A Covid After-Action Report

Well, that was fun!

Five days in the hospital for Wuhan flu doesn’t sound great, but I am very glad I had access to a good community hospital with good nursing and an experienced staff that has seen tons of the disease. My county has been the hardest hit in my state, so I guess I am a bit lucky.

Contrary to the ignorant reports of overwhelmed ERs (lines outside don’t mean anything), my experience was impressive. Triage was perfect. There were lots of typical ER visitors (sprains and sniffles and nausea…) wandering around, but they were placed at the back of the line. I was seen almost immediately, and within 10 or 15 minutes was put in a private room and given a PCR test to confirm the rapid test. That took about an hour, and I was then treated with the hospital’s standard protocol and moved to the Covid wing.

Most of my crushing and awful symptoms rapidly moderated, which was impressive. And very possibly coincidence, but there is no way to know. I was left with profound fatigue, a cough from hell, and clear instructions to use the damned spirometer as much as I could. But as some of you know, hospitals are nothing if not boring and uncomfortable, so that was my entertainment! But please; don’t ask about the food!

One thing I found fascinating and not a little depressing was the real time information available to me via the much-touted electronic medical information systems that are going to revolutionize medical care. Unfortunately the systems in use where I am are an absolute catastrophe…filled with inaccurate information (in real time!) and glaringly obvious cut & pastes by physicians, nurses and clerks. Wrong data about medications, inaccurate descriptions of physical exams, time stamps that are obviously incorrect, and that was from a casual perusal over several days.

Obviously many of those errors are not specific to electronic data…doctors and nurses and clerks make mistakes regardless. But the replication of errors is made effortless by electronic records, and while a cut & paste of a physical exam that wasn’t done on Tuesday may mean nothing, one can imagine that sometimes it can be a very big deal. Any medical malpractice attorney with two functioning synapses would have a field day with these sort of errors, not to mention the undeniable fact that this simply isn’t good medicine.

The larger question for me during this experience is whether the vaccine I got 10 months before had conferred any residual immunity. Clearly, based on the data, the immune response fades over time, so was I protected at all? I have no idea, but what I am quite pleased with is being fit and of normal weight. I was far to the right on the Covid Severity graph, and there is no explanation for that other than the randomness of the disease, but I imagine I would have fared worse had I been fat and unfit.

Could have I avoided hospitalization were other therapies available to me? Perhaps. Monoclonal Antibodies were not available, but neither would they have been the first choice because of the severity of my symptoms. HCQ and Ivermectin? The data on HCQ is sort of crappy, although because it is quite safe there is no particular need for it to be strictly controlled. Ivermectin is another case entirely, with its use a disgusting political football. Other countries have had good outcomes with it, and it is undeniably a safe drug, so absent clear and convincing evidence that it does not work, there is no medical reason for its restriction.

The politics of medicine has roared to the forefront, with the vaccines presented as the Holy Grail against Covid, and Ivermectin and a few other therapies presented by an insanely partisan media as some sort of nefarious plot by the far right to undermine SCIENCE^TM.

A rational analysis of the science, without the vile politics and craven behavior of the bureaucracy in support of their partners in Pharma, or the craziness of the anti-vax purity brigade yields some pretty basic facts.

• The vaccines are modestly effective but their protection fades over time.
• The vaccines should be given to high-risk people first, and then to the general population.
• The risk-benefit analysis strongly suggests that the vaccine should not be given to children.
• The virus is rapidly mutating (as most viruses do) to a more infectious and benign form.
• The current vaccines are probably not as effective against the current strains.
• There are mature, very safe medications that seem to be of benefit against Covid that should be considered for use, just like the other new high-priced therapies that don’t have the safety records of the older medications.

Pharma will do what any corporation will do…maximize profit. I have no problem with that. What I have a huge problem with is the revolving door between government regulators and cushy jobs in Pharma, and even worse, the ability of regulators and our oh-so-honest politicians to profit from investments in the very companies they regulate.

Until the blatant corruption in the system is minimized we cannot trust the basic science being used in support of therapies recommended by our government medical bureaucracy. It is profoundly, irreparably corrupt, and until it is burned to the ground and rebuilt with high walls between Pharma and government we will continue to see these insane disconnects between good medicine and government action.