Dr. Lorrin Pang says he has nothing left to lose.

The embattled state health director for Maui County says his reputation as a medical doctor has been “going down the tubes” since last week when he came under fire for supporting alternative drugs to treat and prevent Covid-19, drugs that the U.S. Food and Drug Administration has warned against.

A state lawmaker from Maui called Pang a “quack” on the Senate floor.

A group of legislative leaders called for him to be fired from the job he’s held as the head of the Maui District Health Office for the last 20 years.

And the Hawaii Medical Board filed a complaint against him that, if substantiated, could result in the loss of his medical license.

“If they take my license for this reason, then I don’t want it,” Pang said Monday.

Dr. Lorrin Pang is Maui County’s top state health official and a physician. Courtesy: Lorrin Pang/2021

Born and raised in Honolulu, Pang is a 1971 graduate of the Punahou School. He graduated with honors from Princeton University and then received his medical degree and a master’s in public health from Tulane University School of Medicine.

Pang, a public health and preventive medicine physician, is a former consultant for the World Health Organization who spent two decades working overseas with the Walter Reed Army Institute of Research. He retired from the U.S. Army and moved to Maui in 2000 for his job as the state’s district health officer.

He said his bosses at the state Department of Health have urged him not to discuss his controversial endorsement of unapproved Covid-19 treatments in the news media.

But on Monday, Pang unapologetically defended the right of doctors who prescribe ivermectin, a drug typically used to treat parasitic worms, and hydroxychloroquine, an antimalarial drug, to help their patients fend off the coronavirus.

Both ivermectin and hydroxychloroquine have failed large-scale clinical trials as a Covid medication and the FDA has not deemed the drugs safe and effective to prevent or treat the respiratory virus.

But Pang, who reiterated that he has never prescribed the drugs himself and strongly supports a vaccine mandate, asserted that doctors can still prescribe them for their Covid patients if they deem it medically appropriate for their patient. 

Pang says he supports their use as a Covid treatment when prescribed by a doctor because of what he deemed promising anecdotal evidence suggesting that the drugs could help.

He also points to a British study published in the American Journal of Therapeutics this summer that found that “large reductions in COVID-19 deaths are possible using ivermectin.”

Doctors, by prescribing the drugs in safe doses and supervising their patients, could ultimately help prove their efficacy as Covid treatments, he said.

Commonly called an off-label prescription, the practice of prescribing a drug to treat an illness for which the drug is not approved typically happens when all of the approved treatments have been tried and proven unsuccessful or, as with Covid, when there’s a lack of an approved drug to treat a new disease.

“I’m fully convinced that off-labeling is a fully approved and valuable FDA process,” Pang said. “It’s very useful because it builds up to formal clinical trials, which leads to approval.” 

Although the FDA recognizes the practice of off-label prescriptions in certain scenarios, the agency has issued warnings against using ivermectin and hydroxychloroquine to treat or prevent Covid.

The most recent FDA warning against ivermectin was issued on Aug. 21, noting it’s largely intended for livestock. “You are not a horse. You are not a cow,” the agency said in a tweet with a link to the official guidance.

The agency has also cautioned against the use of hydroxychloroquine for Covid patients outside of the hospital setting or a clinical trial due to the risk of heart rhythm problems and other safety issues, including blood and lymph system disorders, kidney injuries, and liver problems and failure.

Dr. Chien-Wen Tseng, a family physician and professor at the University of Hawaii John A. Burns School of Medicine, said the practice of off-label prescription-writing doesn’t validate Pang’s endorsement of ivermectin and hydroxychloroquine as Covid medications.

“Yes, there’s some off-label use of medications that’s legitimate, and some of them are important,” Tseng said. “But this is not one of those cases. These two drugs don’t fall anywhere near that category.”

“We need to understand when there’s actually good evidence that something works and when there just isn’t and there’s actually the potential that it can harm,” she said.

Closeup of COVID-19 Pfizer vaccine in syringes inside the Hawaii Pacific Health bus located at Ilima Intermediate School vaccinations. July 27, 2021
The Pfizer vaccine is one of several preventive measures being used against Covid-19. Pang says he is a strong supporter of the vaccines. Cory Lum/Civil Beat/2021

An Uncertain Future

Hawaii Department of Health spokesman Brooks Baehr said on Monday that Pang’s controversial endorsements have not led to any change in his job status. 

And Pang says he’s committed to clearing his name. 

“I’m at the end of my career,” he said. “If they take my job from me, who cares? I still have my degrees and my publications and my reputation — well, half of it.”

Although Pang said he was “furious” that his reputation appeared to be under siege by politicians without medical degrees, he said he was encouraged to continue to speak out about his stance on alternative Covid treatments after getting calls of support from health care workers in places like Kauai, Arizona and Washington.

“All the other docs who are calling me from all over the place, beyond Hawaii, said, ‘Brah, if they can do that to you, I better not prescribe this crap anymore. I better lay low. I better be like a roach in the dark,’” Pang said.

“It’s the threat of repercussions that’s a problem here. And I truly believe that these threats against me — threats of losing my license, my job and my reputation — are a threat to public health,” he said.

Pang sent a letter to Civil Beat on Monday, drafted as a response to the politicians and others who want him fired.

“How can we stand by our decisions, when decision makers try to silence experts, without even asking for input?” Pang wrote in the letter. “Have we forgotten how to ask questions civilly, before acting? Public servants should never be bullied. That is not Aloha. If legislators prefer to bully them, rather than engage in civil discussion, then how can we ever hope to get through this pandemic together?”

In addition to Pang, the Hawaii Medical Board also filed a complaint against another Maui doctor, Kirk Milhoan. Pang and Milhoan, a pediatric cardiologist and pastor at Calvary Chapel, are co-founders of The Pono Coalition for Informed Consent, a website that calls the Covid vaccines experimental and advocates instead for the use of discredited drugs to prevent and treat the respiratory disease.

Pang said he is no longer affiliated with the coalition as of Saturday.

The doctors are under investigation by the state Regulated Industries Complaints Office. If the complaints are substantiated, RICO can then pursue a settlement or a contested-case hearing. The Hawaii Medical Board could then discipline the doctors, including by suspending or revoking their medical licenses.

Milhoan told Civil Beat recently that he has been doing free house calls for Maui residents who are ill, giving out home testing kits for Covid to people who want to avoid coming onto the radar of the Hawaii Department of Health and providing people hydroxychloroquine and ivermectin to prevent and treat the virus.

Pang said he does not endorse all of the views espoused by the coalition he helped create.

Gov. David Ige and Health Department Director Libby Char issued statements last week that condemned the misinformation being perpetuated by The Pono Coalition for Informed Consent. But they refused to answer questions about what actions might be taken against Pang.

State Sen. Rosalyn Baker led a group of legislative leaders last week in writing a letter urging Ige and the health department to immediately fire Pang for his “alarming and outrageous” endorsement of the discredited drugs to prevent and treat Covid, saying, “We don’t need to be treated by quacks.”

Civil Beat’s coverage of Maui County is supported in part by a grant from the Nuestro Futuro Foundation.

Read Pang’s letter:

Not a subscription

Civil Beat is a small nonprofit newsroom, and we’re committed to a paywall-free website and subscription-free content because we believe in journalism as a public service.
 
That’s why donations from readers like you are essential to our continued existence.
 
Help keep our journalism free for all readers by becoming a monthly member of Civil Beat today.

About the Author