class for older adults? ›

5 Most Common Drugs Prescribed to Elderly People
  • Opioids.
  • NSAIDs.
  • Benzodiazepines.
  • Ambien.
  • Medical Marijuana.
Jan 19, 2022

Has animal venom been used to treat diabetes? ›

The Gila monster's bite may be agonising, but humans have been using the lizard's venom to save lives. Over 30 years ago scientists discovered the potential of Gila monster venom as a treatment for type 2 diabetes.

What do doctors use snake venom for? ›

It is used in many chronic pain conditions, acting by inhibiting neuronal N-type calcium channels. Many other drugs are in the development stage. These include serine proteases like Viprin used in acute ischemic stroke to reduce clot formation.

Does lisinopril contain snake venom? ›

History. Captopril, the first ACE inhibitor, is a functional and structural analog of a peptide derived from the venom of the jararaca, a Brazilian pit viper (Bothrops jararaca).

What painkiller is made from snake venom? ›

Pain-relieving compounds—called mambalgins—isolated from the venom of Africa's black mamba snake are as strong as some opiates, including morphine, without the risk of respiratory distress and other side effects common with pain-reducing drugs.

What does the snake in medical symbol mean? ›

The snake figure was associated with Asclepios, the ancient Greek God of medicine, and possessed benevolent properties. It was believed to be able to cure a patient or a wounded person just by touch. The snake is also connected with pharmacology and antisepsis, as snakes possess an antivenom against their own poison.

Has animal venom been used to treat pneumonia? ›

Distilled venom from these animals has been effective when treating people with infections of various microorganisms that can cause pneumonia, staphylococcus, urinary tract infections, and more.

Why we no longer need animal testing? ›

The harm that is committed against animals should not be minimized because they are not considered to be "human." In conclusion, animal testing should be eliminated because it violates animals' rights, it causes pain and suffering to the experimental animals, and other means of testing product toxicity are available.

What animal testing went wrong on humans? ›

More than 114 potential therapies initially tested in animals failed in human trials. Further examples of repeated failures based on animal models include drug development in cancer, amyotrophic lateral sclerosis (ALS), traumatic brain injury (TBI), Alzheimer's disease (AD), and inflammatory conditions.

Why animal testing is misleading? ›

Animal experiments don't accurately mimic how the human body and human diseases respond to drugs, chemicals or treatments. Animals are very different from humans and, therefore, react differently. Increasing numbers of people find animal testing unethical. There are many diseases that humans get that animals do not.

Is animal gabapentin the same as human gabapentin? ›

Overall, gabapentin is safe, but do follow certain precautions. Never give your dog liquid gabapentin made for humans. The reason isn't the gabapentin, but the xylitol it's usually mixed with. This artificial sweetener is safe for humans but is toxic and even fatal to dogs.

Is trazodone for dogs the same as for humans? ›

Trazodone for dogs is the same as the drug used by people. It was developed and designed for humans but is prescribed off-label for dogs. Veterinarians often prescribe Trazodone to help with severe behavioral issues like fear, aggression, and anxiety. It's usually only used when all other options have been exhausted.

Is amoxicillin for animals the same as for humans? ›

Only your veterinarian should determine the best antibiotic and dose for your dog. Human amoxicillin may not be the correct antibiotic for your dog's infection, it may contain inactive ingredients, colors or preservatives that can be dangerous for your pet, the medicine may be expired, or the dose may be wrong.

Can you live off being a vet? ›

A compelling reason to become a veterinarian is the high earning potential. The average national salary is $120,529 per year , which allows many of these professionals to pay off student debt while living a comfortable lifestyle.

Is tramadol 50 mg the same for humans and canines? ›

Tramadol is one of the few medications that can be used for humans and dogs with largely similar effects. In most cases, it's the same drug with different doses given for humans and different animals. Because of the difference in dosing, you should never give your dog “human tramadol” if you have it.

Is tramadol for dogs different than tramadol for humans? ›

Dog Tramadol is one of the few drugs that share nearly the exact same chemical composition as a human medication. The pain meds your pup takes will be very similar to the ones you might have experience with at home, apart from minor alterations in their chemical structure to make them safer for the animal's organs.

What human medications is created from animal by products? ›

Medications may contain animal byproducts that are important for their effectiveness or production. Medications such as conjugated estrogens (Premarin), desiccated thyroid hormone (Armour Thyroid), and heparin come from various animals.

Is veterinary prednisone the same as human prednisone? ›

For many species, including dogs and humans, the two drugs are interchangeable, but cats and horses absorb prednisolone better than prednisone. The FDA (U.S. Food & Drug Administration) has approved some prednisolone products for use in dogs, cats, and horses.

Is animal penicillin the same as human penicillin? ›

The answer is yes, because those antibiotics are the exact same drugs (in a slightly different form and packaging) as those used in people. That's why people will sometimes buy antibiotics marketed for fish and give them to themselves, usually with dosing instructions from the internet.

What is the biggest issue facing veterinary medicine today? ›

Biggest Challenge – The biggest challenge for the veterinary industry by far is the widespread shortage of veterinarians. The two big reasons: poor remuneration and poor job satisfaction. Poor remuneration is a necessary consequence of low production.

Why are people leaving veterinary medicine? ›

Across the country, nearly every veterinary hospital is facing critical staff shortages. Both doctors and technicians are leaving the veterinary profession due to low wages, burnout, and compassion fatigue.

Is being a vet harder than med school? ›

Though aspiring med students have to take the MCAT before applying to medical school, most people agree that vet school is harder than medical school. Vet school isn't harder because it requires more strenuous work.

Why is it so expensive to take your dog to the vet? ›

Like human hospitals, veterinary clinics have diagnostic equipment that is expensive to purchase and maintain. Radiology is a huge investment, especially if state-of-the-art digital x-ray and ultrasound machines are utilized.

Why veterinarians are so expensive? ›

Factors such as the equipment and expertise required, the cost of continuing education for veterinarians, and the necessity for higher salaries to match the increasing demand for quality care all contribute to the rising costs.

How many times can you use a vet prescription? ›

A repeat prescription is a written prescription that can be used more than once. If your pet is on long term medication or preventative treatment, and is stable, your vet may be happy to provide you with a prescription that will last until your next check-up. This is usually between 3 – 6 months.

What is the markup on veterinary medicine? ›

In companion animal practices, an average markup of 125% to 150% is added to the cost of medicine along with a dispensing fee of $2 to $5. Drugs with low turnover rates (less than 8 to 10 times per year) typically have a 200% to 250% markup to cover the additional carrying cost.

How much is reasonable to spend on vet bills? ›

The average national cost for a dog's routine check-up is $50 to $250. Overall vet costs including wellness check-ups, dental care, lab tests and vaccines can total between $700 and $1,500 per year.

How do you handle expensive vet bills? ›

9 ways to get help with vet bills
  1. Discuss payment options with your vet. ...
  2. Check into financial assistance programs. ...
  3. Utilize CareCredit. ...
  4. Use a credit card with 0% intro APR. ...
  5. Ask about Scratchpay. ...
  6. Take out a personal loan. ...
  7. Use your emergency fund. ...
  8. Ask family or friends for financial help.
7 days ago

What is an FDA unapproved animal drug? ›

Unapproved animal drugs are new animal drugs that don't have legal marketing status. They have not been approved, conditionally approved, or indexed by FDA.

Are all veterinary products regulated by USDA? ›

A: The U.S. Department of Agriculture (USDA) is authorized, under the 1913 Virus-Serum-Toxin Act as amended by the 1985 Food Security Act, to ensure that all veterinary biologics produced in, or imported into, the United States are not worthless, contaminated, dangerous, or harmful.

What things are not approved by the FDA? ›

What Doesn't the FDA Regulate?
  • Cosmetics. While makeup, lotions, perfumes, shampoos, hair dyes, and similar products aren't regulated by the FDA, color additives in them must be approved before going on the market. ...
  • Medical foods. ...
  • Dietary supplements.
Dec 8, 2022

What is the US FDA animal rule? ›

The use of the Animal Rule is intended for drugs and biological products developed to reduce or prevent serious or life-threatening conditions caused by exposure to lethal or permanently disabling toxic chemical, biological, radiological, or nuclear substances.

What chemicals are banned by the FDA? ›

  • Bithionol. ...
  • Chlorofluorocarbon propellants. ...
  • Chloroform. ...
  • Halogenated salicylanilides (di-, tri-, metabromsalan and tetrachlorosalicylanilide). ...
  • Hexachlorophene. ...
  • Mercury compounds. ...
  • Methylene chloride. ...
  • Prohibited cattle materials.
Feb 25, 2022

What is extra-label drug use in veterinary medicine? ›

Q: What is extra-label drug use (ELDU)? A: ELDU describes the use of an approved drug in a manner that is not in accordance with the approved labeling, yet meets the conditions set forth by the Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA) and U.S. Food and Drug Administration (FDA) regulations.

What agency ensures that approved veterinary medicines are relatively safe for animals? ›

The mission statement for FDA's Center for Veterinary Medicine (CVM) reads, “Protecting Human and Animal Health.” To achieve this broad mission, CVM: Ensures animal drugs are safe and effective, properly made, and adequately labeled and packaged.

Who regulates veterinary medicine in the US? ›

The Veterinary Medical Board (VMB) has been regulating veterinary medicine in the State of California since 1893. The VMB is a governmental agency whose mission is the protection of California consumers and their animals through the regulation of veterinary medicine.

Does the USDA have more authority than the FDA? ›

Though many Americans may think the USDA is the main inspection arm of the U.S. government — due to its more visible logo on meats and organic certifications — it's actually the FDA that regulates over 80 percent of the U.S. food supply, including dairy, seafood, produce, packaged foods, bottled water, and eggs.

What is the FDA not responsible for? ›

The FDA does not regulate the practice of medicine, medical services, the price or availability of medical products and whether they are reimbursed by health insurance or Medicare.

What is the strongest warning of FDA? ›

A contraindication is FDA's strongest warning and is only added when a medicine should not be used because the risk clearly outweighs any possible benefit.

What COVID medication is not FDA approved? ›

The US Food and Drug Administration (FDA) has not approved the use of either hydroxychloroquine (HCQ) or ivermectin for treating or preventing COVID-19 in humans.

Is Red Bull FDA approved? ›

Is Red Bull regulated by the FDA? FDA regulates all conventional foods/beverages and dietary supplements through its authority under the Federal Food, Drug, and Cosmetic Act. Red Bull Energy Drink is promoted as a conventional food/beverage, and not as a dietary supplement.

What is the two Animal Rule? ›

The two-animal rule states that, when agents such as an antibiotic or vaccine are needed for such diseases, these agents may be licensed if they meet two criteria. One criterion is that they show adequate protection against a deliberate challenge of infection in two species of animals, one being a non-rodent species.

What is the vaccine Animal Rule? ›

The FDA Animal Rule was devised to facilitate approval of candidate vaccines and therapeutics using animal survival data when human efficacy studies are not practical or ethical.

Is animal testing no longer required for drug approval? ›

The new law, signed by U.S. President Joe Biden at the end of December 2022, allows the U.S. Food and Drug Administration (FDA) to approve new drugs without requiring animal data.

Videos

1. Ending the Pandemic of Misinformation and Misperception
(Mayo Clinic Health System)
2. Webinar: How Covid-19 brought misinformation to Ireland
(The Journal)
3. Experts testify at COVID origins hearing: ‘Not some immaculate infection’
(Fox Business)
4. Former CDC director testifies at House hearing on COVID-19 origins | full video
(CBS News)
5. Doctors slammed for misinformation on Covid-19 vaccines | THE BIG STORY
(The Straits Times)
6. Public Health Misinformation Panel, January 12, 2022
(countysandiego)

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