Maui Discussion

Maui Health Officer Issues Follow-up Response to Legislative Demand Seeking his Removal

September 1, 2021, 5:27 AM HST
* Updated September 1, 5:28 AM
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Dr. Lorrin Pang. PC: County of Maui Facebook Live / Akaku (Aug. 31, 2020)

In a second letter defending himself and his job, Maui District Health Officer, Dr. Lorrin Pang took on a third-person perspective, describing his role in the pandemic response and calling legislative actions to seek his removal “reckless,” and “whistleblower abuse.” The letter was released Aug. 30, and widely distributed to the media yesterday.

An initial letter took a more personal approach, explaining both is personal and perceived beliefs about unapproved COVID-19 treatments.

Legislative leaders, including House Speaker Scott K. Saiki, Senate President Ronald D. Kouchi, House and Senate health committees Chairs Representative Ryan I. Yamane and Senator Jarret Keohokalole, and Maui Senator Rosalyn H. Baker, sent a letter to Governor David Ige on Aug. 25, seeking the immediate removal of Dr. Lorrin Pang from his position as head of the Maui District Health Office.

The legislative letter described Dr. Pang a cofounder of a group called the Pono Coalition for Informed Consent that it states, “has been spreading false, misleading, and outright dangerous information about the ongoing pandemic.”

“With the state’s healthcare system near a breaking point and hospitals at capacity,” the letter explains their call to action.

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Both Dr. Pang’s follow-up response letter and the initial Legislative Letter to Governor Ige are included below:

Pang Press Response Letter to Legislative Demands:

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Hawai’i Legislators Dangerously Obstruct FDA Guidelines

Dr. Lorrin Pang oversaw 45,000 vaccine administrations in Hawai’i and has a very strong vaccine mandate position.

Senators accuse Dr. Pang of promoting a non FDA-approved drug. Ivermectin is indeed a safe and effective FDA-approved treatment for parasites. Based on Ivermectin’s approval status, we know the safe dose for humans. However its effectiveness in treating COVID-19 is not confirmed. In general, FDA guidelines specifically allow M.D.s to prescribe drugs at established safe levels, as they study the effectiveness on new diseases, if there are no other better treatments for a given stage of the disease (“off label” use).

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To be clear, Dr. Pang has never prescribed Ivermectin and never prescribed off label drugs for COVID-19. He maintains that early treatment is not a realistic alternative to vaccination. FDA guidelines are clear that doctors are allowed to make off label judgements. Only licensed M.D.s can make this decision.

The FDA is very clear on the criteria: Off label use must be M.D.-prescribed and supervised. Drugs must be manufactured for humans, come from a safe source and be used in amounts below the safe dose determined from the approved labelled use. Standard treatments (such as steroids, oxygen, and monoclonal antibodies) should be considered first. Dr. Pang has always followed these FDA guidelines, taking even more precautions based on his decades of medical experience.

At stake here is the right of M.D.s to make medical decisions. They are trained to do this, while most legislators are not. It is irresponsible, inappropriate, and possibly criminal for legislators to obstruct this well-defined FDA process.

Historically, off label use, under trained physicians, has driven the development of lifesaving treatments. As an example 35 years ago Pang used an FDA approved drug for acne, took it off label at safe acne doses to show effectiveness against malaria. Countless lives have since been saved. Dr. Pang says that for the record, he cannot currently endorse hydroxychloroquine or Ivermectin as effective treatments for COVID-19, but doctors are looking, including off label, using safe doses. Suppressing or silencing this FDA approved approach and the experts who contribute, is restrictive to society’s scientific progress. Moreover, when it relates to medical science and public health, it is potentially dangerous.

As certain legislators have recently pointed out, the worst-case scenario is that untrained patients may self-medicate at overdose levels or use veterinary sources. Dr. Pang agrees, and believes that this worst-case scenario is more likely when M.D.s are unable to be open about off label use with patients, colleagues and regulators, even when speaking as private citizens. Trained physicians have earned the right to issue medical advice within the bounds of the law. Why would public officials with no medical credentials try to intimidate doctors, or go after their licenses? Legislators who do this will only worsen the problem they seek to prevent. Who is really putting the public at risk? The doctor who vaccinates people (and considers back-up treatment options in case of breakthroughs), or the legislator who calls for his removal and de-licensing based on information obtained from the popular press?

Legislators threatened Dr. Pang’s license, job, and reputation in the press and on the Senate floor without first consulting him for clarification. Sadly, he has to now respond publicly, when so much damage has already been done. How can we stand by our decisions, when decision makers try to silence experts, without even asking for input? 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?

Recklessly going after a man of medicine who has saved countless lives, without checking the facts, is unconscionable. Whistleblower-level obstruction by legislators is a potential violation of longstanding FDA guidelines. Any instance of whistleblower abuse in the legislature must be immediately called out for what it is. In everyone’s best interest, it must be prevented as Hawaii moves forward.

Aug. 25 letter from the House and Senate Leaders to Gov. David Ige:

Dear Governor David Ige:

Today’s Star Advertiser (“Top state health official and doctor on Maui promote controversial COVID-19 treatments”) reports that Dr. Lorrin Pang, head of the Maui District Health Office, is a cofounder of the Pono Coalition for Informed Consent (“PCIC”). PCIC reportedly spread false, misleading, and outright dangerous information about the ongoing pandemic. In this capacity, he is responsible for messages including, “if you are under 65, the vaccine is more likely to kill you than save your life,” and the promotion of the use of hydroxychloroquine and ivermectin as COVID-19 treatment options, despite U.S. Food and Drug Administration warnings that the use of those drugs to treat COVID-19 can be dangerous and even deadly.

You understand the state’s healthcare system is reaching (or has reached) a breaking point. Hospitals are at near capacity. Hawaii lacks sufficient medical staff.

Under these circumstances, it is critical that our public health care leaders provide responsible and accurate public health information.

As the lead public health official for the Maui district, we believe that Dr. Pang’s role with the Pono Coalition compromises his position as the Department of Health, Maui District Health Officer. His involvement and endorsement of PCIC directly conflicts with the guidance of the Department of Health, the U.S. Centers for Disease Control, and generally accepted standards of medical practice.

Dr. Pang has undermined the State’s critical public health message and public trust.

Accordingly, after consultation with the Maui legislative delegation, we request that you immediately remove Dr. Pang from his position with the Department of Health.

Please contact us if you have any questions in this matter.

Sincerely,

Ronald D. Kouchi, Senate President
Scott K. Saiki, Speaker of the House
Jarret Keohokalole, Chair, Senate Committee on Health
Ryan I. Yamane, Chair, House Committee on Health, Human Services, & Homelessness
Rosalyn H. Baker, Chair, Senate Committee on Commerce & Consumer Protection

cc: Dr. Libby Char, Director of Health

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