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A Physician Ramble on Covid
I have a visceral distrust of government mandates, probably like most people on Ricochet. In addition, I think Fauci’s early lying to a free people that masks don’t work in order to preserve them for healthcare workers was abominable and sowed seeds of distrust in public health that are bearing fruit today. That being said, derided, discouraged, hated, or mandated, masks work to decrease the spread of COVID.
I am a doctor. My wife is a doctor. We have seen countless COVID-positive patients. Before the vaccines were available, we were protected by nothing but masks and we did not get COVID. Masks work at decreasing the spread of COVID and other respiratory illnesses. Masks — regular old surgical masks — are all that most people providing care to COVID patients in the hospital wear. N95 masks are typically reserved for times when an invasive airway procedure is planned.
Though there were some COVID cases among caregivers, we did not see nurses, doctors, or respiratory therapists decimated. Masks are used in hospitals against other respiratory illnesses as well –RSV, flu, etc. I have been protected from RSV for 30 years by surgical masks–nothing more. Masks work to decrease spread of respiratory illnesses and are a mainstay in their care in hospitals. Do you believe your own doctor or your doctor friends who recommend masks based on decades of experience or do you demand a randomized controlled trial in the middle of a pandemic in order to be persuaded that the general welfare is best benefitted by masking.
The COVID vaccines work as well. Thanks be to God, President Trump, and Operation Warp Speed that the vaccine rollout happened when it did and mitigated the worst phase of the COVID illness in Dec 2020 – Jan 2021. Daily new cases in the US peaked at ~308,000 around January 8. By mid-February, daily case rate was down to 65,000–an 80% drop–due to the vaccine. The need for boosters and lack of best understanding as to when those should be administered does not take away from vaccine efficacy.
Humility as to the limits of our knowledge is one of my big takeaways from Dr. Thomas Sowell and a chief reason that centrally planned economies cannot work. I agree that the elites in charge do not have all (most) of the answers and that at best, their motivations are mixed. In regard to public health guidance, I agree that the CDC turnarounds throughout COVID have been dizzying.
However, shouldn’t humility about the limits of knowledge work in the other direction too? Shouldn’t humility about the limits of knowledge serve as a fetter to broad proclamations about COVID insight based on Google “research?” Shouldn’t unprecedented notification that the nearby university hospital is full and canceling elective surgeries — as well as all the private hospitals in a city — prompt a personal response other than a comparison that COVID is no worse than the flu? Shouldn’t conservatives, of all people, recognize a connection between our personal behavior and the public good?
Starting 20 years ago on “Oprah,” I recognized an aspect of the loss of hierarchy (identified by Richard Weaver in 1948 in “Ideas Have Consequences”) when a world expert on a phenomenon with a depth and breadth of knowledge of a topic would be sat next to a single sufferer of the phenomenon whose emotions were equated to a life of study and concentrated attention to the issue.
Can we still acknowledge that someone may know more about something than I do even if I do not like what they are saying, the way they are saying it, or them? They may be right despite themselves. Should you be so self-assured that you are safe from a bad case of COVID because you never get the flu either and hence a COVID vaccine is unwarranted though you are 56 years old and have five people depending on you in the middle of a pandemic?
Published in Healthcare
I think what is missed in all of this is the disturbing reality that mandates (even private mandates) are tyrannical in nature, and not something we should encourage or even tolerate in the US. If vaccines work, they protect you. Once you have the option to become vaccinated, you have no reason to demand that others do so. Employers (and governments) mandating vaccines are not protecting their own interests in any respect. Unvaccinated individuals are no threat to anyone but themselves, and they are no threat to the business interests (or government interests) in question. Take, for example, the Los Vegas Raiders’ policy that only vaccinated fans may enter. You have the option of receiving the vaccine at the gate! If this is about protecting fans, getting a vaccine at the gate and entering is a ludicrous notion, as the vaccine would take weeks to take effect. But of course it is not about protecting anyone, it is about coercing people to do something you want them to do. That is what all of these mandates are. Coerced behavior, justified because some people believe that the behavior in question is good, and therefore who could possibly object to its being coerced? This mindset is absolutely suicidal for a nation of people who value liberty.
Masks are available for anyone who wants to wear them. Your mileage may vary. Vaccines are available to anyone who wants to obtain one. I highly encourage anyone who wishes to do so to do either of the above. That’s your business. Just as my decisions are my business, not yours.
Mine, too. My son-in-law here in Eugene, OR was scheduled for a hip replacement this coming Friday, but it was canceled indefinitely because of hospital overload.
I’ll say it again. I don’t really believe that this “wave” is any worse than anything that has happened over the past year and a half (during which our hospitals were not ever overwhelmed). In my area, looking just at the graph of “cases,” the current wave has already peaked and is falling, and only ever got up to about 1/2 of the next largest peak. Hospitalizations and deaths are nowhere even close to this winter or even last summer.
But that being said – this is all after 70% of the country has been vaccinated. Shouldn’t that give us some reason for pause, with respect to everything we’re being told about vaccines? Worst case scenario, the vaccines are useless or even possibly making things worse. Best case scenario, the vaccinated are protected and the unvaccinated are rapidly gaining natural immunity. I guess we’ll know the answer to that soon because if that’s the case, there will be very little covid over the winter.
None of that, however, changes the simple fact that if you look at chart after chart after chart, in literally every jurisdiction of the United States (and globally) – you see waves and peaks and declines, and absolutely nowhere does that ever correspond to mask usage, much less mask mandates. That is the sort of evidence that is so glaringly obvious it is amazing to me that there are still pockets of otherwise intelligent individuals who say things like “well, we know masks work. After all, I wear one and I haven’t gotten sick.” If this is the type of reasoning that now passes anyone’s sniff test, we are truly becoming a stupid population.
Well, Ryan, part of the indoctrination of young people for a couple generations now is never to see yourself as an individual with individual, constitutionally-guaranteed rights, but as a member of a group who is only allowed to act in ways deemed acceptable by that group.
Hospitals are supposed to be full. That is the business model. I watched one of the linked “tent” stories and the tents were empty–waiting for wave that has already peaked. The only real problem area is near the Mexico border, where 40% of the illegal aliens are testing for Covid.
Remember how bad the situation got in New York City, epicenter of Covid19, back before vaccines?? They had to bring in a medical navy ship in addition to the tents just to house all of the excess… umm… the … wait, what?
Well, I assume it’s no longer a false positive.
Is this because the only authorized covid therapy is in-patient use of IV therapeutics?
They are sick and need oxygen and monitoring not just therapeutics.
In my state of Virginia, the highest 7-day moving averages happened in January 2021:
Cases 5,903 (1/4)
Hospitalizations 135.1 (1/5)
Deaths 83.71 (1/20)
Current 7-day averages:
Cases 1,743
Hospitalizations 37.3
Deaths 4.71
I have saved many graphs like this. They don’t prove anything, but they do suggest that if the null hypothesis (H0) is that masks don’t help and the alternative hypothesis (H1) that masks help to prevent Covid infections, then 100% of the data I’ve seen show zero plausible support for H1.
This isn’t a scientific study, but it is a mass experiment where the actual outcomes of people wearing masks (or not) can be compared to the alternative. It includes all the people who wear masks badly, but that’s part of the net effect in the population.
So here’s Texas (no mask mandate for a while now) versus Hawaii (full nanny state rules):
So when you write “masks work” I’m not inclined to read much farther because I know you haven’t looked at the overall mass data on mask usage.
Exactly.
Oxygen is therapeutics. And monitoring guides other therapeutics. But they never got any therapeutics prior to being so sick that they needed hospitalization.
This is magnificent. When big-government shills do this, it’s called a “study”.
As Dennis Prager likes (liked? Been a while) to say, “Studies go one of two ways — they either confirm common sense — or they are wrong.”
I hope you are better at reading legal journals than medical ones- if so STICK TO LAW. You quote two untrustworthy organizations (AAPS and SPR- SPR was formerly known as Swiss Propaganda Research!). The SPR article is a sham- I have parsed it in another thread on Ricochet if you care to search- the article would only make a good lining of a bird cage. Next you quote an article that has been retracted BY ITS AUTHORS (“our findings are uninterpretable”) and then misunderstand the remaining article. The Danish study DID NOT SHOW MASKS DO NOT WORK. Anyone who makes that claim is either lying or is ignorant of the study. The study was “powered” to find a 50% reduction in infections with masks as respiratory protection- it did not find such a reduction- but if you care to actually read the study(which you evidently did not) you will find the following statement: “The data were compatible with lesser degrees of self-protection.” In fact the authors clearly state that masks could have reduced transmission by up to 46% according to their data. Additionally, the study did not evaluate masks as “source control” ie protecting others- which is thought to be the predominant way they work. Respiratory protection & source control are additive.
As a conservative physician I looked into AAPS years ago and what I saw clearly dissuaded me from ever joining.
Our census is way up- zero COVID cases early June now we are at levels like last winter. 8 COVID deaths last week- 75% under age 60. Over 90% of admitted patents are unvaccinated.
Again, great news! Get the vaccine and shut up.
A theory on what is going on: It has to do with a basic divide in this nation between the educated and the uneducated. To a gross simplification, the educated include middle and upperclass whites and all classes of Asians, the uneducated includes lower class whites and minorities. It turns out that behaviors associated with the uneducated classes – smoking and overeating among others – are also risk factors for covid. The fact that some educated whites do not get the vaccine is not really the problem (although more on this in a minute), because they can responsibly judge the risks and make a personal decision. If they are in good health and not obese they are unlikely to contribute to a tidal wave of hospital patients. If they are unhealthy and obese, they might very well, but they would also likely get the vaccine in such cases.
The problem is that the uneducated classes are particularly vulnerable to covid, but also prone to refuse the vaccine irrationally. They might have succumbed to the decades of leftist propaganda that the government is out to get blacks and the vaccines are just another nefarious plot. Or they might not know anybody who got sick so they think they are invulnerable, even if they suffer from co-morbidities.
It is the uneducated class that the covid propaganda campaign is aimed at. This is why it seems so simplistic, unreasonable, and coercive to educated people. You don’t argue an uneducated person into a rational decision. By definition, he’s not capable of it. Instead, you modify his behavior. That is what the propaganda campaign is aimed at: Behavior modification. And to modify behavior you play on emotional triggers like fear and the desire to be part of the group. Thus the hyping of covid dangers, the suppression of established facts like the near-invulnerability of children to the disease, and the vilification of those not vaccinated.
Educated people who do not get vaccinated are not a real problem medically since there are not many of them, but they pose a dangerous threat to the propaganda campaign because they provide cover to the uneducated. The fear campaign doesn’t really work if the uneducated find out that some of the educated aren’t buying it either.
This is also why we hear nothing about vitamin D, or losing weight, or generally improving your health as part of the fight against covid. The fear is that any mention of vitamin D will lead the uneducated to treat it as a magic pill: “I took vitamin D, so I don’t need the vaccine, and can still smoke and eat donuts.” The uneducated need a simple message rammed home relentlessly if behavior modification is to succeed: It’s get the vaccine or face ostracism and possibly a painful death.
I don’t think the ruling elites are necessarily wrong in their analysis. But I’m not getting a vaccine just to support it.
The studies I’ve seen show that the vaccine-hesitant trend toward the well-educated and PhDs.
I can’t quote the source here, but I thought the vax-hesitant included the highly educated and the lower classes. The vaccine compliant are the moderately educated. One thing for sure is the low rate of vaxxing among blacks, who are disproportionally obese. That’s a real problem for the powers that be: They’ve been telling blacks for decades not to trust the white power structure, when there is now a pandemic to which they are particularly vulnerable. I’d laugh at their predicament if it wasn’t actually causing people to needlessly suffer.
I have seen this reported as well. Can’t recall where.
Thanks for the post, Gromrus. I have a question about vaccine efficacy. You wrote:
The figures that I see are a bit different, from Worldometer (here), but your statement about the general trend is accurate. You may have been looking at individual days, while I look at the 7-day moving average. The Worldometer data shows a peak of about 255,000 cases/day on Jan. 11, dropping as you indicate to about 65,000/day in mid-February, and dropping further to about 12,000/day in mid-June.
But now it’s up to 139,000/day, despite widespread vaccination and despite natural immunity among the roughly 38 million reported to have had the disease.
Is there an explanation for this?
If the vaccines work, why are cases up so dramatically?
Full disclosure — I’m pro-vaccination, and am vaccinated myself. I am just puzzled about the latest spike in cases.
I do have a suspicion that there may be a significant seasonal effect. I analyzed the wave last summer (July-August 2020), and it seemed concentrated in the hot states. I didn’t analyze the much larger winter wave, but I suspect that it was concentrated in the cold states.
Nope. Now drug resistant. Nor have we actually killed off polio. Indeed, only small pox was truly finished off. Because polio was not finished off, we face the risk of its reemergence, in a more virulent strain, out of the very terrain we just gave up to Pakistan’s radical Islamist shadow regime.
We got this same panic porn last year. Not buying the leftist lies and expert establishment exaggeration.
Yup. The COVID nonsense is the majority of why I stopped watching the news at all early last year.
Except that the medical “profession” is now just as politicized as the social sciences. See the nonsense from the AMA and APA. And clinicians dare not officially vary from government mandated stances, as they will otherwise not be paid by the government or “private” insurance.
This statement seems logically incongruous with historical mask science and recommendations, at least in the western world. We are blessed that COVID-19 does not decimate our children, certainly not as pernicious as seasonal influenza which typically kills thousands every year. So it seems I am faced with one of two conclusions on masking with cloth or surgical paper masks:
1. Either we’ve been correct on ‘mask science’ and known for decades that masking children in schools is unnecessary, ineffective and quite harmful in any number of psychological and social development areas. See Dr. Fauci’s original statement on masking 3/8/2020, which reflected this truth.
OR
2. Physicians, CDC, NIAID and other sundry experts have been derelict in their duties and masks should have been required by children and schools since…well I don’t know, since when? Maybe someone can enlighten me: if masks are this effective, why hasn’t this been the standard protocol in schools for ‘regular flu’, it being a serious respiratory illness?
This doesn’t necessarily question motivations, even though there is strong anecdotal evidence to do so. It does however beg the question: what significant insights were made in the months immediately following Dr. Fauci’s proclamation against masking that now seemingly contradict decades of masking recommendations?
It is not panic porn when hospitals defer elective procedures- which are the cash cows for medical centers. The COVID pandemic has severely hurt the bottom line of many hospitals- the conspiracy nuts like to cite the increased Medicare reimbursement for COVID diagnosis but fail to understand that sick Medicare patients are money LOSERS particularly when they displace a private pay patient who would have had a procedure that generates a large margin over costs.
Re #89 above — I’m not sure how my comment got into the mix. None of the replies was directed at me or addresses the points I was asking about.