General Wellness

DOCTORS ARE MAKING UP THE COVID NUMBERS! How insulting.

Our administration has long attributed our rising Covid cases to “too much testing” when we in fact have one of the poorest track records of per-capita testing of any developed country. In addition, more testing does not cause more hospital admissions, which cannot be denied. In fact, about 2-3 weeks after many recent political rallies by you-know-who, where no distancing and limited mask wearing was observed, hospital admissions in those communities for Covid-19 tripled.

To add to the ridiculous rhetoric, our present administration has made public comments accusing doctors of inflating the covid numbers and making things up to make more money. As a physician who sees patients everyday both in the office and the hospital, this is beyond insulting. I can’t even imagine what ER and hospital healthcare workers must feel when they hear such accusations. For someone whose life may have been saved by having strings pulled by doctors, getting treatments and a level of care unavailable to anyone else, for the President to then insult the healthcare system is beyond reproachable.

There is no question that our healthcare system is broken. It’s not “health care”, it’s “sick care”. Our system is the most costly by an order of magnitude than any other system in the world and yet we have the fattest and the sickest people. Our life expectancy is one of the worst of all developed countries (42nd). Our infant mortality rate is one of the highest (we rank 33rd). Our system is definitely driven by profit but those who profit the most are drug companies, who like nothing more than to see chronic disease numbers rising so they can sell more drugs, healthcare systems, insurance companies and the malpractice legal system which is on constant patrol for any opportunity to litigate. Doctors order tests not always because they are necessary, but to cover the bases so no one can accuse them of “delay in diagnosis”, the most common malpractice claim. Do we order more tests than is necessary, yes we do. Are there corrupt, opportunistic doctors? Of course. But there are corrupt and opportunistic people in every facet of life. No one is standing in a full body suit in an ER, ICU or Operating room taking care ov covid patients to make an extra buck. It’s a terrifying experience.

In addition, there isn’t a doctor in the country whose income has not been affected, some to extreme degrees, by this epidemic. Our practice still has an office which we have not re-opened and the number of patients we are seeing now is much lower, mostly because of new distancing measures we have implemented and fewer visit slots we offer, all to ensure patient and staff safety. Fewer office visits are also a result of patient fears, who often cancel at the last minute or just don’t show up. Video visits are not possible for some types of specialties or visit types.

As long as there has been health insurance, there has been a constant battle between doctors as well as healthcare facilities and the insurance companies who are supposed to pay for the services provided. Rules set by insurance companies are constantly changing and we are required to do more and more administrative work to “justify” a level of care, a test ordered or a treatment recommended. It’s exhausting. They jump on every opportunity to deny payment and even reserve the right to contest services and ask for money back even years after a doctor or hospital was paid. Covid has complicated this interaction considerably.

I’m not an expert on the ins and outs of reimbursement, including those involving Covid-19, but my understanding is that a Covid diagnosis does, or at least did, provide some additional financial reimbursement. But the losses hospitals and doctors continue to experience far outweigh any benefit.

As far as bloated numbers are concerned, even if you assume a small number of Covid diagnoses are “made up” or “exaggerated”, fake Covid numbers can’t possibly account for the approximately additional 500,000 deaths in the US compared with a year ago in the same timeframe.  Although less than half of those are thought to be either from heart attacks, heart failure or strokes, many of those can still be attributed to Covid since the fear of catching it, resulted in delayed treatment and premature death.

I know I’m venting here but the level of frustration keeps rising.

Regardless of who wins the election, wheels are in motion for a very taxing late fall and winter season.

Please follow the science and do what protects everyone:

DISTANCE

MASK

WASH your hands

DON’T TOUCH YOUR FACE

VENTILATE

VACCINATE

WORK ON YOUR HEALTH

Stay Safe and Be Well

AC

WHY HERD IMMUNITY THROUGH NATURAL INFECTION IS A PIPE DREAM.

In simple terms, because it has NEVER happened before, with any pathogen, in the history of humanity.

The closest we have come to eradicating a microbe is with polio, and that is only because of mass, worldwide immunization with a very effective vaccine. And even with polio, there are still occasional stray cases. Even the bubonic plague, which in the 1600’s killed 25 million people, 1/3rd of Europe’s population, still rears it’s nasty head even today. Measles, an infection 10x more contagious than Covid, to which there is 100% protection once you’ve had it or are immunized against it, still occurs regularly. More than 20 million cases a year worldwide, primarily in countries lacking primary prevention like immunization, with numerous hospitalizations and deaths. And as more parents choose unwisely not to vaccinate their kids, more and more cases are arising in the last few years in the US. There is NO treatment for measles. You don’t want to get it. There are complications.

SARS 1, an epidemic also caused by a coronavirus which developed in 2003, has been reported to have been “eradicated” however there have been a few cases, mostly lab accidents, which have been reported. With SARS-1, the transmission rate was lower and death rate higher than our present SARS Cov-2, which is why it “burned out”. 

This will not happen with Covid-19!

It is just infectious enough and only kills a small enough percentage of those infected, that the virus is allowed to flourish and propagate. Don’t mistake “not dying”, with “getting through it” though. Studies on young, healthy people who had mild or asymptomatic infections of SARS Cov-2 showed that 60% of them had permanent lung scarring and more than 70% had evidence of heart damage. Many “longhaulers” are struggling with numerous medical problems months after their infections.

Our administration’s recent admission that attempts to “control the virus” will not work, favoring focusing on treatments and a vaccine, is a sad concession to peoples’ irrational beliefs in “individual rights” and the false belief that this is not real or a conspiracy or whatever lunatic theory they may believe in.

The facts are clear. Numbers are rising and are even worse than where things were back in the spring. The disease is much more widespread throughout the US than where it was back then, so having much higher numbers is not really that surprising. What is concerning is the rate of escalation, the rapid loss of resources like staff and hospital beds and the continued focus on politics rather than lives.

So far we know the following:

• It is very infectious, 3-5x more than the flu. It is much more airborne, even capable of transmission through regular speech.
• The death rate is ~2-3%. If it’s you, a friend or loved one, it’s 100%!!! Remember that 230,000 Americans have already died from this disease.
• Case rate and hospitalizations are back on the rise, approaching, if not surpassing rates we saw in the spring. This challenges our leaders’ blaming “more tests means more infections” theory. We have in fact done much less testing proportionately than any other developed country.
• Although most “get through” an infection pretty easily, the long term complications are still not known. Significant lung, heart and kidney damage has been noted in even “asymptomatic” young people.
• Long-term protection after infection has not been shown. Why? Because we have no long term data since this is a new infection. DUH! There may be some protection early on since re-infection rates are low, but there are re-infection cases out there so clearly, protection is not 100%. There may be no “immunity”, even after a vaccine is developed.

If herd immunity is even possible, we know that :

• 70-80% of people will need to be protected, either from recent previous exposure, or through immunization AT THE SAME TIME. Since protection wanes over time, we all need to be protected at the same time for the virus to “burn out”. If you get sick now, and an immunization doesn;t come around for 6-12 months, your protection may be gone and you may need to be re-immunized.
• We also know that a vaccine needs to be at least 70% effective to achieve this. That is very wishful thinking given our experience with the flu vaccine which, in some years, is only 30% effective. On the other hand, other vaccines, like measles, are nearly 100% effective. Time will tell.
• We also know that surveys show that 40% or more of people would not take the vaccine anyway. 50% of people already don;t get the flu shot annually.

All of this put together means that waiting for herd immunity is wishful thinking. While we do need to work on a vaccine as well as on therapeutics to treat this infection, slowing its progression and focusing on prevention is crucial. In letting it run rampant, hospitals will be overrun, supplies will dwindle and many more people will die unnecessarily. 

DISTANCE. Physical distancing. Although I don’t like social distancing, we are rapidly approaching that unfortunate scenario again given how rapidly numbers are rising. Europe is facing this exact scenario.

WEAR A MASK.Wear an effective one and wear it correctly. They simply WORK!

WASH YOUR HANDS.

DON’T TOUCH YOUR FACE. 

VENTILATE. 

VACCINATE.

GET HEALTHY.

Stay safe and be well. 

AC