ACP Internist Blog


Wednesday, November 17, 2021

Will we be wearing face masks forever?

I don't foresee them disappearing from the public landscape anytime soon.

I think there will be a segment of the population that will continue to wear masks even after the pandemic has subsided. Indeed, there are parts of the world where donning a face mask is routine.

And as we have all seen, there is a vocal segment of the population that will refuse mask wearing regardless of the circumstances. For example, sitting governors, with a keen eye for politics, have ordered that no mask mandates can be instituted in their states. Score 1 for Politics and 0 for Science.

Just as our country has not experienced its last hurricane or wildfire, there are other pandemics lurking over the horizon. So, over time, mask wearing will rise periodically when nature's germ warfare strikes us again.

I also suspect that many health care institutions will require their staffs to wear masks long after the public will have been advised that masking is no longer advised. These hospitals and medical facilities may truly believe that ongoing mask wearing will offer protection with no downside. And, it may serve as a branding function to reassure the public regarding the institution's culture of safety. Many medical images, a stethoscope, the nurse's cap of yore, the white coat, the doctor's black bag and a surgical mask, are viewed favorably by the public.

Have you ever noticed how often physicians being interviewed on television are wearing a white coat when there isn't a patient in site? Image matters.

I don't envision that a face mask will become a permanent wardrobe accessory for me. But I expect to see others masked up on ground and air transportation, in theaters and at sporting or entertainment events. Perhaps, our marketing gurus, who spend their professional lives convincing us to buy products that we don't need, will convince us that masks are cool. Imagine a 30-second ad spot during the Super Bowl depicting a biker on a Harley cruising up a dirt road, sunlight gleaming off the motorcycle, mask in place …

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
Monday, October 11, 2021

Health professionals lying about COVID-19

The COVID-19 pandemic continues. The 96% of COVID-19-immunized physicians in America are becoming infuriated by people resisting vaccine and masking. The unvaccinated population is dying at high rates and leaving their children orphaned. In case you lost track, we are averaging 1,800 deaths a day now and unvaccinated people are 11 times more likely to die of COVID-19 than vaccinated. These COVID-19 patients are impacting the health system and in some states there are no hospital beds (or personnel to staff the beds ) available for strokes, heart attacks, cancer patients and accidents. Patients are being transferred hundreds of miles to other health facilities … if they are lucky to find one open and doctors that will accept the transfer. Why has this happened?

One very important cause is the tiny number of doctors spreading virus misinformation that has a huge influence on what people believe. Telling lies is easy and finding out the truth takes time. We have too much information and it is hard to sort it out. These lies take advantage of information overload and the fact that people are drawn to info that is novel and unusual. They appeal to people (lots of us!) that have distrust of the government. They use their titles and credibility, wearing lab coats, using simplified medical jargon and spouting “new evidence” that will expose corruption and cover-up. They quote their own research as if it is valid and accepted. Many of these doctors have had their licenses revoked (even before COVID-19) or have been kicked-out of medical societies and universities. Tucker Carlson on Fox News is happy to give them a platform and social media feeds us this info, no matter how fringe. One Indiana doctor spread lies in a video that has been viewed over 100 million times on Facebook, 6.2 million views on twitter and 2.8 million views on YouTube.

I have an on-line acquaintance who lives in Florida who told me his 50-year-old unvaccinated wife was fighting for her life in the hospital. I asked him if he was vaccinated and he said “No, there is a lot of confusion about that and the nurses in the hospital said don't get vaccinated.” This is malpractice. It is dangerous misinformation that kills patients, and those nurses should be fired.

Now there is a growing call among medical groups to discipline physicians spreading incorrect information. The Federation of State Medical Boards, which represents the groups that license and discipline doctors, recommended that states consider action against doctors who share false medical claims, including suspending or revoking medical licenses. The American Medical Association says spreading misinformation violates the code of ethics that licensed doctors agree to follow.

It takes years for state boards to sanction professionals, and I don't see any end to the fraudulent websites, pseudo treatments, “Plandemic” videos, and intentional misinformation that is being spread by health professionals. At a time of world crisis, we are failing.

This post originally appeared at Everything Health. Toni Brayer, MD, FACP, is an ACP Internist editorial board member who blogs at EverythingHealth, designed to address the rapid changes in science, medicine, health and healing in the 21st Century.
Thursday, September 30, 2021

TSA fails to protect passengers from COVID-19

We are taught from a young age to finish the entire job. I confess that I still need reminding on this virtue.

I suspect that all of us must plead guilty to partial task completion from time to time. Have you ever washed some of the dishes remaining in the sink? How about cleaning out part of the garage and rationalizing that this is enough work for one day. How many of us have projects around the house that are waiting patiently for our attention as they sit frozen in time?

There are more stark examples when stopping short if the finish line is downright absurd.

Consider some examples extracted from my imagination.
• An artist paints only on one side of the canvas, and I don't mean for artistic reasons.
• A car wash cleans only the rear section of automobiles.
• A publisher distributes books that are 100 pages short of their true length.

Silly, right?

It's easy to conjure up similar examples regarding the medical universe.
• A surgeon washes only one hand prior to surgery.
• A doctor prescribes antibiotics for only half of the standard number of days.
• A hospital housekeeper cleans half of a patient's room after discharge.
• A gastroenterologist begins a colonoscopy and decides to end the procedure at the halfway mark.

In these examples, the medical interventions are all pointing in the right direction, but they are simply insufficient.

Half measures are called that for a reason.

Recently, the Transportation Security Administration (TSA) extended its mask requirement for travelers using air and ground transportation from Sept. 13 to Jan. 18, 2022.

This is the Mother of All Half Measures. Yes, we know that masks have impact and I have been wearing one more often since the Delta variant has taken off. But the better response, which every responsible public health expert (or even novice) endorses, is vaccination. If COVID-19 vaccine has incredible safety and efficacy data, far superior to masking, then why doesn't the TSA require this? Technically, it wouldn't be a vaccine mandate since the individual is still free to forego travel. But I suspect it would make vaccination more attractive for those that wish to use public transportation and air travel.

In addition, masked travelers are permitted to demask when taking food or drink, which markedly decreases the masks' effectiveness.

If we are wheeled into the surgical suite to hear the scrub nurse in the operating room announce that half the instruments have been sterilized, wouldn't we be sprinting out of there like a racehorse?

Why then are we satisfied traveling if we are only half protected?

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
Friday, August 20, 2021

How do we reach herd immunity against COVID-19?

Last week I conjectured that the Center for Disease Control and Prevention (CDC) obfuscated when they recently recommended that vaccinated individuals resume indoor masking under certain circumstances. My speculation was that the policy was justified but that the CDC was not forthcoming in explaining the rationale for the policy revision.

The revised re-masking recommendation, as with every other aspect in this pandemic, has only further polarized a nation that seems to be trying very hard not to heal itself literally and politically. I predict that our collective political affliction will long outlast the coronavirus plague.

I routinely ask patients if they have received the COVID-19 vaccine. Recently, a patient replied that has not received one. I asked what his concerns were and he firmly responded that he would never get vaccinated against the coronavirus. Not much space for dialogue here.

The CDC and public health experts admit that masks are not the antidote. The shortest and surest pathway to the other side is for the unvaccinated to vax up. The government hasn't yet figured out a strategy of how to get this done.

Here are 3 options.

Educate the public so they will voluntarily accept the vaccine to protect themselves and rest of us. Highlight the rather incredible safety and efficacy statistics. Begging, pleading and downright bribing may be incorporated into this policy. This has been our current policy which thus far has failed rather spectacularly.

Mandate vaccinations for every eligible person, either immediately or when official Food and Drug Administration (FDA) approval for the vaccines is granted, which is anticipated in the near term. While you might be tempted to choose this option with zeal and enthusiasm, you may wish to consider what may follow the vaccination edict. One of the pandemic's lessons is that Americans, unlike many other countries, are individualists who are not swayed by serving the greater good. A mandate would fuel protests and refusals to succumb to governmental tyranny. Politicians and candidates would pander to this aggrieved group which might serve to elect and re-elect anti-vaxxer officials. The nation might end up being further divided and not much closer to herd immunity.

Discomfit the unvaccinated sufficiently such that the voluntarily accept the vaccine. If concert venues, airlines, restaurants, public transportation, hotels, employers and retail establishments increasing required proof of vaccination for entry, it might serve to induce vaccination compliance.

What have I left out here? What would you suggest? Give it a shot.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.