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temporaryreality) wrote2021-11-11 09:07 pm
IM Doc 22
IM Doc The same thing happened earlier with fluvoxamine an anti depressant.
This drug came on the radar because it is widely used for antidepressant in institutionalized patients.
In multiple locations last year outside the USA most notably France, it was noted that when the Covid surge hit, the docs and staff all got sick. The patients not so much.
We seem to have forgotten our medical history as a profession during this entire madness. These kinds of accidental observations are to be found everywhere you look in the medical history literature. The fact that we are suppressing this kind of thing is a complete tragedy. It will come with a big payment due soon enough.
How Policies Affect Beliefs and Preferences: The Example of Covid-19 Vaccination Willingness
Yves here. IM Doc, whose father was a public health official, anticipated the findings of this study which found that faith in institutions is essential to implementing public policies. As he wrote in April:
As a young child, I saw my father [a public health officer] struggle through the Swine Flu of 1976 and the vaccine debacle that accompanied that era.
As I grew older, and especially once I entered medicine, he had several heart-to-heart talks with me about a career in Medicine and by extension public health. I can summarize what he told me in two large thrusts. 1) Integrity, truth, and honesty is EVERYTHING in public pealth. Once squandered, it will never return. 2) Public health is 10% science and 90% psychology. Do not ever forget that. You will get nowhere by screaming SCIENCE SCIENCE SCIENCE and you will certainly get nowhere by flashing credentials. And you must have an acute awareness of panic, fear and anxiety. They change everything and your response must always take that into account.
The US has shown a steady decline in public confidence in official institutions. A recently-published study by the Reuters Institute for the Study of Journalism at Oxford found that Americans have the lowest trust in media of adults in 46 countries. The press has been a major channel for messaging about the desirability of getting vaccinated and Covid generally.
And if you have been paying attention at all, the official responses to Covid have been so obviously politicized as to undermine confidence. The flip flop on masks. The flip flop (and maybe flop back) on the lab leak theory). The failure to acknowledge asymptomatic transmission (yet the full court press to vaccinate teens and children would seem to be all about that). CDC chief Rochelle Wallesnky (along with some public service ads) falsely saying the Covid vaccines prevent getting infected. The failure to acknowledge aerosol transmission, and even now, muddled discussions on official sites. The “mission accomplished” approach, over the objections of the national and largest California nurses’ unions. Readers no doubt can add to this list.
In other words, the US has aggressively pre-positioned itself to have difficulty in getting compliance if its wager on the vaccines doesn’t work out as planned and it has to exhort the public to engage in non-pharmaceutical interventions again, like masking up and staying largely at home.
IM Doc's comment (below) references one of these articles:
Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trial (accepted manuscript) Clinical Infectious Diseases. A review of RCT literature. From the Abstract: “Published and preprint randomized controlled trials (RCTs) assessing IVM effects on COVID-19 adult patients were searched until March 22, 2021 in five engines…. In comparison to SOC or placebo, IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease. IVM did not have an effect on AEs or severe AEs. IVM is not a viable option to treat COVID-19 patients.”
The Ivermectin Advocates’ War Has Just Begun Vice
About the Ivermectin paper in the above links ——
I never in a million years imagined myself being a conduit for medical arguments to a wider national audience – but here we are.
I have done everything I can this past year to bring to the owners and commenters of this blog exactly what is happening on the ground and what is happening in my area of academic medicine. It is “on the ground” observation – sometimes very correct – and sometimes very wrong. I hope everyone understands where I am coming from.
I attend multiple conferences via Zoom every week tapping into my old colleagues at one of the premier medicine departments in this country. Yesterday was no different – and this Clinical Infectious Disease meta-analysis by Roman et al was the main topic. Last week’s main topic was yet another meta-analysis of the Ivermectin RCT trials out of the UK by an epidemiologist named Tess Laurie. It had been published in the Journal of Applied Therapeutics.
For those of us in medicine, this is all old hat. For everyone else it is like one blockbuster after the other coming out. I have been doing this for 30 years – I know instantly how to separate the wheat from the chaff – and so do honest brokers in medicine if the take the time to do so.
You would be totally excused if you as a layman said – Wow – the paper in Clinical Infectious Disease ( a much more prestigious journal) is obviously the better paper – so Ivermectin is obviously not going to work.
And you would be wrong.
This episode is an example of a very common tactic that Big Pharma has been employing to bamboozle physicians for a very long time. It often detonates in their face a decade later – but who cares at that point – the money is in the bank. The difference now – is Big Pharma has captured our CDC and FDA – and most importantly in this example our medical organizations – like the Infectious Disease Society of America who publish the landmark journals like Clinical Infectious Disease. They are a fully owned subsidiary of Big Pharma – so Big Pharma is now playing this game for the world to see, not just physicians.
This paper is a standard issue disinformation tactic employed time and time again by Big Pharma. It is such an incredible example – I will be using it for my students from now on.
What am I saying ??? – CID almost assuredly had all of these manuscripts for months – and they chose the one (Big Pharma chose the one) that was the most negative about ivermectin. These studies were all meta-analysis of the available data – and the only possible thing that could be different was the methodology of the studies. All the RCT baseline data is exactly the same – but yet the conclusions were radically different.
So, yesterday, at the presentation, the presenter – and epidemiologist – stood up – and STARTED HIS TALK with this paraphrase – (and this is a very unusual way to start a medical talk) “Interesting study – but there are some caveats – The relative risk confidence in this analysis has been manipulated above 1 – that may negate the whole study, some of the active arms have been converted to placebos – that too may decrease confidence” and on and on and on. Multiple caveats before he even got to the meat – a hallmark of a sloppy study.
I do not have a chapter in medical statistics to write out what these above things and many others mean. But this is a poorly done study. There is an online journal club where other problems are being identified – https://pubpeer.com/publications/955418F3D4D39742CFFA8C1B023AA3
I have never seen Big Pharma make their selection with such an obviously flawed study – they really are scraping the bottom of the barrel. Dr. Tess Laurie – whose study came out last week – is an acknowledged world wide guru of medical epidemiology – I have followed her team’s work for years – and her results are much more favorable – I am far more willing to follow her lead rather than Dr. Roman – someone I have never heard of before.
Similar studies were deployed and written by Big Pharma shills for Celebrex/Vioxx, and opioids – and we all know how that ended.
In medicine, we have bad studies all the time. We all instantly recognized this yesterday – and all realize the truth about this drug yet to be known. If anything, this sloppy effort has revealed an even sloppier effort to discredit Ivermectin. That did not go well yesterday at the conference. There may be enough of us who have been deceived for decades ready to stand up and call bull shit on the whole thing.
But doctors are no longer the audience. Papers like this are broadcast to the heavens for the public to consume – they are doing everything they can to imprint on the public – IVERMECTIN BAD.
As I have said so many many times, medicine at this level – should not be litigated in the media – it takes years of study to understand this stuff – and can be invisibly manipulated at the drop of a hat.
Will be very interested to hear the comments of NC commenters – the most grounded in reality group in the world.
I somehow managed to not put the last paragraph in my comment – here it is –
Someday in the future – when this is all behind us, and this crisis is over, we are going to hopefully have time to reflect on what has happened to our health care system. That is of course assuming that medicine/public health even survives. These issues of credibility and non-trust have been building for years. Physicians repeatedly and ever more commonly rotating between Big Pharma and our academic institutions. Rotating between corporate boards in Big Pharma and the highest levels of regulatory oversight in the FDA, NIH, and CDC. The entire system is now corrupt to the very core. At a time when we needed our public health systems the most, they have been entirely corrupted and/or defunded. And this is the result we have. What do I and thousands of on the ground physicians want with regard to Ivermectin? – We want honest studies done by honest brokers. That is not much of an ask – but it appears to be entirely impossible in our current situation. Thus, the reliance on foreigners, where this kind of corruption is not so endemic. I hope that it becomes crystal clear as we debrief from this nightmare that our public institutions like the NIH should be playing a vital role in this going forward. As was noted by the medical ethicists when I was a young doc, allowing the NIH and big universities to have patents and make money from drugs would be our undoing. And here we are. For example, under no circumstances is Fauci going to allow the NIH or any other federal agency to study things like Ivermectin. The lucre is rolling in from Moderna to which they own the patents and get royalties. That list of issues vis a vis our public health institutions would fill a phone book.
This must stop. I just do not know if we have the will or the heart to do so. It seems that my profession is doing everything possible to hit the brick wall, and it is getting closer as every day goes by.
One of the nice things about 91-DIVOC is that it’s a UofI project. And they do infections rates within Illinois. Agree it’s worrisome, and while things are moving in the wrong direction everywhere, it’s more of a problem downstate (where you have plenty of people who visit Branson and the Ozarks): link here.
IM Doc You should talk to some of my friends in Chicago if you think this is just a down state issue.
Literally shitting bricks right now.
This is an American issue. I have just as many liberal patients balking at the vaccine as I do GOP folks. Continuing to make this political is not in the best interest of the country. I am becoming increasingly pissed at our media for engaging in this bullshit.
If Illinois is like my state the unvaccinated numbers look bad because all kinds of barriers are up to not even bother to test the vaccinated. It is impossible to make any kind of judgment rationally when the numbers are being handled like this.
Until we all learn that lesson, we are in for some hard times.
Just my two cents.
Too good to be true….. That is how Dr. Eric Topol in the above link described the therapies being described in that paper.
This is from the same man and the same medical establishment who have been repeatedly touting the 95% relative risk reduction from the Pfizer vaccine with COVID. Misrepresenting just like Big Pharma has for ages what a relative risk reduction actually means – and thereby misleading the American people about a very critical thing at a critical time. It has been SOP for Big Pharma – but when used in the way it has been, it has been an absolute disgrace.
As I have been saying from the start, that number was way too good to be true. I believe we are starting to see right now what I was talking about. I am not just pulling that out of thin air. This has been discussed widely among physicians I know for months – many if not the vast majority are just far too concerned/scared to say anything in public.
That 95% number was exactly what tipped me off back in December that the promised vaccine efficacy was TOO GOOD TO BE TRUE. PROBLEMS AHEAD. BE ON FULL RED ALERT.
I am hoping beyond hope – and continue to do so – that this is all going to work out OK. I hope so badly that I am so so wrong. But there are multiple trip wires planted by my old professors that have been going off one by one this whole past 6 months.
I am hoping and praying that when this is all said and done and the dust has settled, medicine takes a deep long search into its soul. Our whole culture needs to do the same. There simply has been way way too much deference to Big Pharma and to our authorities.
He submitted the full results to The New England Journal of Medicine in the spring but says the paper was rejected despite what he calls “extremely constructive” reviews. When Cadegiani asked for the reason, Eric Rubin, the journal’s editor-in-chief, responded in an email, “It’s simple—the results are unexpectedly good. Given how good they are, the reviewers felt the data needed a primary review,” meaning they needed to see not just the analysis, but also the original data. “We simply don’t have the capacity to do that,” Rubin wrote in his email, which Cadegiani shared with Science. The Lancet rejected the paper as well.
This set my BS detector to beeping frantically. It’s 600 patients, FFS. How much capacity do you need for that? Surely a result as potentially significant as this might be worth investing a little time? We’re going to pass up a potentially major breakthrough in mortality reduction because nobody at the NEJM could spare the time to review 600 data points?
I might possibly chalk this up to a miscommunication or stupidity if we hadn’t seen exactly the same thing happen with Ivermectin. As it is, I suspect foul play.
IM Doc If you read my original post way back in December about the original paper regarding the Pfizer vaccine, there was a section of it talking about an interview with Dr. Rubin on the Boston public radio station.
Dr. Rubin is actually on the FDA advisory committee for vaccine approval. He is one of 15. There are multiple of them that have obvious COI. I detailed my concern about him being on that committee.
One thing that was mentioned IN HIS OWN VOICE during that interview was that the Moderna FDA meeting was coming right up the next day. He just outright admitted that he had actually not looked at the Moderna data at all – literally 1-2 days prior to the meeting. I am quite literally not making this up.
So, we have the chief editor for the NEJM and one of the members of the FDA vaccine advisory committee admitting that he will be voting on something this consequential – and has not even bothered to look at the data.
So, does it surprise me that the NEJM, its reviewers or its peer reviewers did not take time to look at the original primary data on this paper? – Not in the least. There is far more going on, in my opinion, than just getting it right on this one possibly very helpful therapy. Far more. I am not sure the corruption will ever be fully teased out.
I want to make it clear – back in the days when I was a young doctor at a big academic center – the faculty members were constantly being tasked to do either primary data reviews or peer-reviews of things like this. MUCH MORE than 600 patients. This is really evidence of how far scientific standards have fallen.
Then we get to find out on the fly how shot after shot after shot of playing with mRNA does to bodies?
Or more specifically what the manufactured spike protein does when it floods our bodies after repeated mRNA vaccines/boosters.
I am grateful I can remain a hermit, while others who have to interact with pesky humans who take great risks have no choice. On May 1st, I was ready to get the vaccine and read a couple of articles that led me to hit the pause button.
https://medium.com/microbial-instincts/spike-proteins-used-in-covid-19-vaccines-are-they-safe-e1592b6ba8d3
Spike protein and the brain
A study titled “The S1 protein of SARS-CoV-2 crosses the blood-brain barrier in mice” was published in Nature Neuroscience this month. Herein, researchers at the University of Washington inoculated a dose of S1 portion of SARS-CoV-2 spike protein — without the whole virion or genome — into the blood or nose of adult age mice.
With the advent of many Covid-19 vaccines in a short time, it’s expected that their long-term safety is questioned. All Covid-19 vaccines use the coronavirus spike protein to induce immunity in some way or another. But recent studies have found that coronavirus spike proteins alone — without the whole virion or genome — are sufficient to induce biological abnormalities in brain and blood vessel cells.
Olivier The manufactured spike protein does not “flood our bodies” because it is modified to remain anchored in the membrane of the cell that made it. See, e.g., https://medium.com/microbial-instincts/biodistribution-and-spike-protein-safety-of-mrna-vaccines-an-update-788fe58e39b9 (last section).
Yves Smith Not true. See this from IM Doc:
I invite you to the following document regarding the Moderna Vaccine – I have referenced this several times this year – because it is truly the crumbs we have been allowed to see about the most basic research on these vaccines –
It is a pdf – so I am not able to cut and paste – but go to page 47. This is the middle of the pharmacokinetic discussion in rats and non-human primates. The 6th paragraph down starts off “concentrations of mRNA 1647”. Read the paragraph and parts of the next page. In that, you will quickly realize that the mRNA particles were NOT limited to the deltoid. They made it to every single tissue in the bodies but the kidneys ( This is very common – the kidneys are flush flush flush and things do not hang out there long). They added the fact that the mRNA/lipoprotein particles made it to the brain – across the barrier – and they made it to the EYES and the TESTIS. These last two are included because they are among the most non-vascular tissues in the body. If they made it there – they made it everywhere. They were found in the circulating plasma hours later.
One would assume these mRNA/lipoprotein particles were then left to be absorbed into those cells and do their thing in whatever tissue they happened to be transported to. THIS IS NOT JUST CONFINED TO THE DELTOID.
Pardon me if I am misstating, but didn’t IM Doc say that each round of vaccine, as in needing a third or booster shot, increases the stress for the one being vaccinated? He would have only been looking at two, but I seem to remember he said something like ‘time will tell’ and of course that also applied to any long term effects of the initial vaccinations as well.
Cocomaan We don’t know how well mRNA vaccines work if you are jabbed with them over and over again. It’s hard to find anything studying it.
IM Doc It’s hard to find anything studying this because there is none – we have not had enough time.
But one of the problems with mRNA technology in these vaccines is indeed there will likely be a more vigorous immune response every time they are given making the number of reactions even higher – and this seems to be higher the younger you go.
Studies are already underway on the mRNA booster – and unofficially via friends that are recruiting patients – things are not going so well at all. Many many more are getting very sick. Also, please note that in some of the arms of these protocols – there is a repeat of the two shot process – so you actually are giving people a 3rd shot followed a month later by a 4th. Unofficially, according to my reliable sources, the number of people turning down the 4th shot is astronomically elevated – the 3rd shot reaction is just that bad. All of these subjects have already had a 1st and 2nd shot earlier this year.
Again – this is why something like an inhaled nasal vaccine may be a much better modality.
This has all been so rushed – it is quite a quagmire right now.
Olivier @IM Doc Am I correct that the response to these boosters, while stronger, would not necessarily provide better protection because of the phenomenon of antigenic memory?
If so, booster efficiency over time (as in: with the booster index as x-axis) would exhibit a ratchet shape: starting from a high point, decreasing efficiency until a variant has sufficiently diverged from the original variant that the immune system labels it as new and mounts a fresh response against it. Rinse, repeat and you’ve got the ratchet. Am I onto something or just blabbing?
IM Doc We simply do not have enough experience with these vaccines over a proper amount of time to know if this will happen or not.
This same type of thing happens in the flu shots – they become less protective as we use them year after year – but then we have decades of known experience.
You can assume this might happen – but that is the best I could say right now.
GM There is an additional important question here — is this more vigorous, to the point of impossibility of administering further shots, reaction because of the S protein or because of the mRNA vaccine formulation?
I don’t have an answer, but I do know that mRNA technology has huge potential for curing really serious things like cancer.
And if it turns out that it is not the spike, but the RNA vaccine in general, that means we might have spent all those bullets that would have come very useful later in life for billions of people…
IM Doc Yes –
mRNA technology may be wonderful for things with a one or two hit regimen like cancer. Possibly other immune disorders.
But vaccines where repeated injections will need to happen over time – is still an open question.
And I agree – at this point it is very unclear/unknown if this is the lipoid envelope, the actual spike protein or the mRNA that is causing the problem –
What I will say – when this vaccine approach was first coming to the fore last year, I had multiple conversations with research oncologists and rheumatologists who were very concerned that this very promising mRNA technology would be sullied in reputation if the mRNA vaccines for COVID somehow backfired or screwed up. It really is quite promising for many onc issues – but I see their point about the reputation. Only time will tell.
“But the virus itself attacks the immune system in such a way that it leaves it in this weird inflamed state that can last a long time (there have been multiple papers showing strange T cell subpopulations developing and persisting after COVID). Which means that when the next infection comes, they will have an elevated risk of severe progression.”
Antibody-dependent enhancement (ADE) only occurs with certain types of viruses, such as dengue fever. The very early attempts to create a vaccine for SARS using the actual virus led to ADE. SARS is not COVID-19, but there are similarities. We don’t seem to be seeing any clear signals of ADE so far, but I would not rule it out.
IM Doc I was in a case conference on Zoom this AM. One of the presenters mentioned ADE and that yes, it is a real problem, and yes it is profoundly bad if it happens. We have real life experience with it in multiple failed animal vaccines – and unfortunately as you mentioned above in actual human vaccines.
Because of the very real possibility this could happen with the COVID vaccine – coronaviruses are absolutely one of the virus families where ADE has occurred in animals – the health authorities have been on the lookout for any evidence of this since the very beginning. Absolutely no indication so far – and furthermore, if it was going to happen would have much likelier happened early on not now. The speaker went on to add, however, that if boosters are employed, the guard will have to go up again for ADE and even possibly more stringently.
Also – another similar vaccine issue was discussed at length – which can best be condensed into the story of Marek’s Disease of Chickens. I am not going to type that all out – just go look it up. But that is also a possibility – though remote – and would likely be happening much further down the road.
There was a time in my life that all this grim stuff was really purposely attempted to be kept within the realm of medical professionals. Uninformed speculation on these things can really lead to a lot of panic and fear – but alas we now live in a world where we just let it all hang out for all to enjoy. Somehow – I liked the previous world better.
Lambert, thanks for linking to the CDC community report. There’s underlying data there too. Love the county level detail here. With infection rates AND vaccination rates at the county level that this provides, we’ll be able to see if/when variants start breaking through.
Either that or they’ll stop sharing the dataset.
IM Doc I have not had time to look at these county level graphs very well – I will do so a bit later – having a very busy day.
I would urge one bit of caution in this whole experience. My own county has stopped reliably counting cases sometime in the middle of May. What is currently being reported in my county in this system has no chance of being correct. Why? I personally have had more COVID positive patients than is reported for the whole county.
I know from colleagues all over the country that this is true. We are just no longer counting cases especially among the vaccinated. Where I live, they simply do not want to hear if a vaccinated patient is positive.
Totally moronic – but it is what it is.
At this point, the far more important numbers that have a chance of being reliable are the hospitalization numbers – and eventually God forbid – the death numbers. They simply cannot fudge those very well at all.
My own practice from JUL 5th to JUL11th – yielded 19 positive and symptomatic COVID cases – 17 were vaccinated and 2 unvaccinated. All with one exception mild cases – and the really sick one is already getting better – but it was dicey for a day or two. To put the above numbers in perspective – I live in a county where 54% of age 18-70 are vaccinated – and 92% of those above 70 are vaccinated. Of the 17 positives I had last week – only 3 were in the above 70 group. The only sick one was the only one who had morbid pre-existing conditions, all else were healthy at baseline.
I cannot say this too many times. These vaccines are clearly non-sterilizing. For whatever reason, our health agencies have decided not to follow the protocol in the event that happens.
Until we have an idea where this going – I am reverting back to our prevaccine summer and fall recommendations – It is incumbent on everyone of us to reduce our risk factors – LOSE WEIGHT – GET YOUR BLOOD SUGAR DOWN – EXERCISE HARD – GET ON THE VIT D 2000 daily – GET OUT IN THE SUN – AND GET THE POVIDONE READY TO GO.
LawnDart Povidone? That came out of the blue to me. Can anyone provide helpful links?
QuicksilverMessenger Yves has been writing about this for a while as it looks to be a virucidal. I purchased some and have started the nasal regimen. There are a number of links and studies out there now. I think doing a search for ‘povidone iodine covid’ will get plenty of results
Lambert Strether Apparently, we were onto Povidone on or before February 12, 2020.
I cannot find our original Link, because even though Google has plenty of results for the year, it claims there are no results when I restrict by date. I am so sick of being unable to find material that I know exists. It’s like Google sets the Library of Alexandria on fire on a daily basis, making us more and more stupid.
Bing, DuckDuckGo, and Qwant are equally sucky. And of course our own backstage search is borked. So I’d be patting NC on the back for being early and right, if only I could prove it.
Thank you,
Acacia Not to sound like too much of a nit pick, but that link goes to February 2021.
It is indeed maddening that Google seems to have memory loss at the scale of multiple data centers (do they care?). I was able to do this search (note the date in the URL path):
povidone site:www.nakedcapitalism.com/2020
…to find the earliest mention of Povidone was a comment I posted on August 4th, 2020. Actually, there was one mention of Povidone on NC in 2019, but it concerned disinfecting cat scratches (with apologies to Ted Nugent ;).
Yves Smith I was very careful to talk about it only to Lambert and others personally early on, since I don’t like offering medical advice. But it was the small study on a Japanese mouthwash that is about 0.5% povidone iodine that got me going. I saw something in a secondary pub and Bloomberg soon picked up the story, same Aug 4 date:
GroundZeroAndLovinIt Several studies have found OTC povidone-iodine gargle solutions can help prevent Covid. Here is a link to one study from U. Conn: Simple Oral Rinse Can Inactivate Covid-19. Based on someone here on NC’s recommendation, I recently purchased some Betadine (a brand of povidone-iodine solution) as a precaution (note: the manufacturer denies it has an effect against Covid). I feel better having it on hand, regardless.
IM Doc You can call me old-fashioned.
Povidone has been used since I was a young doctor – and by my forebears back to the day it was invented – as a sterilizer of the nasopharynx.
Old fashioned – I know – but it really seems to work –
It is very important that you get the right dilution. It is 30:1 of the surgical type.
But you can easily make a batch – and then keep it on hand and gargle daily.
There is ample evidence of its both bactericidal and viricidal properties.This link is probably one of the best done studies/reviews about this issue out there. And it also has the benefit of actual testing of SARS COV1 – a close relative of COVID. Povidone was instantly viricidal to SARS COV1 and multiple other viruses as you can see – as well as some really important bacterial pathogens.
Utah If I have a history of graves disease that is currently in remission without any medicine usage, would iodine (providone) be contraindicated? I know you’re not my doctor, but my doctor thinks these vaccines are a cure all. I tend to avoid iodine, even iodized salt if I can help it.
IM Doc In the past years, I have spoken to endocrinology specialists about this.
The ingestion of large amounts of iodine can indeed make some hyperthyroid states worse. It would however require much much more of a dosage load then this would cause. You are not actually investing it. It is a gargle, swish and spit. Followed by the same swish and spit with a mouthful of water a few times.
Fern, I would be very interested to see the paper you are referring to. I have never known this to harm a single patient in 30 years of flu seasons. I cannot fathom a 20% thyroid damage issue.
Utah Thanks for that information, IM Doc. I’ve tried to be so careful because I know graves can come back, but it might be worth the risk to avoid covid. And it doesn’t sound like there is too much of a risk.
Yves Smith When I made my 1% homebrew (stronger than the Japanese mouthwash) I did so after finding a study that said povidone gargles and nose sprays had been tested at strengths up to 2.5% for six months with no ill effect.
Fern One published research letter said that 42% of covid patients treated with topical providine for 5 days had abnormal thyroid readings. Again, that’s only for 5 days. I’m wondering what the effect would be if it is applied daily over a long period of time?
It’s not something I would feel comfortable exposing these delicate tissues to on a daily basis in the absence of thorough safety studies.
https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2775984
Yves Smith Topical povidone is not what we are talking about!!!! That would make you sick.
Topical povidone is 10%.
We are talking about diluting it to gargle strength, which is 0.5% to 1.0%, a 10X to 20X dilution.
GF IM Doc: How is Povidone used to counteract Covid?
Amfortas the hippie gargle it when ya get home.
use the mouthwash, not the stuff they use for surgical prep.
it’s abundant everywhere i’ve looked for it, since i first read about it on NC, maybe a year or more ago….walgreens, cvs and our local pop and pop pharmacy.
kills virii in and around your mouth/nose/throat, which is where it gains entry, and where it might be hanging out after an outing among the mundanes.two guys at the end of my road just got diagnosed with covid…one…88 years old, bowlegged and the spitting image of PI Parker…drives a cattle truck all over the country…and is doing just fine.
the other, the nephew,…maybe late 50’s…works cattle in the pens at the feedlot…and is also a righty/maga guy…is doing poorly.
neither have been vaxxed…the former, because he’s lived like a cowboy his whole life(“…his horse and his saddle are his only companions…”, etc), and it probably never occurred to him.
the latter, because “It Ain’t Real!”
former is one of the most genuinely decent people i’ve ever known…the latter, not so much,lol.jr An NIH study I found which I cannot re-find recommended gargling at least 30 seconds for cleansing and a two hour window of protection.
Mikel “My own practice from JUL 5th to JUL11th – yielded 19 positive and symptomatic COVID cases – 17 were vaccinated and 2 unvaccinated.”
If you recall, which vaccines had they taken? And how long had it been since their last shot?
IM Doc Around here, it has been 45/45 Pfizer and moderna, the other 10 are j and j. It is happening to all of them.
The older patients are now out about 6 months. Most everyone who has been vaccinated was done with it in early April. Then the vaccination numbers fell off the cliff. So all these patients were theoretically fully vaccinated.
Aumua My own practice from JUL 5th to JUL11th – yielded 19 positive and symptomatic COVID cases – 17 were vaccinated and 2 unvaccinated.
I have a hard time rectifying this statement with (regular) headlines like this one from the LA times:
“L.A. County sees new significant rise in COVID-19 cases, 99% involved the unvaccinated”
I wonder how you might explain the apparent disconnect between your findings of ~90% vaccinated for covid positive cases and others’ apparently regular findings of 95% or greater unvaccinated for covid positive cases?
Yves Smith Did you miss our posts and comments on the fact that the CDC is not counting Covid cases among the vaccinated unless they wind up in the hospital? And public health authorities are falling in with the CDC?
This is just pervasive, deliberate bogus reporting.
About the Berenson article on COVID.
This is another source of extreme cognitive dissonance for me.
He is a Tom Clancy like thriller author. In fairness, while he was a reporter earlier in his career, he did a lot of work on Pharma. He has a very good handle on how to read scientific research and to do statistics.
Repeatedly, he has far more closely mirrored the conversation I am hearing in academic medicine regarding COVID. Far more closely than what the American people are getting from mainstream media.
I did not know he was on substack now. This paper is an almost duplicate of a journal club I was at last night.
So our mainstream media seems to not be able to accurately understand/report Covid numbers and epidemiology to the American people but a thriller writer can.
We truly are in the Twilight Zone.
And the hit pieces on him and the visceral hatred directed his way have just been breathtaking to behold.
I do not like his take on masking. As one of the links pointed out yesterday, the answer there is not going to be found in research or RCTs easily or quickly. The framing on masking by our health officials has been abysmal, in that Berenson is 100% correct.
Has Berenson been wrong? You bet. But he seems to immediately correct and make amends. Has Fauci been wrong? Oh yes. But no correction from him – just weaseling. I do not like some of the childish Berenson behavior, but he has been far closer to what is being discussed behind closed doors in medicine than our mainstream media.
Berenson, has participated in egregious lying ad hominems against Zoe Hyde and Kimberley Prather, and seemed to be working in some sort of tag team with Angela Rasmussen, of all people. The problem isn’t that he’s been wrong sometimes, it’s that he’s a liar.
I don’t think he’s what his fans think he is, and I don’t think being right or wrong has anything to do with his job. Information operations aren’t about persuasion nearly as often as about inducing uncertainty.
IM Doc I mean this as no personal offense to you – but your comment is a great example of something that has been let loose on our society by Twitter et al.
I have had the most amazing opportunity as an academic physician to work with some of the great minds of the 20th Century – all the way up to Nobel Laureates.
These people are at times brilliant – but at other times play in the gutter. Almost to the one – there are very very bad character flaws. Some of them lie, some of them exaggerate, some of them have sex with everyone on campus, some of them game their financials, I can go on and on and on.
I have seen the biggest knock down drag outs you could ever imagine in medical presentations – with both sides calling each other liars, scum or much worse. Right in front of 600 people.
That is the way things are done in medicine. If they are not saying it out loud – they are certainly calling each other names behind their backs. You will never find a bigger bunch of prima donnas than on any medical campus anywhere.
It is true of almost everyone – and early on I learned the value of a very simple Bible verse – FOR ALL HAVE SINNED AND FALL SHORT OF THE GLORY.
I do not know about these incidents to which you speak. Nor do I know about the incidents that these supposed offended may have engaged in the same behavior. Given the state of our media – I would not be surprised at anything. It brings out the very worst in us all.
I do know of an article from the Atlantic about Berenson – where I can point out lie after lie after lie.
But what does it matter? – when someone is putting forth hypotheses and statements and following the scientific method – then we should put all that aside – and engage their ideas.
After 30 years of watching this happen on almost a daily basis – you learn how to split that in your mind. Unfortunately – our whole society is on Twitter et all calling everyone else a liar, scum or whatever name they choose. This is literally killing the country – and until we all grow up and act like adults – and realize that every one of us is a fallen being – this may be the end of us all.
Raymond Sim No offense taken. It’s a bit weird to find that I come off as some kind of naif though. I’m passingly familiar with academia, and you’re not really describing anything that doesn’t seemingly hold true across many fields. I would point out though, that you omitted to mention the compliant imbeciles who infest all the fields where lots of money gets sluiced out. The pandemic has made it quite clear that academic medicine is as bad as economics in that regard. Epidemiology and id are mind-blowingly bad.
Now I’ll take my turn to misread you, I wasn’t raised in an Abrahamic religion, and I often find those who were take things I say as attacks on some sort of essential quality of a person or institution, when my concerns are actually utilitarian. I think you’re doing that here.
In viewing these internecine battles, if for some reason you need to make a best guess as to the truth of something, does your knowledge of who has told what lies, and for what reasons not factor into your judgement? Philandering and embezzling are bad signs to be sure, but wouldn’t persistent public lying, even in the face of repeated correction be a bigger red flag?
In fact given your description of the way of things, doesn’t your first concern have to be the degree of confidence you’re going to give to the idea that someone is following the scientific method at all? Assuming that science is what they purport to be doing.
Which brings me to my final point, Alex Berenson isn’t a scientist, he’s a propagandist, an information warrior. He absolutely deserves to be called out as such, whatever it is he may be saying at the moment. The fact that he is disgustingly mendacious is absolutely relevant to his expressed opinions on any topic. And the fact that he took part in scurrilous attacks on Zoe Hyde and Kimberley Prather, two reputable scientists who took up the cudgels on airborne transmission and the measures that will be needed to make schools safe, with the clear purpose of discrediting their cause, by insinuating, for instance, that Zoe Hyde would have all our children subjected to daily anal swabbing at the hands of school personnel, is an absolutely significant data point in approaching anything else he has to say about the pandemic.
IM Doc I could not disagree more
To single out just Alex Berenson as an information warrior undercuts what you say. Are we to dismiss everything anyone without a degree in science has to say? That would take out most of our media and talk show hosts.
I have never read anything by either of the two people you mentioned. I have read some of what Berenson has written and it has at times been very close to points I am hearing in my circles that are just not being discussed by our mainstream media.
I could with some time type out all kinds of inappropriate things said and done by Fauci in the AIDS crisis decades ago.
By your reasoning that would therefore instantly disqualify anything he says from being taken seriously. Unfortunately some of what Fauci did back then led to deaths ( look up AZT). It was not just anal swabs.
What I am saying is name almost anyone and things said in the past can be found to discredit them.
There are those of us who find all kinds of propaganda warriors in the media mendacious. Rachel Maddow and Sean Hannity make a career of it. But these are the people are culture have decided to use to inform the people. Unfortunate that the medical experts in the media fall right in line.
This is the world we create when normal people have to sift through lies for nuggets of truth.
I am just not buying it that just one of them should be singled out.
Raymond Sim I didn’t single Berenson out, his name just keeps coming up, However, I hereby resolve to equitably denounce anyone else I perceive to be doing the kind of shit Berenson does.
Right off the top of my head: Angela Rasmussen, Alasdair Munro, Monica Gandhi, and Peter Daszak are all guilty of the same sort of thing, and they’re real scientists too. They’re real scientists and truly terrible guides in attempting to find the truth. I think it’s because they lie.
I won’t be claiming that every word out of their mouths is a lie, I didn’t claim that about Berenson either. I didn’t say anything anybody says is “automatically disqualified from being taken seriously” and that’s not a reasoned deduction from what I did say.
Anything anybody says about something as important as this pandemic should be able to stand on its own merits if it’s to be taken seriously. It doesn’t matter how credible a figure makes the assertion. I honestly don’t see that it should be at all controversial to point out that habitual liars in particular make poor candidates for the benefit of any doubt.
Maddow and Hannity are, to be sure, more successful creatures of the same type as Berenson. Nothing they say can be taken as true without evidence. Did you want me to denounce them too, if I was going to pick on Berenson?
Fauci is a far more sinister figure than any of the others, but the fact that Berenson pales in significance by comparison is not a sound reason to give him any kind of pass.
IM Doc The scientific method is not just for scientists. It is for everyone to use to process hypotheses and thought processes.
He has put forth an idea or two and thought processes in that paper. Whether he has lied about other things in his life is not the point.
If you think the paper may apply to your life your work or your health you should read it , and then dispute any assertions he makes with your own facts or thoughts.
To just prima facie dismiss because you have experience that you believe he is a liar is itself an ad hominem argument. You are xyz bad thing therefore your argument is automatically bad.
If you find things in the paper to dispute, dispute them. That is the essence of the scientific method. The ad hominem world of social media is completely destroying that.
And I can give you countless examples in medicine and pandemics past where individuals were thought of as liars crazy or worse. But ended up absolutely in the right.
Look up Ignaz Semmelweis for one.
Raymond Sim I’m repeating myself, but I did not dismiss anything Berenson said in the article. In other discussions here I’ve been at pains to point that out, and to point out that your opinion of what he’s said there is of far more note than my own take.
Science isn’t just for scientists, I couldn’t agree more. Cranks are often the ones who are right, absolutely true.
None of this changes the fact that when a liar appears to be telling the truth it’s a good idea to run a self-diagnostic. It’s also a good idea to make sure that people are aware that a person being cited warrants careful scrutiny re veracity and motives.
as I grow older, the medical problems multiply. So it turns out I have atrial fibrillation. After I had been told I didn’t. So this is after I expressed concerns to my doctor after my decline in cardiac capacity, who then had me wear a cardiac monitor for two weeks, told me Ijust had occasional irregular heartbeats (which I found concerning) but not afib, but now my doctor either looked at the data again or somebody told him he was wrong and that I do have atrial fibrillation. Maybe its time to get a new doctor and get a cardiologist as well (I had cardiologists for years after the heart attack, but stopped having one after I retired as they were not all that useful)
So now I am prescribed xarelto. I don’t know. My problem is that so many “new” drugs that I have been prescribed ending up having black box warning, e.g., Plavix, Avandia. I have taken a baby aspirin twice a day after my heart attack (25 years ago) after I stopped taking Plavix and I’m still alive, so I am loathe to add yet another drug to my regimen. Having worked at FDA I know how doctors get their beliefs about drugs. I am not a doctor, and they have education, training, experience that I do not have. On the other hand, two doctors missed diagnosing my Hodgkin’s diesease AFTER I told them I thought I had it. And my self diagnosis of atrial fibrillation was more correct than my doctor’s intial assessment. And I probably know more about how pharmaceutical companies manipulate studies.
https://www.sciencemag.org/news/2020/01/fda-and-nih-let-clinical-trial-sponsors-keep-results-secret-and-break-law
For 20 years, the U.S. government has urged companies, universities, and other institutions that conduct clinical trials to record their results in a federal database, so doctors and patients can see whether new treatments are safe and effective. Few trial sponsors have consistently done so, even after a 2007 law made posting mandatory for many trials registered in the database
….
Science examined more than 4700 trials whose results should have been posted on the NIH website ClinicalTrials.gov under the 2017 rule. Reporting rates by most large pharmaceutical companies and some universities have improved sharply, but performance by many other trial sponsors—including, ironically, NIH itself—was lackluster. Those sponsors, typically either the institution conducting a trial or its funder, must deposit results and other data within 1 year of completing a trial. But of 184 sponsor organizations with at least five trials due as of 25 September 2019, 30 companies, universities, or medical centers never met a single deadline.
From Google search
New Study: Xarelto No Better Than Aspirin At Preventing Blood Clots. A new medical trial comparing low-dose aspirin with expensive Xarelto found that aspirin was just as effective at controlling proximal deep-vein thrombosis or pulmonary embolism.Mar 12, 2020.
The Historian You definitely need a new doctor, but there is no way of actually knowing if the new doctor will be any better or worse than the one you have.
Like you, I was told to wear a monitor for a month because I was having bouts where my hearr rate slowed to 40 bpm and I would feel faint. Even though I had several of these bouts, the doctor said the monitor showed my heart rate was ‘unremarkable’. So I asked to see some of the strips from the monitor and the doctor said he didn’t have them – that a company in NJ was supposed to be monitoring the monitor and that they only sent him a report that said ‘unremarkable’. So I had all the expensive tests, and even though I am still having these bouts and I actually had some in the doctor’s office, the cardiologist said that there was nothing they could do – just a product of ‘old age’ – I’m 72 – and that I would just have to ‘live with them’. So I am looking for a doctor in a new town, and all I am finding when I search for doctors is how well their patients like them – not much else! So I guess bedside manner is now more important than competence?
IM Doc In Medicine – this is known as a PRESS GANEY score. It is one of the worst abominations to have been released on medicine in my lifetime – right up there with the electronic medical record.
You are right – it is far far more important for modern docs that work for a health system or corporation that their patients leave the office with a smile on their face.
I am all about having a good bedside manner – I am told by my own patients all the time that I do – and to be honest that is all I care about. But the drunkard beating his wife who left my office yesterday afternoon most definitely did not have a smile on his face when he left – nor did the lady eating 2 bags of Doritos daily with a blood sugar of 313.
When we as a society wonder why we have an obesity problem in this country – I think a large part of the reason is our new generation of physicians and health care are navel-gazing and marinating themselves in a bathtub of happy scores. And the evil part – their incomes and their bonuses depend on it.
It is a disgrace.
Stevew Thank you IM Doc for all your posts. Not that I disagree, but please enlighten us with your take on electronic medical records.
drumlin woodchuckles Is it that a new generation of physicians and health care are navel-gazing and marinating themselves in a bathtub of happy scores? Or is it that the people who determine their incomes and bonuses and their even staying employed are marinating them in it? Whom should we blame here?
IM Doc It started with the administrators and handing over the leadership of medicine to the MBA crowd.
At this point, the docs have just allowed it to happen for so long that I am not sure who is responsible.
IM Doc I obviously do not know you at all – but I understand your situation – and where you have questions are the same questions I have had for a very long time.
First of all – there is a cardiologist trained in EP who seems to have his head screwed on correctly – who writes a very informative blog about rhythm problems – and other cardiac issues. His name is John Mandrola –
Secondly – do not spend another cent ( or Medicare cents ) on cardiac monitoring – those 30 day monitors literally cost 5-7 K dollars. It is a total scam that should have no excuse of happening anymore. When I say I work for an industry that is a wealth extraction machine – I am not kidding.
There is a device called a Kardia Mobile. Look it up on Amazon. The least expensive one is the kind you need – about 80 bucks the last time I looked.It goes into your cell phone – and when you need to intermittently monitor your heart or certainly when having any kind of symptoms – you put your fingers on it – and it will do an ECG. They do exactly the same function as the big expensive ones – for literally 1-2% of the cost – AND you get to keep it forever – to monitor yourself for all time…..
I have not looked in to them much – but a colleague has told me about another device out there called Oura Rings. They actually have the ability to monitor your heart 24/7 – and they fit on your finger like a wedding ring. Again, I have not had the opportunity to personally evaluate – but I will be soon. To be honest, I usually try these things out on myself first.
I have been using these Kardia Mobile devices exclusively for the past 2 years. A colleague of mine in a big city who worked for a hospital system was fined by bonus reduction for ordering these at all. I am sad to say the MBAs in the mahogany offices have the docs by the gonads in these big HMOs like Kaiser and the big hospital systems in Anytown USA.
I am sick and tired of all the scams. The fact that XARELTO now almost 10 years after its introduction is costing patients 500 bucks a month or so is an absolute sin. Coumadin is about 25 cents a pill – so less than 10 dollars a month. You just have to be monitored – way more at the beginning but much less often as time goes on.
And yes – there is nascent controversy about whether people do better with AFIB on ASPIRIN or XARELTO/ELIQIUS/WARFARIN.
I am old-fashioned. There was a time when I was young when the internist’s job was to sit down and comprehensively go through all of this with the patient. I still do. But I also do not work for a hospital system and I do not have an MBA as my boss demanding I see 30 people a day. And drug reps are banned from my office.
fresno dan IM Doc
July 13, 2021 at 12:11 pm
Thank you for the good advice. I only have a flip phone – I remember when I use to ride my brontosaurus and they made it lllegal to ride and talk on the phone at the same time, but maybe its time to come into the 21st century.
Rants:
1. Google gave me search results of electrophisiologists in Nebraska and Virginia, even though the search querry specifically said located in Fresno, CA. good grief…
2. Of several doctors and practices called, nobody picks up the phone. Phone trees. After going through the tree, I’m told to leave a message.
3. Phone numbers that appear to be phone numbers of physicians, but are actually the number of physician referral services.
Reprogrammed CRISPR-Cas13b suppresses SARS-CoV-2 replication and circumvents its mutational escape through mismatch tolerance Nature. The Abstract concludes: “[T]he recent dramatic appearance of variants of concern of SARS-coronavirus-2 (SARS-CoV-2) highlights the need for innovative approaches that simultaneously suppress viral replication and circumvent viral escape from host immunity and antiviral therapeutics…. The specificity, efficiency and rapid deployment properties of reprogrammed Cas13b described here provide a molecular blueprint for antiviral drug development to suppress and prevent a wide range of SARS-CoV-2 mutants, and is readily adaptable to other emerging pathogenic viruses.” Good to finally see some focus on treatment. And CRISPR as a platform, hmm…
Rodeo Clownfish The idea of using reprogrammed Cas13b as a treatment seems a bit scary. That is literally a tool for rewriting genetic code. I did get an mRNA vaccine, but I would not consent to CASPR-based treatment unless imminent death was the clear alternative. How can we trust that the product does only what it is advertised to do? They could slip in genetic programming to perform unwanted changes (insert favorite paranoia here).
JohnnySacks They don’t ‘slip in’ anything, so stop there. The uncertainty is that the CRSPR guide attaches to an unexpected area of DNA and modifies it.
IM Doc I agree with what you are saying. The idea is not to slip in anything.
Here is the problem from someone dealing with real-live patients all day long.
The world population was repeatedly and vociferously assured that the mRNA vaccines were just going to stay in the deltoid. Be located in the general injection site for a few seconds and do their thing and be gone. This was screamed from the rooftops for weeks and months when these were being introduced. From the pharma companies, their paid shills, and all kinds of commenters all over the Internet.
But yet – right in black and white, in the pharmacokinetic section of the Moderna vaccine application for the European Medical Agency – it clearly states that lipoid particles and S proteins were being found all over the body – and indeed were found in circulating plasma up to 6 hours later.
IN OTHER WORDS, A COMPLETE 180 FROM THEIR DATA SUBMITTED TO REGULATORY AGENCIES. DATA THAT THEY KNEW ABOUT LONG BEFORE ANY OF THESE COMFORTING EFFORTS WERE INITIATED.
This was not a hypothesis to be debated. This was firm hard facts right in their own material.
And now we may have this possible new technology – and we expect people to believe a thing about it?
That is the problem – and Big Pharma and all this dissembling is just making it worse by the day.
Phillip Cross “Not surprisingly, everything the establishment tells us about covid vaccines has been a calculated lie. One of the biggest and most treacherous lies is that “mRNA vaccine shots stay in the arm and don’t circulate nanoparticles around the body.” Now we know that is a complete lie, as new research conducted in Japan shows that Lipid NanoParticles (LNPs) containing the mRNA code are widely circulated around the body after vaccination, reaching the brain, spleen, large intestine, heart, liver, lungs and other organs.”
https://sciencebasedmedicine.org/covid-19-vaccines-are-going-to-sterilize-our-womenfolk-take-2/
Are you the Mike Adams quoted in this article?
IM Doc I am most definitely not.
However – if you would look at the EMA documents – I will get it for you as soon as I have time to find it – it is clearly there.
Things that are so easily called out like this are what cause great amounts of consternation among the populace. It is the very wellspring of conspiracy theories.
TRUTH AND TRANSPARENCY ARE THE ONLY WAY. Until we learn that – this kind of thing will just continue to happen and get worse.
I am afraid that as a primary care provider – I am right on the front lines of this every day – and I see and know what makes people think the way they do.
Once you let out deceptions as egregious as this mRNA circulating one – that can so easily be falsified – you have opened the door to every kind of conspiracy theory imaginable.
This is the OFFICIAL MODERNA DOCUMENTATION submitted to the EMA – for approval of the vaccine. It is a pdf – look at page 46 in the 6th paragraph down – that begins IN NON-HUMAN PRIMATES. THere are also other figures and documents detailing the issue elsewhere in the document.
The EMA has completely different laws and requirements than we do – so quite a bit of things are found there that are not found here.
Skunk This author in the article below mentions that there was no literature on the tissue tropism in relation to the lipid nanoparticles, even though this would usually be an important consideration:
https://medium.com/microbial-instincts/concerns-of-lipid-nanoparticle-carrying-mrna-vaccine-into-the-brain-what-to-make-of-it-42b1a98dae27IM Doc I put the wrong page number – Sorry – it is on page 47/169 – the 6th paragraph down – starting with CONCENTRATIONS of mRNA – it is a brief detail of all the places the mRNA that supposedly just stays at the injection site was found.
Sorry about this – trying to do this on the fly. This one is correct.
antidlc Fauci took the Moderna vaccine. didn’t he?
I wonder how he feels about that decision.
Phillip Cross Thanks for the PDF.
As far as I can tell, they are talking about a test in mice and hamsters, and it says that the s-protein is undetectable in most areas within 24 hours of the first dose, and it’s undetectable in the liver and lymph nodes within 3 days.
I guess I never saw anyone claim otherwise, but why is this supposed to be so scary anyway?
IM Doc Multiple concerns there –
The most onerous of which is that it clearly crosses the blood brain barrier – indicating that it would be being taken up by neurons.
Brain tissue is irreplaceable – and we just really do not know for certain what damage is being done by these S-proteins on the loose.Furthermore – and FYI – all documents like this for drug authorization and approval do all the measurements in animals – that is standard issue. This one is particularly rushed – so the human documentation will presumably be forthcoming. You can rest assured if this is happening in other mammals – almost certainly happening in us as well.
I would not call this scary. I would call this evidence that yet again – our health officials are big liars. I have come to the conclusion that they can be trusted on very little. THAT is scary.
Re: Breathrough infections / wedding
Wedding may have been in an outdoor open tent, but everyone shared a bathroom or two.
Is anyone testing the bathroom(s) they used?
And the guests from India were negative before they got on a plane. Was there follow up on the flight passengers?
Interesting & positive trial results for Covid involving Budesonide, which came about due to the authors noticing while treating Covid patients that unexpectantly people who should be vulnerable due to already having a respiratory disease were underrepresented as patients.
This led to them wondering whether it could be something to do with the widespread us of Glucocorticoid / Steroid inhalers, leading them to doing a study.
.https://clinicaltrials.gov/ct2/show/NCT04416399
& drbeen in a short video for him walks through it.
https://www.youtube.com/watch?v=i3OVnN_NxO8&t=2s
Good news for asthmatics anyhow.