Words of Healing: Stop the Monstrous Science by Dr. Franken… : Emergency Medicine News

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medical ethics, misinformation, pseudoscience

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Truth is another plague victim.

—Nicholas A. Christakis, MD, PhD, Apollo’s Arrow: The Deep and Lasting Impact of Coronavirus on How We Live

We doctors have been humiliated by a sci-fi tale electronically advertised as breaking medical news, and it has plagued our American village. Some of this information is pseudoscience, but some is not, which makes vivisection of the facts murkier and stormier. Some medical informants don’t have evil intent. They reasonably said, “What’s the harm of trying x if it doesn’t hurt you and it might help you?”

One response to this seemingly common-sense approach is that you lose scientific integrity, the proper process of scientific method on which modern medicine has established a reliable foundation. If we allow a doctor to use his professional degree as an indicator of his personal therapeutic experiences and beliefs, we all lose the battle for truth and trust, regardless of intent.

This rush for treatment with little more than anecdotal information and crude studies is even more damning now that we have validated prevention with vaccines and proven treatments with pharmaceuticals. Now we have patients who will not get a vaccine, although it has been proven in over four billion people, but they will take ivermectin bought from a grocery store because their primary care physician or a “expert” found on Facebook said: “Why not?”

The contemporary American physician risks becoming a pre-professional entertainer of late 19th century medical spectacles (e.g., Dr. Oz). Confidence is hypnotized and massaged by emotional appeal or political conspiracy. My Kansas medical community, which has always been a stronghold of strong and respected physicians, now has practitioners who, like Dr. Frankenstein, seem scientifically Promethean as they drive through the village promoting their discovery that works from a different brain.

We have PCPs and their minions giving IV Vitamin C, Ivermectin, Vitamin D supplements, Zinc tablets and Azithromycin along with steroids for anything COVID-19 related. (References against these therapeutics can be found in my article, “The Drivers of COVID-19 History”, REM. 2021;43[12]:26; https://bit.ly/3Dc0LN1.)

We have physicians on School Advisory Committees who recommend that masks should never be required for K-12 students. Some OB/Gyns have even told their OB patients not to get vaccinated. A pathophysiology has evolved to create the lie. There is a vigilantism and bestial elation in appreciating the disfigurement of traditional medical institutions and approaches. It’s as if the year 2020 unleashed a monster that drove everyone scientifically mad!

Recommit to ethics

It’s time to reign over our unattached colleagues and shout above the maniacal crowd that much of the COVID-19 news by “medical experts” is bad science. Sacks of reports are daily dug up from filth and shocked into a life of deformity. Medical news has been turned into a capitalized product of media companies rather than preliminary data awaiting thoughtful dissection by scientific communities. Medical education and physician organizations need to recommit to ethical climate change to create straight-headed professionals.

Medicine backed by statistics is rarely flashy – it is usually slow, tedious and boring, not the lightning-laden current medical information intended to alarm and astound. The smell of electrified and burnt experimental flesh is so pungent that we lose taste and smell to all thoughtful science around us. Let me move this call from a colorful argument to some rather bland non-fiction examples of some black and white numbers (all before Omicron).

Up to 50% of all COVID-19 transmissions are asymptomatic or presymptomatic. (Proc Natl Acad Sci USA. 2020:117[30]:17513; https://bit.ly/3swRzQ3.) This is the impetus for mask-wearing (now preferably surgical or respirator) and physical distancing during times of high prevalence.

The decrease in real-world COVID-19 transmission among U.S. K-12 children using cloth masks is an absolute decrease of 18.5 cases/100,000 per day (35 unmasked cases versus 16 masked cases per 100,000 per day). (MMWR Morb Mortal Wkly Rep. 2021:70[39]:1377; https://bit.ly/3oFE27I.) These studies have primarily used cloth masks of varying styles and features among a population that could be said to have been confused by poor compliance.

Community-based surgical masks in a large randomized controlled trial with 350,000 Indonesian villagers showed an absolute difference of 1% (8.6% vs 7.6%) and a relative difference of 11% during a period of low incidence without significant tissue difference v. no mask. (Science. 2022;375[6577]:eabi9069.) Surgical masks in the over-60s subset made a 35% relative difference in infection.

Myocarditis and pericarditis due to COVID-19 infection were 11/100,000 and those from the vaccine were 2.7/100,000 with an absolute difference of 8/100,000. (N English J med. 2021;385[12]:1078; https://bit.ly/3Lt03QL; JAMA-cardiol. 2021;6[10]:1202; https://bit.ly/3uHJvyC.) No serious findings occurred in the vaccinated group, but the numbers were insufficient to make a statistical comparison of disease severity.

Profit, Votes, Fame

Monoclonal IV infusion (bamlanivimab-etesevimab) resulted in a 5% absolute difference in hospitalizations and was performed in high-risk outpatients within three days of laboratory confirmation of COVID-19 (2.1% versus 7% in the placebo group). (N English J med. 2021;385[15]:1382; https://bit.ly/3GLTtkJ.) Deaths were reported with hospitalizations and were different with 11/518 in the monoclonal group and 36/517 in the placebo group, but this 11 versus 36 is not powerful enough to draw independent conclusions.

Oral molnupiravir (antiviral) resulted in a 3% absolute difference in hospitalization of 48/709 versus 69/699 in the placebo group in a randomized, placebo-controlled, double-blind trial in high-risk unvaccinated patients with mild to moderate symptoms where hospitalization was a surrogate marker of disease progression. (N English J med. 2022;386[6]:509; https://bit.ly/3rxwdkS.) Subgroup analysis revealed more hospitalizations among diabetics and those with previous COVID (unclear if vaccinees would parallel a previous COVID subgroup).

A booster combined with two Pfizer vaccines reduced infection by approximately 5% compared to two Pfizer vaccines alone (6.6% versus 1.8%) and reduced mortality (0.16/100,000/day = 65 deaths versus 2.98/100,000/day = 137 deaths). (JAMA Medical Intern. 2022;182[2]:179; N English J med. 2021;385[276]:2413; https://bit.ly/3uH6ObY.)

Among this extremely brief sample of recent COVID-19 data, one must be struck by how little absolute difference was found between interventions that could be misinterpreted as not making much difference. Remember that a 1% absolute difference in mortality among a large number, say eight million, could mean the difference in 800,000 lives!

The other point to remember is that these studies are specific to unique cultures and populations at any given time, not to mention the biases inherent in the type of study. These studies have multiple layers of complexity and potential confusion deserving of many statistical point-and-counterpoints between scientific experts skilled in the interpretation of statistics. In other words, no one should walk away after reading the conclusion of one of these studies and giving a quick nudge to its implementation, not to mention the posts you click on using your phone.

Only corporations, political parties, and mad professors who claim profits, votes, or fame speak with that kind of brash certainty. Medical professionals with statistically cooler heads must police this information, come out of this storm into the light, and tell frantic citizens to go home while we work to stop the Dr Frankensteins among us from destroying us with monstrous approaches. to medical science. There is no greater honor than to be trustworthy. We need to revive a principled and prescriptive medical science.

Dr. Mosleyis an emergency physician in Wichita, KA.

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