Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
Doing Harm by Doing Nothing
Doctors are supposed to be known for their commitment to “do no harm.” But is it possible to do harm by refusing to act?
Our medical community is not helping its patients to deal with the pandemic of fear and disease. The Wall Street Journal has reported that the very treatment which could save lives is being ignored, due to the timidity of doctors and hospitals:
Doses of monoclonal antibodies—Covid-19 therapies authorized for emergency use last month—are sitting unused in hospital pharmacies, even as cases surge across the country.
Hospitals say the rollout of the therapies has been stunted by a lukewarm response from infectious-disease specialists, who say they want more clinical trial data before using them on a regular basis. Medical centers are also grappling with a lack of awareness and interest from both the primary-care doctors who would normally prescribe the drug and patients who are offered it. And some places are dealing with a shortage of space and staff to administer the therapies.
So on the topic of the greatest current health threat in America, the medical community is wringing its hands:
‘To be really certain about the results, you need greater numbers,’ said Rajesh Gandhi, an infectious-disease physician at MGH and a member of the Covid-19 treatment guidelines panels at the National Institutes of Health and the Infectious Diseases Society of America.
While doctors wait for greater numbers in the “results,” greater numbers of people are dying. These are the professionals whom we’re supposed to admire; we put our lives in their hands every day.
How many people will need to die, and how great must the numbers be, to try to save those who are most ill?
Published in Healthcare
If they were approved by the FDA, the be-all and end-all of approvals, then why are so many doctors ignoring them? And as I already asked, how many would equal a “greater number” for them to agree to use them? I am not dissing all doctors in general, but I don’t think these decisions are based on wisdom or a rationale. I think they are afraid. Did you read the recent comment by Fauci that he lied about the numbers that would lead to herd immunity, because he was trying to coax us into getting the vaccine? (The link is in Comment #7 above.) Does that sound like good science or medicine to you? Sounds like manipulation and being treated as children to me. People don’t always act out of rational decision-making.
If this virus is such a deadly threat that our children and grand children will be left with a smoking ruin of an economy, not to mention the harm done societally, then rolling the dice on decades-old medications, with minimum side effects, seems logical and reasonable.
Covid is either a threat, or it’s not. We’re being told one thing while the medical community treats it as another.
Well, trust Fauci to guide you in the right direction.
Can you think of any answers to this question? They are answered in the article that you linked — and if you follow the link-within-the-link about the approval for emergency use, you’ll find this WSJ article about these experimental treatments being touted by — wait for it — Bill Gates.
I don’t automatically distrust Gates, by the way. But I don’t automatically trust him, either.
I would think that an emergency use approval is necessarily provisional, which implies that it is quite sensible for medical professionals to treat the approval differently than a typical FDA approval. Does this seem wrong to you?
Then, for some reason, you go to Fauci. So we can’t trust Fauci. But then you seem to think that we should be trusting the FDA’s emergency approval, for some reason. And not trusting the other doctors who are more skeptical of the treatment, and would like to see more data.
Susan, I’m sorry if I’m picking on you. I’m confident that you are sincere, but you (and I, and everybody else) are facing questions about which there is great uncertainty. And yet, you write a post expressing a great deal of certainty that the medical profession is doing a terrible job by not adopting this new treatment. You essentially accuse them of needlessly killing people.
I am not speaking for Susan.
But I will confidently accuse them of needlessly killing people. And by “them”, I am speaking of the global medical community. (YMMV) Countless cancers that would respond to early treatment are going undiagnosed. People killed by ventilators to keep medical staff safe. Our seniors are dying from “failure to thrive” and God only knows what else because they no longer have a loved one available, bedside, to keep an eye out.
The third world will pay an even bigger in every way, especially medically.
Bill Gates isn’t the one who gave it provisional approval.
No it doesn’t seem wrong. But here is why emergency use approval is given:
Sheep 1: Why are they corralling us like this?
Sheep 2: To give us a dip for our own health and protection.
Sheep 3: To shear off our winter coats.
Sheep 4: To move us to greener pastures.
Sheep 5: It’s a cook book!
Like lambs to the slaughter. In fact, I’ve been reading about Malthusian and dystopian projects for a long time. Does The Great Reset include reducing the earths population from 7.5 billion to 0.5 billion or not? Does it include aggregating money and power in a few and letting the population of
Venezuelathe US starve and die of disease, limited and poor-quality water, poor sanitation, and protein-calorie deficiency?I’m ready to believe just about anything, Flicker.
I’m not sure the Hippocratic Oath is a requirement for doctors to practice . . .
Right.
Well, honestly I don’t think it’s a cookbook.
Today is Day 9 for AUDad and his covid case. He finally agreed to get a lung X-ray. I was on the phone with our dr.’s office, (who has done a stellar job with me. Prednisone helped immediately and my case seems far lighter). They said they were not going to just sent over orders for an X-ray. He would need to be evaluated. Great thing too. Lungs are not bad but he has possible kidney complications. A bag of IV fluids, a steroid, and three hours later, he is home to recover.
Salute!
I hope you are both fully healed soon, AUMom!
Your family doctor is probably not a specialist. They don’t know everything, and they might even tell you when they don’t know. They usually tell you when they’re reciting from the CDC Bible Stories, too. Those stories are often true, so I don’t discount them out of hand, but I do apply a grain of salt.
I sometimes have learned things about health care that my doctor doesn’t know, but my doctor knows a lot of things I don’t know. I try to work through the issues with doctors accordingly.
Government doesn’t treat medicine as a science or an art. Rather it’s a part of the bureaucratic process. It’s not there to produce a result, that is healthy people, but rather to perpetuate the process. Healthy people is just a fortunate side effect of said process, when it happens at all.
Every institution of our government has rightfully earned our mistrust.
To the extent doctors are wary, they are just like the rest of us.
Here’s hoping we can find trustworthy scientists to help us push through both the censorship and bureaucratic punishment…
Honestly, only G-d can help us discern.
At Coronavirus – For Health Professionals (michigan.gov) “’Patient Treatment Protocols’ What should I use to treat a COVID-19 patient?” They are as follows:
Letter from Dr. Khaldun on COVID-19 Impacts on Racial and Ethnic Minorities
Best Practices for Accessibility at Michigan Testing Sites
MDHHS COVID-19 Practice Management Guide
EMS Tipsheet for Spotting MIS-C
Guidance for Health Care Facilities for Discharge of COVID
Guidance for Health Care Facilities for Admission of COVID
Guidance for Health Care Facilities for EM of COVID
Hospital to Post-Acute Care Transfer Form for COVID-19 – UPDATED 3/27
Guidance to Protect Residents of Long-Term Care Facilities
Michigan EMS Coronavirus Disease (COVID-19) Response
Addressing patients emotional needs during COVID-19 workup and diagnosis: Guidance for Clinicians
Of these, only two seem to include actual treatment recommendations. The EMS Response link includes document “14.06 – Clinical Treatment…” and was issued 03/23/20 and updated 08/28/20. That’s great for EMS. It helps them get critical Covid patients to the ED. But what about once the patient arrives?
The more comprehensive, because it includes in-patient care, EMS protocols, PPE, utilization of resources, etc.,“MDHHS COVID-19 Practice Management Guide” was issued 3/27/20 with no indicated updates and appears to be a 33 page DoD document authored by 57 people with 5 pages of references and an additional 33 pages of appendices, including 20 pages of color coded cookie cutter charts for scarce resource management from the Minnesota Department of Health. But not to worry, every page has this footer, “Guideline Only/Not a Substitute for Clinical Judgment“.
If the pandemic months are school years, we should be learning Algebra and The State of Michigan is still at, “Everything we needed to know we learned in Kindergarten.”
Thanks for this information, KCVolunteer. Considering how often treatments and protocols change, this is sad. For everyone.
I noticed this a few weeks ago on the Mass.gov website pages devoted to covid-19. None of them had been updated for months. It is the weirdest thing. The virus dominates every news cycle, but there’s little response within the public health field other than something to do with “people of color.” I wonder if the riots last summer are a factor.
I also think that pursuing prevention strategies–the masks and social distancing and contact tracing–diverted the state and local governments’ attention from treatment angles to largely ineffective, out-of-date containment angles.
And did the election have anything to do with why there was so little new information on the covid-19 pages? Most government employees at the state and local levels are Democrats. Were they holding their breath hoping that election would get rid of Trump?
It was just bizarre to see these pages that did not address any of the recent studies or experiences within states and cities and towns across the country. The state governments should be the clearinghouse for the latest information.
I’ve been thinking about these factors a lot, Marci, and I think they believed that it all just keeps changing all the time, so why bother changing the data when it will just change again? I hope I’m wrong . . .
I’ve seen the same. State and local governments still using guidelines developed in March when we knew little about how this virus operates. But that’s kind of how governments work: they’re the last to adapt to changing conditions. (For example, Republicans still think they can win elections by emulating the Romneys and Bushes.)
It’s a serious dereliction of the responsibility they have to the state’s citizens.
The lack of up-to-date information explains a lot of the frustration town and city governments have right now. It would be like going to the National Weather Service website and finding that it hadn’t been updated with the latest weather forecasts for months.
It’s extremely poor executive leadership.
Pulled out of a Pentagon desk drawer no doubt, where it has languished lo these many years.
“What’ll we assign the intern to?”
“Have him update the PMG. That’ll hold him most of the summer.”
Appended at the last minute in an effort to look busy.
But it is a remarkable simulacrum of “planning.” Output has been generated. Butts have been covered. Mission accomplished.
I would never want to burst your bubble Percival, and never having been in the military, if these people are the interns, we don’t stand a chance.
Of course they may have just taken the credit.
DoD COVID-19 PRACTICE MANAGEMENT GUIDE
Clinical Management of COVID-19
To consolidate resources and optimize the management for patients
requiring clinical care during the global COVID-19 pandemic.
Contributors
Lt Col Renée I. Matos, MC, USAF
COL Kevin K. Chung, MC, USA
CDR John Benjamin, MC, USN
LTC Matthew A. Borgman, MC, USA
Laura R. Brosch, RN, PhD
Robert F. Browning, MD
CAPT Timothy H. Burgess, MC, USN
Col Francis R. Carandang, MC, USAF
LTC Jacob Collen, MC, USA
LTC Christopher Colombo, MC, USA
Ms. Polyxeni Combs, MS
CAPT Konrad L. Davis, MC, USN
COL Sean N. Dooley, MC, USA
COL Jeremy Edwards, MC, USA
CAPT Eric Elster, MC, USN
MAJ Emilio Fentanes, MC, USA
MAJ Brian Foster, MC, USA
Dr. James Giordano, PhD
Mr. Joshua Girton, JD, LLM, MBA
Mark Haigney, MD
LTC Mitchell Hamele, MC, USA
COL Bonnie H. Hartstein, MC, USA
Maj Alison Helfrich, MC, USAF COL
Mrs. Jennifer Hesch,JD
COL Patrick Hickey, MC, USA
Col David Hsieh, MC, USAF
CDR Ashley E. Humphries, MC, USN
Maj John Hunninghake, MC, USAF
MAJ Nikhil A. Huprikar, MC, USA
CDR Michael J. Kavanaugh, MC, USN
Lt Col Jeremy Kilburn, MC, USAF
Maj David A. Lindholm, MC, USAF COL
COL Frederick Lough, MC, USA
LCDR Donovan L Mabe, MC, USN
Col Leslie Matesick, MC, USAF
CAPT Ryan C. Maves, MC, USN
CDR Sean Mckay, MC, USN
Maj Krista Mehlhaff, MC, USAF
COL Clinton K. Murray, MC, USA
Lt Col Jason F. Okulicz, MC, USAF
COL Neil Page, MC, USA
COL Jeremy C. Pamplin, MC, USA
LTC Wylan C. Peterson, MC, USA
Mr. Joseph Procaccino, JD, MFS
Col James B. Sampson, MC, USAF
LCDR David C. Shih, MC, USN
Bich-Thuy T. Sim, MD
LCDR Scott Snyder, MC, USN
Col Barton C. Staat, MC, USAF
Mr. Randy W. Stone, JD
Col Deena E. Sutter, MC, USAF
Lt Col Bryan D. Szalwinski, MC, USAF
Maj Robert Walter, MC, USAF
Mr. Bryan T. Wheeler, JD
Col Leslie Wood, MC, USAF
CAPT Luke Zabrocki, MC, USN
Mr. Michael J. Zleit, JD
Draft Release Date: 20 March 2020 Publication Date: 23 March 2020
No, go ahead. I didn’t even look. I am surprised that it wasn’t some old biological defense protocol that wasn’t polished up and pushed out there.
Bureaucratic organizations self-protect first. That means they welcome massive amounts of Type 2 error before they will admit to the possibility of a whit of type 1 error.
More people will die, but the FA has been celebrating that scenario for 50 years.