Thanks for your question. Let’s drop our usual Donnybrook and I appreciate your thoughts and would like to share mine with you.
One is the things covid did was disrupt the usual way medicine was practiced. I actually think this was a good thing. Once it really got rolling in the first six or eight months left was right, up was down and not a lot made sense. The problem was this was the first real and serious pandemic any of us have lived through. It hit as the first pandemic where there was also social media and instant reporting. Opinions and thoughts became gospel truth and because lives were at stake, rejection of those opinions became foci of rage.
As an Intensivist I saw the end product too many times and especially during delta wave. So we were all clinically grasping at straws. Our first brushes at treatment was HCQ. Because there was fear and spread and people hiding under their desks, many physicians like myself were confronted with friends and families of ours or nurses and people we worked with who were getting the disease and at that time the death rate was around 1.5%.
So a lot of us who worked in hospitals said what the hell better than doing nothing and prescribed HCQ. So I would see or talk to a patient and call in the rx. Remember at these times we were starring with drive through testing and all the other fear mongering
So I did have early treatment experience because people and colleagues had access to us and we didn’t want these people getting to our level. So hell yea we tried. And a lot of people progressed. So we know it wasn’t a silver bullet.
Then came IVM. Same story. I actually gave IVM to someone teetering in the ICU snd they turned around. I was really optimistic but the next 30 or 40 patients no effect. I had very close colleagues who got sick and i treated early with no effect. So I only saw very weak results. It wasn’t too long after the IVM fad that the vaccines were released. This was early 2021. Delta was august 2021. Despite being rung up and called a liar by Jane and RAnsomnote Gods honest truth is that during delta I didn’t have a single vaccinated patient die. This was when breakthrough infections were starting so we learned vaccination wasn’t perfect but is sure stopped death for the delta strain.
Also at this time was when we were seeing monoclonals. I was very aggressive with them. Unbelievably there was this stupid rule that if admitted to hospital you couldn’t receive them. There was some pretty strong evidence that once into late disease monoclonals were ineffective because at this point it is the inflammatory response not the actual virus. So neutralizing the virus early it makes sense it would stop progression as viral load seemed to be related to progression to severe disease. That’s why I was bearish on IVM after the monoclonals were available because on my judgment it delayed treatment and viral load was increasing.
Essentially I had a silver bullet and there was a lot of people saying untrue things about the treatment and insisting on the more ineffective treatments. So I would not prescribe IVM of HCQ because it was inferior and delayed care.
When it got personally political to me was when Biden started reducing production and redistributing it to blue states. There is the smoking gun that is problematic. The good news though was the disease continued to evolve and we ended up with omicron which stopped lethal disease. Today it is so stealth I actually do not test patients any longer unless there is some really complex reason I need to know and if positive then they get monoclonals (yeah they are still around)
So I don’t recommend boosters unless a specific reason
I certainly don’t test because it’s insane and over 55% or patients are asymptomatic. I am not seeing any critical illness or other issues so in my clinical judgment it’s over. We can either go back to complacent or address oncoming issues
1. Never should the CDC or any advisor to the president have the power to flatten the curve. It’s unconstitutional on its face
2. Never should mandatory testing or treatment be required.
3. However on the patient side demanding treatments as a right is also not proper. Physicians must be allowed their judgment
4. State boards should be dismantled who restricted prescriptive authority. There was no due process and this in my opinion is a violation of the law. My ability to practice cannot be changed without due process and if I treat with something that is out of bounds the patient has the right to sue. The boards of medicine and pharmacy made huge errors and overstepped
5. Physicians and practitioners who profited grossly from questionable treatments should be investigated. I am not including IVM or HCQ. Unfortunately the evidence is equivocal so I cannot really say that anything but a judgment call should be allowed there.
6. I do not exclude the possibility that covid 19 was an artificial genetic shift. While I don’t think it was straight out biological warfare I suppose that possibility exists. I think after hearing everything Fauci funded illegal gain of function research beyond or borders. For that he should be criminally prosecuted.
So that’s sort of my thoughts. I hope you have a good night
Remember, little keyboard. Fat fingers. Sorry for typos.
Now let's not get carried away. What would FR be if Bagster and Gassie weren't at each other's throats. It's like them two aliens (Frank Gorshin forever fighting on Star Trek). No time to make a meme for that, just imagine it.
Your #'s 1-6 would require a complete dismantling of the socialized medical structure of the entire country from the top down. Networks, etc.
I'm all for that too. Let's go back to this and Doctor's making house calls like when I was a kid and got the mumps.
(brevity due to dinner time)