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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
From the DeSantis-medical round table, what I understood is that people were coming in for other things and we’re testing positive for Covid in the admissions testing. They weren’t there for Covid. So the Covid rates in hospitals are directly related to our testing campaign, not actual hospital necessity.
One of the hospital administrators said they were halting electives at that time, not due to full hospitals, but to hopefully prevent the spread from those already there to anyone coming in for an elective.
That isn’t panic.
From what I gather, the Delta variant spreads a lot more easily that previous COVID. Also, in my area of the country (the South) complete vaccination rate is only 35 – 40%. That’s a lot of people left to be infected.
My hospital never closed so this is unprecedented to me. And no one is panicking. The hospitals are taking care of the sick. But there are consequences to sick people when hospitals go on diversion as many have done because every bed is occupied. Patients have to go somewhere else. A friend of mine’s mother a state away was having chemotherapy induced lung problems and had to be admitted to a community hospital in a town of 3,000 at a distance of 130 miles from her main hospital. None of this could be said to be leftist. I am certainly not in any way hospital admin establishment. I did not exaggerate.
A very interesting analysis (based on Israeli data) of vaccine efficacy against Delta and after 4-6 months. The analysis shows how what data *appears* to be saying may be something very different from what it actually means when the effect of important variable (age, in this case) is taken into account:
https://www.covid-datascience.com/post/israeli-data-how-can-efficacy-vs-severe-disease-be-strong-when-60-of-hospitalized-are-vaccinated
My point is that these are diseases that no longer pose a major concern in areas where modern medicine is practiced. This didn’t happen by chance, but through modern medical science. I didn’t meant to suggest these diseases were utterly and permanently destroyed in every nook and cranny of the planet.
My point is simply that, when it comes to making medical decisions for yourself, you may want to consider the old “dance with the one that brung ya” adage. Modern medicine, while far from perfect, of course, has “brung” us a long way.
But I’m talking about following the advice of your personal doctor, or other medical professionals you know and trust. And again, they are part of a medical system which has made tremendous leaps in understanding and treating and preventing diseases.
If you don’t trust your doctor, okay, that happens, but find one you do trust. (I assume you’d want to do this regardless of politicized COVID issues.) I realize it may be different for others, but for me, virtually every doctor and nurse I see as a patient, or know personally, and who I know for certain are not giving me politicized advice, recommends vaccines and masks. Not only that, but they’ve gotten the vaccine and made sure their family members have, too. A relative of mine, head nurse at an ER, and who, the last time I saw her 2 weeks ago, could not put her phone down for a second even long into the evening, trying to manage the influx of covid patients, was adamant that her teenagers get the vaccine. She is planning on having her 11 year old get it, the day he turns 12. This is obviously not politicized for her, and not about getting paid.
And what about Gromrus, and Kozak and MiMac? Is their advice on this driven by politics and money?
Also, if you’re worried about politicized medical advice, then that’s all the more reason to avoid getting it from internet forums and youtube. (Not that you were arguing otherwise, Clifford.)
How do you know?
Repeatedly, I see people exclaiming that the people they disagree with are politicizing things.
But you know what is confounding evidence of actual politicization? Changing decades of previous research, burying it, modifying it, reversing it in just 3-4 months after a new event. THAT is politicization.
That’s not simply being wrong and engaging in careful study. There wasn’t enough time for such consideration to occur. If there was re-consideration involved, then the absolute shutdown of the opposite argument would not have been so severe. Legitimate controversy exists. How I know it is politicized is that, according to you and Mr. Doctor Authority in the OP, there is absolutely no debate or controversy. It is obvious masks work.
Well no, actually. It isn’t obvious. The science does not say it is obvious. Nothing about the science says it is obvious. At the very very MOST, it is controversial and debatable.
Things that have been politicized:
Origins of COVID – It was never obvious that COVID originated in a wet market. In fact, the very manner in which the government handled this rather mild illness (it is mild. 2018 had a higher excessive death rate than 2020. No one is crying about the flu) should have been proof positive that they knew this was a manufactured virus. They completely abandoned decades of viral study and knowledge in attempting to understand this virus.
Mask Efficacy – All previous studies on mask use (saying they were not effective in the general population) were abandoned or had conclusions altered 3-4 months into the Covid Panic
Brand New Vaccine Technology – Previous attempts at a coronavirus vaccine had resulted in cytokine storms (sounds like COVID 19) and re-infections proving to be deadly. This is the first mRNA vaccine and previous attempts at new vaccines do not always work. It takes years to get them to be as safe and effective as we want them to be (Recombinant vaccines took 5 years to perfect). In previous years, even one death or adverse reaction would have been enough to return to the drawing board. Now, we wave them off.
Ivermectin and HCQ – Previously demonstrated to be effective medications against SARS Cov 1 (is that what we call it?). Now, dangerous and deadly medications. Previously available to human beings as a legitimate medication. Now, exclusively referred to has horse de-wormer.
Child Development – Previously accepted as unquestioned scientific fact that young children develop socially by engaging with the faces of the people around them. In fact, early screening of autism is a young child that does NOT look at a parent’s face. Now, all research being removed from internet to justify putting masks on children.
Anywhere where the consensus has severely altered to the point where any previous position is now verboten, there has been politicization. Anywhere where new information is met with unquestioned loyalty and debate is argued as “politicization”, that side has done the politicization.
Because I know them. These are people I know well and who I know to be capable professionals. Also, as I mentioned, they practice what they preach.
Again, all this information you see about studies, and theories etc… is all stuff that requires expertise to properly filter down to making a decision on something. MiMac’s discussion about certain studies above is a great example. When you apply that filter of medical education, training, and experience to them, those studies, even ones that seem airtight to the intelligent layman, look quite different.
This is a political forum, with great discussions with very smart people and I enjoy it a lot. But it’s not a substitute for that filter, or for the trust I have in medical professionals that I know personally. I’m not going to ditch all of that because someone linked to some article somewhere about a study that came to some conclusion the person liked better than others because it matched their politics. That’s not to say that they’re wrong. They may well be right. But when it comes to making personal medical decisions, I’m going to go with the people who I know are experts. I’m speaking only for myself here. If you want to do something else, go for it.
MiMac’s studies have been proven to only be true in clinical studies. They are not indicative of real life mask use.
How do we know? Because all of the studies he sites are limited to properly fitting n95 masks.
Guess how many people are wearing those? Not many.
You know what they ARE wearing? Little jersey-cotton nappies that look like they came form a hanes package. Designer masks with cutesy designs that show off individuality. Some disposable thing they dug out of their purse or back pants pocket.
THAT doesn’t work in the real world. And MiMac has repeatedly ignored that reality on the ground while pushing his little study on perfectly fitting masks that leave rings around people’s mouths and noses. He has repeatedly ignored that the studies of the masks were for short durations and proper mask hygiene (washing and disposal). None of his studies actually apply to the stupid mask AmEx sent me with a tag that “makes no claims at preventing viral transmission.” Even my 12 year old can read that and say this is all fraudulent.
I live in a rural community with many “uneducated” people who adamantly resist taking the vaccine. They are not formally educated, but that does NOT translate to stupidity. The rationale you just offered for providing simplistic, fear-mongering messaging is exactly why the “uneducated” and many well-educated citizens outside the coastal elite regions of the country continue to resist vaccination. They hear the arrogant condescension behind this messaging perfectly well.
(Edit: My extended family and I are all fully vaccinated and my brother is a scientist who worked on one of the Covid vaccines currently being used. I’m as pro-vaccine as they come, but can see how many resist with the insultingly simplistic, contradictory and patronizing information being peddled by the governmental powers that be.)
What I turn to experts for is specialized knowledge that I don’t have. I turn to a doctor for specialized medical knowledge. What is the covid infection rate? How dangerous is it to different demographics? What are the risk factors? etc. The doctor I trust is the one I trust to give me the real facts, not one I’m going to blindly follow whatever advice he offers. Actually, I would be suspicious of a doctor who encouraged me not to reflect on decisions but wanted me to do whatever he said without question. And that’s what we are getting with covid. Shut up and get with the program.
The medical expert has an advantage on me in determining the medical facts, but no advantage when it comes to assessing risk and making prudential judgments. A nurse makes her kids get vaccinated. So what? The father of my best friend growing up was an orthopedic surgeon who refused to let his kids have bicycles for fear of broken bones. The guy was a great surgeon but a poor assessor of risk when it came to parenting.
Just from the headlines — 60% of H are V says very little about x% of V are H, which would be a real headline. Some Bayesian math can help — needs data or estimates. I’ll take a look and then attempt some Bayesic arithmetic. Wish me luck!
So, you think I should ignore the advice of my doctor (and again, virtually every other doctor and nurse I know), and all their education and training and experience, who are part of a medical science system that has conquered a great many diseases in recent history, and instead base my medical decisions on factors such as: who said what about the wet markets and bats, endless back and forth over mask fabrics and fitting, internet arguments about ivermectin, mRNA, HCQ, and who knows what else, among people I don’t know personally and who may well have no idea what they’re talking about? When I know for sure I don’t know anything about these things. Does that seems wise? It doesn’t to me.
The CDC is telling landlords that they are not allwed to evict deadbeat tenants. Is the CDC another federal entity with its own SWAT teams? Modern medicine is not the relevant part of this problem.
I do understand that there are some studies contrary to the use of masks. I do not accept “the science is settled” when talking about other things like Global Warming so I would not try to apply it here. Science is ever evolving an very few things are actually “settled”.
That said here is a list of studies or reviews (an article that looks at multiple prior studies) from peer reviewed Journals. The basic understanding is that masks do work. They are not a miracle or a silver bullet but they are effective. Different masks have different levels but your jersey-cotton nappies do work, in real life.
The warning label on your AmEx has more to do with our legalistic society than whether or not the mask would have any positive effect. You can still get Covid if you have a mask, the mask is about lowering the odds not eliminating the possibility, the people who gave you the mask just did not want to be sued if you got Covid and tried to say it was because their mask was not perfect.
https://www.kxan.com/news/coronavirus/do-face-masks-work-here-are-49-scientific-studies-that-explain-why-they-do/
I agree with you that there are issues with masks especially in Child Development. This is a problem we need to consider. Blanket mandates are a bad idea. That does not mean that there are not specific situations (very large indoor gatherings) where it would be bad to recommend/mandate masks.
I don’t care what you do. But I don’t appreciate people taking their preferences and cloaking them with unwarranted legitimacy.
What you do is legitimate for you. But don’t go around thinking you are better than the person who looks at the information available and draws different conclusions.
Masks are not scientifically settled one way or the other.
That’s not what I’m getting. I’m not talking about talking-head doctors on CNN. I’m talking about personal doctors. Doctors who will answer questions, perfectly happy to let me reflect on whatever I want to reflect on, etc….
This is not a competition between me and the doctor, where I’m counting up advantages. I don’t understand approaching it that way. I am analyzing what information is coming to me and from where. Again, the doctors I know are far more credible, as far as I can tell.
Should I bring this up when I ask my doctor about my glucose levels? I don’t think I will. Same with my covid questions.
Nor should you! Anyone who thinks this is not extremely dangerous is historically illiterate.
She has been pulling out those same studies for over a year, which is certainly a great example of something, but probably not what you think. The interesting thing about science is that when models and non-clinical “studies” end up not playing out in the real world (or in actual more rigorous studies), you alter your hypothesis. This has become so politicized and certain people (of which mimac is a fantastic example) are so married to it that they will not allow any amount of evidence stand in their way. That is specifically why the use of government coercion to advance a “scientific” viewpoint that has been disproven again and again is such an amazingly dangerous practice.
Yeah…I hear you. I’m still going to the listen to the doctors I know on this. I don’t have the tools to properly analyze these studies, but the people I know who do have those tools, seem to come down in favor of vaccination and masks when the topics have come up. That’s not so say they are all for mandates, but they back those practices. I don’t claim to know anything. I’m just playing the odds here.
You remind me of the first covid-inspired mask study. Scientists put an infected rat in one cage, and a non-infected rat in an adjacent cage, and draped a mask in between. This was their idea of science.
I don’t have COVID questions. I have runaway government questions. To each his own.
I don’t have any problem with that. I have a problem with the fact that most mask zealots wish not simply to “play the odds,” but to use the government to coerce the entire population to follow suit. I absolutely believe in your right to do what you believe is best, provided I am allowed to do the same.
The fact that this is again being forced on school-children means, unfortunately, that it needs to be fought everywhere. This isn’t just creeping totalitarianism, it is outright tyranny.
By “advantage” I just mean that there is a reason to think he knows more than I do, and so it is appropriate to defer to his judgment. It’s not about competition.
I’m thinking of my orthopedic surgeon, who has done several knee operations on me since 2007 and, in 2018, told me I had arthritis developing in my hip and knee. I’m a long-distance runner so this was bad news. We discussed it, and I asked a lot of questions about how the arthritis might degenerate, how continuing to run might affect it, how I might help it through diet, and the like. He laid out the medical facts and the probable results of different courses of action. What he did NOT do was make the risk judgment for me, as in “you have to stop running immediately” or “get a hip replacement now” as some doctors might have done. I appreciated that greatly, and through a combination of moderating the running, cross-training, and an anti-inflammatory diet I’m still able to run half marathons three years later with little further deterioration in my joints.
This is not what we get with covid. Instead, we get “you better get that vax or the hospitals will overflow” and “kids have to spend a second year in masks or we will all get sick.” It’s not laying out the medical facts honestly and allowing people to make their own risk judgments, but a non-stop propaganda campaign that has little to do with educating the public and everything to do with herding them in the preferred direction.
Then you would be aware that in 2019, the CDC position was that masking for the public to protect against respiratory infection was ineffective. Data and science B.C (before Covid) is more trustworthy than the propaganda we are getting now.
The CDC was focused on guns, climate change, and racism then. They didn’t have time for silly things like “disease control.”
Yep. And they are all going to get infected. They have the option of getting a vaccine if they want one, and they have the option of not getting one if they don’t want one. Not terribly surprising, given the fact that the fatality distribution for covid is exactly the same as the fatality distribution overall. At this point, though, there is zero excuse for continuing to force people to take measures that you want to take. If you want to do it, do it your own damned self, and more power to you. My own governor has decided that the mere existence of covid means that he is now emperor and there are no individual liberties in this state (Washington). He should be tarred and feathered.