After a long hiatus, I've decided to dive back into the Naked Capitalism comments section to fish for IM Doc's remarks on his experience as a physician "in the time of covid." I tend to search only through the posts that have some health-related theme in the title (or the links/watercooler posts), therefore, I may be missing some.

So, starting with June 2022... it turns out he was quite busy.

Without further ado...

MikelJune 2, 2022 at 10:40 am

Notes from the Deathcare world:

A relative was telling me how she just found out medicare would no longer cover podiatrist visits by diabetic patients. The nurse said it’s the insurance companies making the decisions. Not even the alleged “medicare supplement” is covering that procedure.

 

1. floraJune 2, 2022 at 11:10 am

   Is that traditional Medicare with medigap or is it Medicare Advantage (MA) that’s stopped covering? Medicare Advantage is not traditional Medicare. ( MA insurance companies go to long lengths to hide the fact their plans aren’t traditional Medicare or Medigap plans. surprise.)

    
2. IM DocJune 2, 2022 at 11:18 am

   Your nurse relative has informed you correctly.

   I just found this out last week when I had to admit an elderly patient for osteomyelitis of the toe. I was horrified to learn they had not had a podiatry appointment for some time. It is not that they are not covered – it has to do with how many they have in a year, etc. I just cannot keep up with the regulations anymore. Standard Medicare has one approach and then the infinite numbers of Medicare advantage plans have all their own. I often joke that they each get together and change the plan coverage every Tuesday afternoon. There is no primary care physician or office staff on this planet that can keep up with all of this. It is absolutely overwhelming.

   To add on to the nightmare, there are dozens of my patients every day now playing “dial for drugs” because there are so many shortages everywhere. The above patient could not secure antibiotics prescribed by an urgent care and did not want to “bother” my office during COVID. Yes, we are now officially sending our elders out with prescriptions that may or may not be able to be filled.

   If you have elders or infirm in your sphere of influence, I urge every one of you to keep an eagle eye on them. Things are already screwed up – and getting more screwy by the week. Many of them just do not have the mental acumen or the stamina to keep up with it.

   I cannot stress enough – I have never seen this level of chaos in medicine in my life. Not even close.

   It is not just baby formula, folks.

    
   1. floraJune 2, 2022 at 11:29 am

      Thank you for this information. yikes!

       
   2. ambritJune 2, 2022 at 11:46 am

      Oh boy. I had better start seriously investigating “natural” substitutes for my hypertension meds.
      Anecdotally, I still cannot find a medico around here who will write a prescription for “The ‘I’ Drug.” If anything, the local low socio-economic status clinic is visibly cutting back on procedures and scrips. My medica recently had a claim to Medicare for blood work related to my cholesterol level denied because it was “…too soon after the last claim.” (Her words.)

       
   3. IM DocJune 2, 2022 at 1:31 pm

      FYI –

      This is a report from 60 Minutes from just the past few weeks about the issues related to drug shortages –

      https://www.cbsnews.com/news/generic-drugs-pharmaceutical-companies-60-minutes-2022-05-22/

      This report mainly deals with all the trouble that hospitals are having procuring simple basic drugs – like GLUCOSE – you read that right – GLUCOSE. We can make sugar galore for Froot Loops, Snickers, Dr Pepper and Hostess Twinkies – but making sugar for preemies? TOO HARD AND NOT ENOUGH PROFIT IN IT. What is happening to this country?

      But the problems in the outpatient world are just as bad. Just now in the office a patient’s daughter reported the grandson had to drive 80 miles to get her mother’s potassium prescription. We had similar issues with magnesium this morning. Thyroid replacement is a very precise dosing – yet we often have to get by with higher or lower because many of the myriad doses are not available that week.
      Getting things like Ensure and Boost for the malnourished is becoming an ongoing daily problem. Simple old antibiotics are often unavailable forcing us to use others that may not work as well or have unwarranted toxicity issues. Various types of birth control pills are up and down on availability and changing them out is not a great idea. And the shortages are rotating and unpredictable. What may be available today is impossible to find 2 weeks from now and then widely available again 2 weeks later.

      It really is all getting to be too much. I go into work every day telling myself – “I am not going to let anyone die today.” Simple things that we used to be able to do like personal call backs on labs and tests are just no longer able to be done. We have far too many critical issues that must be dealt with immediately. And there is the constant spectre of something falling through the cracks. That is not a sustainable morale. My staff, what we are able to keep employed, is just bug-eyed by the end of the day. I know from colleagues that this is more widespread than we would like to imagine.

      I am not griping. It is an untold privilege to do what I do. But every day is a gut punch. And patients rightfully are getting more frustrated and angry by the day. I pray that what happened in Tulsa yesterday will not become the norm.

Below, check out the comments by Fiery Hunt (later in the snippet) and by "Skip Intro" and ask yourself - since when do vaccines require precautionary actions on the part of the injected... aren't they supposed to BE THE PRECAUTIONARY ACTION?  The answer may be "Since we started using "vaccines" against a virus that's never been successfully vaccinated against..."

Space Station 11June 2, 2022 at 4:12 pm

My .02 regarding the current Covid wave…I too have heard of many in my circles testing positive, but almost exclusively with minor symptoms (including my elderly mother who was laid up for about 36 hours, but did take paxlovid). As for a community perspective, well, I am a mid-career emergency medicine physician at a larger inner city academic institution- level 1 trauma/burns, regional referral for ECMO- and I have not seen a ‘sick’ case of Covid in months. Probably not since 2021. By sick I mean- needing to be admitted on oxygen, needing to be intubated, considered for ECMO, etc. I’ve canvassed a lot of my faculty about this and everyone has the same experience- lots of positive tests, but usually with minor symptoms or completely unexpected (e.g. in trauma transfer patients).

I’m not sure what to make of this. I guess I have a middle-of-the-road attitude w/r/t the pandemic: I was very worried initially, treated a lot of very sick patients in the initial and Delta waves, I’m vaccinated and boosted (required for employment, although we had almost nobody in our staff quit d/t the vaccine mandate), follow masking guidelines when required but I will admit that I don’t often wear them in public now. Covid has become, basically, a nuisance to me- a reason for my kid’s daycare to shut down, as has happened multiple times requiring a very difficult scramble for my wife and I (she’s also an EM doc with irregular hours). Our entire family got Covid in January after my 1 year old brought it home from daycare, and there’s really no protection against that, which probably contributes to my current attitude. As for my patients, the opioid/meth crisis and a very obvious rise in violence (GSW/stabbings) over the past 1-2 years is a much bigger public health concern right now.

Just thought I’d give my thoughts as a long-time reader.

 

1. Fiery HuntJune 2, 2022 at 5:18 pm

   Thanks Doc…appreciate the perspective.

   Been very much preoccupied by the conflicting thoughts of “This is an ongoing PANDEMIC!” and “It really doesn’t seem to be that big a deal…”

   Nice to hear an informed voice that’s not screaming “We’re DOOMED!”

    
   1. Fiery HuntJune 2, 2022 at 5:25 pm

      And just like that, Alameda County in SF Bay Area just reinstitued an indoor mask mandate today.

      https://www.sfgate.com/bayarea/article/Bay-Area-county-mandates-masks-17215847.php

       
2. IM DocJune 2, 2022 at 5:49 pm

   I am not sure what to make of this whole situation either.

   And it is always good to have other physicians with whom to compare notes.

   The COVID pattern in the past 2 months has taken a completely different direction than I would have expected. I live/work in a very vaccinated area that is surrounded by very unvaccinated areas.

   We are no longer doing any kind of official counts through the health department for outpatient care – so I have no official numbers. What I am seeing and it has now been a fairly consistent pattern for weeks is absolutely huge numbers of cases in my own practice – as in 7-8 times the numbers seen in the exact weeks from 2021. In a population that is now almost completely vaccinated. I find that very concerning. The same cannot be said of the unvaccinated areas which I really am not hearing from at all. So that right up front is a problem. We are having many times more the cases in a year that has vaccinated patients – compared to a year that did not – 2021. And almost entirely, the cases being called into me ( assume that would be the sicker patients) are from the highly vaccinated areas and almost always vaccinated/boosted patients.

   Furthermore, seeing a routine around 5% of patients being routinely screened in the hospital prior to surgery, tests, etc being positive and having no symptoms at all. Just found on routine screening. This is a rather large number. Multiple issues as outpatients living in the same house where I have all the vaccinated/boosted patients ill, while the unvaxxed are positive but with just minimal symptoms or not sick at all. Very strange.

   Seeing the exact same thing here as you are as far as admissions – almost zero. And the ones that are being admitted are often for social reasons – and would never have been dreamed to be admitted when the hospital was stressed. And certainly no ICU, vents, or ECMO.

   But many of these patients as outpatients are indeed fairly ill – but not hospital level. Again, the concerning thing is the overwhelming preponderance of these ill patients being vaccinated/boosted – and the fact that they are in such much higher numbers than what was seen in early June 2021.

   Since no formal numbers are being counted, it is very hard to make any judgements. But with talk in the doctors’ lounge it is clear my colleagues are seeing mostly the same thing. I am hearing similar stories from my colleagues across the country.

   So we have a vaccine that seems to definitely be preventing death/bad illness, at least from acute respiratory issues. But at the same time, as outpatients, the vaccinated seem to be much more affected with case numbers and outpatient illness. Almost invariably, the sicker the patients are as outpatients, the more likely they are to have been vaccinated/boosted. Really vastly so. I do have concerns with this pattern going forward and what this may portend if more noxious variants are conceived.

   I have never felt so strange as a physician. I have been trained and practiced for decades to take in what I am seeing around me and listen to my colleagues and mold what I do based on what I am seeing. But, those in charge of our public health apparatus seem intent on continuing on the same course and not really being too transparent with how they are arriving at their recommendations. It is very disquieting. Because a lot of what is being recommended does not seem to be appropriate with what is going on in my world or many of my colleagues.

   I am not sure what to think. One thing I know for sure. This is not over.

1. Fiery HuntJune 2, 2022 at 7:39 pm

   One possible thought as to why the vaxxed are “sicker” than the unvaxxed:

   Behavior.

   Vaccination rates here in the Bay Area are pretty damn high and Alameda County just announced there’s more hospitalization now than last summer during Delta.
   So many people here in the Bay Area act as if getting “boosted” is some sort of magic spell that wards off Covid. Travel, gatherings, hell, just going out to restaurants, bars, music venues..
   Can’t help but wonder is there isn’t a correlation between wealth, lifestyle and being an extrovert…(high vaccination rates) vs working class (“essential workers”!) introverts…(non-vaxxed).

   Spending hours in gatherings, traveling, attending events versus just wanting to go home.

   The alternative seems to point toward a vaccine= worse response to infection and that’s a whole nasty can of worms.

    
   1. floraJune 2, 2022 at 9:22 pm

      Forgive me pointing out the original and boosters were sold on exactly the promise they would ‘prevent infection and transmission.’ People believed what they were told, imo.

       
2. IM DocJune 2, 2022 at 7:48 pm

   https://www.cbsnews.com/news/covid-19-vaccine-boosters-infection-rate/

   This is a classic example of what I am talking about. The article seems to be pointing out the same thing I and my colleagues are noticing as I describe above.

   What is concerning to me is the response. My response would be “what is going on medically to produce such an outcome?… what if anything does this mean for the future?…..how should this help us with our advice for the legion of increasingly skeptical patients who are asking every day about getting a 4th shot?” The response described in the article is paraphrased as such – “recording case calculations is the problem, therefore, we should stop doing it.” No curiosity about why this is happening.

   Understanding WHY things are happening is often a fundamental part of understanding biomedical issues. This is the beating heart of being a diagnostician. And so many times we seem to be ignoring the WHY because the numbers are inconvenient or not fitting the current narrative.

   I can point to many many such articles where the discussed response does not seem to make much sense. This is what is being pushed out to our populace. They are not stupid. They see the same things I do and are bringing them to me daily unsolicited. It is very frustrating for everyone.

    
   1. Skip IntroJune 2, 2022 at 8:11 pm

      It may be wishful thinking, but in my experience many people who are vaxxed and boosted believe they are completely safe, and take virtually no precautions. They are suffering from vaccine-propaganda-induced risk blindness.

NC post says: IM Doc flipped out when he saw this tweet. And GM confirmed that it’s not true, that more died under Biden even if you give him a one-month grace period after he was sworn in:

 

Here's NC talking about hospitals gaming numbers (heh, that's only happening in June of 2022?)... and they have very nicely quoted the famous Dr. Natalia as well... When I clicked on her link the original post cannot be viewed (must be blowback from being ratioed) -- but also interesting to note that the follow-up comments are filled with people asking "Really? Is this common? Haven't seen that here?..." in other words, Dr. Natalia, cite your sources?
 

A new way for hospitals to game the data:

 

 

 

 

IM Doc writes: “I would guess with Omicron about 60% of the patients were on Dexamethasone – so no – not an adequate proxy” for hospitalization.

Just a reminder:

As with everything else, because the United States is not a serious country, our hospitalization data is bad. Here the baseilne is off:

 

 

Hospital trick: patients admitted with covid in 10-12 days become post-covid & no longer counted as hospitalized covid patients. ICU is full of post-covid patients that are here for 30, 40, 50 & more days. Not counted in the official stats.

— Dr. Natalia  (@SolNataMD) January 24, 2022

In this post (https://www.nakedcapitalism.com/2022/06/100-million-people-in-america-are-saddled-with-health-care-debt.html) on healthcare debt, IM Doc says, 

IM DocJune 17, 2022 at 1:34 pm

I thought Obamacare was going to be affordable? Remember it was called the Affordable Healthcare Act?

A plan put in place by the party of the working man, with a big smile on their face. “It is a big f#$%ing deal”.

Actually Obamacare was the final nail in the coffin of my profession. It was the hand-over of all that generations of physicians had held dear. Handed over with gusto to Big Hospital, Big Insurance and Big Pharma.

There are now more people in debt to these big industry companies than ever before. And they have no compassion, no mercy, no soul.

Every single month, when I have new students, one of the first things we do is listen to an old song by Woody Guthrie — the best rendition of it is by Merle Haggard at this link –

https://www.youtube.com/watch?v=e0f78MDOUJw

I reiterate the following words from that song to those students all the while they are looking at me as if I am from outer space ——

Jesus Christ was a man who traveled through the land
Hard working man and brave
He said to the rich, “Give your goods to the poor.”
So they laid Jesus Christ in his grave.

He went to the sick, he went to the poor,
And he went to the hungry and the lame;
Said that the poor would one day win this world,
And so they laid Jesus Christ in his grave.

Yes, if Jesus was to preach today like he preached in Galillee,
They would lay Jesus Christ in his grave.

American New Deal Liberalism at its finest – something that virtually no one remembers today in all our woke glory.

I know I am the old man from the before times. I realize that. We live in such a much more advanced world today, don’t you know.

For thirty years, I did everything I could to model this for my students and residents and colleagues. Just as it had been modeled to me by my grandfather. He gave everything he could to help those around him – and died not wealthy in financial terms, although not poor either. No, he died very wealthy indeed, as there were 6000 at his funeral praising him for all he did for them.

I do my best to tell these kids it is far better to build your obituary than it is to build your resume. There is something transcendental about giving everything you have and expecting nothing in return. It strengthens you to give your time and energy to those who have nothing.

My profession has sold its soul to Mammon. The consequences are just now being fully realized. My grandfather always told me about his youth. And how it was all fun and games until one day the money just vanished. “That will happen to your generation one day, son, and when it does you will know instantly who you can trust.” His words strengthen me every day as I see this going on all around me. I know it cannot last long.

IM DocJune 20, 2022 at 2:45 pm

I must get something off my chest.

There is also a lot of very incorrect information circulating about this issue and I feel it needs to be addressed so we can all be on the same page.

You may have heard that the American Board of Internal Medicine ( ABIM from now on ) has decided to go after Drs McCollough and Kory – 2 of the more famous dissenters from the COVID narrative. This all blew up over this weekend. I am hearing from all kinds of sources online that ABIM is going after their LICENSE.

Please note – this is NOT THE CASE. Licenses to practice medicine are administered by the states. The ABIM nor any other Board can go after someone’s license. They are however, trying to strip them of their ABIM certification. That is a way in which the ABIM certifies that a doctor has demonstrated expertise in whatever field it is given. These are completely separate issues. The ABIM is duty bound to report anything negative it finds about a physician or their conduct to the state licensing board, but that is the end all to their ability to affect a license.

Losing your Board Certification however is not without consequences. Most insurance companies will not contract with physicians unless they are certified. Most hospitals will not have them on their staff either. However, a physician can obtain a license from any state in the country and practice medicine.

The bureacratic overreach of these certifying boards has been the subject of much strum and drang the past 10 years or so. They are very expensive and time-consuming to maintain and have basically become a manner of rent extraction from the plebes to the medical elite. In my and many other’s opinion, the initial certification is of great import – all the rent extraction and multiple tests for the rest of one’s career does nothing but enrich the chosen few of these Board’s leadership. It is very much a scam. The entirety of this can be found documented for years on the following website – drwes.blogspot.com – if you are so interested. In recent times, this has led to multiple states banning the Boards from this onerous behavior.

Alas, the ABIM has now apparently dragged the AMA into this whole affair. The AMA has put out a very ominous statement in the past few days that they will be going after any and all spreaders of “disinformation” and will be using the social media, media, Medical Boards, State licensing agencies and anything else at their disposal to silence the evil doers.

As a medical historian and teacher of history for decades, I would suggest to the AMA and I have already personally relayed to the 2 members of the ABIM that I know personally that medicine has a very long history of exactly the kind of behavior they are planning. I am very hard pressed to come up with a single instance where it has worked out well for those going on the witch hunt. In fact, it has often detonated in a very bad way for them. I am going to assume this will end in a similar disaster for these agencies and they should take heed of the warning from history before they have completely torched whatever credibility they have left.

Medicine is science. And unfortunately, for these people who have decided science is their new God, it is never settled. Just in my career, I have seen aspirin, statins, hormone replecement therapy, and opioids used for years because it was “settled” science only to have that overturned with lots of experience and lots of very good research. I have also sat and listened to countless presentations and debates about these issues that were often very vehemently violent. Everyone watching knew the stakes, and knew the hearts of the partisans on both sides. But the verbal and public debate was critical for our understanding and how to proceed going forward. Those who have their finger on the scales thinking they “know the way” are often proved very very wrong.

So censoring or punishing these COVID dissenters in a very public way like this is exactly the wrong thing to be doing. These agencies seem to have no clue that they are holding on to just a shred of credibility that could vanish if they are perceived by the public in the wrong way. A much more appropriate way to handle this is to get McCollough and Kory on one side and experts of your choice on the other – and let them have it out online or on national TV. Everyone in this country has a stake in this debate – let the American people watch. Dr. Hotez and Dr Offitt and Dr. Wen, there will not be a better way to make these two like boobs. You are clearly very confident in your position – I would say go for it. WHAT DO YOU HAVE TO BE AFRAID OF?

There as so many examples of this behavior in medical history that have gone off the rails for the witch hunters, it is hard to come up with a “best” one. Probably, the most congruent for a situation today is the case of Dr. Ignasz Semmelweis. I would encourage everyone to read his story. It is so important that the pre-eminent medical historian of the 20th century, Sherwin Nuland, wrote an entire book about him called THE DOCTOR’S PLAGUE.

Dr. Semmelweis had an idea that he felt would make life much safer for patients in the hospital He went all over Europe and discussed his findings in all kinds of venues. The areas that followed his advice, notably Scotland and parts of France, had marked improvement in the situation. That did not sit well the leaders of the day – most notably Dr. Koch ( famous for his postulates and the Fauci of his day). He and others went about destroying not his ideas – but his reputation, his livelihood and eventually his sanity. They did not really want to argue the merits with him – just tarnish him.

What was the grave “disinformation” that Dr. Semmelweis was peddling? It is basically local infection control in the operating room , ie the aggressive use of PPE and disinfectants on the skin during surgery. This egregious “disinformation” has likely saved billions of lives since Dr. Semmelweis.

A Supreme Court justice had a famous line that “sunshine is the best disinfectant.” Jesus Christ himself taught us that we will know the truth, and it will set us free.

ABIM and the AMA – I urge you to get these two on the stage and let’s have a real debate about these issues. If your contentions are so correct, what do you have to lose? Give them everything you have – make them look like morons…….WHAT ARE YOU AFRAID OF?

My concern is they saw the Dr. Fauci/ Rand Paul exchange last week and realize there is actually a lot to be afraid of.

 

1. voislavJune 20, 2022 at 3:24 pm

   McCullough has repeatedly lied about vaccine sideeffects, including claiming 50,000 deaths from vaccines in the US. He didn’t do this as a private citizen, he used (and misrepresented) his medical credentials to advance this information. I’ve done tons of scientific research (50+ papers), worked on covid research early in the pandemic, so I am familiar with how bad a lot of covid research is. That is not an excuse to go about spreading lies, lies that cost lives.

   When it comes to McCullough and people like him, I take a very dim view. Criminal charges should be a minimum, forget revoking their medical license. I understand the argument for open discussion, but not when people are dying because of their scummy behavior. There is no reasoned discussion when one side is making stuff up. Show me data, we can discuss how dismal statistical analysis in medical sciences is, but the onus can’t be on one side to disprove assertions made without any evidence.

    
   1. IM DocJune 20, 2022 at 10:54 pm

      There are times in emergencies when we as practicing physicians have to not depend so much on exact studies which will come much later. We have to depend on what we are seeing and hearing with our own eyes and pay very close attention to colleagues both in our area and those we know elsewhere.

      So what have I seen with my own ears and eyes? I have one patient in my practice who most certainly died from the vaccine complication. I have done all I can do to report it last April and was completely blown off by both the FDA and CDC VAERS program. Interestingly, it is a very unusual problem that was the demise of this patient that timed perfectly when they got the vaccine. Over the months, this problem has now become a fairly commonly reported issue with these vaccines. I have also had two other patients who just literally dropped dead within hours/days of the vaccine. Both were younger and healthy at baseline. I cannot as safely call them vaccine deaths. It may have been random chance but I doubt it. I have had another patient who had the worst blood clot I have personally ever seen within days of the fourth shot and died from it. I have had 27 severe or critical vaccine complications over the past 18 months, confirmed to me just today by an audit of charts done by colleagues in my hospital noting how much higher this was in 2021 compared to the past two years.

      This is real time information. It will not appear in any published studies for probably years. It is definitely a clue to what has been going on, though. And we cannot ignore the most ominous issue which is the very substantial increase the life insurance companies are having to pay out since the introduction of the vaccines. I am certainly glad that you have read 50 plus papers, but my life’s training and work would say this kind of data will arrive in papers much later. We must react to what is going on now. On the ground docs must monitor all that is going on around them and make judgements.

      I have many colleagues all over the USA who will readily admit that yes they have had at least one vaccine related complication leading to death. It is not uncommon at all. Unfortunately as you state no one on a federal level is too interested in improving data collection.

      A quick Google search reveals there are right at 65000 practicing internists. Let’s say a third can make the 1 death statement. I think that is probably low from discussions. That would be 25000 deaths or thereabouts. Now, we must add the even larger workforce of family and general practitioners who number over 100000 and all of a sudden the 50000 number is not out of the ball park at all.

      I can see where a reasonable person could make that claim. And I would be willing to testify to that in court and even bring these patient’s families if needed and let the jury decide if the timing of the deaths and their nature are realistic for vaccine issues. It may come to that since the FDA does not seem to be really interested in helping us with this issue at all.

      And sorry, your claim of scaring people holds no merit. Look at the rotavirus vaccine disaster of 1999. I believe we had less than 20 deaths from that and it was suspended instantly. The swine flu disaster was less than 50 patients. The denguevax did not even make it out of trials because of this issue. There was a time when we weighed risks and benefits and realized that even 20 or 50 deaths across the country was too high a price to pay. Surely, you must realize there have been way more than 50 deaths from these COVID vaccines. But now Pharma has co-opted our regulatory agencies. We are the blind leading the blind.

FraibertJune 20, 2022 at 3:29 pm

I think there’s a larger game in play here.

You’re right that the most rational and fair way of addressing the dissenters’ views is a public debate. However, that lets the dissenters speak, and the real point is to prevent them from speaking. The method chosen by the elite also discourages future dissenters from getting ideas–my guess is that revocation of board certification (which, as you note, already has serious professional consequences) is just a way point towards the real destination of onerous state licensing investigation and (in the establishment’s ideal world) license revocation.

It’s all just another variation on “lawfare.”

To that end, Drs McCollough and Kory are ideal targets. Both were pretty successful physicians if you look them up.

 

1. IM DocJune 20, 2022 at 6:17 pm

   Both are so successful as physicians that it is going to be very difficult to take them down using this tactic. If they succeed in gutting their ABIM certifications, I can guarantee you that the lawyers will be lining up to take their case. I happen to know two of these lawyers who take on Medical Boards and licensing agencies on the behalf of physicians and their nicknames among their peers are Ballbuster and Nutcracker. And they have earned every bit of those names..

   I have read the list of wrong think put forth by ABIM on both physicians. If they do take away their board certification, lawsuits will soon follow. And then in the course of events will be discovery. I know enough about the situation to realize that if discovery proceeds, I am thinking the ABIM may be in a very bad position. Especially in this climate of every month something new comes out. For example, a year ago, both were being cited for discrediting the claim of 98% effectiveness and that the vaccines would cause the vaccinee to be a dead end for transmission. How has that worked out in the fullness of time? There are other things on these lists that I am certain will be just as likely to not go well for the establishment narrative.

   In other words, this has the potential to be very interesting. Stay tuned.

IM DocJune 21, 2022 at 9:27 am

Sorry, this was meant for the censoring article……this is in regard to the impending investigation of COVID narrative challengers Drs. McCollough and Kory. Sorry all, I put this comment in the wrong post……..

And for those interested in how the ABIM ( American Board of Internal Medicine ) conducts their investigations, I would point you to this piece of journalism.

http://drwes.blogspot.com/2017/03/fact-check-on-abims-director-of.html

This was a few years before COVID, but as far as I know, the basic regime is still in place. These organizations are accountable to no one, certainly not their members.

Please note, it is not physician scientists who are investigating, it is washed up GI Joe military-adjacent goons with an attitude. I can only imagine how their “security” thinking has evolved since the start of this pandemic. Sadly, my forebears in medicine would be shaking their heads in absolute shame.

America, is this how you want this COVID issue investigated? This approach or a public debate?

This is all very concerning to me. The health of the nation is involved here. Why are not enterprising young journalists not all over this stuff? This is what careers are made of.

 

1. floraJune 21, 2022 at 10:13 am

   Thanks for the link. I’d guess if the ABIM pulls their board certification of either of these two docs a lawsuit will follow, where discovery should be interesting.

    
2. Tom StoneJune 21, 2022 at 10:54 am

   There are perhaps three internet based outlets where an enterprising young journalist might get such an expose printed.
   None of the networks would touch it and none of the print outlets would either, with the possible exception of “Teen Vogue”.
   The going has gotten very weird indeed.

    
   1. floraJune 21, 2022 at 12:10 pm

      Most of the MSM is owned by 6 giant corporations/billionaires. MSM isn’t a large, dozens of owner/ players, diverse, media ecosystem. Might have something to do with nearly identical stories in print, on TV, on radio, and on the twit/fb pages. Glad Teen Vogue is breaking out of the bubble.

       
3. IM DocJune 21, 2022 at 11:05 am

   I can answer my own question about the young journalists.

   Here is today’s wonderful example –

   https://twitter.com/mtracey/status/1539086445209690112

   One of the most well known reporters at The Washington Post mocking and condescending a suffering COVID patient.

   Lateral ableism???? In decades of human care, I have never heard that expression even once. When I performed a google search, there were three different definitions, and for the life of me, I cannot figure out how any of those definitions applies here.

   These people just like to throw out “big words” and hope that everyone thinks they are really intelligent.

   I used to think that this young reporter, Ms. Lorenz, had all the signs of narcissitic bipolar syndrome with a touch of borderline. It is becoming more and more clear to me by the day that she would fit right in with Ti or Do of the Heaven’s Gate Cult.

   Of course the Washington Post of Watergate lore is not investigating any of these important medical things now – they are too busy giving this psych patient a platform.

June 21, 2022 at 11:37 am

I don’t think she was mocking him (that was the whole point!), but she was certainly atrociously condescending. She was also stupid to call out Yglesias for his original joke. I mean, pick your battles, Taylor.

A real shame because as far as I can tell she is one of the few mainstream journalists who continues to draw attention to the ongoing seriousness of SARS2 and Long Covid, which is a genuine service at this point. Unfortunately dragging out stupid shite like “lateral ableism” instead of something like “yep, you know what, fair play, I see your point, good health to you” is not exactly ‘hearts and minds’ stuff.

I must admit, as a psych patient, I am surprised to see you refer to psych patients with such casual derision. Presumably people with psychiatric illness are entitled to journalistic careers, so long as they don’t go full Stephen Glass?

 

1. IM DocJune 21, 2022 at 11:58 am

   Yes – even I get carried away with my disdain for these people. I should be much more measured with my words.

   What I would say is she is the toughest kind of psychiatric problem to deal with. She has a severe personality disorder. Probably borderline given her behavior when I have seen her on TV interviews and her propensity to dox and torment people for doing the same things she is. Projection is one of the worst symptoms of borderline and she seems to have added severe passive aggressive tendencies. She is also very adept at what is known as “splitting”. That is a well known combo for a very difficult and frustrating patient. They cause nothing but chaos among providers when we try to care for them. We physicians use the words “psych patient” and quite frankly worse frequently to vent our frustration in private to peers and really that has nothing to do with the legion of people out there who have organic psychiatric issues like depression anxiety and schizophrenia, etc.

   It is very concerning to see someone with this type of behavior being given such a platform where she can manipulate and “split” an entire country.

   Again, I should be much more measured with my words and realize I am not with peers on this board. For that I apologize.

   Unfortunately as is so often true with borderline patients, any good in the world they do is often extremely overshadowed by all the antics and mayhem they cause – just like this reporter.

Raymond SimJune 21, 2022 at 3:35 pm

So Doc, remember back when I had some harsh things to say about Alex Berenson, among others? You made a rather impassioned argument involving the need to accept that bad people can do good things, even if for the wrong reasons.

Taylor Lorenz has, as Basil Pesto notes, been a rare mainstream media voice calling for Long Covid to be taken seriously. Yglesias on the other hand is a minimizer.

Who cares what sort of emotional horror show Lorenz may be?

Additionally, while I greatly appreciate your contributions here, and I’m deeply grateful and indebted, to you for them, your remarks about Lorenz seem perilously close to tele-diagnosis. And surely your last sentence isn’t meant to imply being a psych patient should make one subject to deplatforming*? But it reads that way – what exactly is her offense?

*If it does mean that, can we deplatform that Canadian loon psychologist? I’m against censorship, but I’m really sick of his face showing up in my YouTube suggestions, and the republic’s shot to hell anyway, so ill wind and all that …

 

1. IM DocJune 21, 2022 at 11:10 pm

   Well, psychiatry is the one area of medicine that is very able to be characterized on video and what someone wrote. Indeed, 2 of the 4 semesters of my med school human behavior had finals with just 10 written paragraphs and we had to identify the psych disorder from the written word. 1 other semester had 30-60 second snips from movie and TV shows of behavior that we then had to diagnose and the other semester had brief live acting.

   It is fairly easy to identify personality and behavior disorders from video snippets. Her videos I would say are classic textbook examples of behavior identified as borderline and narcissist. I would be happy to use them in any demonstration for students when trying to demonstrate it. I do this all the time. Just today, I used a short snippet of Sophia from The Golden Girls to demonstrate to my students confabulation – a sure sign of micro vascular dementia.

   As for why she got all my animus about that tweet. I have zero tolerance for using photos of suffering patients to make any point. Especially a virtue signaling point. For the same reason, I had such vitriol for all the young doctors making TikTok videos about the unvaxxed. If I had exhibited either of those behaviors as a medical student or resident 30 years ago, I would have been fired instantly. I would flunk a student on the spot for the whole rotation if they pulled a stunt like that just once. We live in a different world now but I tend to not just ignore but actively dismiss anything people who use these tactics say. I find it incongruent with informed discourse.

   I would appreciate if you could point me any place that Berenson has taken a photo of a suffering patient and behaved that way. I certainly have not seen it. He is often very juvenile in his comments but nothing that rises to the examples I have outlined above. Indeed, his juvenile comments often make what he has to say very difficult to get to. But again, I have never seen him engage pictures of suffering people. I have a tolerance for him because he is one of the few journalists that truly seems to be able to handle statistics in medicine. He had the Big Pharma beat at the NYT in the day they when were doing real news. You can instantly tell the difference between him and the stenographers that are all over the mainstream media today covering this story. He is the only one I know of that understands relative vs absolute risk, as one example, and did his best to explain that to people all the while the NYT and CNN were screaming 95% 95% 95%. I realized long ago that Berenson is an example of how the media would have handled this pandemic in my youth – tough questions and hard nosed assertions. It was amazing watching as all the other media types melted like snowflakes in reaction to him this past year. And because he actually knows how to engage scientific literature, who has had the benefit of being proven correct way more often than these others? As a professor, we learn to put up with a lot from students when they are being hammered by others but who clearly are persistent with their convictions.

   About her take on Long COVID. This may be so. But what is happening to her is one more piece of evidence I have that she is deeply into borderline personality. It is a characteristic of these people that whatever good they do is dwarfed by their constant antics and hysteria. A comment above points out she has been demoted. This too is characteristic. Constant job loss, resignation or firing. People cannot stand to be around them as charming as they may be. If she is the spokesman for Long COVID in the mainstream media, I would suggest that position needs someone else immediately.

   By the time they are 50 or so most of these borderline patients have had it hammered out of them. If they manage to survive. I certainly hope she can see that while being demoted and begin to work on her behavior.

    
   1. Raymond SimJune 22, 2022 at 12:32 pm

      Well, psychiatry is the one area of medicine that is very able to be characterized on video and what someone wrote. Indeed, 2 of the 4 semesters of my med school human behavior had finals with just 10 written paragraphs and we had to identify the psych disorder from the written word. 1 other semester had 30-60 second snips from movie and TV shows of behavior that we then had to diagnose and the other semester had brief live acting.

      Wow, your response is far more interesting to me than the original topic, and coming from you it’s quite disconcerting.

      Eschewing all sarcasm, your remarks strike me as an indictment of psychiatric diagnosis, and potentially medical diagnosis and pedagogy generally.

      Is it just me? I’d be very interested to read others’ takes on the passage I’ve quoted.

       
      1. IM DocJune 22, 2022 at 3:09 pm

         Actually I would disagree with you.

         I would make it very clear that the teaching of human behavior in the modern medical system is just a remnant of what it was when I was young.

         My education in human behavior came from a line of thought back then that was called “transactional analysis” – I’m OK – You’re OK. It was about half the time in the first 2 years of med school – that is how important it was thought to be for medical providers.

         TA was very big in the 60s 70s and 80s. Not so much now. I do think it should be though. I see students struggling with dealing with patients all the time.

         Basically, it employed what is known as the therapeutic sequence. To make things simple – there are about 15-20 different personality types. And you as a provider should be able to spot them instantly. They all behave in very different ways. And not just active behavior – how they hold themselves, how they dress, how they do makeup, how they speak, how they move their eyes, hand gesticulations, how they move their mouths, etc.

         About 40% of the population is estimated to be what is called “a genital character” – you are able to bounce around in the personalities depending on the situation. Sometimes, it is important to be antisocial sometimes histrionic. These patients are considered “normal”. The other 60% are “stuck” in one of the personalities and are dysfunctional because of it.
         And you as the provider have to be able to recognize these instantly, because how you proceed through the therapeutic sequence is dependent on what you are seeing from them.

         Therefore, it is critical to be able to instantly evaluate appearance, cues, speech patterns, eye movements, mouth movements, etc. You must know the “character” you are dealing with at all times. You would approach telling a borderline they have cancer much differently than a schizoaffective, etc.

         It takes years to master this – but it is essential. And it is a large part of what makes a “bedside manner.” But this type of thing is completely ignored in modern medicine – these kids today are learning none of this.

         Accomplished actors know these things instinctively and can change their mannerisms accordingly. For example, within 5 seconds of seeing Glenn Close in Fatal Attraction, I knew the character was a borderline personality disorder. She is an incredible actress. And yet within seconds of watching Glenn Close in Dangerous Liasions it is crystal clear that her character was a narcissitic personality disorder.
         Within seconds of watching or listening to Stevie Nicks, it is crystal clear she is a schizoaffective personality – and the witch stuff all makes sense. I can go on and on and on. And as a physician, I would handle these patients very very differently.

         I am very appreciate of the era in which I grew up. Human behavior and the ongoing mastery of it is essential for a physician – and it is being completely ignored today.

psmithJune 21, 2022 at 12:36 pm

On the topic of COVID, Eric Topol commented that BA.4 and BA.5 (taken together) now represent 35% of new cases in the United States:

https://twitter.com/EricTopol/status/1539267655604924417

He also mentions the new study on the risk of reinfection. Deepti Gurdasani has a thread about that:

https://twitter.com/dgurdasani1/status/1539237795226689539

 

1. Basil PestoJune 21, 2022 at 4:34 pm

   The reinfection study is ‘hoo boy’ stuff. I expect it will be hoisted to links tomorrow. The general conclusions aren’t unexpected by any means but to see it so starkly in writing is… rather bleak.

    
   1. psmithJune 21, 2022 at 4:39 pm

      Yes, I found it upsetting reading, especially in the context of precautions being dropped and new variants becoming dominant.

       
      1. IgnacioJune 21, 2022 at 6:03 pm

         Thank you psmith
         That was interesting read. My bad I now don’t have time and/or willingness to go to the actual paper being this always a good exercise.

          
   2. IM DocJune 21, 2022 at 5:57 pm

      This is an example of something I am seeing on the ground. In rather large concerning numbers. Lots of reinfections and many are so quick after the preceding infection. This is a first blush attempt at research for what me and many colleagues are already seeing for the past month or so since the post-Omicron phase started.

      It seems like the patients tend to get more ill on every episode as well.

      I really would like for someone to really do these kinds of studies with the vaccines in mind. They do not appear to be effective in stopping this at all nor do they seem to be that effective in mitigating the symptoms. What is very concerning to me is to this day is that many of the vaccinated have a feeling they are safe and sound. If they get sick, it will not be bad. They CANNOT become critically ill. So far we are not seeing that much critical illness – but I promise you, the vaccinated are getting very sick.

      I am really concerned if/when a more virulent variant comes around.

In this post (https://www.nakedcapitalism.com/2022/06/fast-and-furious-omicron-new-variants-defy-explanation-and-dont-bode-well-for-future-either.html), NC takes on the proliferation of Omicron variants. You may consider reading the whole post, which I'll not copy here.

Here is IM Doc's comment following the post:

IM DocJune 22, 2022 at 12:04 pm

I view my most important job as a physician to be education of my patients. To tell the truth as I see it at all times and to give my commentary on the current data based on experience. I took to doing this on this site earlier in this pandemic because I could not see that was happening too often in the media landscape.

As such, I will give this update on where we are in my practice with just today’s numbers, which I will be discussing with inquiring patients today.

My staff and I maintain a spreadsheet daily of what we are seeing. No one in officialdom seems to care about this type of on the ground data – but I think one day it will be very helpful for those learning about what happened during this pandemic. Every morning I am given a condensed top line list of the patients with COVID that were encountered the day before.

Right up front, I work in one of the most vaccinated counties in the USA, >80% vaccinated – >60% boosted. The surrounding areas where a good number of my patients come from is at best 50% vaccinated.

Yesterday, I had 45 COVID patients evaluated by me or my staff. More than 50% of these were from 2 different superspreading events, one a wedding, the other a performance. Out of these 45 patients, one was completely unvaccinated, 17 were double vaccinated, 9 were vaxxed with one booster and 19 were vaccinated with 2 boosters.

The very concerning thing to me is how many of these were reinfections. Of the 45 patients, 37 were reinfections, and 11 of those have just been within the last 6 weeks.

This is right in line with what I have been seeing for the past few weeks and it is also right in line with what is reported in this paper. Reinfections are becoming more and more frequent – and the patients, vaccinated or not, are getting sicker with each episode.

First of all, the majority of these patients at this moment in time are not all that sick. But some of them really are quite ill. 12 from yesterday to be exact.

Much has been made of Simpson’s paradox in our national media the past few weeks in an attempt to explain away all these infections and reinfections in the vaccinated. It is a very complicated statistical concept, but in general it basically is this – I work in a >80% vaccinated area so I would expect >80% vaccinated patients. Therefore, we are good. THIS IS EXPECTED. The writers of these articles know nothing of medical statistics and this is profoundly misleading. It is making people much more comfortable than they really need to be.

It is absurd to invoke Simpson’s paradox in this situation for 2 reasons –

a) Simpson’s paradox has never been invoked in a vaccine situation to my knowledge – not one time. This goes back to the sterilizing vs non-sterilizing issue. We would just not even see patients at all if the vaxxes were sterilizing. Simpson’s paradox is perfectly appropriate to discuss in medical therapy for heart disease, etc.. For vaccines, it is completely inappropriate.

b) Much more important – June 21st of 2021 – I had 2 COVID patients – in a much less vaccinated environment – June 21st of 2022 I had 45. This is important if you assume some seasonal variation. YOU SIMPLY CANNOT HAVE THIS LEVEL OF DIFFERENCE and invoke Simpson’s paradox

What these writers and news outlets are doing is very dangerous – and is giving the vaccinated a sense that they are bulletproof. WE ARE ALL GOOD – MEDICAL STATISTICS TELL US THIS WAS EXPECTED – EVERYTHING IS GREAT. This is not a good message. It is not based in reality.

My education bullet points to my patients—— This is very serious. Your vaccine status is giving you zero protection from catching and transmitting this virus. We have no idea what these frequent infections can do to you, but my sense is it is not good for you. PLEASE PLEASE do not depend on this vaccine to protect you from infection. Take every precaution you can. There is evidence that it may protect you from severe illness, but even that seems to be not as solid as it was before.

And I go back to what I have been saying all along. Get healthy, get your a1c down, get your waist size down. Eat well. Sleep well. Enjoy good times with your family. Get out in the sun. De-stress. Get going on the VIT D and ZINC. Please please be careful.

Everyone here – I would say the same to you – please be careful.

.....

I will, however post the entirety of this next post as it's pretty much IM Doc's email to the NC folks:

Growing Revolt Among Medical Practitioners Against Vaccinating Toddlers for Covid

Posted on June 24, 2022 by Yves Smith

1. Pediatrician4UJune 26, 2022 at 2:54 pm

   Hi! Pediatrician of 25 years here. I’m sympathetic to the political leaning of this site, and had to jump in and say that the idea that there is mass hesitation or that “the worm in turning” in the medical community against protecting our children from covid with these vacccines is not correct. I’m willing to say “anything is possible” wrt the specific experiences shared here by the author of this post, but the idea that there is a movement among *medical professionals* (especially ID docs!!) against toddler vaccination against Covid is frankly laughable and makes me give a bit of side eye to the rest of this post. I had to share this reality check.

   I work in a suburban purple area and of course among families, there is some vaccine hesitancy, but the medical professionals including all of the injection nurses are are strongly in favor of these vaccines and their potential to save lives. No one is resigning- we are *thrilled*. Covid has been the #4 or #5 cause of death this last winter among the ages 1-5 yr. It has killed more/mo than RSV or Influenza ever does. Your pediatric nurses and doctors are very happy that we finally have the chance to reduce this impact.

   My professional recommendation is for god sake’s, please protect your child from Covid. Advocate for better public policy wrt ventilation and masking, etc, but PLEASE also take this simple and safe step.

    
   1. Yves SmithJune 26, 2022 at 8:21 pm

      I don’t mean to come down hard on you, but just because a situation is bad (having toddlers get Covid) does not mean a particular proposed remedy is good. But your comment comes off as if your need to be able to Do Something has blunted your critical thinking.

      First, IM Doc spent 15 years on an Institutional Review Board, five years as its chair, and so he is intimately familiar with the drug approval process and the statistical reviews. He is adamant that these vaccines are being used when previous vaccines, like the one for swine flu, were pulled off the market at a far lower level of deaths and complications.

      Second, it appears you completely ignored the information from the infectious disease specialist. With the 0-5 injection only having just started, meaning comparatively few toddlers have actually gotten the shots, they have killed more 0-5 year old children than Covid has over the entire history of the disease! How can you be in favor of them in the face of data like this?

      Third, I expect IM Doc to address this himself, but I am highly confident his data set is bigger than yours. He was formerly a professor at a major teaching hospital, participates religiously in their various Zoom grand rounds and other information-sharing, as well as keeps up with his students, many of whom are at tertiary medical centers, and can give readings on what is happening there.

      Fourth, if nothing else, you are ignoring Publix’s refusal to administer the vaccines to 0-5 year olds. They have over 1000 pharmacies. They can’t get enough of their staff to administer the shots to offer them.

      Fifth, your geolocation belies your claim to live in a purple area. 4 of the services say you are in San Francisco. One says Boulder Creek, which is in the general area of Silicon Valley and blue. The last is Pittsburgh, where the city is a bit less blue but still rated as liberal, than Allegheny County.

       
   2. IM DocJune 26, 2022 at 11:25 pm

      There have been interesting further developments in the story since the last writing. They thought they were going to have an enormous demand for baby vaxxes – but apparently the appts were only filled for one day and a few into the next. Now it is crickets. In other words, the parents seem to be deciding en masse to give this a rest for now. It seems very likely that the nurses will have their jobs back, because there will be no baby vaxxes in this county – or just sparingly, so that the supervisors can handle the babies if needed.

      I am hearing similar reports all over the country – there is very little demand in the first week other than the very large cities.

      This comment pretty much encompasses the talking points of the CDC. These issues the commenter brings up are similar in tone to how the CDC is describing the situation. Interestingly, there are entire states where there has just been a handful of kids in the hospital with COVID for the whole time. There are many towns like my own where we have never had a kid hospitalized through this whole time. Certainly not minimizing this – but I think we have to take a cold hard look at data as we were trained to do and really assess risk benefit ratios.

      I am not going to write this all out – Vinay Prasad MD has 2 videos that I think spell it all out. I have but minor quibbles with what he says. Here is the thing – Do I agree with everything Dr. Prasad says? Oh no. But I am a student of science enough to know that he is doing these expositions from a good place – and he happens to be very congruent with my own reading of the literature. Unlike the CDC. The horror of horrors was earlier this year in the Supreme Court when a Justice used obvious bad data and misinformation to vote to maintain the vaccine mandate. This is an example of where bad science and repeating misinformed talking points can cause real harm.

      Dr. Prasad discusses the obvious lies and distortions meant to scare parents into vaccinating kids – https://www.youtube.com/watch?v=ykwMAur0RTM And here in this video he goes through the evidence of benefits and risks to these kids from 0-5 for vaccination – https://www.youtube.com/watch?v=CJnOn6Phzfo. As a member of an IRB for 20 years – and a journal club attender for more than 30 – I can find nothing in these analyses that is invalid. If you are so intent on vaccinating the 0-5 – and so sure the benefits would outpace the risks – I would love to hear why.

      I would ask your commenter another very important question – Why is it that countries all over Western Europe have had their medical regulating agencies say NO? – in a big way? Would this commenter engage with me – and go down the list of the FDA committee members that made this decision – and see how many of them may be corrupted with other arrangements with Big Pharma? – Is even one of them a truly independent adviser without conflicts of interest?

      With regard to the worm turning and doctors not being concerned about this……a few things indicate that I am not just making shit up as implied here –

      This is from Marty Makary MD – MPH – of Johns Hopkins Univ

      This is his tweet in response to one of the above Dr. Prasad videos –

      https://twitter.com/MartyMakary/status/1539616084139151360

      There it is in black and white – he is guessing fully 40% of peds in rural areas will not be recommending this to their patients. That includes our pediatrician – who was vehemently telling us not to vaccinate our own kids – who are older than 5 months ago. And he was making very good sense when doing so.

      And then this letter came out this weekend from a group of doctors including both Dr. Prasad and Dr. Makary – and as you can tell there are multiple signatories who are peds or ID docs urging a relook or reframing of the entire vaccination of babies scheme. I cannot say I agree with everything in that letter – but I certainly agree with the vaccination issue.

      https://www.urgencyofnormal.com

      I am not just making this “worm turning” up. There are literally thousands of American docs who have signed this letter. When I looked through just the first few dozen – there were multiple peds and ID docs. ID docs are indeed questioning this issue, regardless of what you say. I spoke with one personally on Friday.

      You reference the ID doctor that made the comment in that conference. Please note – he is a dean of Infectious Disease in this country. As a young man, I saw him take up the armor when similar things were happening during the AIDS pandemic. He tolerated no bullshit from the CDC or Fauci or manipulating data. That is an understatement. He tolerated no bullshit from anyone when it came to patient care. What he did the other day – I would have expected nothing less. He is one of this country’s legends. But a key word is RETIRED. He has freedom. He does not need to be worried about being fired or punished. That is the problem. We cannot have a rational discussion about these issues other than the CDC talking points. Thank you for kindly reiterating them. It is now time for my generation to pick up the armor. As I discuss above – the uptake of the vaccines is apparently way lower than expected in many places in this country and that is because of the abysmal performance of our federal agencies. The trust in them in this country is cratered and will likely take years/generations to fix. This latest turn with the baby vaxx is no different. Unless we immediately began to demand complete transparency and a cessation of the propaganda, our entire profession and the health of this nation are at grave risk.

       
2. Pediatrician4UJune 26, 2022 at 11:03 pm

   I didn’t realize posting an opinion to the comment thread that didn’t fall in line with the group majority would result in an attempt at doxxing. I didn’t think that’s what this site was about.

   I think the author of the post will agree that your assertion in point #2 above is incorrect even if you take that slide at face value. According to that slide, how many children age 6mo-4yr have supposedly died of covid vaccine? The one we just started providing last week? The only children in that age range that have received the vaccine so far are the ones in the trials. Are you seriously suggesting that more children 6mo-4yr died during the trials (btw– NONE did), than have died of Covid disease itself?

   I don’t usually use confrontational language like this, but I’m reacting to the tone of your response. I’m a pediatrician who considers themself quite anti-Big Pharma. I counsel honey over Robitussin. I dissuade families for falling for Pharma marketing of “toddler formula” (totally unnecessary btw– it’s just the drug companies creating and marketing a made up product you don’t need). But being against Big Pharma doesn’t mean I never prescribe a medication. Or recommend a safe life-saving vaccine.

   Fwiw, i stand by my characterization of the town I work in (though it is literally the least relevant part of my comment- just some background).

    
   1. floraJune 26, 2022 at 11:46 pm

      You may be all you claim to be. Still, something seems off to me, something sort of ad-speak sounding about your comments. Maybe it’s just enthusiasm. But it does sound like a sales pitch. Probably just my quirky parsing of what I read. I’m not a medico.

       
   2. Yves SmithJune 26, 2022 at 11:48 pm

      First, it is false and an attack on this site to say you were doxxed. We did not publish your name, your phone number, your home or work address, or your e-mail. We found three different places from which you might have made your comment. Even if we take the one that is the best fit with your claim of purple (Pittsburgh), it has 4,900 doctors. The ratio of pediatricians to doctors nationally is about 6.5%. Applying that to 4,900 says there are over 300 pediatricians in Pittsburgh (and that is assuming you actually were in the city and not practicing somewhere else in the county). In other words, it is impossible to identify you personally based on what we said.

      The comment about you being in a purple voting area was not “some background”. It was to try to undermine IM Doc’s using his experience in his very blue and very vaxxed county as not representative by presenting yourself as being in a less Democrat leaning area that was nevertheless toddler-vaccine-gung ho. So that was part of your argument, not ancillary information.

      IM Doc in his reply to your earlier comment provides additional substantiating information that shows that many doctors and parents are skeptical of using this vaccine on toddlers.

      And as for your effort to critique a slide from a former and highly esteemed Dean of Infectious Diseases, you appear to have a reading comprehension issue. The information came from the VAERS database. VAERS does not include clinical trial results, it is to report adverse results on vaccines in use. IM Doc said he even checked the 37 death and permanent disability reports about Moderna to see if they looked to be MD submitted or from patients. Their doctor-like use of medical terminology and writing style strongly suggested they were provided by doctors.

      These deaths and other bad outcome are in the 0-17 age group in VAERS, which given that there are unlikely to be any adverse reports in the database from the shots that started last week, this effectively means it covers next older aged cohort, 5-17. You could look it up on VAERS yourself. They are almost certainly less fragile than toddlers. There’s no reason to expect better outcomes on average and good reason to worry about worse ones.

      And the number of vaxxed 5 to 17 year olds is also likely to be lower than total toddlers exposed to Covid since it spread in a big way in the US (say early March 2020; by contrast, the Pfizer vaccine was not authorized for use on 12-15 year olds until late August 2021 and for 5 to 11 year olds, until the very end of October 2021. So we have less than a year with these vaccines for these populations, versus two years plus of Covid risk for toddlers. That means the time/population corrected level of bad outcomes is even worse than the simple comparison suggests.

      I strongly suggest you reconsider your vaccine-for-babies enthusiasm.

       
   3. IM DocJune 27, 2022 at 1:43 am

      I think the ID doc’s point is that we have had less than 350 kids who have lost their lives to this virus and we have had the 250 deaths reported in VAERS at the same time in a much shorter time. No they were not 0-4 they were the older kids. He never suggested this was babies. Nor did I.

      I tend to be on the very safe side with babies. So did the FDA in the past. See the story of Frances Kelsey MD to understand what I mean. How many pharma dollars did Dr. Kelsey have coming in on the side when she stood up for the kids of America? How many current members of the committee in the FDA that approved this are free of conflict? Should not the American people and certainly our kids have the assurance for this grave a matter that those in charge are free of conflicts?

      As I stated, I looked through some of this deaths and they appear to be genuine. This is the next closest age range to whom we are dealing with here. There clearly are a lot more deaths than I am comfortable with. And have never seen any IRB be comfortable with that trade off.

      And this safety is unresolved…..I will say once more that we had a severe safety issue in my community that all knew about. Never addressed in any way by the authorities and massive distrust was the result. And now they want us to vaxx babies with a minimal at best efficacy with that risk signal out there. Unfortunately, these are babies, and repeatedly saying the vaccines are 100% safe etc is just not going to cut it with the parents of America. The trust has been severely affected. I deal with this every day of my life like no other time in my career.

      As I have stated before, it is leading to my own moral injury.

      I would like for him and any others to listen to that Dr. Prasad video and point out their differences. That is where the debate should be had.

      That is the issue at hand.

Kevin Smith MDJune 25, 2022 at 7:09 am

re: “…absolute risk of serious AE from mRNA vaccines exceeds the absolute risk reduction of serious covid-19 infection.”

I’ve run lots of clinical trials, and helped write some protocols: …. so, depending on the definition of “serious adverse event” {SAE}, I might prefer to have the SAE than to be so sick with covid that I wind up in hospital.

I think the headline would be likely to mislead the casual reader.

 

1. IM DocJune 25, 2022 at 8:25 am

   I feel this is one of the most important studies put out in the past year. The more I have thought about it, it may be one of the most seminal papers in my career over decades.

   They are fairly clear what their definition of sae is and not sure I would feel the same way as you do.

   This paper is a direct result of the dissembling and obfuscation of Big Pharma and our government agencies. The authors used multiple back door approaches with multiple data sets to come up with these results because the real genuine data that would answer the questions remains under lock and key. It is an absolutely fascinating study on how one may get answers in more than one way. Indeed, this will be required reading for students on my IM rotation from now on. It is important in two ways. The fascinating ways they deduce this data and a warning for the future about trying to subvert science and hide data. We cannot allow this to go on.

   And these are not just Twitter bot writers. They are quite frankly the shining lights of medical data studies and epidemiology. Sander Greenland writes THE medical epidemiology book used by medical students everywhere. His book sits proudly on my shelf. Doshi is the editor of BMJ, the last of the Big 4 with its reputation not in tatters, and Kaplan is the CSO of the AHQR. These people live and breathe math in medicine and how to do approrpriate trials. They are our supreme experts in this realm. This simply cannot be ignored. And as someone who has spent decades on IRBs and journal clubs, I am just blown away by this work.

   And the basic end result is that they found many more had to endure side effects from the vaccines than the vaccines prevented hospital stays. Damning. And it was much worse for Pfizer. Furthermore, as they state, and is clear from careful reading, they very likely are very much understating the ratios and the effect is likely much larger. But they cannot know for sure. Because the raw data has not been released from either Pharma or our govt agencies. As far back as my original post more than a year ago on the vaxxes, I stated that was a HUGE problem with the initial studies. Something did not seem right and the only way to find out is the raw data. And here we are 18 months later and not a step further down the road. We now have lived experience that they are a huge disappointment in containing infection despite the “triumph” framing, and we have all kinds of red alert signals about side effects. And still no data. These vaccines have been coerced on our population. Our leaders must step up to the plate and demand the data to be released. There is no other way to get to the bottom of this. The authors of this study have laid out in the best possible way what we can know and they too are begging for the data to be released. They assert this is critical because the raw data can lead us safely to risk stratification for vaccine administration for demographics, something we cannot do even remotely now. We are blasting them into everyone.

   Where is the data? How is withholding data consistent with science? Given all that is happening around us, why is this being allowed to happen? Why are we allowing these vaxxes in our kids without the most full picture of benefits and risks freely available to the parents and their doctors? Why is there not an Act of Congress or Executive Order to do so?

   This paper, by these experts who cannot be ignored, is a blatant indictment of our current situation. And given the reputations of these authors, it is an indication of the shift happening in my profession about these therapies. We cannot allow our current status to continue on.

1. Joe WellJune 25, 2022 at 4:20 pm

   If they are minimizing adverse events, why was there such a freakout about the very small risks of cardiac problems from the J&J and Astrazeneca vaccines?

    
   1. square coatsJune 25, 2022 at 7:07 pm

      Indeed. The mrna vaccines have seemed stinkier and stinkier to me (not because of mrna technology per se but because of just about everything else).

       
   2. Yves SmithJune 25, 2022 at 10:43 pm

      How about the number of people at the FDA getting royalties from Pfizer products?

       
      1. JBird4049June 26, 2022 at 2:18 am

         I am reminded of the company that made thalidomide, Grünenthal, which was founded by Nazi doctors who had prisoners for their often lethal tests during the war. The company not only quickly knew about the problem, they suppressed the information and kept encouraging thalidomide’s use worldwide because of the profits they were making. I have forgotten anything more about the mess except that the FDA prevented its use in the United States and IIRC the legal prosecutions in Germany ended in very lenient settlements.

         Considering the past, it would be unsurprising to me if American officials were making bank off of the mRNA vaccines. I wonder what the people in the 1960s FDA would think about today’s medical establishment including its regulators.

          
         1. IM DocJune 26, 2022 at 10:04 pm

            This is a story I tell every year to my students in medical history. Her name was Frances Kelsey, MD. She was the FDA official who through sheer will cut through all the hubris and crap and greatly minimized thalidomide in the USA. We all owe this women a debt of gratitude. Her name is largely forgotten today but not by my students. She is one of the greats and one to be emulated.

            https://www.npr.org/sections/thetwo-way/2015/08/08/430709628/frances-kelsey-fda-officer-who-blocked-thalidomide-dies-at-101

            The NIH makes quite a bit of royalty from the Moderna vaccines. It is unclear to me how much Fauci and his top lieutenants are personally making – the news is a bit opaque – but I am certain if we have a GOP wave this year, that is all going to come out in the wash.

...
Not covid related, but since I've posted his comments related to his political sea change, here's another:

IM DocJune 25, 2022 at 9:52 am

Actually no they are not rolling their eyes. I happen to be of the camp that this should be between a woman and their doctor. But I personally am pro life. This was one of the first indications that I was no longer welcome in the Dem Party. I was told to my face in front of others on multiple occasions that I was a horrible misogynistic mansplainer. Please note, I never one time have ever expressed a desire to get in the way of someone else who has different opinions to have an abortion. But because I expressed an opinion that I MYSELF would never be ok with a child I sired to agree to an abortion, I am worthy to be damned to hell. Now, I just never bring it up. I wonder how many like me out here who used to be reliable Dem voters are out here. I think it may be substantial. But it is hard to hear them through all the screaming.

You leftists can have it. The authoritianism in your actions is revolting to the vast majority of us in the middle. It is not just abortion. It is the entire framework of how you relate to the world. It is a form of authoritarian Manichaeism that is getting quite concerning. It is also fascinating to watch the many ways it is imploding on itself just as it has so many times throughout history. Your comment above, stripped of any nuance about this very complex issue, is a textbook example of Manichaeism. It does nothing but harden those of us who have struggled with this issue all our life that the Dem Party and its leftist core are not our home. The sad thing you cannot see through all the righteous screaming is that much of your base – the Latinos and the African Americans – have similar feelings that I do. I think November may be a surprise for you.

I am still struggling with the fact that my side of the spectrum has become far more authoritarian than the other side ever dreamed. It is unsettling. Even more so is the fact that the partisans on what I used to call my side cannot even seem to see the problem. The huge number of what I call New Deal Dems out here in the heartland who I have contact with regularly feel the same way I do. We need to start working on issues of the common working people and put the identity politics aside. They are absolutely toxic to a functional society.

thoughtfulpersonJune 25, 2022 at 10:13 am

“By abolishing longstanding legal protections, the U.S. Supreme Court’s reversal of Roe v. Wade serves American families poorly, putting their health, safety, finances, and futures at risk. In view of these predictable consequences, the editors of the New England Journal of Medicine strongly condemn the U.S. Supreme Court’s decision.”

Not every day the editors of the New England Journal of Medicine condemn a decision of the SCOTUS.

https://www.nejm.org/doi/full/10.1056/NEJMe2208288

 

1. IM DocJune 25, 2022 at 10:29 am

   I write this as a medical historian.

   There may be very well thought out reasons why this ruling is bad. I am struggling with it myself. However, I know for sure that I will not depend on the NEJM for help with this issue. They do not have a very good record when you look at the big arc of history. They were avid supporters of things like eugenics, forced sterilization, and frontal lobotomies in the past among many others. These editorials are written not by actual practicing physicians but by the most ivory tower detached academics who would not know how to handle a patient in any way. The same is true today.

   The NEJM should be used as a gauge of how elite physicians are feeling at the time it was written. And not of how something should be viewed going forward. Their opinions often appear quite embarrassing to the medical profession many years later. I often use these kind of editorials from decades ago for student readings. It shows us how the “cool kids” thought at the time and how ridiculous they sound now. It does not even have to be decades. Their editorial pronouncement that the COVID vaccines were a “triumph” 18 months ago seems a bit off today.

Jason BoxmanJune 27, 2022 at 10:04 am

The column on Paxlovid being a failure on its own terms, with the terms of the trial hidden from public view, and approved in secret by the FDA, might get buried by all the justified Roe coverage, but this too is absolutely beyond scandalous. Social murder. (Peddling this drug to the exclusion of funding development for ones that might work, or do work today.)

An updated, more recent analysis from 1,153 patients (out of a possible 2,246 patients) showed a lackluster, non-significant 51 percent relative risk reduction. A sub-group analysis of 721 vaccinated adults with at least one risk factor for progression to severe Covid-19 showed a non-significant relative risk reduction in hospitalization or death (treatment arm: 3/361; placebo: 7/360).

…

But unlike Biogen, I couldn’t even find any online record of a meeting by Cavazzoni justifying the protocol amendment for Paxlovid, let alone an adequate one. Pfizer would have had to provide detailed reasoning in its protocol amendment and the FDA kept those requests and changes a secret. It’s just another example of the FDA’s total lack of transparency.

https://www.theamericanconservative.com/articles/biden-pays-big-bucks-for-pfizers-latest-flop/

It’s too bad the author is all-in on herd immunity, but the information on Paxlovid is nonetheless damning.

This country is in terminal decline.

 

1. IM DocJune 27, 2022 at 12:19 pm

   Over the past month, I have had some experience with Paxlovid. Enough to confidently make a few observations. We have been using it for patients who are higher risk because of age and medical issues, and only those who are not on contraindicated meds. So a fairly substantial number.

   1) It really does not work all that well. Indeed, many patients do not feel better at all after several days. They often feel much worse. I have had multiple couples and families where one spouse demands Paxlovid and the other demands VitI/flovoxamine/some kind of steroid/NSAID – and invariably without exception – the second group does better much quicker. This is observational, case record level data – but is entirely consistent with what I have seen before in the pandemic. Again, the fact that all of these other agents have not been studied in any kind of trials but what are known as “show trials” IOW meant to fail – is an indictment against our medical agencies. This will not age well.

   2) I have now had a handful of these “rebound” cases. Without exception, they are significantly more ill on the rebound – and this is 10 or so days later. There was an initial burst of discussion about this but again, now, as usual, crickets. I have no idea what this rebound phenomenon means. But it is a very real phenomenon.

   3) It is very expensive. 700 dollars or so per course. It is being covered and paid for – but SOMEONE is paying for it. And again, the paltry effect does not seem to be worth the billions being spent.

   4) Lots of dropouts. It makes many patients feel much worse in so many ways within just a day or two that they just stop taking it. I have some very serious qualms about this given the fact that this is absolutely what we are NOT supposed to do with antivirals. This kind of behavior is what leads HIV patients to become resistant to HAART. But there is a significant minority of patients who just feel so much worse they quit taking it.

   5) There is absolutely no help with reinfection guidance from our agencies. I have so many patients now who are having 3 or even 4 reinfections that it is becoming hard to keep up with the numbers. Invariably, they are sicker each time. Majority are certainly not hospital level – but we are headed that direction if this keeps up. And so many of these people have already had a course of paxlovid on the last reinfection that may have just been 4 weeks ago. ( I view this as a completely different issue than the rebound – that very clearly happens within 6-10 days). No guidance on this at all – do we give them a second round of paxlovid this close after the first round? What is that going to do with viral resistance? What do you want me to tell these many patients who have had both vaccine and paxlovid failure – they are becoming very angry…..I am getting so used to being the whipping boy for the patient’s frustration. And I really cannot fault them – they have very valid points.

   6) Getting back to patient anger and hypocrisy. I have just gotten to passively shaking my head when I see the usual tweet from one of our politicians – So and So, I have my 3rd bout of COVID – but thank God I have been vaccinated and boosted, you should be too. Things would be so much worse for me now, but because of my vaccination status, I have very mild symptoms. Nevertheless, the PAXLOVID I am on will help me too.

   DO YOU NOT UNDERSTAND YOU ARE COMPLETELY HYPOCRITICAL in THIS STATEMENT – This drug is only to be given to those who are high risk. That does not include Justin Trudeau, Pete Buttigieg or Jen Psaki, Gavin Newsom or Kamala Harris among many others. All of whom have made variations of the above statement. (I do not include Dr. Fauci in this list because of his age he actually is high risk). First of all, if you are legitamately getting Paxlovid – your symptoms must be much worse than you are letting on. Secondly, this is very very poor modeling behavior. You as politicians should be modeling the CORRECT thing for the world. What you are doing is undermining the entire project.

   There are days I want to just give up.

marymJune 28, 2022 at 11:11 am

The anti-abortion movement, including electing anti-abortion candidates and appointing an anti-Roe judiciary, has been going on for 50 years. The participants in that movement are responsible for this decision. They don’t get to blame it on proponents of vaccine mandates, whatever else one may think about that issue.

 

1. IM DocJune 28, 2022 at 2:52 pm

   I am so sorry – but one of the most important aspects of medical ethics is that the principle in question must be universal in its usage and understanding. A principle of medical ethics simply cannot be applied to one issue and then not another. The resulting moral chaos will become destructive very quickly. This is just the way it is.

   One side can simply not vehemently use medical ethics principles on its pet issues and then ignore the same on those they oppose.. That would make them moral morons as is being evidenced today. The hypocrisy from the very same politicians is just overwhelming. They look life fools.

   I do not think anyone is blaming the loss of Roe vs Wade on the proponents of vaccine mandates. I think they are rightly pointing out that the hypocrisy on display is revealing to all involved that ignoring ethical principles in critical medical issues in our society that they have screamed from the rooftops for years really makes them look like zeroes. I will assume from this day forward that someone like Elizabeth Warren is a moral zero until proven otherwise. She clearly is unable to rationally parse through an ethical dilemma. It pains me to say that. But she has been proving this with so many other issues over the past two years that this seems like nothing. The same can be said for many others I used to respect.

   Since both abortion and vaccine mandates of a non-proven, no-safety record substance are both medical issues – both must be evaluated on medical ethics in exactly the same way. You simply do not get to be ethical on one issue and not the other. Unless, of course, your name is Joseph Mengele or many others throughout history who have – and we all know the consequences.

   This is absolutely fundamental to medical ethics.

   The issue of “my body, my choice” goes right to the heart of medical autonomy – one of the most important medical ethics principles there are. It is absolutely relevant to abortion – but equally relevant to the mandate issue as well. Again – the fact that this has rightly been used for generations now for the abortion issue – and then tossed out the window in a heart beat for the other side speaks volumes in the hypocrisy for the side doing it.

   The big bugaboo with medical autonomy in the hundreds of debates I have been witness to over my life – is what about the autonomy of the fetus?…..When does a fetus have autonomy?

   The other issue that gets less press but is equally important – is “this decision is between a woman and her doctor”. That issue goes right to the heart of medical privacy – another ethical issue that was tossed right out the window by the mandate crowd – the same ones who have been chanting it for decades. I would love for you to come and talk to a patient of mine – a young woman with a clotting disorder – who came to me to discuss her options with the vaccine mandate at her work. Together ( a woman and her doctor) came up with the decision that these were not a good idea for her. I filled out a medical exemption. It was summarily dismissed by the employer. She got the shot – and 2 days later had a massive PE. Thankfully did not die. But the same people who are now screaming about this issue with abortion were all over her facebook feed demonizing her for even thinking about getting a medical exemption – she showed it to me – tears in eyes – “these people are my friends.”

   Sorry – there is no other way. Medical ethics are non-negotiable. They are not for some issues and not others. Failure to understand this is why we are in the mess we are today. The few medical ethicists that came out to support these mandates were simply unable to make their case. And as is always the case with the truth – it will eventually come to light.

   I struggle with the abortion issue mightily. I read posts like the one above – and I get it. I have had decades as an instructor in medical ethics to go over this in my mind and soul. But what has happened in the past year has demonstrated to many people that the moral and ethical fiber in this country is very thin indeed.

Another political one...

IM DocJune 30, 2022 at 12:05 pm

About the foreign trip.

I had the Biden remarks to NATO on TV this AM – and it was all about NATO and Russia.

And then something happened that just rocked me. As in I will never trust Biden again – nor basically his party until the clean sweep is done. During the NATO Russia speech in front of the leaders of the free world, Biden took a fairly deep swipe at the US Supreme Court and them being against human rights and specifically mentioned Roe v Wade.

What the hell does Roe v Wade have to do with NATO or Russia? Does anyone else seem to see the supreme irony in comments like that spoken to the European nations – who almost to the one have MORE RESTRICTIVE abortion laws than many of our US States.

Call me old-fashioned. But I do remember a time when it was absolutely looked down upon for any American politician to go onto foreign soil and talk down to the world any other politician or any other political instituion. And yet – he goes onto foreign soil and makes this kind of comment about the US Supreme Court, and equal branch of government – at least the last time I checked.

Totally classless and totally disrespectful of centuries of precedent.

I, an officially former Dem, am rapidly becoming a member of the “I will crawl over hot coals” to vote these people out. They are not worthy of the position. Furthermore, my wife especially, has begun to make donations to the other side – she is so horrified. It is also official – after more than 5 decades between us being Dems, we are no longer. Our official party registration was changed on the first day it was able to be done in our county today. And my God, the place was packed with people doing the same thing.

I am so very disappointed with my party. I cannot believe what they have become.

IM Doc posts/comments for March 2022.

Naked Capitalism ran this post on March 3rd. Here, IM Doc is quoted and he comments in the section below.: https://www.nakedcapitalism.com/2022/03/pfizer-february-2021-post-marketing-vaccine-side-effects-tally-raises-alarms.html. Although it's long, I'm just going to copy the whole thing here. 

The topic is the Pfizer document with the extremely long list of adverse events they were prompted to look for during the course of the study. There seemed to be a fair amount of debate on the ecosophia site over whether this list was actual adverse events or a list of things frequently associated with vaccines in general that should be monitored in this case.

IM Doc seems to feel that this is not just a generic list but actually a list of reactions and results that for some reason were on the radar for this particular Pfizer cocktail.

I thought it was useful to include the entirety of the comments section to get a sense of the conversation.

Pfizer February 2021 “Post Marketing” Vaccine Side Effects Tally Raises Alarms

Posted on March 3, 2022 by Yves Smith

1. PlutoniumKunMarch 3, 2022 at 7:24 am

   The first I saw of this was a number of ‘debunking’ threads from the usual suspects on Twitter, which seemed suspiciously pre-prepared.

   The information is far too haphazard for a definitive take – which may well be deliberate. But it certainly backs up the many anecdotes I’m sure plenty of us have heard. I have one friend who fell quite ill when she got the second Pfizer shot back in August and is still not fully recovered (she tested negative for Covid). There might of course be many other explanations for her ill health, but the incuriosity of the medical establishment is very telling.

    
   1. ahimsaMarch 3, 2022 at 8:00 am

      “…but the incuriosity of the medical establishment is very telling.”

      intellectual curiosity is perhaps the opposite of hubris

      I suspect many in the medical establishment are victims of their training which seems to promote rote-learning, hubris, and an adherence to hierarchical strictures while discouraging independent thinking from first principles (perhaps an unfortunate consequence of increasing specialisation?).

      To offer a personal concrete example: my partner chose to get vaccinated and then boosted. While disagreeing with the latter (our low risk vs. the data long trending in the wrong direction) I pleaded that she should at the very least insist that the syringe be aspirated to reduce unnecessarily added risk.

      The doctor effectively refused to respect her patient’s wishes citing institutional protocol, dismissing aspiration as outdated, and even cIaiming it could damage the mRNA vaccine in the syringe. I was furious with the outcome arguing aspirating clearly cannot harm the patient or vaccine but quite obviously help reduce (the very small) risk of unintended intravenous delivery.

      About 10 weeks later the German vaccine authorities issued new guidelines revoking their standard recommendation for administering vaccines and now explicitly recommend aspiration for all SARS-CoV-2 vaccines. The aforementioned doctor will of course now dutifully aspirate everytime.

      To my mind, such a doctor is not a practitioner of medicine and healing but simply a box-ticking, faithful servant of the medical establishment.

       
      1. KLGMarch 3, 2022 at 10:02 am

         “To my mind, such a doctor is not a practitioner of medicine and healing but simply a box-ticking, faithful servant of the medical establishment.”

         Some of us are trying to reverse this very real trend, but swimming upstream is exhausting.

          
         1. ahimsaMarch 3, 2022 at 12:41 pm

            Hallo KLG, no offence intended, more exasperation. Very trying times for me witnessing all the groupthink and scapegoating in German society at the moment.

            I wish you strength in your struggles.

             
      2. Basil PestoMarch 3, 2022 at 9:41 pm

         I had to make a bit of a (very polite) song and dance to get my syringe aspirated for my 2nd AZ shot. nurses were unable/unwilling so they had to get a doc to do it. He was happy to but slightly condescending re: my request. I mentioned the recently released (at the time) paper hypothesising that AZ thrombocytopenia may have been caused by vaccine binding with a protein in the blood (iirc) he said he and his colleagues had seen it but weren’t inclined to aspirate because “it wasn’t part of the protocol”

         This was presumably part of the same constellation of protocols that insisted I take my FFP2 respirator off and replace it with a surgical mask upon entry to the vax clinic.

         A Canadian doctor friend was a bit mystified that aspiration should be controversial because she’d just been taught that’s how you inject.

          
   2. Kris AlmanMarch 3, 2022 at 9:13 am

      The publication of what ought to be regarded as an explosive revelation of the range and frequency of its Covid vaccine side effects has gotten barely any notice, even on Twitter.

      Perhaps twitter purged all the accounts that critiqued the Pfizer vaccine after this report?

      And can we expect more purged accounts with their “experimental Birdwatch program, which seeks to enlist Twitter’s users to flag and debunk misinformation on the social platform”?
      https://www.msn.com/en-us/news/technology/to-fight-misinformation-twitter-expands-project-to-let-users-fact-check-each-other-s-tweets/ar-AAUyF83

       
   3. lordkoosMarch 3, 2022 at 11:43 am

      In March of 2021 I went into the ER two weeks after my second shot of Pfizer. I had extreme dizziness and some pain in the middle of my chest, like a bubble or pressure in the esophagus. These symptoms were far outside my normal ongoing health concerns (which are fairly minimal for my age) and have not repeated since that time. They could find nothing at the ER and released me after a couple of hours when I felt better. I am 90% certain it was the vaccine. I will not take another MNRA vax from here on out.

       
2. E.L.March 3, 2022 at 8:15 am

   Oh no, 7k people got a fever and 10k reporting here got a headache and the next largest side effect group is muscle aches. Gosh, I do seem to remember all of these being publicized and expected possible side effects. 20% of the self reported side effects are a headache, how terrifying. And continuing down reading the actual document instead of this fear-mongering bit, 1927 of these reports are Covid-19, which somehow, I don’t think is an actual side-effect of the vaccine. Off-label use is a ‘side effect’ reported here too. That gets you a lot of the way to N=42k, I gotta say.

   I think the call out for changes to menstrual cycles is valid, and I’ve seen a lot of requests (speaking as someone with a menstrual cycle) to report those effects. For the actually concerning immune disorders, half the reported ones here are filed under ‘Hypersensitivity’ which seems to be a VERY general term and about the same number are ‘Resolved/Resolving’. But I don’t see anything here incredibly irresponsible. So many of these things are also side-effects of the virus itself, and speaking as someone who was in NYC when cases started going up, who got sick without being able to get a test and who remembers how accurate the antibody tests weren’t… Good luck clearing up that data, that’s all I have to say.

    
   1. Yves SmithMarch 3, 2022 at 8:50 am

      I suggest your read Appendix 1. Paints a very different picture. Try reading out all those possible side effects on a TV commercial.

       
      1. DeanMarch 3, 2022 at 11:28 am

         It is not clear what that list represents. Are these all actually reported events from vaccinations? From the statement it appears to be a broader list of potential events, many of which are associated with COVID-19 (so might not be associated with vaccine):

         “The AESI terms are incorporated into a TME list and include events of interest due to their
         association with severe COVID-19 and events of interest for vaccines in general.”

         Looks to me like CYA to say they looked for any possible adverse event.

          
         1. Yves SmithMarch 3, 2022 at 8:37 pm

            No, per IM Doc, who was on the board of an IRB for about a decade and a half and its chair for a few years, Appendix 1 is a standard section. These are reported events.

             
            1. DeanMarch 3, 2022 at 11:22 pm

               With all due respect for IM Doc, his expertise, IRB experience, and wisdom this document was submitted to the FDA not an IRB. Whether IRB’s and the FDA have different criteria for reporting I do not know.

               I can only speculate, based on the language referring to the appendix, that Pfizer included potential adverse conditions that may not have been caused by the vaccine. But rather included conditions associated with severe SARS-CoV-2 infections as well as those caused by other vaccines.

                
            2. TBellTMarch 4, 2022 at 11:44 pm

               At least one scientist disagrees with such a reading 4:01

               “This is not a list of adverse events that have occurred after covid vaccination, it is a list of adverse events of special interest. What that means is that they are events that are particularly important to track or monitor and the list is actually drawn up before the start of clinical trials, so they reflect what could potentially happen, not what has actually happened”

                
   2. JeffMarch 3, 2022 at 9:14 am

      Good articulation of the type of resistance that will continue to be the boilerplate response rolled out each time any criticism is leveled at vaccines. “See, there’s no smoking gun.”.

       
   3. IM DocMarch 3, 2022 at 9:26 am

      Not sure you have ever sat on an IRB.

      Before COVID, this would have never flown.

      And I am glad you are so assured of the benign nature of the side effects of this vaccine. I would love for you to talk to a few dozen of my patients or their families. That is just it, though. Our entire media, officials, and official medicine have decided they are not real. Just imagine how these people feel. I do not have to imagine. I know.

      Instead of dealing with this forthrightly, our officials have decided to conceal. And part of the consequences of that is the vaccination program for COVID is now moribund. The reputation of public health and medicine is on the lowest ebb I have ever seen. We may have permanently damaged our entire vaccine program for everything else. I typically give out 800 or so flu shots. This year was 62. And for the first time in my life, I am having threats of physical violence expressed to me by patients against health officials and authorities. Both of which came from family members of those suffering from the completely “ benign” side effects. I have been able to talk them down. But what happens if the pcp is someone telling them it is all in their head and the side effects are non-existent. What if their PCP is one who completely blows off this kind of document?

      Give this whole process another several months. We are all going to find out what is real.

       
      1. SEMarch 5, 2022 at 10:00 am

         The people who are experiencing some of these effects are reporting in here http://www.realnotrare.org. I have been talking to my congressperson about it.

          
         1. SEMarch 5, 2022 at 11:37 am

            sorry, it is http://www.realnotrare.com

             
   4. Still Above WaterMarch 5, 2022 at 4:19 am

      “20% of the self reported side effects are a headache, how terrifying.”

      My sister-in-law, who almost never has headaches, got one the night of her second shot that lasted almost two months. Yes, some people find the prospect of never-ending pain to be terrifying. Please, learn how to empathize.

      As for C-19 being a side effect, IM Doc noted on this blog back in February of last year:

      “I have frankly been stunned by the number of people who become COVID positive with symptoms within a day or two of the first dose. Many HCW and fully 25-30% of the nursing home patients. I do not believe this is related to behavior because these are mostly a captive audience still following protocols in the NH, HCW who are still under directives for PPE, and the 75 and up crowd I know are still taking things very seriously. This was such an issue that they tested all our shot-givers and all were negative.

      In other words, we are not vaccinating thirtysomethings who then go out to party. Nor are the shot-giving personnel seem to be infected and giving it to the patients.

      Again, this is a very clear pattern. Vaccine is given and within 2 days they are coughing or fevering and are COVID positive.”

      I’ve since seen this phenomenon confirmed elsewhere.

       
      1. Still Above WaterMarch 5, 2022 at 4:39 am

         Please note that these post-shot cases are always counted as unvaccinated, thus increasing the supposed efficacy of the shots. Without this statistical sleight of hand, it’s likely the 50% efficacy required for FDA approval would never have been reached.

          
3. disco discoMarch 3, 2022 at 8:32 am

   The illuminati already planned for this scenario back in 2017, did a rehearsal document Johns Hopkins Univ. – SPARS pandemic exercise.

   It was covered in chapter 17 – Vaccine injury – in their SPARS pandemic exercise handbook. I guess they just look in the book for how to respond.

    

    
   1. Mr. HouseMarch 3, 2022 at 9:46 am

      Its funny, it does feel like so much of it was premeditated. Like it was all script, with so many plot holes mind you, it was easy to see where they were trying to take us. Covid never scared me, but peoples reaction to it sure as heck did.

       
      1. disco discoMarch 3, 2022 at 11:30 am

         https://www.centerforhealthsecurity.org/our-work/Center-projects/completed-projects/spars-pandemic-scenario.html

          
4. Mr. HouseMarch 3, 2022 at 8:48 am

   I would submit they knew this before they rolled it out. I work for a very large Healthcare/insurance company. They had a townhall in Febuary of 2021 about the jabs. They were stating then, in Febuary of 2021 that you would likely need boosters, maybe up to three times a year. They didn’t state this to the public, i wonder why? But they knew. If you want to destroy our for profit corrupt medical system and replace it with something more humane, now is the time.

    
5. Mr. HouseMarch 3, 2022 at 9:01 am

   “But Pfizer remains a big winner. The Biden administration is determined to move on from Covid, as if Covid doesn’t have a say. And Ukraine is a huge aid in diverting attention from the ongoing pandemic.”

   Many of us have resolved that this can not be swept under the rug like 2008. I myself think much of what happened in 2020 was connected to 2008. If you let this get swept under the rug, something even worse will happen again in the not to near future. Nobody got punished for 2008 and how well did that work out for us? This was even worse in my opinion then 08, do not let it fade away because it be even worse next time.

    
6. Kris AlmanMarch 3, 2022 at 9:20 am

   Also… what to make of this Swedish study?

   Intracellular Reverse Transcription of Pfizer BioNTech COVID-19 mRNA Vaccine BNT162b2 In Vitro in Human Liver Cell Line
   https://www.mdpi.com/1467-3045/44/3/73/htm

    
   1. Yves SmithMarch 3, 2022 at 10:02 am

      Not what the vax alarmists would have you believe.

      First, the transcription was, as the headline clearly says in vitro.

      Second, was done in a cancer cell line, as in not normal cells

      Third and most important, the section transcribed was “junk” DNA, as in genetic code that normally does not do anything.

       
      1. SEMarch 5, 2022 at 12:07 pm

         I think does not normally do anything is an overstatement of the inactivity of Junk DNA. That is what people said 20 years ago. Less so now. Line 1 elements (the ‘junk’ in question) are biologically active, and a part of multiple disease etiologies. Some examples:

         https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7426637/

         https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4124830/

         https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7426637/

         The in vitro transcription is merely evidence that this needs to be looked into in vivo, which did not happen as a part of the vax safety testing and should have.

          
         1. Yves SmithMarch 5, 2022 at 9:08 pm

            Biomedical prof KLG and scientist GM do not agree. First, from scientist GM via e-mail.

            The scientific community has a lot to answer for here unfortunately.

            “Junk DNA” has been hyped as something important for several reasons:

            1. Religious motivations, including by a lot of scientists themselves. Because if 90% of the genome is junk, then why did God make it that way? Can’t be, it must be that the genome is 100% functional.

            2. Non-religious anthropocentric bias. We are humans, the most advanced and perfect creatures on Earth, it cannot be that the genome is in such a degenerate state

            3. Pure selfish greed. If the whole genome is functional, then we can ask for a lot of money to study it.

            The reality is that genome is indeed 90% junk, and that anyone who thinks otherwise is deeply ignorant of basic evolutionary theory. Unfortunately that does include a lot of big name scientists, because the training system they have passed through sees no utility in teaching them such basic things, so they are not taught any of that, and then you have big shot PIs having published hundreds of papers and raked in tens of millions of dollars who have never heard about the relationship between effective population size and the power of natural selection to purge mildly deleterious variation. If the selective coefficient is smaller than ~1/N_e, then that allele becomes effectively neutral. This is precisely the case with transposable element expansions in large-bodied organisms (such as mammals), so they don’t get purged even though they are deleterious. The result is that the genome has become bloated with junk DNA over time, and not just that, that is only a part of a long list of degenerate features. Because effective population size for mammals in between 10^4 and 10^5, and for humans in particular it is on the very low end of that range. So we are some of the most genomically degenerate creatures on the planet, even without the effects of advanced technological civilization on relaxing natural selection even further (however, that will last only very briefly on an evolutionary time scale because technological civilization is doomed to self-destruction).

            And KLG:

            Yes, LINE-1 activation is associated with disease, and these transposons that make up a large fraction of the human genome can be activated in transformed cells (cancer) and perhaps in cells/organisms poisoned by xenobiotics. Yes, also to “junk DNA” sometimes, maybe oftentimes, being DNA for which a function has not been found. Long non-coding RNAs, for example, are important in heart and other developmental pathways. This was a surprise to many, who though RNA was not stable enough for this activity. What most molecular biologists, who should know better, is that the secondary and tertiary structure of RNAs in vivo can protect the molecule from degradation by RNases. Those of us who have purified mRNA are very skittish. But in my long experience purifying RNA from all kinds of cells, most of those who have problems with RNA stability have lousy technique. And poor hands.

            The recent paper by Markus Alden et al. on reverse transcription of spike mRNA in Huh7 cells, which are identified as “human liver cells,” is not particularly credible even though the materials and methods and execution seem sound. Huh7 cells were initially grown from a liver tumor 40+ years ago in Japan IIRC and have been used now and again as experimental models. But, immortal, transformed human cell lines are not good models for the study of human disease at the cellular level (but they can be very useful in the study of cell structure, adhesion, and motility). This is one (good) reason that the National Cancer Institute has instituted a very high bar for approval of studies using such cells. This was not true 20 years ago, and a lot of work that is not relevant to cancer etiology and progression was funded. This is not to say that current NCI funding prerogatives are correct or particularly wise, though. These transformed cells are often severely aneuploid and otherwise deranged, as they accumulate mutations during passage and propagation in culture. One often wonders if they could even grow in the organism. Different derivatives of HeLa cells (a long and fraught topic for another time) respond completely differently regarding LINE-1 activation. Some isolates show very active transposition and some are virtually inactive. They are the same cells though when analyzed by their source, American Type Culture Collection, ATCC #CCL-2 IIRC. LINE-1 seems to be mobilized in Huh7 cells, and that certainly accounts for the apparent reverse transcription and insertion of spike coding DNA into the genome of these cells. But this work is also made possible by the sensitivity of PCR. It can pick up events that occur at a vanishingly small frequency.

            Moreover, in the Abstract of the Alden et al. paper the first sentence notes “Preclinical studies of COVID-19 mRNA vaccine BNT162b2, developed by Pfizer and BioNTech, showed reversible hepatic effects in animals that received the BNT162b2 injection (thanks to a colleague for noticing this).” Perhaps. But the jump from that statement to demonstrating spike protein coding sequence in the genomic DNA of Huh7 cells says absolutely nothing about “hepatic effects” in animals. This may indicate motivation on the part of the authors, as does their chosen journal (also a different topic for another time). An effect on severely deranged liver cells that were isolated from a liver tumor a long time ago an have since evolved into something else, perhaps. But so what?

            There are many and manifold reasons to suspect these vaccines, which really are not vaccines as understood by virtually all of us. But rare events in deranged cancer cells that have been passaged in vitro through hundreds, maybe thousands, of generations is not one of them. Moreover, very rare events happen constantly in dividing somatic cells. The vast majority are inconsequential.

             
   2. Robert E Most, MDMarch 3, 2022 at 11:20 am

      Yves has this about right. There is NO indication that biologically active DNA is transcribed in these cells, and yes the fact that Huh7 is a cancer line (something like HeLa) makes the headline results nearly meaningless.

      What does matter is that LINE-1 is increased. LINE-1 is part of the regulatory network and is increased in several specific cancers. (colorectal being #1) But again, these are cancer cells; they clearly do respond to the mRNA with increased LINE-1, but how abnormal are they in this regard? I am pretty sure that we are seeing vax-associated increased cancers due to suppression of p53 which is a ubiquitous reguatory protein. I have not seen anything on LINE-1. So don’t worry about this, at least not yet. The greater threat based on current knowledge, is probably sub-clinical myocarditis.

       
      1. Joseph DeSimoneMarch 3, 2022 at 1:40 pm

         It appears that everyone doesn’t with the CDC regarding DNA safety. See: https://americasfrontlinedoctors.org/news/post/how-worried-should-the-vaccinated-be-new-study-shows-vaccine-converts-to-dna/

          
         1. Robert E Most, MDMarch 3, 2022 at 3:01 pm

            This is a secondary reference. Peter McCullough, MD, whom I greatly respect, was very worked up when this issue broadly came out months ago. (I’m not gonna search for the paper. ) He and MIT prof Stephanie Seneff wrote about this earlier. Seneff is also worth our attention (glyphosate expert) I’m not saying it is not possible; just saying they don’t have evidence and their bias is to get worked up over this. Also, general note: AFLD does good work but they are not good with statistics. (Bayesian analysis eludes them.)

             
7. PKMKIIMarch 3, 2022 at 9:56 am

   Question is, is this a sign that the vaccine has an extreme outlier number of side effects (rates aside) for a vaccine? Or is this a sign that the study did a sloppy job of controlling for variables and existent conditions? The list is big, but it also seems bizarre in the variety; like, even if you were designing a drug to create side effects it’d be impressive to get a list this long.

    
   1. Yves SmithMarch 3, 2022 at 10:03 am

      This wasn’t a study. It was a compilation of voluntary reports from all over the globe. I never reported my side effect, even though I regard it as pretty bad, and I suspect quite a few others didn’t either.

       
      1. chrisMarch 3, 2022 at 1:05 pm

         We didn’t report my two daughters’ menstrual issues post vaccine either. My poor younger daughter had just started her cycle 6 months prior and thought she knew what would happen. Post vax she had extreme bleeding – as in times when no amount of pads could help her. My oldest had the opposite. Almost complete cessation. Both were scared. Gynecologist told us they’re OK but they definitely experienced the kind of side effects that the media has decided cannot happen.

          
   2. Robert E Most, MDMarch 3, 2022 at 12:10 pm

      I think they list a huge number of possibilities along with real concerns. You will be worn out before you get to Guillame-Barre Syndrome. I believe that this is deliberate obfuscation.

      Many of us knew in advance that a multiplicity of effects were possible (and I’m an amateur). James Lyons-Weiler in particular warned of many immunogenic epitopes on the spike protein. Some of this appears to be the result of an attempt to design a Live Attenuated Vaccine, so an accidnetal leak of Tony Fauci’s hubris is a leading hypothesis.

       
   3. LexMarch 3, 2022 at 12:29 pm

      Beginning in November, following first our annual flu vaccines and then Covid Boosters… in my husband the side effect looked like a sudden attack of some systemic arthritis. All of his joints hurt; he was diagnosed with “frozen shoulder” and treated first by his doctor and then a PT. He lost the strength in his hands he’s just now recovering. He’s 63.

      For me (64) it was cellulitis (Nov 3) that the combination of Keflex and Bactrim didn’t slow down in the least. It was only defeated by three days of prednisone. A month later (Dec 8) I woke up in the the night to a dull pain in my lower right abdomen. I tried to address it through the night but in the morning gave up and walked into the emergency room (which was btw completely empty at 6 a.m.). Diagnosis: appendicitis. And a fewer hours later I was wheeled in for an appendectomy. No further episodes for either of us; the recovery has been slow though. It took us a few months to look at what had happened to both us and the timing. Who got their shots when and what happened next.

      If these unfortunate incidents had occurred to just one or the other, we would have passed it off as a run of bad luck but it was just too coincidental. I think the virus (even when delivered in minute amounts via syringe) exploits the holes in our individual immune systems. The list of side effects (cut and pasted in) acknowledges the sheer breadth of those immunological weaknesses across humanity.

      We’ve been shoring up our immune systems ever since.

       
      1. Kris AlmanMarch 3, 2022 at 4:11 pm

         Last year I developed a frozen shoulder (aka adhesive capsulitis), subsequent to the 2nd jab of the shingles vaccine. It took ~8 months to resolve with aggressive PT–though it was too painful to do much PT in the first couple of months.

         Relating my symptoms to two of my friends, I heard of two more cases of frozen shoulder after the Pfizer vaccine.

         Turns out frozen shoulder has been reported after pneumococcal and influenza vaccines. It’s been blamed on the administration of the vaccine, but I know that wasn’t the case for me.

         In a case report of bilateral adhesive capsulitis after the influenza vaccines, the authors postulated that cytokines may be involved in the pathogenesis and it is most likely that a systemic immune response.
         https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3072

          
         1. Antagonist MusclesMarch 4, 2022 at 12:30 am

            Although I had shoulder pain and range of motion problems prior to the Pfizer vaccine, that pain was slightly worse after the shot. Is it a coincidence that pain in my right shoulder exacerbated several days after the first jab, which was administered in my right deltoid, whose responsibility is raising my arm? It is certainly conceivable that a shot in the deltoid caused local inflammation, which then incapacitates the muscle. I should note that I tend to sleep on my right side. The good news is my shoulder is pain free now.

            The length of the adverse events on page 30 of the linked document was laughably long. I thought about “Alphabet Aerobics”, the alphabetical rap song by Blackalicious.

            Yves states in the post that adverse events are undercounted. Here is my additional anecdotal side effect. I also had a flare up of eczema on my back one week after the first jab. I have had eccema before but never on my back.

             
8. fresno danMarch 3, 2022 at 10:11 am

   My own bete noire is adverse event reporting in the US. Sometimes the forest is missed for all the trees.
   Adverse event reporting post marketing is voluntary
   Although FDA valiantly (/sarc) tries to justify volunteer adverse event reporting, it simply is absurd.

   https://www.fda.gov/drugs/surveillance/questions-and-answers-fdas-adverse-event-reporting-system-faers#:~:text=FDA%20receives%20voluntary%20reports%20directly,report%20to%20the%20products'%20manufacturers.
   Healthcare professionals, consumers, and manufacturers submit reports to FAERS. FDA receives voluntary reports directly from healthcare professionals (such as physicians, pharmacists, nurses and others) and consumers (such as patients, family members, lawyers and others). Healthcare professionals and consumers may also report to the products’ manufacturers

    
9. GumnutMarch 3, 2022 at 10:12 am

   The closest image I have heard for the situation around this is ‘it’s like one of those [alien/zombie] movies, where they have infiltrated the population, the protagonists run to the authorities to warn, just to discover their eyelids are blinking vertically’.

   I follow closely what are moderation-passing sources here on NC & will abide by local customs – if Malone/Kirsch et.al. are to screechy/ “over their skis”, then please have a peruse of Jessica Rose’s (was in links for ivm study a few days back) or Igor Chudov’s substacks.

   German health insurer exec getting fired over reporting considerably higher adverse event numbers in his 11million insurees (over 10% of the German population = decent sample size one would think) than the public Paul Ehrlich Institut (PEI) numbers is like a brazen Orwell memory hole operation in plain sight. He gets fired within days. At the Bundespresskonferenz, the government spokesperson makes clear he is fully aware of the open letter (from BKK exec to the PEI, had been in Welt newspaper, not biggest, but major paper), but (one must assume deliberately) says the absolute numbers are “mostly people feeling a bit off and being written off sick for a few days”, while the letter is explicit in that it counts explicitly only vax adverse side effect diagnosis codes (in German health system all diagnoses have an alpha-numerical code & there are explicit vax side effect codes), not being written off sick (that is clearly not a diagnosis). Then a few days of Ukraine media distraction and then today the hit-piece on tagesschau.de that the exec is an anti-vax looney (Querdenker), nothing to see here. Never met the guy or seen an interview, but an insurance exec from one of Germany’s biggest health insurerers (prime PMC) speaking out, knowing that this is a likely career-ending move. I don’t know, working hypothesis is alien-movie * 1984. The gods help us.

    
10. Laura in So CalMarch 3, 2022 at 10:39 am

    I have 3 people in my immediate circle (all vaccinated and 2 boosted) who have significantly worsening health issues or new potentially serious health problems. My sister has a long standing auto immune disease that has flared significantly in the last 6 months. She developed a new problem with chronic anemia and is having to get iron infusions. This might be related to the vaccines or not. My best friend started having nosebleeds a week after her booster. After a month of this, she had blood tests done and her white blood cell counts are elevated. She beat leukemia 25 years ago with a bone marrow transplant and now we are worried that it has come back. More tests are coming. My father is having issues swallowing and had tests scheduled to image a mass or obstruction near his trachea/esophogas. I fear issue with his lymphatic system. Maybe cancer. He is 80 but was in excellent health. Both my best friend and my father had covid at some point as well as the vaccines so that muddies the water.

    I’m frightened and sad. I anticipate spending a lot more time in the future helping those close to me deal with their health problems.

     
    1. floraMarch 3, 2022 at 12:40 pm

       Similar stories in my circle of friends. Fit people, walkers, gardeners, but older, so one could say its only coincidence’. Problems began within a month of taking the second dose. Their docs are adamant it isn’t vox related. At this point I ask myself how their docs can be sure it isn’t related?

        
       1. JBird4049March 3, 2022 at 10:04 pm

          They can’t and neither can you, but all the lying and non-thinking with bonus massive corruption makes it very hard to believe that the vaccines and/or Covid are not responsible. Individually, it easily could be something else, but…. It is stuff like this that makes the antivaxxers believable, and next time when there is an effective vaccine for another lethal disease, could anyone be blamed for not taking it? That will get people killed. The stupidity, greed, and near-sightedness is just awesome to see.

           
11. ChristopherJMarch 3, 2022 at 10:54 am

    Thanks Yves for sticking to the knitting. If these vaccines have been harming people, I have not participated in the experiment, then the cat is well and truly out of the bag. This links with the Edward Dowd’s revelations of fraud by the vaccine companies and much higher all cause deaths than they had been anticipating. There is no way the insurance companies are going to cop bigger than expected pay-outs if the deaths are linked to these vaccines.

    Cannot be covered up. U

     
12. Robert E Most, MDMarch 3, 2022 at 10:58 am

    I’m a clinician with about 5 years on the research review committee of large health system, did a small bit of research during medical school, based in part upon research-tech training in immunohistochemistry and such – not average for an MD to start as I come from a science family. So I was early to the lab-leak hypothesis (99% proven now; you can ignore the NYT please) and early to analysis of the mRNA transfections as potentially very harmful. I am not surprised by any of this though the 3% mortality figure still seems high to me versus clinical observation and chatting with hospitalists and nurses (nurses often better observers and more ethical than docs). I did psychiatric consults to an ICU before losing my job as the hospital went to a vaccine mandate. (I’m a past reader of Naked Cap, MMT-informed, but too preoccupied teachng myself virology-immunology to keep up the past two years. I feel remiss in not contributing here in more ways than one.)

    A few comments and references:
    The lack of information about the underlying population –
    we do know that the test population was enriched for healthier people. It is low in subjects with diabetes, HTN and obesity. We also know that people who had adverse events after the first jab were osmetimes dropped from the study, and that serious events were sometimes mislabeled.

    IM Doc: “in normal times, this would be in the Phase IV period. I have no idea how this is done for an EUA.”
    The control group was destroyed by the Pharma Cos., by vaccinating them. All we have left is the unvaccinated population. WE are probably in better general health to start with, so there is that limitation to what will be seen in the next few years, but we will begin to stand out for lower mortality, cancer and cardiovascular deaths and lower autoimmune diseases. This is already being seen in insurance data and reports are suppressed. Some of the intermediate term “vaccine” effects are buried within the massive increase of deaths in working age Americans. All the Sudden Adult Death Syndrome, footballer deaths and student athlete deaths that get reported (locally; suppressed nationally) are just the visible tip.
    On insurance data, see: https://roundingtheearth.substack.com/p/vaccine-induced-mortality-part-9?utm_source=substack&utm_campaign=post_embed&utm_medium=email&s=r
    I have not read it myself but I am familiar with the data and it is an excellent blog.

    We are also seeing that effects of immune compromise (certainly Original Antigenic Sin and probably some percentage of Antibody Dependent Enhancement, probably some immune suppression-CD8 cells especially – due to toxicity of the spike protein) are resulting in NEGATIVE efficacy in Scotland and Israel, where they did keep better statistics. Both countries are now obscuring the figures.
    We have thus far not seen the progression to severe disease as happened in Marek’s Disease. I think we got lucky with Omicron, but that is a complicated story. The vax-transfections have clearly pushed evolution of variants and almost certainly have prolonged the pandemic – another long discussion.

    One check on VAERS under-reporting is the leaked CMS data reported by Attorney Thomas Renn. Deaths are probably 2.5 – 3 x the events reported through VAERS, which is deliberately designed as a bottleneck. (“Anybody can report” – No! it takes months for even something as obvious as Guillame-Barre Syndrome to make it through the gauntlet of reviewers.) Renn is also working with DOD figures that credibly show 10x the baseline rate of neurological events. I say credible as a 24 year-member of the Am. NeuroPsychiatric Assoc, and direct clinical experience of how neurologists under-report. Because MDs are afraid to “increase vaccine hesitancy” they do not report – sometimes for reasons as case histories can be complicated – so we do not know the variance from baseline for something like Bell’s Palsy. Doctor Porn like “MedPage Today” works hard at “debunking” suggestions that events are causally connected (spare me the “Correlation does not equal …” crap!)

    A lot of doctors have been pretty nearly brainwashed and at this point their awakening from this nightmare may have less to do the size of Med School loans and mortgages than the impossible guilt over having been duped into harming patients (Meanwhile Janice Woodcock of the FDA opiate mafia has been made 2nd in command of the whole agency. You will find more truth in season 4 of Goliath than in all the NYT reporting of the last 2 years).

    I cannot begin to tell you all the cheap-tricks-dumbed-down-immunology sold by Anthony Fauci over the last 30+ years. Doctors believe that crapification, and it has been pushed on the public by nearly all media.

    IM Doc: “In general, this list in most documents like this I have ever seen is 2-3 maybe 4 pages long – NOT 10.”
    I suspect that the list includes low probability events and possibilities in part as obfuscation.

    These mRNA products should not be called vaccines. The 20+ year old term for this procedure is transfection.
    Start saying it:
    “mRNA transfection procedure” or “Vax-transfection”
    Stop using the changed definition from the propaganda arms of the Big Pharm Octopus.

    Finally, we have all been woefully miseducated. The twitter link here leads to a broadly and deeply educated neurobiologist who is self-educated in immunology and able to represent and critique the views of top world viro-immunologists like Wolfgang Wodard, and Geert Vanden Bossche, DNA/RNA experts and manufacturing process knowledgeable. He has been broadly correct from the beginning, unlike all the compromised “experts”, some of whom some of you follow. You can easily find links to Gigahom Biology on Twitch TV and to his own website.
    SAR-CoV2 is not the last “leak” from a lab; Gates and Fauci have virtually promised us that. Better to get educated now: https://twitter.com/jjcouey/status/1499376101403111427

     
    1. TinkyMarch 3, 2022 at 12:20 pm

       Thank you for your perspective, Doc, and thanks for helping to legitimize my very first “alternative” source on the topic of COVID, Jonathan Couey, aka J.C. on a Bike (on Youtube). During the early months of the pandemic, I had a number of posts linking to him removed, on various sites, because he dared to challenge the mainstream Zoonotic origin narrative.

        
       1. Robert E Most, MDMarch 3, 2022 at 1:17 pm

          Seeing your comment alone makes the effort worthwhile. When I read “Proximal Origins” by that group of virology-liars (since self-debunked along with Fauci thanks to FOIA’d emails) I had read the Ralph Baric Menachery-Zengli Li Shi 2015 paper https://pubmed.ncbi.nlm.nih.gov/26552008/ about 5 times. (Describes their creation of a chimeric CoV).
          “Proximal Origins” was so immediately obviously bad science, so clearly a cover-up, that I felt a bit crazy. Cover-up? But yeah, NIH and NIAID intellectual property is behind all this; how exactly we cannot know. The structure of the spike protein, the RaTG13 oddities … so I felt relieved when J.C. took apart the paper. Chris Martenson saw almost exactly the same thing at the same time.
          I have also fought for HCQ and against Remdesivir in my own hospital, where maybe half the staff is followers, but most docs looked at me like I have two heads. My previous supervisees (MDs) think of me as “retired” OK!
          Healthier for me to be out of the corporate environment. In my own place soon, I’ll be able to host video conference seminars with “JC on a bike”. Tonight, he teaches network neurobiology – almost heaven for me!

           
13. TuttiMarch 3, 2022 at 10:59 am

    Contrary to the safety norms we were used to, commercial press had a single and impossible to overcome “true” on the safety of a new vaccine never proved before.

    We have seen this before. And it is repeating again in Ukraine.

    I never reported my effects. There was/is not a service/platform to do that. I consulted two doctors and they aggressively dismissed any relation with the vaccine.

     
14. ScrewballMarch 3, 2022 at 11:37 am

    Maybe it’s just me, but between the opioid epidemic with the pill mills, to this, I don’t think big pharma gives one good $hit if they maim and kill people as long as they make money. Neither do the politicians nor the BS artists of the media.

    And we still have people who think the jabs are perfectly safe, should be mandatory, and if you get the shots you will be safe from getting the virus.

    Orwell would be proud.

     
    1. Arizona SlimMarch 3, 2022 at 2:15 pm

       Sotto voce: Screwball, I agree with you.

       And this NC post is yet another reason why I have chosen to remain in the control group. I don’t think that these jabs are safe or effective.

        
       1. ScrewballMarch 3, 2022 at 3:35 pm

          We are in the same group Arizona Slim. I do all I can with what I have. I did read the other day (somewhere, maybe on Twitter) that someone who buys the drug that cannot be named ordered some more (I need to do the same) and it was held up in customs. That could be a problem.

          I have also read the post office was refusing to deliver if they knew what it was. I know my mailman pretty well so I point blank asked him. He said he was not aware of any order to not deliver. That is good news.

          I have to wonder as well, how long ago would this news we are reading about here be front and center to the public? From my perspective, any and all “non-good” news about the vaccines hasn’t been covered, or you had to really look hard to find it.

          That just isn’t right. We have a right to know. Even if it’s people who won’t believe it anyway (and I think there are such people).

           
15. MoonbeamMarch 3, 2022 at 11:48 am

    The most telling perspective RE: Table-7 (Pfizer footer pages 15-25) :: “Conclusion: This cumulative case review does not raise any new safety issues.”

     
16. Tvc15March 3, 2022 at 12:22 pm

    Yves mentioned, Reuters commentary not particularly helpful. “Reuters Chairman Is Pfizer Investor and Board Member”. I’m sure nothing to see here.

    https://www.pfizer.com/people/leadership/board-of-directors/james_smith

     
17. floraMarch 3, 2022 at 12:41 pm

    Thanks for this post.

     
18. Senator-ElectMarch 3, 2022 at 12:50 pm

    Readers may be interested in this Twitter thread.

     
19. Michael McKMarch 3, 2022 at 1:49 pm

    Thank you.
    A few months ago I checked out VAERS. It is not too hard to navigate and I found that there were 8490 deaths reported for 2021 associated with the COVID vaccines and only 1880 deaths reported for all other vaccines from 1990 through 2018 combined. A dismissive doctor on a radio show who did not allow followup questions claimed 25% of Covid VAERS reports came from outside of the USA as if 6350-odd deaths vs 1880 is that much less alarming.
    That the anomalous signal can be so strong yet the system rolls blindly along with the bulk of the population seemingly A-OK with things as they are speaks volumes to our apathy regarding our war mongering and our (unrecognizable to Adam Smith) form of “Free Market Capitalism”.

     
20. ItsAllThereMarch 3, 2022 at 2:02 pm

    Dr. Fauci’s first approach was to abort the three-year clinical trials at six months and then vaccinate the controls —a preemption that would prevent detection of long-term injuries, including pathogenic priming. Regulators initially intended the Pfizer vaccine trial to continue for three full years, until May 2, 2023. (14)
    Because the FDA allowed Pfizer to unblind and terminate its study after six months—and to offer the vaccine to individuals in the placebo group—we will never know whether vaccinated individuals in the trial suffered long- term injuries, including pathogenic priming, that cancelled out short-term benefits. Science and experience tell us that many vaccines can cause injuries like cancers, autoimmune diseases, allergies, fertility problems, and neurological illnesses with long-term diagnostic horizons or long incubation periods. A six- month study will hide these harms.

    14 ClinicalTrials.gov, “Study to Describe the Safety, Tolerability, Immunogenicity, and Efficacy of RNA Vaccine Candidates Against COVID-
    19 in Healthy Individuals,” (April 30, 2020), https://clinicaltrials.gov/ct2/sho w/NCT04368728?term=NCT04368728&draw=2&rank=1

     
21. MajiaMarch 3, 2022 at 4:37 pm

    I suffered a serious systemic allergic reaction to Moderna and my spouse has suffered just about every vascular “side effect” that exists from this “vaccine,” all of which have been documented by specialists as vaccine injuries. A year later the medical bills caused by the vaccine continue to accumulate.

    Although our lot number has been linked with a very high adverse events rate, I suspect the reason we had such severe reactions was also compounded by our early exposure to the virus.

    I am absolutely convinced that every exposure to the spike protein increases likelihood of these severe reactions. Individual vulnerabilities are varied as are reactions, complicating population level analysis but the empirical evidence is growing to support this hypothesis. Yet, I see that Biden proposes to purchase 3 additional “vaccines” per US citizen (as reported in WSJ).

    As a social theorists of liberalism, I was and remain shocked by citizens’ willingness to give up their bodies to a pharmaceutical-biotech complex that does not have a history of transparency and has had severe and recent proven ethical lapses.

    But then again, how many of us voluntarily received the vaccine that was made mandatory for our employment?

    As a student and teacher of crisis communications, I would regard pandemic crisis communications as ethically impaired and anti-democratic as censorship and stigmatization of dissent were deployed in the vastest, most well-orchestrated display of propaganda humanity has ever witnessed.

    The country is divided so to avert civil war another spectacle will be devised to keep the emotional economies charged but fractured.

    However, I believe we aren’t done with the spike protein and that we also aren’t done with the techno-fascism elements seeking to exploit it.

    The challenge is preserving happiness, democracy, and human rights – especially rights over one’s own body and its mobilities – in an increasingly inhospitable and walled-world.

     
    1. Robert E Most, MDMarch 3, 2022 at 10:13 pm

       Although our lot number has been linked with a very high adverse events rate:
       Are you in the NorthEast? higher spike fidelity in manfacturing in that area; “broken bioweapon is safer” per one Pfizer insider, Sasha Latypova.

       I suspect the reason we had such severe reactions was also compounded by our early exposure to the virus.
       Absolutely! 2-4 times higher rate of signif adverse events if vax tops off natural immunity.
       The cumulative effects show up as reduced immune response to the N protein of CoV2 after third jab per UK NHS data.
       Inflammatory effects are likely to be cumulative – but most of us think you can clear spike over time

        
       1. MajiaMarch 4, 2022 at 10:32 am

          We are in the southwest. Here is our Moderna Lot # Lot 030B21A

          The question of the duration of these mutagenic spike proteins is indeed very salient.

           
22. lordkoosMarch 3, 2022 at 6:03 pm

    I wonder if the reason there are more women reporting (apart from the sex-specific reproductive issues) is that women in general may be more sensitive and in touch with their bodies than men. It could be likely that men try to “power through” their symptoms and not report them unless they become very serious.

     
23. DGMarch 3, 2022 at 6:06 pm

    So Pfizer released more documents

    The document discussed here is the post marketing experience

    Lots of documents

    https://www.icandecide.org/pfizer/

     
24. NSA_ID #1734519XZ2March 4, 2022 at 12:48 am

    After my second dose of Pfizer, within 10 days I developed enthesitis in my knee (patellar tendon). Went from being a very good runner and triathlete, to not being able to run at all. It doesn’t heal, and flares up with even moderate exercise. I was suspicious that it was a vaccine injury, perhaps related to psoriatic arthritis, then subsequently saw a study about enthesitis as a Covid side-effect. So pretty sure they are related.

    After my booster I also got tachycardia, and had elevated d-dimer and had to see a cardiologist.

    None of this is documented. And I know several other people with significant unreported side effects.

    Criminal fraud. I want to see some folks in jail. But I’m not holding my breath. (And yes I was very aware during the financial crisis and it’s aftermath.)

     
    1. IkeMarch 9, 2022 at 10:10 pm

       People are played russian roulettes with their bodies and health. Pulling the trigger with each injection of the booster they allow into their body.

        
25. WillemMarch 4, 2022 at 6:23 am

    Father of a friend died about a month ago. Fully vaccinated I believe (the whole family) a few months after this he has a mild stroke. Daughter drives him to the hospital where has seizures and a heart attack during a four hour wait before they move him to the IC and he’s put in a coma for the next 50 days. Wakes up with a lot of damage … A few days later his daughter gets the call that he died. Cause: herpes infection in the brain. I just knew that vaccination had something to do with it. Sure enough quite a lot of case reports post vaccination. This was weeks ago. Yesterday I saw these pages. My eye caught a few dozen mentions of herpes … encephelatis …. anyway. He was a kind man. They lost him and they don’t have any clue as to why. I have quite a few of those anecdotes. Look up theysayitsrare on instagram.

     
26. Yves SmithMarch 4, 2022 at 8:57 am

    You are ignoring that IM Doc has seen precisely this sort of report from 15 years of being on the board of an IRB, which oversees drug trials. He’s never seen anything like this.

Many days later...

MikelMarch 17, 2022 at 8:24 am

“Some hospitals ask patients, visitors to remove N95s, citing CDC”

They’ve lost their minds. Hospitals and clinics are exactly where the people with co-morbidities go.
What the hell???

So hospitals and climics become ground zero for the spread of disease.
This is a whole new level of psychotic.

All I can ask now is who do they think they are killing? And why does it make them feel so good?
HOSPITALS? NO MASKS? And waves of covid sick people still showing up at…Hospitals.

 

1. IM DocMarch 17, 2022 at 9:22 am

   There are days when I see all this going on around me that I just want to assume the fetal position.

   There are extreme consequences to turning over your health care system to MBAs. They care far more about good satisfaction surveys than patient outcomes. I am most definitely not kidding, this is not snark.

antidlcMarch 17, 2022 at 3:51 pm

Also, from my post in today’s LINKS:

So Jha is the new covid response guy.

Check this out:
CDC announces the new mask guidelines on Feb. 25:
https://www.cnbc.com/2022/02/25/cdc-relaxes-mask-guidance-allowing-most-people-to-ditch-masks-if-hospitalizations-remain-low.html

On the SAME DAY, an opinion piece by Jha appears in the NY Times:
https://www.nytimes.com/2022/02/25/opinion/cdc-covid-guidelines.html
We’ve Entered a New Phase of the Pandemic. It’s Time for New Metrics.

If the opinion piece appeared on Feb. 25, then Jha would have submitted it prior to Feb. 25, the date of publication. So…he knew about the guidelines ahead of time, right?

(h/t to Justin Feldman)
https://twitter.com/jfeldman_epi/status/1497425778287468548

Anyone find it weird that a public health dean wrote about these policies approvingly before they were even announced (given the publishing timeline) and then administration officials highlight it as evidence their own policies are supported by the scientific community?

 

1. IM DocMarch 17, 2022 at 7:24 pm

   You should have heard my conversation with another prominent public health dean today about this appointment.

   The frequent use of 4 letter words would have made George Carlin proud.

   There are many who for their own reasons are remaining silent in the public health community ( to their forever shame) who are very unhappy with the entire COVID situation and history. We will see how this all works out.

   As much as I have really thought Dr. Fauci and Dr. Walensky need to be cashiered after all the missteps and disasters, I have no doubt that it is very likely their replacements would be even more corrupt and problematic. Trust me, the well is deep.

   This move today just solidified my feelings in that regard.

NC quotes IM Doc on the same topic a day or two later:

And we are only going from bad to worse, with the downtrade to Brown’s Dr. Ashish K. Jha no doubt reflecting the official Administration posture that Covid is over. As IM Doc said by e-mail:

We have now replaced a lying corrupt Bond villain with a moronic cipher.

I cannot remember a single thing this man has been correct about.

And I will always remember the glee with which he pounced on the unvaxxed.

This is really bad news.

floraMarch 18, 2022 at 5:55 pm

Cholera? I remember back when the US had a public health department that aimed for Public Health.

an aside:

The Vindication of D.A. Henderson

“We should remember the man who called out this crazed ideology back in 2006. He is Donald A. Henderson, the world’s most important epidemiologist at the time. He had worked with the World Health Organization and is given primary credit for the eradication of smallpox. His book on the topic is a tour de force and a model of how a genuine public health official goes about his work. ”

https://brownstone.org/articles/the-vindication-of-d-h-henderson/

 

1. IM DocMarch 18, 2022 at 7:29 pm

   Flora,

   My father, a public health officer himself, was in the same generation as Dr. Henderson, and this piece took me back to many aspects of my childhood, listening to my father collaborate with genuine public health officials.

   My father has now gone on, just like Dr. Henderson. But I really wonder at times what those two and so many others would say right now. I can guarantee you they would not be very happy.

   Thank you for sharing this piece. The enclosed pdf at the end from 2006 is pretty much an encapsulation of what has been taught for generations regarding strategies in a respiratory viral pandemic. It is like the accumulated wisdom of centuries was just thrown out the window. And to our eternal shame, my profession just zipped their mouths as the few “heretics” out and around were burned at the stake. The day of reckoning will come soon enough.

   I have had the feeling since the beginning that no one with any knowledge, wisdom, or experience was in charge – or even in the conference room seated at the table. Our national response reminds me of young interns I have attended to in my life – all kinds of ideas to throw at the wall in a critical situation, but no ability to learn from mistakes. And absolutely no ability to change course suddenly when conditions change. And certainly no one in charge to exhibit wisdom and to be the calm in the storm.

   The most profoundly disturbing was the fact that anyone and everyone who just slightly deviated from the accepted narrative was tarnished, censored, bullied and threatened with their livelihood. WHETHER YOU AGREE WITH WHAT THEY ARE SAYING OR NOT, THE BEAUTY OF THIS COUNTRY IS WE ARE ALL FREE TO EXPRESS OUR OPINIONS. But that is not what happened. Painfully enough we have documentary evidence from Fauci and Collins of the plans to undermine anyone and everyone in their way. And God only knows what is in the redacted part. The word “redacted” alone is scary in this situation. That word should be used only in national security. Allowing redactions in public health is anathema to everything medicine should be standing for. The years that Fauci has been in charge will one day be remembered as some of the least edifying in my profession’s history – both now and during AIDS.

   And just like days past, in the fullness of time, these actions taken will be revealed, and instead of detestable heretics, many of these silenced people will be remembered as heroes.

   The invocation in the piece of Poe’s Masque of the Red Death was very sentimental for me – as this exact story was presented to me as a young medical student decades ago in Public Health 101 by an 82 year old professor. I will never forget his admonition in a very heavy German accent – “Always remember students, just like the prince in the castle, we think we can hide, but the contagion and more importantly the truth will always find us – and it will often find us right in the middle of our victory party.”

Lambert posted this
“Biden’s Supreme Court nominee Ketanji Brown Jackson refuses to define the word ‘woman’ because she’s ‘not a biologist’ as she is grilled on day two of her confirmation hearing” [Daily Mail]. “Quoting late Supreme Court judge Ruth Bader Ginsburg, Blackburn said: ‘Physical differences between men and women are enduring. The two sexes are not fungible. A community made up exclusively of one sex is different from a community composed of both.’ ‘Do you agree with Justice Ginsburg that there are physical differences between men and women that are enduring?’ the senator asked. When Jackson claimed she had never heard the quote, Blackburn asked directly: ‘Can you define the word ‘woman’?’ ‘Can I provide a definition?’ Jackson responded. ‘No, I can’t,’ she declared, before adding: ‘I’m not a biologist’. 

to which IM Doc replied:

IM DocMarch 23, 2022 at 2:55 pm

For whatever reason, patients are opening up about political items of concern to them more than they ever have before. I feel at times like I am sitting on the barometer of the nation’s current zeitgeist.

This morning has been particularly illuminating. It has to do with Lambert’s above link about the Supreme Court nominee not being willing to discuss what is the definition of a woman.

Please note, these comments are being made to me unsolicited – the last thing I want to do is talk about politics with my patients. But both of these comments were made to me this AM by patients in my bright blue corner of the USA.

#1 – A 24 year old Latino soy boy man-bun wearing Bernie Bro. – “Who are these people trying to kid? – That woman is either a liar – or she just does not care about the truth – Believe me, I know what a woman is…..”

#2 – A 74 year old white female – former college professor in the humanities…..”What do you think, doctor, I for one am a bit taken back and confused……they have been forcefeeding me and my colleagues in the University for years that biology has absolutely nothing to do with gender identity – and yet when directly confronted with this issue, she falls back on biology. I think many of these people have no idea what is real and just say things they think are going to make them feel good. It makes me mad. So many excellent faculty resigned or were fired at my institution for trying to argue these facts from a biologic perspective. If they had been kept around to teach, maybe people like this poor woman would not be so confused. I wonder what all the women’s lib leaders of my youth would think about this? What has become of my Democratic party that such nonsense would be front and center in their issues?”

I just let people talk. I think people need a safe outlet to talk these days for their mental health. But unfortunately, I have no answers myself. I have thought the same things.

Again, it is absolutely unprecedented in my life how many people want to have small talk in their visit about politics. It used to be kids, vacations, etc – now it is all politics all the time. What have we done to ourselves?

Related to this:

“Harvesting the Blood of America’s Poor: The Latest Stage of Capitalism” [Mint Press]. “Teenager blood is in high demand in, of all places, Silicon Valley, where anti-aging technologies are the latest trend. One company, Ambrosia, charges $8,000 per treatment to aging tech executives, infusing them with the blood of the young, turning these individuals into bloodsuckers in more ways than one. Despite the fact that there is no clinical evidence that the practice has any beneficial effects, business is booming. One committed customer is PayPal co-founder turned Trump surrogate Peter Thiel, who is reportedly spending vast sums of money on funding anti-aging startups. Thiel claims that we have been conned by “the ideology of the inevitability of the death of every individual” and believes that his own immortality may be just around the corner, a notion that has deeply concerned academics and commentators alike.” • From 2019, still germane.


IM Doc replied

IM DocMarch 24, 2022 at 2:49 pm

Harvesting the blood of America’s Poor – as linked above.

As wild as this sounds, I will attest to the fact that this is a very real phenomenon. I have one young athletic and healthy college student who is at a major coastal university. His entire tuition, lodging and food as well as a generous monthly stipend is provided by the billionaire. His only job is to show up every 2-3 weeks to remove a pint of blood. A pint of blood is then removed from the billionaire and the young jock’s blood is transfused. I do think the blood is appropriately tested on every transfusion as well – just as it would from the American Red Cross.

The young man is thrilled that his college is being covered this way – but is also concerned about long-term health issues for him. The whole situation is very sad….. And the issue is that this is not really a recognized process – so I am literally winging it with my monitoring of this patient.

There is not a shred of medical evidence I have found that shows this to be anti-aging at all. Furthermore, there is not really any medical guidance about the care of patients who are getting their blood removed like this over this long a term. Furthermore, there are many states that do not allow this type of thing to happen – and it may be a Medical Board issue for the responsible physician. Of course, in this instance, we are talking about California – which has in the past few decades become an “anything allowed – the crazier the better” state with regard to its biomedical ethics. But other states like Massachusetts and New York and New Jersey are not that far behind.

As I asked my ethics colleagues a few months back – Can anyone explain to me how this is any different than vampirism? Just as Bram Stoker satirized the mores of Victorian England with Dracula – there has got to be a clever writer/observer out there who could throw a haymaker with this practice.

What a commentary of a profoundly disturbed culture.

The moral decadence at times is just overwhelming.

My, my, my, how Yves's tone has changed since the early days:

1. Kathleen SkeelsMarch 28, 2022 at 12:03 pm

   I assume that China’s vaccine is not very effective and therefor they are having more trouble controlling Covid infections?

    
   1. Yves SmithMarch 28, 2022 at 6:11 pm

      Our vaccines do not control infections. You’ve clearly bought into official propaganda. They at most reduce the incidence of severe outcomes.

      And Omicron and BA.2 largely escape them. From IM Doc yesterday on what he is sure is a spike in BA.2 cases:

      17 patients in ER and on the phone so far. All vaccinated and 11 boosted. No unvaxxed. No J&J, though to be fair, that was only about 4% of our vaccines here. 7 of them reportedly had Omicron during the holidays. All are pissed. The vaccine failure displeasure is really beginning to shine. No admissions as of this afternoon.

      The obvious different issue – this appears somewhat worse than Nov-Jan Omicron and the GI symptoms are much more common. Lots of intractable diarrhea and vomiting.

      In the long run, that may greatly intensify admissions if that remains a problem. Dehydration and not eating always makes admissions more likely especially in the elderly and diabetics.

      I do not have a good feeling about this.

      Did you miss that Shanghai locked down mainly over asymptomatic cases, something we don’t even worry about in the West?

      As for the efficacy of China’s vaccines, we’ve made a point of trashing them in the press, when in fact their efficacy at the only thing we measured and publicized, efficacy v. hospitalization, is comparable to the Astra Zeneca two shot regime. China also publicized its data on how its vaccines performed v. preventing infections (IRC only a bit over 50%) and we rubbished them on that, when there’s no evidence ours do one iota better based on that metric.

This post is probably worth reading, though I won't post it here because IM Doc isn't particularly present (a comment follows the link, though):

https://www.nakedcapitalism.com/2022/03/the-covid-data-is-making-me-queasy-and-cdc-changes-and-reform-proposals-arent-helping-me-any.html

IM DocMarch 28, 2022 at 3:55 pm

I used to share this quote with my students all the time – and I will share it now with everyone here – it is a very simple quote – but is absolutely true –

‘When a doctor does go wrong, he is the first of criminals. He has the nerve and he has the knowledge.’

Sherlock Holmes
The Adventure of the Speckled Band
Sir Arthur Conan Doyle
The Strand Magazine
February 1892

1. antildlcMarch 29, 2022 at 9:12 am

   985 US COVID deaths “tolerated” yesterday.
   https://coronavirus.jhu.edu/data/cumulative-cases

   #CDCFAIL

    
   1. anniemooseMarch 29, 2022 at 11:41 am

      antildlc
      March 29, 2022 at 9:12 am
      985 US COVID deaths “tolerated” yesterday.

      A considerable portion of the population rejects all measures concerning Covid 19. What are your suggestions to solve this problem.

       
      1. John BeechMarch 29, 2022 at 2:20 pm

         As usual, education.

         For example, 30-second television spots of;

         1. Lebron James talks about protecting his grandmother for why he got the jab. Ditto other big name athletes.

         2. Gwen Stefanni or any of many singers doing same, e.g. Blake Shelton, Rhianna, Puff Daddy, Snoop Dog, Madonna, Guns N Roses, etc.

         3. Any of many ministers about how being selfish puts others in the congregation at risk as they roll up their sleeve.

         4. Random woman taking the jab explaining her pal is battling breast cancer and she doesn’t want to put her at more risk.

         5. A few Joe 6-pack types talking about how good old Glenn was laid to rest when C19 ran rampant through their plant for why he’s getting the jab.

         6. POTUS stripping off his coat and rolling up his sleeve on national television for protecting staffers around him on why he’s getting the jab.

         7. Expectant mom taking it explaining why it’ll protect her unborn child.

         8. Older adult taking the jab and explaining they want to be able to hug their immuno-compromised granddaughter.

         . . . I can think of example after example all day long! Bottom line? We have the means to motivate folks to do this. We have just totally failed in the arena of leadership skills to move the needle vice the difference between ‘my rights’ versus responsibility to country and fellow citizens.

         How to pay for it? Auction off the sponsorship of these spots in exchange for a tiny logo in the lower right hand corner of the screen. They’ll line up around the block to pay for this.

          
         1. gepayMarch 29, 2022 at 4:01 pm

            How is getting vaccinated with a jab that doesn’t stop infection going to help anything? Even the CDC admits it is not effective at stopping transmission. Is my memory wrong in thinking it was promoted as being 95% effective as well as safe?

             
            1. ambritMarch 29, 2022 at 10:26 pm

               I have taken to refering to this sort of behaviour as “Kabuki Medicine.”
               As with bureaucracies the world over, being seen to be “doing something” is just as important as actually being effective at the task.
               As good old Shakespeare said: “The Play’s the thing.”

                
         2. IM DocMarch 29, 2022 at 4:23 pm

            And what do I tell all my patients and their families who have been vaccinated – and/or boosted – but have either died of COVID or who have quite severe complications…..
            The number of them is way more than trivial.

            What do I tell all their neighbors and fellow town members who come in and use them as examples as to why they should not be vaccinated?

            What do I tell the scores of current patients who are vaccinated/boosted – and they thought they were safe to go to parties, etc and still get infected and or hospitalized? I notice you conveniently do not say a word about non-pharmaceutical intervention in your reply.

            I am actually getting very frustrated with the whole thing. Thinking like you describe in your reply is actually quite dangerous in the environment of a vaccine only strategy and a non-sterilizing vaccine. And the other problem with your list of examples above is THAT IS EXACTLY WHAT WAS DONE FOR THE FIRST 6 MONTHS IN THIS VACCINATION DRIVE. My Facebook feed was filled with celebs and doctors and God knows who else taking the vaccine.

            Nothing like this happens with polio or measles vaccines because they are actually sterilizing.

            As I have said from the very very beginning – there are extreme consequences of putting a non-sterilizing vaccine out into the general population but selling it as 95% effective in PREVENTING infection. THAT IS STILL ON THE INFORMED CONSENT DOCUMENTS.

            The entire reputation of the health care system is at stake. And stupid human tricks as you list out above are just not going to persuade anyone at this late date when all have seen how completely ineffective this current group of vaccines is in ending transmission.

DelMarch 31, 2022 at 11:22 am

“Effect of Early Treatment with Ivermectin among Patients with Covid-19”
=
“We gave nutritious food to people with stage three cancer and it didn’t work!”

Ivermectin is a prophylactic, taken ahead of infection, along with vitamins and minerals.

Big Pharma will lie, cheat and steal lives to downplay inexpensive, out of patent drugs.
i.e. The Annals of Dermatology and Venereology reported that in a French nursing home, all 69 residents—average age 90—and 52 staff survived a COVID-19 outbreak.16,17 As it turns out, they had all taken ivermectin for a scabies infestation. COVID decimated the surrounding community, but only seven elder home residents and four staff were affected, and all had mild illness. None required oxygen or hospitalization. 17 C. Bernigaud et al., “Ivermectin benefit: from scabies to COVID-19, an example of serendipity,” Annals of Dermatology and Venereology (December, 2020), https://c19ivermectin.com/bernigaud.html

 

1. Basil PestoMarch 31, 2022 at 12:15 pm

   Ivermectin is a prophylactic

   Sorry but no, it has often been advocated by its devotees as a treatment post-diagnosis (within a short timeframe, similar to Paxlovid) over the past year as well as as a prophylactic. To that end, I believe many NC readers have been using it as such, and if I recall correctly, IM Doc has been monitoring its clinical performance in his own practice when used in this capacity, not when used as a prophylactic.

   There are no vitamins or minerals with proven efficacy as a prophylactic against C19. If anyone thinks, for example, that Vitamin D is a prophylactic against C19, this recent study would appear to cast serious doubt on that: https://www.medrxiv.org/content/10.1101/2022.03.22.22271707v1 . I take Vit D myself, in the hope (and it is merely a hope) that it will lead to improved outcomes in the event of SARS2 infection.

    
   1. JBird4049March 31, 2022 at 12:51 pm

      The problem shown here is the lack of trust that the medical community and Big Pharma have earned. Ivermectin might have a limited effect or be useless, but how can we trust what they say? The studies that they have done in the recent past seem to be flawed in someway or other. Then the constant screaming about horse paste, the gaucheness of taking it, or the horrors of Ivermectin without actually saying what the problem might be.

      It is almost like the story of the boy who cried wolf. If this new study is honest and does show the ineffectiveness of the drug, why would people trust it?

       
2. MaritimerMarch 31, 2022 at 4:43 pm

   That study specifically states:

   “Inclusion criteria were an age of 18 years or older; presentation to an outpatient care setting with an acute clinical condition consistent with Covid-19 within 7 days after symptom onset;”

   Dr. Peter McCullouch an expert Covid clinician had stressed over and over and over again that you must prevent and then, if infected, treat early, early, early. “7 days after symptom onset;” or even 2 days would send Dr. McCullouch ballistic. See FLCCC.

   And even now, in my humble jurisdiction where Dark Ages Medicine is practiced, the protocol for Covid is no prophylaxis. Then if you test positive, stay home until you get sick and then come to the hospital.

    
   1. TBellTMarch 31, 2022 at 6:18 pm

      If the drug has such strict protocols on when it is to be administered it’s practically worthless, because symptoms can be confused with other illness and many people downplay symptoms until positive test.

      Paxlovid is recommended within five days.

       
      1. trulyMarch 31, 2022 at 10:01 pm

         The Reis study talked about here shows that even when IV is used late it can cut mortality by 12%.
         Someone check my math but I think that would have been 120 lives saved yesterday alone. In the U.S.
         What a death cult this country has become that saving 120 lives isn’t worth considering.

          
   2. whatidontknowisalotMarch 31, 2022 at 9:49 pm

      I for one am looking forward to IM Doc analysis of this.
      You mention the 7 days part. But there were protocol changes too that raise eyebrows. One was that if vaccinated you were to be excluded. that was later dropped but we don’t get to see vaccination status…odd to say the least. The other was ; no use of Zinc. All IVM protocls use zinc.
      third was; widespread use of IVM in that community: also not really assessed.

       
   3. Yves SmithMarch 31, 2022 at 10:03 pm

      From IM Doc via e-mail:

      Thiis is the exact study that came out in preprint in the fall last year.

      It was literally laughed off the stage during its presentation – and these were ivermectin skeptics doing the laughing.

      I remember one comment in particular – “If they are going to put this down – they are going to have to do much better than this This is a joke.”

      There are 2 method problems – that are so overwhelming as to completely invalidate the study.

      Firstly – Ivermectin is widely available over the counter in Brazil where this study was conducted. Not only that, at the time of the study and continuing today, it is part of the infection pack provided by the government. So, ivermectin is being widely taken in the population. And yet, somehow, there was no effort to have any kind of exclusion criteria from the study for those already taking IVM. NONE. Therefore, it is very likely that large numbers of the “placebo” or control arm were literally on IVM as well during the study which would instantly negate any conclusions.

      The likelihood of this outcome brings me to point #2 – If you look at the tables – you can see there was a literal 40% drop out of subjects from the placebo arm. It goes completely unexplained in the study. As an IRB veteran – that is an instant red flag. It is very unlikely any such problematic issue as this would have allowed patient recruitment in any IRB I have ever been on. The investigators must discuss why they think this is happening……and the most likely reason is the study was not blinded properly – and the subjects knew they were on a placebo and went back on their IVM government pack or whatever. Again – it is not even bothered to be discussed. THIS IS WHAT THE ENTIRE REASON FOR PEER REVIEW IS THERE FOR.

      Again, this is so flawed – it was literally laughed out of the room by IVM skeptics last fall. To see it published in NEJM is just icing on the cake. It is yet another example of the profound influence of Big Pharma dollars on this entire profession.

      This is now all over the news as THE END for IVM. When it is such a flawed study that nothing can be assumed from the conclusions. I am literally ashamed of the members of my profession – they are asking no hard questions at all.

      It does not help that one of the sponsors of this study is the Bill & Melinda Gates Foundation. What incentive could they have to purposefully torpedo IVM? Which is basically what this is.

      This is Fauci’s tried and true handiwork – to purposefully engineer studies to make things look bad. He is also very good at purposefully engineering studies to make things look much better than they are – like REMDESEVIR.

      This is EVIDENCE BASED MEDICINE at work – just like Big Pharma wants it. And those of us who have worked in the ethical research organizations such as IRBs for decades are just shaking our heads this AM.

 I notice that the embedding of media (generally twitter posts) is spotty throughout this series - if you want to see what's being referred to, visit the Naked Capitalism site.

 First half of December 2021. IM Doc wasn't active on NC for nearly the first two weeks. When he popped up again, it was in a quote on the main post of the day, 12/11/21. This is also relatively short.

From IM Doc, keep in mind only a small sample…and remember his county has a very high vax rate:

27 [new] COVID cases – on top of the 21 that we had yesterday –

48 total…42 vaccinated – and of those 11 are boostered. 6 unvaccinated….

As far as mildness – 7 of these patients met the criteria for monoclonal antibodies because of the severity of their symptoms….

I am holding my breath about mildness. This will be the third big wave that we have had – OCT of last year – JUN-OCT of this year, and now. All 3 started with these large numbers of younger healthier people often in family clusters, etc. and took weeks to get going and really settle in. The hospitalizations and critical illness lagged behind the initial surge by weeks. This seems to be exactly the same pattern right now. These patients have all been large groups of family clusters. Many have been jetting around the world on holiday. The BIG difference now – many many more vaccinated are getting sick. Again – THIS IS NOT MILD. These people are getting severe flu like illness – just at this point only one has been admitted out of this group – so we are not admitting a lot.

Jason BoxmanDecember 11, 2021 at 11:41 am

The governors of Maine and New York deployed the National Guard in response to dangerously low capacity at statewide medical facilities due to the pandemic.

And because hospitals run to maximize profit don’t like spare capacity?

 

1. GFDecember 11, 2021 at 3:03 pm

   Don’t these National Guard nurses, doctors etc have day jobs as nurses, doctors etc? Are they being pulled from their current medical oriented job when called up? Who takes over their day jobs while they are away?

    
   1. IM DocDecember 11, 2021 at 4:01 pm

      Sssshhh –

      Don’t tell anyone – that is a secret – that no one is supposed to be allowed to ruminate over.

      But in all seriousness – the National Guard in my state has had a presence in the hospitals for a few months now. I am not sure we would be able to survive without them – the depletion of regular employees has become so devastating.

      An actual MD or DO is fairly unusual in their ranks. That is even true of RNs. The few of them that have medical training are basically field medics. That kind of experience is something we can dearly use in the hospitals right now. However, for the most part, the National Guard here are being used for all the other positions – orderlies, front desk people, patient transporters, meal delivery, etc. The ranks of those regular employees in the hospitals have been absolutely torpedoed and these troops have been a welcome relief. However, this is in no way a permanent fix. Most of these Guardsmen have only basic rudimentary medical training. They are very eager to learn and I have been doing all I can to help in that regard. And I am in no way criticizing them. They have saved us and our communities.

      But it is essential for our political leaders to understand – it takes at least 10 years to train an MD. It takes at least 4-6 years to train an RN. Even the more mundane jobs that the CNAs and orderlies and clerks do in the hospital are just simply not intuitively obvious. It takes training and patience to do even the most simple task – for example walking a demented little old lady down the hall.

      You cannot invent these folks out of thin air. When these employees have resigned in the past 6 months or so – literally decades of experience walked out the doors with them. And FIRING them is the absolute peak of imbecility. One of the hospitals I know well fired over 200 people in the past 2 months. I will simply say that the VP of risk management, who I know well, in that organization called me this week and will be submitting their resignation this coming week. They can no longer handle the stress. They are averaging many multiples a week above average of potential lawsuits because the care has gotten so tenuous.

      The thought that you can just stick used car dealers and accountants that are weekend warriors into these roles and have it be “OK” is simply ludicrous.

      I have no idea what is going to be the next phase of the plan once the pandemic is calming down. The hospitals and nursing homes are still going to be cratered.

      This is not just COVID. For decades, it was obvious that there were not near enough doctors and nurses being trained. And to make things worse – there was an extreme imbalance in the specialties chosen by the grads. The economic pressure of medical school has caused most med graduates to gravitate to things like DERM and ORTHO which we do not need and the primary care fields are just withering. Over the past 10-20 years, we have been stealing docs and nurses from other countries to do our primary care. But no one ever thought to ask what would happen if the ready supply of foreign help was no longer available. Now the big push is to have nurse practitioners fill in these roles – but LOL funny is the fact that the NPs are avoiding primary care like the plague as well.

      Just to understand the scope of the problem – our hospital has had 11 positions advertised in the local paper for the past 3 months. They had ONE application for ONE position this past week.

      We have a big problem. We will see what happens.
      
       

Here's a whole relevant NC post

Omicron Cases Serious in Denmark and Overall Morbidity Picture Not Pretty Either

Posted on December 14, 2021 by Yves Smith

Hank GeorgeDecember 14, 2021 at 7:08 pm

“Another concerning thing I am beginning to hear from my oncology friends is the absolute explosion of soft tissue cancers that are happening. This is especially true of malignant melanoma and renal cell carcinoma. One of my oncology colleagues noted to me the other day that he found it very troubling that these two in particular were going parabolic – the two soft tissue cancers whose etiology most have to do with a disordered immune system. Lymph tumors like lymphoma and myeloma are also apparently going off the charts as well.”

I am very suspicious of this statement. It strongly suggests it wasn’t written by a physician or for that matter anyone with even a nodding acquaintance with oncology.

Melanoma and kidney cancer are never referred to as “soft tissue cancers.” Neither are lymphomas or multiple myeloma.

Soft tissue malignancies are mainly sarcomas and primary bone/cartilage cancers. They have far lower incidence rates than the cancers mislabeled here as being of “soft tissue” origin

I spent 50 years as one of the country’s leading life insurance medical underwriters and I guarantee you no experienced underwriter with a degree in basket weaving would make such a dopey mistake as mislabeling melanoma, kidney cancer, lymphoma and multiple myeloma as soft-tissue malignancies.

The stench here is quite disconcerting, doubly so considering the importance of hyping up the latest COVID-19 variant like chicken little running around the barnyard trying to rake in billions more vaccine revenue!

 

1. DwightDecember 14, 2021 at 7:23 pm

   He didn’t describe lymph tumors as soft-tissue malignancies. And what about “subcutaneous metastasis of sarcomatoid renal cell carcinoma”? https://pubmed.ncbi.nlm.nih.gov/28675457/
   I have no expertise, just curious if your accusation is correct.

    
2. Yves SmithDecember 14, 2021 at 8:28 pm

   IM Doc has taught for years at a med school which has top tier national standing in his speciality, internal medicine, and been on an Institutional Review Board for over a decade, including as its chairman, for clinical trials. You are out of line in challenging him and even worse in accusing him of not being a doctor and us of not having vetted him.

   I hoisted his comment from e-mail, which on the one hand he knows is fair game within our Covid Brain Trust unless they’ve asked that it be treated as confidential, but on the other hand he did not write with publication in mind. His response:

   This is a classification scheme that has been ongoing change for years –

   When I was young – these were both referred to as soft tissue cancers – however, now they are referred to as solid tissue cancers.

   THat is my fault – and I should always endeavor to be much more accurate in my writing –

   The fact is that medical people would look at that statement and know exactly what I was talking about.

   Currently – SOFT TISSUE cancers – are muscle, ligaments, bone, and SKIN

   SOLID TISSUE cancers are all the organs – so technically today a RENAL CELL CARCINOMA would be considered a SOLID TISSUE cancer –

   FLUID and LYMPH CANCERS are leukemia’s and lympomas.

   When I was young the SOFT and SOLID were all lumped together in SOFT –

   I am sorry – this person is a severe nit picker. We older physicians make “mistakes” like this all the time – and everyone knows exactly what we mean. Someone who is trying to discredit a statement with an overdone argument has no such grace.

 First half of November posts and comments

fresno danNovember 1, 2021 at 2:59 pm

Our illustrius medical system #8
So again the hospital calls me about Covid testing… and I have to explain that I tested positive at their lab (September 10), by their technicians, and it was reported to their doctors. (I was vaccinated and had no symptoms) I have been admited to that hospital twice in the last 4 months, and will be admitted again on Wednesday. No wonder the medical system costs so much – if you pay someone to ask the same question, to which you have the answer, over, and over, and over again and again, which is of no use what so ever, its a big waste of money.
 

IM DocNovember 1, 2021 at 3:29 pm

Let me explain this phenomenon at least partially –

This has all come from the advent of EMR and the documentation changes started about the same time as Obamacare.
You may not be aware of it – but your physician has to write a document in your chart even for the simplest visit that is basically a 1040 form and 8-10 pages long.

Yes, all of your data is already in their system. But it would require a human brain to go through all the previous notes and data arrays and pull it out and put it in the new note. It is so much easier for the patient to sit in the waiting room and do all that work for them. All of that data you are entering goes into the note from that day’s visit – and is critically important for the level of care and the reimbursement that your doctor’s non-profit corporation gets from that visit to fund the multimillion dollar salaries the MBA CEO on the golf course is getting.

It is a completely malevolent process. I despise it in every way. I fought this shit for years – and got nowhere.. This is a huge reason why I now make my home in Green Acres far far away from any kind of “non-profit” corporation.

I will repeat again – the EMR, evidence-based medicine, and corporate owned health care are the three things that have most destroyed my profession. All 3 are demons from hell. I would give anything to go back in time to when the nuns were running our hospitals. It was not perfect for sure – but at least patient care was a top priority.

Off covid-topic, but interesting:
 

IM DocNovember 2, 2021 at 9:37 am

Anecdotes from a very remote area – the end of the supply line – and where my family and I live – I guess we are going to feel it first because of the remoteness.

We do not eat out that much – but this was a holiday weekend – and so we ate out on both Friday and Saturday. Not many national chains here almost all local.

Friday night – a very nice upscale American cuisine type place. The first thing that gave me shivers because of a flashback to my 1970s youth was seeing the menus covered in little sticky papers so the prices could easily be changed between menu printings – talk about a flashback to the 1970s.

The waitress arrived – and went through a laundry list of items that were on the menu that were not currently available – like 20 things. Anything having to do with calamari, seafood, pork were the three I remember the most. We all got hamburgers – and that was that. No mayonnaise available – and each patron was given one pack of ketchup – no ketchup bottles available. The people at the next table ordered pizza – and we heard the waitress telling them cheese only – they cannot procure any of the processed meat like pepperoni at this time.

The next night we went to the local Mexican place. Chips were brought but no salsa and no queso. The dip brought with the chips was some kind of Mexican cole slaw. Lots of cabbage and not much else. Asked the waiter – where is the salsa? – we got 1 box of tomatoes instead of our usual 12. All tomatoes are being used for the entrees. No queso because we have no processed cheese. And they too had begun to use the sticky price approach on the menu.

Went to the grocery store on Sunday – again very minimal canned vegetables and fruits. Interesting that all the fresh varieties of the same seemed to be in abundance in the produce area….Are people hoarding the cans? Or are we having some kind of problem making or distributing cans? Who knows? The pharmacy area looked like it had been looted. OTC meds, shampoo and soap largely empty.

Our grocery always does a turkey promotion this time of the year – not this time. No free turkeys. And when you got to the turkey area where historically there would be freezers full – there were two. And I mean big ones – that only grandma would dare to cook.

This has been going on for weeks….I am starting to get a little alarmed. And so thankful the family and I spent our summer canning our garden stuff. Multiple 50 lb bags of flour and sugar and rice all stored safely and ready to go.

***
 

British Medical Journal: “Researcher Blows the Whistle on Data Integrity Issues in Pfizer’s Vaccine Trial”

Posted on November 3, 2021 by Yves Smith

So far, no major US or UK press outlet has taken up an article at the British Medical Journal that calls the integrity of the Pfizer clinical trials for the Covid-19 vaccine into question. At a minimum, the results for 1 000 of the roughly 44,000 participants were compromised.

IM Doc, who was the first of several to send this link along, said it was also discussed at a conference yesterday. A participant told him a speaker said: “If true, this is terminally damning and none of the data of that trial can be believed.”

The BMJ substantiated the claims of a former regional director and trained clinical trial auditor Brook Jackson of Ventavia Research Group, which was running a portion of the Pfizer Covid-19 clinical trials in several sites in Texas. In the two weeks she was involved, she saw data falsification, unblinding, poorly trained vaccinators, negligence via not following up on some serious adverse events, and large scale failure to complete test on participants who reported Covid-type symptoms. Jackson first escalated internally, and when that got nowhere, reported to the FDA. She was fired the same day.

The BMJ published this list of half the concerns Jackson reported to the FDA:

Participants placed in a hallway after injection and not being monitored by clinical staff

Lack of timely follow-up of patients who experienced adverse events

Protocol deviations not being reported

Vaccines not being stored at proper temperatures

Mislabelled laboratory specimens, and

Targeting of Ventavia staff for reporting these types of problems.

Jackson received a follow-up call from the FDA but there was no indication the agency took action. In fact, 11 months later, when the Pfizer vaccine received full approval, the FDA had peculiarly not inspected the Ventavia research sites despite the company fully expecting an inspection and being in fear of it before Jackson filed her complaint. From the BMJ:

… after the full approval of Pfizer’s vaccine, the FDA published a summary of its inspections of the company’s pivotal trial. Nine of the trial’s 153 sites were inspected. Ventavia’s sites were not listed among the nine, and no inspections of sites where adults were recruited took place in the eight months after the December 2020 emergency authorisation. The FDA’s inspection officer noted: “The data integrity and verification portion of the BIMO [bioresearch monitoring] inspections were limited because the study was ongoing, and the data required for verification and comparison were not yet available to the IND [investigational new drug].”

Allowing Pfizer to withhold data is simply outrageous. As IM Doc said by-mail:

This is exactly why I spent so much time in the original Pfizer research guest post about the fact that my mentors would have literal carts full of binders of just the kind of data being discussed in this BMJ report. That was back in the day when peer review meant just that. They would have gone over these data in fine granular detail. This kind of thing would have been caught.

I am not sure that level of access was even provided to the peer reviewers in this case – or pretty much most anything these days – it is all proprietary. And as I pointed out in the guest post, Dr Rubin a member of the FDA committee admitted in the radio interview that he had not even bothered to look at the material for Moderna just a day or two before the vote. This BMJ article is bringing to light what happens when people just simply do not care and do not do their jobs. But gladly accept paychecks and favors for their companies or interests.

We pointed out late last year that STAT, which is hardly an anti-drug company publication, had criticized the FDA for obvious and grotesque corners-cutting on its data validation when the Emergency Use Authorization was issued. STAT came down on the FDA because it assumed the FDA had not allowed enough time and had not assigned enough manpower to the task. Reading between the lines with the benefit of the new BMJ report, it instead appears the FDA let Pfizer provide very little data and the FDA tolerated that and hence didn’t have much of a data-scrubbing/testing task. From its Did the FDA understaff its review of the Pfizer/BioNTech vaccine?:

In what is arguably the most important decision the Food and Drug Administration has made this year — its emergency use authorization of the Pfizer/BioNTech Covid-19 vaccine — the agency apparently assigned only a single reviewer in each of two key scientific disciplines (clinical and statistics) to do the work in three weeks that usually takes months to do….

Unlike its counterparts in other countries, the FDA is believed to be the only drug regulator in the world that consistently receives and reviews patient-level data from the clinical trials that underpin drug and vaccine approvals. To perform such rigorous analyses, the FDA typically spends around 10 months (a mere six months for applications given “priority review” designation) in an effort that involves reviews by experts representing various scientific disciplines: clinical medicine, statistics, pharmacology, chemistry, pharmacovigilance, and more…

Given the urgency of the pandemic, the review of the Pfizer/BioNTech vaccine was conducted far faster than usual. The centerpiece of the analysis was data from the company’s 44,000-participant Phase 3 trial. FDA reviewers had just three weeks, from Nov. 20 to Dec. 11, to complete their analyses. It was a monumental task, which raises the question: Why didn’t the FDA devote additional reviewers to it? According to the FDA’s review memo, some scientific disciplines, such as pharmacovigilance, had multiple reviewers involved. But the two disciplines tasked with examining the clinical trial data and results, the clinical and statistical reviewers, were seemingly left to do their work solo.

This seems wholly inadequate on at least two levels. First, without additional reviewers it is hard to comprehend how the work of several months could be squeezed into a matter of 22 days (including Saturdays and Sundays). In-depth review calls for examining patient-level data — a large feat that involves auditing and reviewing individual case records as well as independently rerunning analyses on the raw data.

I find this section the most troubling:

After Jackson left the company problems persisted at Ventavia, this employee said. In several cases Ventavia lacked enough employees to swab all trial participants who reported covid-like symptoms, to test for infection. Laboratory confirmed symptomatic covid-19 was the trial’s primary endpoint, the employee noted. (An FDA review memorandum released in August this year states that across the full trial swabs were not taken from 477 people with suspected cases of symptomatic covid-19.)

477 missed test results out of 40,000ish participants may not sound like much until you recall the very small number of infections that served as the basis of Pfizer’s efficacy claims. From the New England Journal of Medicine paper on the Pfizer clinical trial:

Among 36,523 participants who had no evidence of existing or prior SARS-CoV-2 infection, 8 cases of Covid-19 with onset at least 7 days after the second dose were observed among vaccine recipients and 162 among placebo recipients.

I don’t see how anyone can believe the efficacy claims in light of the much larger number of possible Covid cases that Pfizer never bothered to diagnose.1

The BMJ report also warns that the unblinding that took place at the Ventavia sites could have been a large-scale problem:

Early and inadvertent unblinding may have occurred on a far wider scale. According to the trial’s design, unblinded staff were responsible for preparing and administering the study drug (Pfizer’s vaccine or a placebo). This was to be done to preserve the blinding of trial participants and all other site staff, including the principal investigator. However, at Ventavia, Jackson told The BMJ that drug assignment confirmation printouts were being left in participants’ charts, accessible to blinded personnel. As a corrective action taken in September, two months into trial recruitment and with around 1000 participants already enrolled, quality assurance checklists were updated with instructions for staff to remove drug assignments from charts.

As Lambert tartly observed: “If so, we don’t really have an RCT at all.”

As IM Doc summed up:

This is exactly the reason I recoil from “evidence based medicine”. As a profession, we no longer understand that the “evidence” is literally just what Pharma wants you to see. I learned that the hard way with Vioxx and also the opiates. The scales fell off the eyes when it became clear how much they had lied and manipulated.

This Pfizer research is “pristine” in the eyes of the evidence based medicine folks. It has been peer-reviewed. It was an RCT. It had more than sufficient power. It was accompanied by an editorial in one of the world’s leading medical journals describing it as a triumph. EVIDENCE – on a grand scale. Nobel potential. And yet – it may have been fatally compromised by laziness on Pfizer’s part and everyone that reviewed it. And the motivation of these independent research companies is to keep the cash coming – no matter how sloppy they do their work. I have been involved in more than one complete audit of trials in their hands that have gone bad like this. This is why I have a problem with “evidence based medicine”. EBM is nothing more than Pharma’s way to control the minds of physicians.

No one who has been paying attention should be surprised that vaccination rates have no correlation with Covid case levels. These vaccines were falsely sold as magic bullets for the pandemic. Politicians desperately wanted a solution. Medical professionals and investigators had long accepted Big Pharma giving them the mushroom treatment. So we have vaccines that do have utility in protecting individuals from the worst outcomes, but don’t do much good in preventing contagion.

And this mis-selling of what the vaccines do is of critical importance. GM has made this argument repeatedly:

The existence of vaccines will kill more people than vaccines will save directly.

Because it gives the politicians the excuse to let it rip.

Without vaccines the daily death toll becomes unacceptable and someone has to do something about it and contain the contagion. Which we know how to do, we just don’t want to.

With vaccines it either becomes “tolerable” (even if it is nothing but; see the UK) or even if it does break hospitals (as happened in many states in the US in August and is still happening in various places), it can be ignored by blaming the “anti-vaxxers”.

But in the long term it is the area under the curve that matters.

Welcome to a world run for the benefit of Big Pharma.

_____

1 And remember, before you say, “Oh, Pfizer couldn’t have done anything nefarious,” we pointed out last December that the study was effectively unblinded to the participants and the study nurses who kept on top of reactions and were tasked with determining if someone who reported Covid-like symptoms needed to be tested. They could identify a fair number who’d gotten the vaccine by virtue of the high level that had bad reactions to the first and even more often to the second shot, the prototypical feeling really sick for 6 to 48 hours. As we wrote:

Epidemiologist Ignacio had already raised another concern: that the high frequency of strong adverse reactions meant the study was unblinded to those patients:

First and foremost, we are looking to very transient results obtained in a period too short to be relevant to evaluate the efficacy of the vaccine. It is well known that vaccines induce antibody peaks just about 12 days after the second shot. We are looking at this peak. Very relevant regarding the possibility of some short lived sterilizing protection in the upper mucosa.

Second, the high reactogenicity of the vaccine, way higher than the placebo, removes one of the blindnesses of the trial. You know if you are a recipient of the vaccine. As IM Doc says, the reactogenicity is way above what can be considered normal or standard and with potential to be problematic, and a behaviour changer in the recipients which can have very significant effects in the numbers observed obtained in so short times after vaccination. This effect will be diluted by time in later reviews but it can be quite important in the first review.

STAT agreed that the effective unblinding was a concern:

One of us (P.D.) raised questions about potential unblinding in the trials through the vaccine’s side effects, as well as about the confounding effects of fever- and pain-reducing medications, which participants in the vaccine arm took three to four times more often than those in the placebo arm. Yet the FDA’s review shows no evidence that any of its scientists investigated either of these issues, and without more scientific staff devoted to the task it is hard to imagine how they could.
***


It's possibly worthwhile to visit the main page of this post to read the whole comment thread. Here's one of IM Doc's that appears there:

IM DocNovember 3, 2021 at 7:06 pm

With all due respect – I would not pay any attention at all to Webster’s Dictionary in this case. The definition of vaccine was indeed changed on the CDC website itself sometime in early September of this year. That is not in dispute. I have been at a lecture in the past 2 weeks decrying this fact – showing the two definitions side by side – listening to the speaker, a vaccinologist, demonstrating complete chagrin that the new definition the CDC has put forth made no historical sense whatsoever.

I would also direct your attention to a recently FOIAd email chain from the CDC officials themselves in early September.

https://www.scribd.com/document/536749738/CDC-Emails#from_embed

My question would be – “What do “certain people” and their statements have a thing to do with how the CDC defines a scientific/medical term like vaccine?” When do “certain people” have a say in what has been decided science for generations? Who indeed are “certain people”? If “certain people” are causing such confusion by their statements, why is the CDC not directly addressing those statements, instead of this kind of run-around – guaranteed to further erode their credibility?”

I am not one for falling for right wing conspiracy theories or talking points. But when one of them goes out of the way to produce a FOIA – and you can clearly see that the definition was changed strictly for political or “messaging” reasons by high level officials at the CDC almost as a lark – well – a reasonable person left or right can deduce that we have a problem.

Why is our main stream media not ALL OVER this kind of thing. If we are going to change the definition of vaccine for valid reasons – let’s have a discussion and a conversation about it. If we are doing it because “certain people” are making us look bad or asking tough questions – well, that is straight out of Orwell – and does not make the CDC look good at all.

Can you point to me where these CDC emails have been denied or refuted? It would make me feel much better if you could.

****

IM DocNovember 5, 2021 at 3:11 pm

The last three days here in my office after the election have been quite revealing. The intensity just keeps increasing.

My most important job as a physician is to be an advocate for my patients. I still have a love/hate relationship with the modern Dem party – of which I have been an active part for the past several decades – I guess I would add that what I am about to say is an attempt to advocate for what is left of them too. Hopefully, some elected Dem officials read this blog and comments – maybe it will help them get a clue.

Since WED AM, I have had in my office 3 different patients, all blue collar working young men, all 3 from 3 different ethnic groups – all in occupations that we now consider front line and vital – and all are critical to the current supply issues in this country. All 3 work for national corporations who have now been mandating the vaccine – and their time is up. All 3 have resigned – plunging their 3 separate companies into even further chaos ( 2 of them are quite critical) at least locally.

They will not be taking the vaccine. There is no convincing them otherwise. ALL THREE have IgG titers to COVID that are over 50. They have all had COVID in the past year. I have written exemptions on this basis for all 3 – and they have been summarily dismissed. I as their physician am not even allowed to speak with anyone in HR. That is simply out of the question.

The companies are going to take a revolver to the head to kill a fly – and blow their own heads off. There is no scientific or medical explanation for this behavior – none at all.

The young men have all resigned. They however are all going to be OK – although there are tears of anger and frustration this week. One has lined up a journeyman electrician position, one will be starting at plumbing school/apprenticeship and the other will be starting to work at his own uncle’s welding business as an apprentice. All have told the trucking and rail industries that they worked for that they can rot. I know all of these kids’ families – and their parents and grandparents are all FDR type blue collar Dems. They have all known this day was coming – and all of these family members have been in and out of my office the past few weeks – with all kinds of variations on FJB. EVERY SINGLE ONE. They have been life – long Dems. That is now over. A realignment is happening on a grand scale in this country. If the Dems are not careful – they are going to find themselves all alone with the PMC – while all their other constituencies melt away. It is happening here slowly and surely in my blue area right before my very eyes.

THIS WILL NOT BE FORGOTTEN. NOR HAS A SINGLE PATIENT IN THIS SITUATION FOR THE PAST FEW MONTHS – NOT ONE – HAD A THING TO SAY ABOUT THE GOP – NOT A WORD – it has all been FJB.

I am not sure I have ever seen such a self-own politically in my life. DEMS – If you are reading this – you need to wake up – this is going to be a disaster for you.

But let me tell you what is going to be worse.

I have had dozens of young parents in my office the past few months who as a part of their visit ask me if my kids are going to be vaccinated. My response is NO – the math just does not work out for healthy kids to accept that risk. I just cannot see doing this until much more is known. The calculus is completely different for those who have cancer, cystic fibrosis etc. Many European countries whose health officials have not proven to be liars or gasbags have come to the same conclusion.

I have now had 3 families in the past 2 months as new patients that have moved from their deep blue coastal area to get away from the forced kid mandates and the craziness in the schools. Dems all. But no more. The political talk in my office has been unprecedented. I do not engage in it or participate. I do listen. It is all FJB – or insert governor of choice – looking right at you New Jersey. That was not an accident on Tuesday.

The absolute rage that is building for any attempt to force a mandate on kids is something I have never seen before. I think this will be an absolute red line for many parents – red or blue.

The current statistics tell us that between 1 and 3000 and 1 in 6000 of these kids are going to have heart problems. They may be over or underestimating – that is the best guess right now. Other countries have paid attention. These Dem leaders have not – THEY WILL NOW OWN EVERY SINGLE PROBLEM WITH THESE KIDS – and the above stats are just the heart problems – I am hearing things from friends that chill me about other issues.

When I was young, it was not unheard of for politicians of both parties to bring up Biblical concepts to make points. The Dems were very good at bringing up moral issues right out of the Sermon on the Mount. That was long ago – before it was considered shameful to discuss morality and Scriptures in our new Science-Techno world.

It was therefore very discordant to hear the Dem NY Gov Hochul start talking about Jesus the other day – and “acts of love”. It is very clear modern politicians should not be doing that – they have lost the ability to do it with meaning and impact. They appear condescending instead.

As a veteran of years of Sunday School – I can quote Jesus right back at people. And the quote that has been running through my head the past few weeks about mandating vaccines for kids is right out of the Book of Mark – 9:42 – “And whosoever shall offend one of these little ones that believe in me, it is better for him that a millstone were hanged about his neck, and he were cast into the sea.”

Dems, I am doing what I can to warn you. YOU ARE GOING TO OWN EVERY BIT OF THIS. I have been doing this for 30 years – have never had people openly discussing their disdain for a current situation like this – NEVER. I fear this is not going to go well for you at all if you keep this up. I hope someone is paying attention.

I was young during the AIDS crisis. I saw what the HIV anti-virals did for AIDS in this country virtually overnight. Would it not be wise, Dems, to put this non-sterilizing vaccine stuff on the sidelines – and let’s wait and see what happens with the new drugs? It has all the potential to be a game-changer – just like with HIV.

Sorry all, this has been a crazy week. Very very busy – but not with COVID.

Thank you for allowing me to rant.
 

IM DocNovember 5, 2021 at 6:48 pm

I should add – all of my kids have been vaccinated with all other childhood vaccines.

Without one second of hesitation on my part. The math of risk/benefit makes absolute sense in every case.

The vast majority of these concerned parents are the same way – and I would say most of them like myself have been fully vaccinated for COVID as adults. Many of them, like myself, became an unfortunate statistic of a breakthrough COVID infection. Many of them have shared breakthrough stories of family or friends. Some media types are STILL to this day peddling the lie that breakthroughs are rare, further eroding any credibility they may have had. It is so common as to be a constant discussion for me all day in these situations and most notably about boosters. In my part of the world, the older high risk people seem to be happily lining up for boosters – which is good. The younger people are not so pliant. I am not at all sure how this is going to turn out either.

It is the spectre of the COVID vaccines which have not been fully tested that are of concern to everyone with regard to the kids.

diptherioNovember 8, 2021 at 2:55 pm

Re: Covid tests

We are in trouble. We are seeing a lot of unvaccinated children & young adults scary part is even older vaccinated people coming in very sick

All their tests are negative so no one thinks they have COVID that’s of the people who agree to test. They have all the COVID symptoms
https://twitter.com/DrCSWilliam/status/1457708785720569867

IM DocNovember 8, 2021 at 6:10 pm

 

He should be testing them for RSV and Coronavirus OC43 – both of which have very similar presenting symptoms as COVID.

But the problem there is the test is actually a panel test. (I do believe that you can do RSV by itself – but that often does not cross the doc’s mind in adult patients. It should this year however.). These panel tests are often 20 or so viral tests at once – and can cost up to 2000 dollars – maybe more. The cost of which is almost universally bounced by insurance companies as being un-needed. Therefore I am very hesitant to order these tests on people who I know cannot afford them. That includes most everyone under Medicare age on our current crappy insurance. ( Never had any issues ordering these tests and having them covered until Obamacare and its insane deductibles came around). Now, if I feel it is essential and really important not to miss, I have a sit down talk with the patient about the cost. ( Yet another thing I am doing so many times weekly that I never had to do before Obamacare.).

Here is the thing – the RSV wave has struck very very early this year. Usually a DEC-MAR event – it has been horrific here and in all kinds of places in the middle of the summer. Very unusual. Happening in adults all the time as well. I have now had more positive OC43 patients in the past 3 months that literally triple my lifetime numbers from 3 decades. It too is usually a winter thing – and very uncommon for people to be sick enough to seek medical attention. But not this year.

As has been the case for 18 months, strange things are happening.

But – no – the answer is not to just to assume every negative test is wrong and that your patient has COVID. That comes from the fear and panic and crazy that has been going on the past 2 years. Some of them are probably falsely negative for sure – but most – absolutely not. It is a very bad habit I have seen being picked up by HCW everywhere – BLAME EVERYTHING ON COVID.

This next post (not a comment) was featured on NC as part of their fundraising drive - but it's worth putting here because it gives an insight into who IM Doc is and why his comments matter..

IM Doc: Naked Capitalism – Fierce and Independent Thinking in the Age of Covid

Posted on November 9, 2021 by Yves Smith

The Rev KevNovember 9, 2021 at 8:34 am

“St. John’s asks for supply donations during global shortage”

I have to admit that I do not understand the helplessness on display here. Aluminium crutches? Look, how about going with wooden crutches and forget aluminium ones. I am pretty sure that there is no patent on them nor do they need constant software updates. Here are some plans that took me all of 20 seconds to find online-

https://www.wikihow.com/Make-Simple-Crutches

You put out a standard plan of them and ask help from any place that has a wood-shop. Schools, prisons maybe, home-handymen, hobbyists. Use the money that would have been spent on aluminium ones for timber and the fittings instead. It would not take long to build up a supply of them and probably in different sizes.
 

IM DocNovember 9, 2021 at 10:35 am

Yes, this same issue is occurring at my hospital as well and I hear from docs all over that this is happening not infrequently. I heard yesterday that a big non-profit corp in one of our big cities has put a moratorium on all durable medical equipment leaving the buildings in any way.

The wood issue brought above is very important. Modern ortho devices are not usually made of wood for 2 reasons. The one Yves brought up is one of them. It is easier for PT and rehab to work with patients with lighter and stronger equipment. Plus, when wood breaks it often causes injuries. I have really never seen an aluminum crutch break.

The second reason is also very important. WOOD of any kind is a Petri dish. In the past 30 years or so, there has been a sustained move away from using anything made of wood in patient areas. Using metal where it is possible is a much better barrier for bacterial infections. There is a reason all the doorknobs in homes decades ago were made of brass or copper. The same issue applies to all the metal objects being used in patient care in modern hospitals.

Just think – we have determined some very amazing ways to decrease infections in the hospital. How many of those are going to go bye-bye unless we can figure out this supply problem? I can think of multiple others that are vulnerable. How long is this going to last? And what will be left with in the wake?

Something that has also crossed my mind – but I have heard literally nothing about is titanium. I do not even know if there is a problem. Titanium has become indispensable in modern medicine. All kinds of equipment – and implants like hip replacements. If we are struggling with aluminum – is titanium that far behind?

As far as the other comment about medical waste. I could not agree with you more. Take one look at any hospital and you will see a Mt Everest of trash going out every day. If you think the consumer throwaway and crapification culture is bad – you haven’t seen anything until you look in a hospital.

I am just old enough to remember when for example saline was given in glass bottles that were then recycled and autoclaved in the hospital and used over again. And again. Now mountains of plastic bags are thrown away every day. This is for two reasons – first of all MBAs run the hospitals – and CHEAP! Is literally the only consideration.

Secondly, in modern medicine, saline is used as holy water. Every patient in the hospital is getting it in often exorbitant amounts. Saline was used quite sparingly when I was a young doctor. It is a constant struggle to get these young kids to break this cycle. You see – medicine is now a “check box” operation. Order sets magically appear and you just check boxes on a computer – no brain work involved. It is really that way. I cannot tell you how many situations I have been in with students and residents where they were literally flooding a patient’s lungs. It is a constant battle. And that is just saline. Mounds and mounds of plastic on every drug used in the hospital. Where reusable glass and metal was the rule just a generation ago.

This society has a lot of lessons to learn.
 

IM DocNovember 9, 2021 at 11:45 am

A question I forgot to ask – maybe someone here would have some insight.

Much has been made in some corners about the disappearance of Gavin Newsome. I have heard all kinds of wild stuff – up to and including him having a bad reaction to the COVID booster.

I think all of that talk is just a deflection for the masses.

What I cannot get out of my brain at this point is the following. We have a supply crisis that has now officially landed in hospitals all over America…

Forget the booster shot – this is a crisis for which the ports in HIS state are largely responsible.

WHERE THE HELL IS HE?

If we do not have our governors on the job and working during this kind of crisis – why on earth do we even have them?

*****

On this post:

McKinsey, the Force Multiplier for the Opioid Crisis, Goes All in With Anti-Public-Health Messaging on Covid

IM Doc is quoted (the full post may be of interest to readers but I'm not including it here):

IM Doc added:

Having an infectious disease become endemic is not the same as having a sore throat as much as our media would like to portray it that way. If COVID follows form to the previous coronavirus pandemics that have become endemic, we have literally years to go before our immune systems collectively call a truce with it.

I do not see the vaccines making a huge dent in this – especially the way we have chosen to play that game. HIV is raging in Africa but not here in the developed world….Why? We just simply do not make our meds available cheaply to them….The CEOs need to make tens of millions for their yachts. Why do people think this would be any different with COVID vaccines or therapies? Alfred Schweitzer and Jonas Salk are long gone. Today, it is all about greed. And things are going to be worlds different between HIV and COVID. COVID is going to be infinitely more difficult to contain.

IM DocNovember 12, 2021 at 3:19 pm

This article – https://www.latimes.com/science/story/2021-11-12/cdc-shifts-pandemic-goals-away-from-reaching-herd-immunity

I do not know when exactly – probably a year ago during the initial vaccine push, I was making the point repeatedly in comments here that herd immunity was simply not achievable in coronaviruses and several other virus families. This has been settled science for decades. As I have pointed out, when you look at basic science on coronaviruses and respiratory viruses in general, this simple fact is clearly stated. Herd immunity like we see in the measles for instance is simply not something that will ever happen with this virus. But yet Fauci, Walensky and others were pushing this all the time for months on end.

It is not that I am that much of an expert, it is literally settled science over decades of time. And now almost 2 years later, the experts at the CDC are going to change their tactics because the herd immunity promised with these vaccines is not possible.

Did someone just now at this late date at the CDC bother to look at a standard issue Infectious Disease text?

When you begin your argument with lies and dissembling, it is not long you have painted yourself into a corner. When you keep going, before long you become a babbling moron. Our health officials have now earned that status with a good chunk, possibly a majority, of our population. And I promise you, the derision is so intense, that it will not be recovered, at least in our life times. It pains me to say that. But facts are facts. And the number of doubters is growing daily.

If herd immunity is not possible, what then is the medical or scientific reason for a vaccine mandate or a vaccine passport? – I am all ears. Please someone, anyone, explain this to me so I can help my ever growing panel of despondent patients who are now living through the torment of their lives. It is clear in my little community, this torment is harming way more young families and little kids than COVID ever will. The constant stress of young fathers unable to staff their businesses or fill their orders and having their business crumble into dust is becoming overwhelming. Having 2 or 3 young men in the office daily crying in anguish is just not something I have ever dealt with before. And all of this strain is not totally the fault of the mandates, but a good chunk of it certainly is. As each day gets closer to January, it is getting worse and worse.

200 years from now, assuming humanity survives, this era is going to be right up there with the Salem Witch trials as an example of mass hysteria. The COVID narrative in this country is rapidly turning into a religion if not already there. It could not be further from the tenets of science.

My deceased father and another life mentor always told me as a young man that the decade that actually brought forth the most prescient movies was the 1970s. Among their favorites and how absolutely correct they have turned out to be were Rollerball and Network. After this weekend’s movie watching with my wife, I would add another to the list – The Donald Sutherland/Leonard Nimoy late 70s Invasion of the Body Snatchers. The 1950s one was good but is a bit campy and dated. The 70s one got me right in the heart. The paranoia captured in that film as the characters realize that something had taken over the minds of their peers is exactly how I have felt for months around the Covid true believers in my own profession. I felt very unsettled at how exactly the movie reflected our reality today.

I was personally told today by a colleague after a Zoom conference that I needed to be very careful. Asking hard questions was going to earn me the side-eye – and perhaps a letter to the Medical Board. When did asking tough questions become evil in American science, medicine or discourse? In the past – when someone asked a tough question, there was debate. It was not unusual for someone to get destroyed in the debate. But it brought out all kinds of thinking points. And everyone learned and science progressed. These “narrative” people do not view these debates as just off bounds anymore – they are now viewed as IMMORAL and possibly ILLEGAL. Anyone who dares question anything is to be destroyed. The end.

How did we get here? As the article points out above, even settled science is now being suppressed if it questions the official narrative.

Another quote I heard this week on a podcast – “Who knew that conspiracy theories were actually spoiler alerts?”

With articles like this admitting the truth of critical and basic medical facts more than a year into a crisis like this, I cannot tell you how unsettled I am.
 

AumuaNovember 14, 2021 at 2:26 am

Yeah, FJB because it’s Biden’s fault that gas is going up. Just like it was Trump’s doing that caused it to fall to $1.21 or whatever last year. Because of his big focus on energy independence, right? Or did oil and other markets collapse for some other reason… I can’t quite put my finger on it.

Inflation, that’s all Biden’s doing too. Cause of all the money he’s spending! Trump certainly didn’t authorize spending trillions and trillions on his watch, nope.

Propaganda everywhere.

 

1. IM DocNovember 14, 2021 at 5:59 am

   Sorry, those are not the things my Dem patients bring up about Biden.

   Now that they themselves or their family members are facing hardships because they are losing their jobs or businesses, they bring up watching their President firing a huge chunk of Americans with his rictus grin in full display.

   Unfortunately, that is simply not propaganda. That was there for all the world to see.

   There have been smaller incidents like this, Reagan and the air traffic controllers, but nothing of this magnitude.

   No, the Dems are going to own this one. And it is most definitely not propaganda. Anyone who thinks that should spend one day with me instead of listening to Rachel or reading dailykos.
   
    

 Lambert Strether

September 16, 2021 at 3:13 pm

> Five minutes on the VAERS site

Needs a link. An addition, AFAIK, no quality assurance is performed on VAERS data. Am I wrong?

 

1. IM DocSeptember 16, 2021 at 3:35 pm

   I am not sure there is anyway to link to a VAERS query once you have left the main page.

   You can go to the VAERS site here – https://wonder.cdc.gov/vaers.html

   There is no way I can tell to do any linkage after you have started a query – but then again – I am fairly computer illterate.

   Unfortunately, it took me weeks and weeks of playing with this before I could ever come up with a correct search. Interestingly, all the time, searching through this leads to different findings. I am sure there are just tweaks or wording issues.

   This is a hideously cumbersome system – I think they did it this way on purpose.

   I did this same search (see my other comment) and found almost exactly the same findings.

   There is no quality assurance – but it is easy to tell that some of these entries are very likely legitimate. Some of the others – who knows?

   I just have no clue how to link anything once you have left the front page.

Industrial Culture HandbookSeptember 16, 2021 at 2:52 pm

“The FDA has not authorized or approved ivermectin for prevention or treatment of COVID-19,” equals “do not prescribe.” — Hope is the enemy. If Covid doesn’t kill you, a secondary infection will.

Monoclonal antibodies and the vaccine are almost the same thing, the difference is the vaccine allows your own body to create antibodies as opposed to a lab creating antibody proteins with an intensive use of resources.

 

1. Lambert StretherSeptember 16, 2021 at 3:21 pm

   > “The FDA has not authorized or approved ivermectin for prevention or treatment of COVID-19,” equals “do not prescribe.”

   It does not. A doctor may prescribe Ivermectin for off-label use regardless of the FDA or CDC’s opinion. I don’t know what you mean by secondary infection. The placebo effect (“hope”) doesn’t cause them, so far as I’m concerned.

    
   1. The Rev KevSeptember 16, 2021 at 7:28 pm

      Here in Oz, our doctors have been forbidden from prescribing the horse-paste to those who want it for protection from the virus or as treatment. I suspect that this was done as part of negotiations with pharma companies as a precondition for importing their vaccines here. We are still importing Remdesivir though so there is that.

      https://www.news.com.au/world/coronavirus/australia/australian-gps-banned-from-prescribing-ivermectin-to-covid19-patients/news-story/6291379ada4720568584c7717651f794

       
2. IM DocSeptember 16, 2021 at 3:28 pm

   I am very sorry to inform you – but you are completely and terminally wrong in your assessment of the FDA approval issue.

   Once a drug is approved by the FDA for any use whatsoever – any licensed physician in this country can use that drug for whatever indication he/she may deem doable. This has been this way for decades.

   This has never been questioned before either. There are all KINDS of drugs out there in every day use that are not approved for the indications they are being used for. BOTOX, all the hormone blockers for gender transitioning, amiodarone for AFIB, I can go on all day.

   If they push this too hard with ivermectin not being allowed to be prescribed – they are going to open up a pharmaceutical wasp nest like nothing ever seen in this country. Just wait till the red states start banning the hormone blockers for gender transition as just one of many many examples.
   
    

LeeSeptember 16, 2021 at 4:32 pm

In related news:

Ivermectin: Australian regulator bans drug as Covid treatment after sharp rise in prescriptions

Ivermectin: Northern Ireland seizures of unproven horse drug used for Covid

The combination of viral mutations and waning immunity, whether from vaccines or infection, could make treatments such as monoclonal antibodies, ivermectin, or something yet to be discovered our the best option for individual survival and the avoidance of civilizational collapse.

And why the hell are those RCTs of ivermectin we’ve heard so much about taking so long?

 

1. clarky90September 16, 2021 at 5:39 pm

   A suicidal intake of ivermectin was reported in a 19-year-old woman with severe Loa-Lao filariasis. She developed nausea and vomiting, and moderate neurological manifestations including ataxia, reactive mydriasis and hyperreflexia after possibly ingesting 100 times the recommended therapeutic dose (≈400 3-mg ivermectin tablets). She received conventional supportive treatment and could be discharged from hospital on day 4 post-ingestion [Djeunga et al., 2019].

   “ivermectin human toxicity cannot be claimed to be a serious cause for concern.”

   EXPERT REVIEW REPORT
   MEDICAL SAFETY OF IVERMECTIN

   Link to Toxicology report (requires email for free PDF download): https://www.medincell.com/ivermectin/

   https://www.youtube.com/watch?v=ATiX0-2PEr4&t=251s

    
   1. IM DocSeptember 16, 2021 at 7:00 pm

      I can suicide on Tylenol – I can suicide on Advil – I can suicide on Listerine Mouthwash. All are easily available OTC.

      A suicide overdose – where bottles of pills may be involved is not even in the same league of issues as a toxic side effect.

      Suicidal overdoses are handled completely differently by the authorities.

      The TRUTH of the matter is this agent has been in wide distribution over continents for the past 40 years. It has literally been given in billions of doses at this point. It has one of the best safety profiles of any drug in the PDR.

      The fact that one patient committed suicide with it – is not evidence of a safety problem with the drug. That is an apples to oranges comparison. I am pretty sure if I took 100 times the recommended dose of pretty much any medication in the PDR I would be dead. By the way, that is not just pharmaceuticals – you can absolutely overdose yourself to death on plain simple tap water.
      
       

IM DocSeptember 16, 2021 at 3:05 pm

I would just like to make certain that everyone knows that there are indeed reports in VAERS of testicular swelling after the vaccine. I am able to find about a dozen. I have not searched for adjacent type diagnoses – lymph node swelling, genital pain, etc. All of these dozen or so reports date back long before this whole issue – and some of them have been filled out by physicians. I have also looked for erectile dysfunction. Quite a few hits – but after looking over them, I can not be certain about the provenance. Honestly, there are quite a few, extending back for months. and I just do not have time to read over them. They are there, however.

I am saying this because if you look at the PDR entry on any pharmaceutical used in the USA, you are going to find a laundry list of complications and side effects. This often goes on for 2-3 pages in very small type. They are forced to list every single one.

The VAERS is all we have right now. However, when the PDR entry of this vaccine is finally published, if it is true to form, both testicular swelling and erectile dysfunction should appear in the long list of side effects.

I have no idea what is going on with this young singer. But the fact that these issues exist on VAERS is a problem for all those bashing her today for making stuff up – or her family making stuff up. These issues appear to be rare. RARE IS NOT IMPOSSIBLE. RARE HAPPENS. To wit, I am personally dealing with a patient in the hospital this minute with a condition that happens in America only 1-2 times a year. For whatever reason, the “rare fairies” delivered this patient to my ER yesterday.

I cannot support bashing her given the facts that are available. Patients in my practice have had very strange and almost unique reactions to this vaccine – I have no doubt that this could very well have happened to her family member. Hopefully, he sought medical attention.

Why do media and social media figures feel they have the authority to question anyone else’s medical issues? When did this ever start being something in our discourse? I get it with political figures or Presidential candidates….but a family member of a rock singer in Trinidad? Are there not more important things to talk about on these news shows?

Disparaging others on national media for stating their truths is just inexcusable. Especially coming from St Joy Ann Reid. Look at how fast Ms Minaj destroyed Ms Reid. It is very easy to do when your opponent is a moral zero. I just cannot believe the media in this country. Nor can I believe the Twitter mobs – but more importantly the Twitter corporation censoring her for this kind of thing is very ominous indeed.

 

1. Lambert StretherSeptember 16, 2021 at 3:44 pm

   As I understand it, VAERS is system of poorly vetted digital submission. In other words, it’s more like 4Chan than the curated NC comments system. To me, it’s not trustworthy.

   As for Minaj, she’s a celebrity and can say whatever comes into her head for clicks, especially when it concerns her boyfriend’s sexual function or dysfunction. She also says:

   Minaj said in a separate tweet that she had not been able to complete enough research of her own on the COVID-19 vaccines to get one in time for the Met Gala, a star-studded fundraiser for New York’s Metropolitan Museum of Art.

   Later, Minaj added that she will get vaccinated to be able to tour.

   My view is that even at my advanced age, I personally notice and care about the state of my testicles (“No news is good news”). My intuitive sense is that a very large number of men do the same. In other words, if this were a real issue, we would have heard about it long before now, especially because no tests are required. This is even more true, given that liberals are not the only political faction given to fomenting moral panics or motivated reasoning.

   As far as erectile dysfunction, I will refrain from n=1 testimony, but this idea is persuasive at the narrative level because of all the other weird vascular stuff Covid does. My impression, however, is that erectile dysfunction has many overlapping causes, which could include being cooped up at home, pandemic stress, etc. This is something that would, I think, take a real RCT to sort out.

    
   1. IM DocSeptember 16, 2021 at 3:57 pm

      I am just saying that we should not just discount the story out of hand. If real – it is very very rare.

      Unfortunately – VAERS is the only system we have to monitor vaccine complications. There is another called CISA – but that is just about the same level of problems.

      But remember – we were promised over and over again early on in the vaccination program with the EUA that side effects and problems would be vigorously monitored. This system is what is in place to cover those promises.

      VAERS and CISA is what we have. I am certain that the FDA very likely has other ways they are monitoring complications – but that is not open to community physicians like myself. This is all we have.

      And yes – the testicular issue is very rare – 12 out of millions (even if the 12 is not really 12 but 6) is very rare – but it is there – and as I stated I can tell that some of those reports are put in by physicians. I give those absolute credence.

      I have had to look things up on VAERS multiple times this year to see if some strange thing happening to a patient was unique or if there were others, and the N was 3 or 4. Fortunately, the vast majority of my patients did not have any significant problems – and these things resolved. But it can give great comfort to people to know that yes – this has at least been reported.

      This is our horribly broken system – and it is what we in clinical medicine are forced to use. That is the way it is.
      
       

Andrew WattsSeptember 17, 2021 at 3:49 pm

RE: What the Never Trumpers Want Now. It’s clear that Frum is completely delusional, and so he and his will fit in very well with the liberal Democrats.

Those whom the gods wish to destroy they first make mad. -Euripides

 

1. IM DocSeptember 17, 2021 at 6:36 pm

   I have always found the antecedent quotation from Sophocles to be a much more appropriate comment on our time ——

   “τὸ κακὸν δοκεῖν ποτ᾽ ἐσθλὸν τῷδ᾽ ἔμμεν’ ὅτῳ φρένας θεὸς ἄγει πρὸς ἄταν”

   The IM Doc translation – “Evil appears as good in the minds of those whom the gods will soon lead to destruction”

   This is found in Sophocles – ANTIGONE – Lines 620-621

   For the purists – I did the best I can on the Greek letters.

IM DocSeptember 17, 2021 at 4:29 pm

I was just in the hospital’s doctor’s lounge in between patients when the FDA vote on the boosters came down 16-2 AGAINST.

As is usual, the physician’s lounge television was tuned to CNBC at that very moment. That is how I found the news.

Amazingly, they had Dr. Fauci on almost immediately.

What a perfect encapsulation of the whole situation. The nation’s medical ( scientific ) head of the COVID response, is on CNBC – a FINANCIAL channel to let the world know his thoughts in between breathless takes on plunging Pfizer and Moderna stock prices. I cannot think of a more befitting example of all that is going wrong.

 

1. petalSeptember 17, 2021 at 4:36 pm

   Here’s a link to an article about it in the DM: FDA panel votes 16-2 AGAINST recommending to approve Pfizer booster shots to healthy people under 65 because there is not enough evidence they are safe

   Tbh, I am surprised.
   Stay tuned for the fallout I guess. Funny he was on CNBC. How fitting.

1. KengfernoSeptember 18, 2021 at 12:11 pm

   re: booster shots. I haven’t seen any info that indicates that they are any different from the original vaccines. That they are basically the same thing and the booster shot just refreshes the original vaccine as it declines in efficacy. Is that correct?

    
   
   
   1.  
      1. Zachary SmithSeptember 18, 2021 at 2:12 pm

         Might the effect be better if a person who was originally inoculated with Pfizer to receive a Moderna booster?

         From my (uninformed) point of view, the mix-and-match strategy makes lots of sense, especially if the same-brand boosters are just more of the same.

         What do we know about the Novavax vaccine? – Expert Q&A

         “The Novavax COVID-19 vaccine (NVX-CoV2372) is a protein-based vaccine. Protein-based vaccines have a good safety and efficacy track record and are used in adults and children to prevent diseases such as hepatitis B, pertussis, influenza, pneumococcal illness and meningitis. They are typically given together with an adjuvant to boost the immune response and ensure both humoral (antibody) and cellular (T cells) responses. The Novavax vaccine is made from multiple copies of the SARS CoV-2 spike protein, formed into tiny particles (nanoparticles) and then mixed together with an adjuvant derived from tree bark. It is given as an intramuscular jab like other COVID-19 vaccines, with two doses given three weeks apart. After injection, the nanoparticles are taken up antigen presenting cells, which then display the spike proteins on their surface and stimulate the immune system to make antibodies and cellular responses.”

         I’m going to be paying a lot of attention to this one.

          
2. IM DocSeptember 18, 2021 at 12:16 pm

   This has been becoming more and more obvious over the past few weeks. It may indeed be directly responsible for the terrible numbers coming from Israel – where the relative risk reduction for the vaccine (They pretty much only used Pfizer) is now down to 16%. And cases after large swaths have received the 3rd booster are now going parabolic. Once an RRR is below the 25% level – we begin to approach the level of worthless.

   https://news.yahoo.com/big-gap-between-pfizer-moderna-034719881.html

   I have been carefully counting the exact vaccination information on every single one of the breakthrough cases I have been seeing ( assuming if they actually know).

   I work in an area that was predominantly Moderna for the first several months because that was all we had.

   It has been interesting to note that since August 1st, precisely 72.7% of the breakthroughs have been vaccinated with Pfizer. (Remember the large predominance of Moderna in my area – making the number all the more striking). All but 2 of the vaccinated admissions that I have had since August 1st have been with Pfizer.

   Fascinating.

   Either the dosing schedule, the dosing amount or something about the freezing/delivery is causing them to fail more rapidly. Or it could be something with the actual biochemical mechanics of the vaccine itself. Above my pay grade.

   However – this has been a topic of conversation for weeks among colleagues both local and far away. Being noticed everywhere. Not that the news media would say a word for months – somehow the flood gates are being opened right now.

   FYI – the discussion in the past few weeks at the FDA to only booster the Pfizer patients was most decidedly NOT because Moderna and J&J were tardy with the paperwork and Pfizer got theirs done first as multiple media stories put forth. Tardy paperwork for a multi billion dollar pharmaceutical my ass. Use your brains.

IM DocSeptember 18, 2021 at 12:56 pm

Houston, we have a problem. (Actually a misquote – but close enough).

Said during an event from my childhood. When a major American scientific and technical achievement was having severe problems. Integrity, honesty, courage and ingenuity saved the day during that crisis. We are about to find out if this country still has it or not. We will see.

I got home from work last night – and watched about 3 hours of the FDA meeting video from yesterday. I have the benefit of being a physician and I possess the learned ability to cut right through the bull shit and recognize at least partially what is going on.

The Pfizer part was the standard issue “drug rep” bullshit I have come to be so accustomed to all my life. All talk no substance. Lots of manipulation of data. Lots of threads that make no sense with the statistics at hand.

The real concern for me was when the safety experts began to talk. I must admit that rage filled my heart. All these months of “perfectly safe, perfectly effective” really took a hit. I will put it like this.. These experts were saying things about the safety issues with these vaccines that would have had them censored instantly from Twitter, Facebook or YouTube. I am surprised that YouTube has left the video up. MC Escher could really have a field day with the hole these tech companies have dug for themselves.

It clearly has gotten the attention of many of my medical colleagues as well. We are going to see how this all plays out.

I guess I have little faith in our current establishment. After all, these Pfizer problems have been somewhat known for months. I have been hearing things for quite a while. AND YET – that is the vaccine the FDA gave full approval to. I honestly do not know if there is anyone left with the integrity to stamp out all the corruption.

Sorry guys, rant off. I do feel some vindication after watching that – that all these safety issues I have been seeing may have some substance. I just do not know where we go from there. It seems to me the die has been cast and the American people are entrenched on all sides.

This is exactly the worry public health officials for generations have had when we combine medicine with politics.

ChetGSeptember 21, 2021 at 4:43 pm

What one didn’t have in the 60s and 70s but which one has today is fast-food restaurants everywhere. That has to make a difference, and since they’re popular, the weight climb is, to my mind, understandable.

I can give one other example: Since the start of the pandemic, I’ve lost about 15 pounds. The difference? My wife and I stopped eating at local restaurants (good food but perhaps large portions). In the end, I think eating less will make the largest difference.

 

1. IM DocSeptember 21, 2021 at 6:43 pm

   Not only did they not have fast food restaurants everywhere in the 60s and 70s – but the big offender in the problem is sugared drinks.

   When I was a kid in the 1960s/1970s – the small drinks at fast food places were about the same size as a shot glass. The LARGE drinks back then were SMALLER than the small drinks are now. The large drinks now are actually often appearing to be 1 liter or more.

   That kind of liquid processed carb is absolutely hellacious – and millions of Americans do this to themselves daily.

CarlaSeptember 24, 2021 at 8:32 am

Re: Actual Healthcare, as in Expanded, Improved Medicare for All:

Last night, I attended a webinar Physicians for a National Health Program (PNHP) held on Direct Contracting Entities, which are posing an immediate threat to traditional Medicare, completely privatizing it and putting it entirely under the control of Wall Street. There is plenty of information about DCE’s available at the PNHP site. I urge my compatriots here, particularly physicians, but health care advocates (which is all of us, right?) as well — to please consider signing and sharing the petition linked below.

https://pnhp.salsalabs.org/DCEpetitionSeptember2021/index.html?eType=EmailConfirmation&eId=2a6c743b-1860-4199-bd8b-fe67420c752f

 

1. IM DocSeptember 24, 2021 at 9:17 am

   Thank you very much for this link.

   If people only knew the almost weekly tragedies I get to deal with because of Medicare Advantage Plans – it would get some attention. Somehow these stories are never told.

   This Direct Contracting Entities would be the next step in the ultimate dissolution of Medicare and handing it over to “non-profit” entities. Look around you right now at the staffing crisis in the hospitals in this country as just one small example as to where this will all lead.

   I can only hope these kinds of ideas will fail.

makesiSeptember 24, 2021 at 4:05 pmSome data on compliance with healthcare worker vaccine mandates. At the UPenn system in PA, 1% (380 out of ~39,000) quit. At Maine Health in ME it was .19% (45 out of 23,000).

1.  
2. IM DocSeptember 24, 2021 at 6:31 pm

   At my small rural hospital –

   I would say basically the mass exodus of employees has already happened long before anyone dreamed of vaccine mandates.

   Nurses are just plain burned out – and have left – we have gone from 40 or so a year ago – down to 16 now. The nursing home attendants have left in droves – the 20 dollars an hour offered – cannot compare to the 25 dollars an hour at the Dairy Queen.

   There is also a large contingent of remaining nurses – who literally REFUSE to take care of the unvaccinated patients – causing massive logistic headaches for the managers. I find that approach to be reprehensible. Did any nurse when I was young get the privilege of refusing to take care of an AIDS patient? Did any of my fellow interns? ABSOLUTELY NOT – would have been considered immoral.

   The ranks of the CNA and orderlies is so dwindled that I am reliving my intern year – and taking patients back and forth from radiology myself .

   I would say that the cratering of the employees was going on long before the vaccine mandates occurred. A loss of 1 employee now would be critical. I am guessing things may be similar for the examples you provided. I am hearing from colleagues this is going on everywhere. My hospital actually has it good compared to others in other places.

   I will put it to you like this – our current hospital load – COVID and others – is absolutely crushing because of the staffing deficiency. However – this amount of patients would have been a breeze last year during the last crash.

   Somehow – none of this is even remotely conveyed in the news stories.

    

1. Terry FlynnSeptember 25, 2021 at 7:38 am

   Health care falling male life expectancy etc. Cancer treatment has effectively collapsed in Nottingham UK.

   https://www.independent.co.uk/news/health/nhs-cancer-chemotherapy-delay-nottingham-b1925484.html

   Those who receive chemo to make palliative care less unbearable (palliative chemo) are receiving letters saying “that’s it bubye”. I would say more if I could but I can’t. All hell has broken loose. I’d say more if I could but suffice to say a 10 year waiting list means “don’t get cancer in East Midlands – you’ll be dead before proper diagnosis”. The cull has begun.

    
   1. petalSeptember 25, 2021 at 9:04 am

      Terry, I can’t say more, but was informed yesterday by a friend in the know that chemotherapy is being rationed. Between that and other supply issues(needles, syringes, etc), they said don’t get sick. This person is expecting a bad winter. My mother also cannot get sulfasalazine anymore due to a shortage. They now instead want to put her on something that has bad side effects and she’s had a bad experience with previously. Good times.

       
      1. 1. IM DocSeptember 25, 2021 at 9:43 pm

            FYI – I cannot speak for chemotherapy.

            However, we are having all kinds of issues with the supply of the multitude of immunologic medications for autoimmune disorders. Humira and Embrel are available but many of the others not so much. We are doing all kinds of changes on these patients.

            Since many of our modern chemotherapy drugs are similar to these medications, I am assuming there may be shortages of them as well.

            I was told by the pharmacist in the hospital that the issue is many of the manufacturing companies have been tasked with making monoclonal antibodies for COVID – and it has affected the ability to process all these others in a normal time frame.

            It has also been an interesting year – in that every single COVID medication in the hospital – IV steroids, remdesevir, and multiple abx for secondary infections have been on back order this year at times for weeks. And now even the monoclonal antibodies are being rationed. This is very very peculiar in American medicine. We have shortages of this and that before – but nothing like this past year. Eye-opening.

In reply to a comment about off-label uses for medications (also, sorry the indent-formatting got lost about here):

IM DocSeptember 25, 2021 at 9:56 pm

Viagra was initially going to be a blood pressure medication.

The backbone chemical structure of all the SSRIs was originally created to be used as a coloring agent for paint and shellac.

Gabapentin was originally a seizure medication.

One of the components of Bactrim – now a common antibiotic – was originally an anti-parasitic.

Some of the common older diabetic medications were originally modeled for chemotherapy.

Even ivermectin is now used by not a few urologists for a very difficult urinary problem called interstitial cystitis.

Shall I go on?

The history of Pharma products is replete with chemicals that actually worked better for other indications than their original intention. Many of these were not found out until the drug was released and then subsequently experimented with by physicians for other uses. Much of these discoveries were total serendipity.

LeeSeptember 25, 2021 at 10:24 am

“I hate videos as a medium for conveying information but this is worth your time.”

I hate to begin my day by differing with she who so impressively and graciously runs things at this site but as both an avid reader and a fan of video, I must rise in defense of the latter medium, and offer as an example an 18 minute recent interview with an ICU nurse working at a hospital in Tennessee that is currently being overwhelmed by Covid patients. The type of information provided by this young woman’s observable demeanor would be difficult, perhaps impossible to convey by symbols on a page. After all, anatomically modern humans’ ability to communicate viscerally through voice and gesture precedes literacy by tens of thousands of years.
 

IM DocSeptember 25, 2021 at 10:10 pm

Incredible video –

All I can say – I have been doing this for 30 years.
I have never seen nurses and other staff leaving in droves like is happening now. Not even close. All over the country. I have never seen MDs and DOs retiring and leaving practice like they are now. Just in the past 6 months, 5 of my graduating residency class have hung it up. 3 were Critical Care docs, 2 were hospitalists. I do not find that to be a coincidence.

Since my earliest days as an intern, I have had a real soft spot for nurses, CNAs, and RTs. They have repeatedly over the years saved my ass so many times I cannot count. To see them put in the position they are today is absolutely heart-wrenching. All the time I have them coming up to me and just erupt into tears.

I do not believe the American people truly understand how close we are to the event horizon of totally unraveling our health care system. It is that bad. I really fear if this situation goes pear-shaped this fall and winter.

I feel like the wrath of the whole country is on me every day. I and my staff never know when someone will go off. I never know how many times I am going back to the hospital when my waiting room is packed. People are angry and at times very out of control. I am very very tired of having to pick up after the constant miscommunication disasters of our federal health officials. People have every right to be very angry.

This week’s shit show – trying to explain the federal health officials’ guidance on who gets the Pfizer boosters. The FDA and the CDC are saying two completely different things. It is literally – “who are you going to believe – the FDA or the CDC?” ——. In 30 years – I have never been put into that position. Not once. Not in the darkest days of the AIDS crisis was there this much confusion. I literally have to do the very best I can do – and hope that all the years of training are solid guidance in the chaos.

Never in my wildest dreams.

bassmuleSeptember 25, 2021 at 11:43 am

A few items from a New Yorker interview with Céline Gounder, an epidemiologist and infectious-disease specialist at Bellevue Hospital and on the faculty of N.Y.U.’s Grossman School of Medicine, and was a member of the Biden-Harris transition team’s COVID-19 advisory board:

What we’ve also seen, and this is typical of any vaccine, is that right after vaccination you get a big surge in antibody levels up front. But that’s not the only part of your immune system that kicks in; your immune system is forming a memory response, through memory cells. And so the antibodies may drift back down over time, but your memory cells are still there. Then, if you’re reëxposed to an infection, your memory cells kick into gear, and you get another surge of antibodies. The issue is that it takes three to five days or so for your immune cells to start revving up to make antibodies, and in that time the virus can still infect you and replicate—the incubation period with the Delta variant, for example, is about four to five days. Your immune system nips it in the bud before you get really sick, but you could still end up with a breakthrough infection.

“That’s really how most vaccines work. They’re not preventing all infections—that’s what we call “sterilizing immunity,” and that’s actually quite rare. What most vaccines do is prevent the infection from taking off and making you sick. One of the problems with this whole debate around boosters is that people have had very unrealistic expectations of what vaccines can or can’t do. They think that seeing breakthrough infections is a failure of the vaccines, when it’s actually quite predictable and normal.”

If you have already been fully vaccinated, there are diminishing returns on what that extra dose of vaccine will do to protect you, versus what it will do if it’s in the arm of somebody else in your community. You have to think about risk in terms of your risk reduction through vaccination, multiplied by the risk in the community. You as an individual will stand to benefit most by reducing risk in the community, if you’ve already been fully vaccinated. And the best way to do that is to vaccinate people who are not yet vaccinated.

And it is still a scarce supply, you know—not just in the United States, but around the world. Less than four per cent of people in Africa have been vaccinated, and that’s going to be the incubator for new variants, which will threaten our pandemic recovery. This is not humanitarian. This is not about generosity. This is pretty much about self-interest: if you are actually interested in getting on the other side of this, you have to start paying attention to people who are not vaccinated—not just here but in the rest of the world.

What COVID Booster Shots Can and Can’t Do

IM DocSeptember 25, 2021 at 10:20 pm

I would have to do some research – but I honestly do not believe any of the other available vaccines has this high of a breakthrough rate. The flu vaccines are non-sterilizing – but I have never known them to have the kind of breakthrough cases we are seeing now.

The author of this piece really must go and look at all the articles from our media, politicians, and medical leaders from earlier this year. She really does have her head up her ass. The fact that you “could not get infected” was being screamed from the rooftops for months all the while with the ubiquitous 95% , and 97% claims. I am looking at my vaccine consent form right now. It clearly states that my experimental vaccine will prevent COVID infection.

There were those of us with our hair on fire trying to get our colleagues to realize these vaccines were being severely oversold. Our efforts went nowhere. I became more and more concerned the more I heard my patients and their supreme confidence that they were done with COVID after the vaccine. Just look at the writing of many of our very brightest journalists – Andrew Sullivan for example. He wrote several pieces in the spring celebrating the fact that COVID would be over by JUNE. Where did he get that idea, I wonder?

Writing such an article at this stage of the game is really a “Lucy grabbing the football” trick.

This is my concern – If these people are not careful, the anti-vaxx movement which is now a fringe has the possibility of becoming mainstream. And that could be generational. They just simply do not get it. And they do not understand that articles like this do so much more damage to their credibility.

 

 

jrSeptember 26, 2021 at 11:45 am

” On average, breakthrough infections seem to be briefer, milder, and less contagious. Among the fully immunized, catching the coronavirus doesn’t mean the same thing it did last year. “It’s a very different kind of infection than in people who are immunologically naive,” Lindsey Baden, an infectious-disease physician and COVID-19 vaccine researcher at Brigham and Women’s Hospital in Boston, told me.”

Which coronavirus is Lindsey referring to? Aren’t there different flavors? Isn’t Mu already ignoring the vaccines? Lambda seems recalcitrant as well. Tell me I’m wrong!

Oh wait, it doesn’t matter, my vaccination has expired anyway…

https://www.theatlantic.com/science/archive/2021/09/post-vaccination-covid/620140/

IM DocSeptember 26, 2021 at 4:52 pm

 

I have dozens of patients who would be very happy to compare notes with Dr. Baden.

I am wondering what they would think of having their cases described as being mild.

I am not sure these people like Dr. Baden are actually taking care of patients.

The vaccinated do seem to MOSTLY avoid critical outcomes. But oh do they ever get sick. Just as sick as all other patients this past 18 months.

Vaccine-Only Mandates as a Manifestation of the Bizarre Civil War-Stoking Impulses of the Professional-Managerial Class in the US

Posted on September 28, 2021 by Yves Smith