Tag Archives: Dr. Fauci

ICU doctor warns: ‘We could lose control of the virus again’, Especially with the George Floyd protests! What About AI to Help in the Post Pandemic Planning!

I am concerned about what I see in society, what I am calling pandemic fatigue and its effect on the behavior of the average bored, anxious and moderately depressed citizens. Adriana Belmonte reported that the U.S. has the highest number of coronavirus cases around the world, but the rate of infections has declined in several parts of the country as a result of social distancing restrictions.

Dr. Lakshmana Swamy, an ICU physician at Boston Medical Center, warned what could happen if people take too much of a lackadaisical approach towards the pandemic.

“What are people seeing across the country in our numbers?” Swamy said on Yahoo Finance’s The Ticker recently. “They’re seeing coronavirus cases go down. That’s fantastic.” 

But, he added, “what you’re not seeing is that the hospital is still jam-packed with people that were deferring care, who were staying at home, scared of coming in. So, the hospital is still really busy. No one’s getting a break here. It’s terrifying to think that now on top of this, as we start to reopen, we could lose control of the virus again.”

‘What I’m seeing in Alabama … terrifies me’

There are currently 20 states experiencing an increase in the number of coronavirus cases. Most of these states — including Alabama, Florida, and Georgia — were among the first ones to reopen their economies over the last month. 

“What I’m seeing in Alabama, of course, terrifies me, as it does so many people,” Swamy said. “We’re all suffering from lockdown. It’s a huge hit, of course, to the economy, to individual people, to health, to everything. But it pales in comparison to the cost that the virus takes when it runs free.” 

Although many are calling for an end to social distancing restrictions because of its impact on the economy, research from the National Bureau of Economic Research (NBER) has indicated that reopening the economy “will have a much smaller-than-expected impact.”

“You look across the country where people haven’t been hit as hard, thank god,” Swamy said. “But you see that people don’t get it. It’s a really abstract concept. It’s hard to believe in that, right? It takes a lot of trust to believe what you’re seeing and hearing.”

“The masks are sort of a symbol of it,” he continued. “The bigger thing is social distancing. I mean, crowds together in open spaces, or especially in closed spaces, it’s terrifying. And it takes weeks to see the effects of that. So people will feel like ‘oh, look, we did that. It’s no problem. Hey, look, they did it over there. We can do it here, too.’”

Although there is still a lot to be known about the coronavirus, one thing that Swamy said he pretty much knows for certain is that there doesn’t seem to be herd immunity, which would mean that enough people had the coronavirus that they wouldn’t be able to get it and transmit it again.

“It’s a lot of science that’s unknown there,” he said. “But I think what we know is that we can’t rely on the virus not being able to hop around and catch like wildfire, even in Boston.” 

‘We’re going to see a spike in COVID-19’

Adding to the stress are the recent protests against police brutality that have taken place over the past week in response to the killing of George Floyd by a Minneapolis police officer, Derek Chauvin. 

Large crowds amassed in major cities across the country, and although many of the participants wore face masks, they were still in close proximity to others protesting. Some health officials worry this could cause a new spike in coronavirus cases.

“I am deeply concerned about a super-spreader type of incident,” Minnesota Gov. Tim Walz said on Saturday. “We’re going to see a spike in COVID-19. It’s inevitable.”

Gov. Andrew Cuomo (D-NY) and NYC Mayor Bill DeBlasio voiced similar concerns during recent press conferences, with Cuomo urging people to “demonstrate with a mask on.”

“It’s heartbreaking, because what we see over and over again is two to three weeks later, the cases start hitting and you see a surge and you see spikes,” Swamy said. “I hope that doesn’t happen anywhere else. But the virus is here. It’s everywhere. So it’s heartbreaking. I hope we can get to people before the virus does.”

Health officials worry about second coronavirus wave after George Floyd

Edmund DeMarche of Fox News was also concerned about another spike in the pandemic especially in light of the George Floyd protests. Health officials in the U.S. have new concerns that the nationwide protests over the George Floyd death in police custody could spark a wider spread of the coronavirus after many cities reported bringing the virus under control.

Scott Gottlieb, the former Food and Drug Administration commissioner, told CBS News’ “Face the Nation” that there are still some “pockets of spread” in communities. He said there has been an uptick in new coronavirus cases in recent days at the epicenter of the protests.

Minnesota Health Department Spokesman Doug Schultz said Sunday that any spike from the protests will not be seen until six to 10 days after its transmission, the Star Tribune reported. The report pointed out that the Minneapolis provided hundreds of masks for protesters.

Gov. Tim Walz said, according to the paper, that he is “deeply concerned about a super-spreader type of incident … after this. We are going to see a spike in COVID-19. It’s inevitable.”

The U.S. has seen more than 1.7 million infections and over 104,000 deaths in the pandemic, which has disproportionately affected racial minorities. Protests over Floyd’s death have shaken the U.S. from New York to Los Angeles.

“There’s no question that when you put hundreds or thousands of people together in close proximity, when we have got this virus all over the streets … it’s not healthy,” Maryland Gov. Larry Hogan said Sunday on CNN’s “State of the Union.”

Demonstrators are packed, many without masks, many chanting, shouting or singing. The virus is dispersed by microscopic droplets in the air when people cough, sneeze, talk or sing.

Dr. William Schaffner, an infectious disease expert at Vanderbilt University, told the New York Times that the “outdoor air dilutes the virus and reduces the infectious dose that might be out there, and if there are breezes blowing, that further dilutes the virus in the air. There was literally a lot of running around, which means they’re exhaling more profoundly, but also passing each other very quickly.”

Despite much of the protest and riots taking place outdoors, looters ransacked stores in various cities. The virus is notoriously transmitted by asymptomatic carriers. The Times reported that Keisha Lance Bottoms, the mayor of Atlanta, told those out protesting to “go get a COVID test this week.”

Fauci Estimates That 100,000 To 200,000 Americans Could Die From The

And now look at Dr. Fauci’s prediction for ultimate mortality rate. Bobby Allyn reported that Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Sunday that 100,000 to 200,000 Americans could die of COVID-19, the disease caused by the novel coronavirus.

The nation’s leading expert on infectious diseases and member of the White House’s coronavirus task force says the pandemic could kill 100,000 to 200,000 Americans and infect millions.

Dr. Anthony Fauci said based on modeling of the current pace of the coronavirus’ spread in the U.S., “between 100,000 and 200,000” people may die from COVID-19, the disease caused by the novel coronavirus.

Fauci’s comments on CNN’s State of the Union underscore just how far away the U.S. is from the peak of the outbreak based on predictions from top federal officials. As of early Sunday afternoon, there were 125,000 cases in the U.S. and nearly 2,200 deaths, according to data from Johns Hopkins University.

Public health experts say that because of undocumented chains of transmission in many parts of the country, the number of new coronavirus cases in the U.S. is set to keep surging as more and more test results become known.

Dr. Anthony Fauci says there could potentially be between 100,000 to 200,000 deaths related to the coronavirus and millions of cases. “I just don’t think that we really need to make a projection when it’s such a moving target, that you could so easily be wrong,” he

Fauci said the 100,000-to-200,000 death figure is a middle-of-the-road estimate, much lower than worse-case-scenario predictions.

He said preparing for 1 million to 2 million Americans to die from the coronavirus is “almost certainly off the chart,” adding: “Now it’s not impossible, but very, very unlikely.”

However, Fauci cautioned people not to put too much emphasis on predictions, noting that “it’s such a moving target that you could so easily be wrong and mislead people.”

What we do know, he says, is that “we’ve got a serious problem in New York, we’ve got a serious problem in New Orleans and we’re going to have serious problems in other areas.”

Fauci’s coronavirus fatality estimate comes as the White House considers ways to reopen the economy, including easing social distancing guidelines that officials have set forth to curb the spread of the fast-moving virus.

One in three Americans is now being asked to stay indoors as new cases soar, especially in New York, which accounts for nearly half of the country’s cases.

When asked if it is the right time to begin relaxing some of the social distancing measures, Fauci said not until the curve of new infections starts flattening out.

He refused to guess when exactly that may occur.

“The virus itself determines that timetable,” Fauci said.

According to the Centers for Disease Control and Prevention, the seasonal flu has killed between 12,000 and 61,000 people a year since 2010. The coronavirus death rate is far greater than the flu’s. For the elderly population, the coronavirus has been found to be six times as deadly.

There is currently no vaccine for the coronavirus. Experts say developing a vaccine for the virus could take at least a year.

Artificial Intelligence in Healthcare: A Post-Pandemic Prescription

David Nash noted that in what now seems a distant pre-pandemic period, excitement about the potential of artificial intelligence (AI) in healthcare was already escalating. From the academic and clinical fields to the healthcare business and entrepreneurial sectors, there was a remarkable proliferation of AI — e.g., attention-based learning, neural networks, online-meets-offline, and the Internet of Things. The reason for all this activity is clear — AI presents a game-changing opportunity for improving healthcare quality and safety, making care delivery more efficient, and reducing the overall cost of care.

Well before COVID-19 began to challenge our healthcare system and give rise to a greater demand for AI, thought leaders were offering cautionary advice. Robert Pearl, MD, a well-known advocate for technologically advanced care delivery, recently wrote in Forbes that because technology developers tend to focus on what will sell, many heavily marketed AI applications have failed to elevate the health of the population, improve patient safety, or reduce healthcare costs. “If AI is to live up to its hype in the healthcare industry the products must first address fundamental human problems,” Pearl wrote.

In a December 2019 symposium addressing the “human-in-the-middle” perspective on AI in healthcare, internationally acclaimed medical ethicist Aimee van Wynsberghe made the case that ethics are integral to the product design process from its inception. In other words, human values and protections should be central to the business model for AI in healthcare.

Health equity should be a driving principle for how AI is designed and used; however, some models may inadvertently introduce bias and divert resources away from patients in greatest need. Case in point, a predictive AI model was built into a health system’s electronic health record (EHR) to address the issue of “no-show” patients by means of overbooking. Researchers determined that the use of personal characteristics from the EHR (ethnicity, financial class, religion, body mass index) could result in systematic diversion of resources from marginalized individuals. Even a prior pattern of “no-show” was likely to correlate with socioeconomic status and chronic conditions.

Fast forward to today when AI seems to be a permanent fixture in national news coverage. Noting that journalists often overstate the tasks AI can perform, exaggerate claims of its effectiveness, neglect the level of human involvement, and fail to consider related risks, self-professed skeptic Alex Engler offered what I believe are important considerations in his recent article for the Brookings Institution. Here are a few:

  • AI is only helpful when applied judiciously by subject-matter experts who are experienced with the problem at hand. Deciding what to predict and framing those predictions is key; algorithms and big data can’t effectively predict a badly defined problem. In the case of predicting the spread of COVID-19, look to the epidemiologists who are building statistical AI models that explicitly incorporate a century of scientific discovery.
  • AI alone can’t predict the spread of new pandemics because there is no database of prior COVID-19 outbreaks as there is for the flu. Some companies are marketing products (e.g., video analysis software, AI systems that claim to detect COVID-19 “fever”) without the necessary extensive data and diverse sampling. “Questioning data sources is always a meaningful way to assess the viability of an AI system,” Engler wrote.
  • Real-world deployment degrades AI performance. For instance, in evaluating CT scans, an AI model that can differentiate between healthy people and those with COVID-19 might start to fail when it encounters patients who are sick with the regular flu. Regarding claims that AI can be used to measure body temperature, real-world environmental factors lead to measurements that are more imperfect than laboratory conditions.
  • Unintended consequences will occur secondary to AI implementation. Consolidation of market power, insecure data accumulation, and surveillance concerns are very common byproducts of AI use. In the case of AI for fighting COVID-19, the surveillance issues have been pervasive in countries throughout the world.
  • Although models are often perceived as objective and neutral, AI will be biased. Bias in AI models results in skewed estimates across different subgroups. For example, using biomarkers and behavioral characteristics to predict the mortality risk of COVID-19 patients can lead to biased estimates that do not accurately represent mortality risk. “If an AI model has no documented and evaluated biases, it should increase a skeptic’s certainty that they remain hidden, unresolved, and pernicious,” said Engler.

Based on what we’ve learned about the limitations and potential harms of AI in healthcare — much of which has been amplified by COVID-19 — what treatment plan would I prescribe going forward? First, I would encourage all healthcare AI developers and vendors to involve ethicists, clinical informatics experts, and operational experts from the inception of product development.

Second, I would recommend that healthcare AI be subjected to a higher level of scrutiny. Because AI is often “built in” by a trusted business partner and easily implemented, objective evaluation may be waived. As data science techniques become increasingly complex, serious consideration must be given to multidisciplinary oversight of all AI in healthcare.

Another paper that I am working reviews the need for a more complete method to contact trace and follow-up the recovered as well as those not infected on a large scale so that we can predict the next spike early. This way we can avoid the horrid effect of a second pandemic and the ultimate effect on healthcare and the economy.

Dr. Atlas and Others on coronavirus lockdowns: ‘The policy … is killing people’ and Not from the Corona virus!

As a physician I only stopped seeing my patients for two weeks during the pandemic. Why? I considered my patients cancer care a necessary demand. My cancer patients needed surgical procedures and the hospital didn’t consider those procedures urgent. So, I offered to do their surgical procedures in my office surgical suite under local anesthesia. If I didn’t the tumors would continue to grow and possibly metastasize or spread reducing their chances for cure. This brings up the important consideration that this pandemic is allowing our regular medical and surgical patient to result in delayed diagnoses and treatment. Victor Garcia reported that the Coronavirus lockdowns may be “killing” just as many people as the virus because as I mentioned, many people with serious conditions unrelated to the virus have been skipping treatment, Hoover Institution senior fellow Dr. Scott Atlas said Saturday on “Fox Report.”

“I think one thing that’s not somehow receiving attention is the CDC just came out with their fatality rates,” Atlas said. “And lo and behold, they verify what people have been saying for over a month now, including my Stanford epidemiology colleagues and everyone else in the world who’s done this analysis — and that is that the infection fatality rate is less than one-tenth of the original estimate.”

Even White House coronavirus task force member Dr. Anthony Fauci is acknowledging the harm caused by the lockdown, Atlas said. “The policy itself is killing people. I mean, I think everyone’s heard about 650,000 people on cancer, chemo, half of whom didn’t come in. Two thirds of cancer screenings didn’t come in. 40 percent of stroke patients urgently needing care didn’t come in,” Atlas said. “And now we have over half the people, children in the United States not getting vaccinations. This is really what [Fauci] said was irreparable harm.”

More on Dr. Fauci later in this post.

“And I and my colleagues from other institutions have calculated the cost of the lockdown in terms of lives lost,” Atlas said. “Every month is about equal to the entire cost of lives lost during the COVID infection itself. This is a tragic, misguided public policy to extend this lockdown, whether or not it was justifiable in the beginning.”

Many states are currently reopening their economies slowly, while a few have pledged to extend the lockdowns through the summer.

The doctor also argued against keeping children out of schools, saying there’s no reason they can’t go back. “There’s no science whatsoever to keep K-through-12 schools closed, nor to have masks or social distancing on children, nor to keep summer programs closed,” Atlas said. “What we know now is that the risk of death and the risk of even a serious illness is nearly zero in people under 18.”

Lockdown measures have kept nearly 80 million children from receiving preventive vaccines

Caitlin McFall of Fox News reported that the coronavirus pandemic has resulted in stay-at-home orders that are putting young children at risk of contracting measles, polio and diphtheria, according to a report released Friday by the World Health Organization (WHO).

Routine childhood immunizations in at least 68 countries have been put on hold due to the unprecedented spread of COVID-19 worldwide, making children under the age of one more vulnerable.

More than half of 129 counties, where immunization data was readily available, reported moderate, severe or total suspensions of vaccinations during March and April.

“Immunization is one of the most powerful and fundamental disease prevention tools in the history of public health,” said WHO Director-General Tedros Adhanom Ghebreyesus. “Disruption to immunization programs from the COVID-19 pandemic threatens to unwind decades of progress against vaccine-preventable diseases like measles.”

The WHO has reported the reasons for reduced immunization rates vary. Some parents are afraid to leave the house due to travel restrictions relating to the coronavirus, whereas a lack of information regarding the importance of immunization remains a problem in some places.

Health workers are also less available because of COVID-19 restrictions.

The Sabin Vaccine Institute, the United Nations Children’s Fund (UNICEF) and GAVI, The Vaccine Alliance also contributed to the report.

Experts are worried that worldwide immunization rates, which have progressed since the 1970s, are now being threatened.

“More children in more countries are now protected against more vaccine-preventable diseases than at any point in history,” said Gavi CEO Dr. Seth Berkley. “Due to COVID-19 this immense progress is now under threat.”

UNICEF has also reported a delay in vaccine deliveries because of coronavirus restrictions and is now “appealing to governments, the private sector, the airline industry, and others, to free up freight space at an affordable cost for these life-saving vaccines.”

Experts say that children need to receive their vaccines by the age of 2. And in the case of polio, 90 percent of the population need to be immunized in order to wipe out the disease. Polio is already making a comeback in some parts of the world, with more than a dozen African countries reporting polio outbreaks this year.

“We cannot let our fight against one disease come at the expense of long-term progress in our fight against other diseases,” said UNICEF’s Executive Director Henrietta Fore. “We have effective vaccines against measles, polio and cholera,” she said. “While circumstances may require us to temporarily pause some immunization efforts, these immunizations must restart as soon as possible or we risk exchanging one deadly outbreak for another.”

Six Social Health System Teams to Encourage People to Seek Healthcare

Alexandra Wilson Pecci noted that the campaign, which aims to encourage people to get healthcare when they need it, comes as providers across the country have seen a dramatic drop in visits and revenue during the COVID-19 pandemic.

Six of Los Angeles County’s largest nonprofit health systems with hospitals, clinics, and care facilities are teaming for BetterTogether.Health, a campaign that aims to encourage people to get healthcare when they need it, despite the current pandemic.

The campaign, from Cedars-SinaiDignity HealthProvidenceUCLA HealthKeck Medicine of USC, and Kaiser Permanente, comes as hospitals and healthcare provider offices across the country have seen a dramatic drop in visits and revenue.

“We know many patients who in the past dialed 911 for life-threatening emergencies are now not accessing these vital services quickly,” Julie Sprengel, President, Southwest Division of Dignity Health Hospitals, CommonSpirit Health, said in a statement. “We are instead seeing patients that delayed, postponed or cancelled care coming to emergency departments with serious conditions that should have been treated far earlier.”

Indeed, outpatient hospital visits experienced a record one-week 64% decline during the week of April 5-11, compared to pre-COVID-19 volumes, according to research from TransUnion Healthcare. In addition, hospital visit volumes further declined 33%-62% between the weeks of March 1-7 and April 12-18.

Those stats were echoed in a Medical Group Management Association (MGMA) survey last month showing that physician practices reported a 60% average decrease in patient volume and a 55% average decrease in revenue since the beginning of the public health emergency. 

In addition, nearly two-thirds of hospital executives expect full year revenues will decline by at least 15% due to the coronavirus disease 2019 (COVID-19) outbreak, according to a Guidehouse analysis of a survey conducted by the Healthcare Financial Management Association (HFMA).

The campaign’s website and PSAs communicate messages like “Life may be on pause. Your health isn’t.,” “Thanks L.A. for doing your part.,” and “Get care when you need it.”

In addition to lost revenue, healthcare providers are warning of a “silent sub-epidemic” of those who are avoiding getting medical care when they need it, which could result in serious, negative health consequences that could be avoided.

“There is concern that patients with serious conditions are putting off critical treatments,” Tom Jackiewicz, CEO of Keck Medicine of USC, said in a statement. “We know that seeking immediate care for heart attacks and strokes can be life-saving and may minimize long-term effects. Our hospitals and health care providers are ready and open to serve your needs.”

The BetterTogether.Health public service effort combines those health systems’ resources to create a joint message that will include multi-language television and radio spots, and billboards, messages in newspapers, magazines, digital, and social media; online information, and links to healthcare resources.

It’s reminding people to seek care for things ranging from heart attack symptoms to keeping up with children’s immunization schedules.

“Receiving timely treatment by skilled medical professionals is essential to helping us achieve for our patients and communities the best possible outcomes,” Tom Priselac, President and CEO of Cedars-Sinai Health System. “Please do not delay getting your health care. We encourage you to call a trusted health care provider like your doctor’s office, hospital or urgent care center.”

Doctors raise alarm about health effects of continued coronavirus shutdown: ‘Mass casualty incident’

Furthermore, Tyler Olson reported something that most of us physicians realized as this pandemic continued that and that more than 600 doctors signed onto a letter sent to President Trump Tuesday pushing him to end the “national shutdown” aimed at slowing the spread of the coronavirus, calling the widespread state orders keeping businesses closed and kids home from school a “mass casualty incident” with “exponentially growing health consequences.”

The letter what I stated in the beginning of this post, which outlines a variety of consequences that the doctors have observed resulting from the coronavirus shutdowns, including patients missing routine checkups that could detect things like heart problems or cancer, increases in substance and alcohol abuse, and increases in financial instability that could lead to “poverty and financial uncertainty,” which “is closely linked to poor health.”

“We are alarmed at what appears to be the lack of consideration for the future health of our patients,” the doctors say in their letter. “The downstream health effects … are being massively under-estimated and under-reported. This is an order of magnitude error.”

The letter continues: “The millions of casualties of a continued shutdown will be hiding in plain sight, but they will be called alcoholism, homelessness, suicide, heart attack, stroke, or kidney failure. In youths it will be called financial instability, unemployment, despair, drug addiction, unplanned pregnancies, poverty, and abuse.

“Because the harm is diffuse, there are those who hold that it does not exist. We, the undersigned, know otherwise.”

The letter comes as the battle over when and how to lift coronavirus restrictions continues to rage on cable television, in the courts, in protests and among government officials. Those for lifting the restrictions have warned about the economic consequences of keeping the shutdowns in effect. Those advocating a more cautious approach say that having more people out and about will necessarily end with more people becoming infected, causing what National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci warned in a Senate hearing last week would be preventable “suffering and death.”

But these doctors point to others that are suffering, not from the economy or the virus, but simply from not being able to leave home. The doctors’ letter lists a handful of patients by their initials and details their experiences.

“Patient E.S. is a mother with two children whose office job was reduced to part-time and whose husband was furloughed,” the letter reads. “The father is drinking more, the mother is depressed and not managing her diabetes well, and the children are barely doing any schoolwork.”

“Patient A.F. has chronic but previously stable health conditions,” it continues. “Her elective hip replacement was delayed, which caused her to become nearly sedentary, resulting in a pulmonary embolism in April.”

 Dr. Mark McDonald, a psychiatrist, noted in a conversation with Fox News that a 31-year-old patient of his with a history of depression who was attending school to get a master’s degree in psychology died about two weeks ago of a fentanyl overdose. He blames the government-imposed shutdown.

“She had to stay in her apartment, essentially in-house arrest as most people here in [Los Angeles] were for weeks and weeks, she could not see her therapist — she could speak to the therapist over the phone but she couldn’t see her in person. She could not attend any of her group meetings, which were helping to maintain her abstinence from opiates … and she relapsed into depression.

“She was just too withdrawn to ask for help,” McDonald continued before noting that due to regulations only six people could be at her funeral. “She was simply trying to escape from her pain… I do blame these actions by the government for her death.”

Fox News asked McDonald, as well as three other doctors who were involved with the letter, if they thought the indirect effects of the shutdowns outweighed the likely direct consequences of lifting them — the preventable “suffering and death” Fauci referred to in last week’s Senate hearing. All four said that they believe they do.

“The very initial argument … which sounded reasonable three months ago, is that in order to limit the overwhelmed patient flux into hospitals that would prevent adequate care, we needed to spread out the infections and thus the deaths in specific locales that could become hotspots, particularly New York City… It was a valid argument at the beginning based on the models that were given,” McDonald said. “What we’ve seen now over the last three months is that no city — none, zero — outside of New York has even been significantly stressed.”

McDonald is referring to the misconception that business closures and stay-at-home orders aimed at “flattening the curve” are meant to reduce the total number of people who will fall ill because of the coronavirus. Rather, these curve-flattening measures are meant largely to reduce the number of people who are sick at any given time, thus avoiding a surge in cases that overwhelms the health care system and causes otherwise preventable deaths because not all patients are able to access lifesaving critical care.

McDonald said that “hospitals are not only not overwhelmed, they’re actually being shut down.” He noted that at one hospital in the Los Angeles area where Dr. Simone Gold, the head organizer of the letter, works “the technicians in the ER have been cut by 50 percent.”

Gold also said the effects of the shutdown are more serious for the vast majority of people than the potential virus spread if it is quickly lifted.

“When you look at the data of the deaths and the critically ill, they are patients who were very sick to begin with,” she said, “There’s always exceptions. … But when you look at the pure numbers, it’s overwhelmingly patients who are in nursing homes and patients with serious underlying conditions. Meaning, that that’s where our resources should be spent. I think it’s terribly unethical… part of the reason why we let [the virus] fly through the nursing homes is because we’re diverting resources across society at large. We have limited resources we should put them where it’s killed people.”

People of all ages, of course, have been shown to be able to catch the coronavirus. And there have been reported health complications in children that could potentially be linked to the disease. Fauci also warned about assuming that children are largely protected from the effects of the virus.

“We don’t know everything about this virus … especially when it comes to children,” Fauci said in a Senate hearing last week. “We ought to be careful and not cavalier.”

Newport Beach, Calif., concierge doctor Dr. Jeffrey Barke, who led the letter effort with Gold, also put an emphasis on the disparity in who the virus effects.

“There are thousands of us out there that don’t agree with the perspective of Dr. Fauci and [White House coronavirus response coordinator] Dr. Deborah Birx that believe, yes, this virus is deadly, it’s dangerous, and it’s contagious, but only to a select group of Americans,” he said. “The path forward is to allow the young and healthy, the so-called herd, to be exposed and to develop a degree of antibodies that both now is protective to them and also prevents the virus from spreading to the most vulnerable.”

Dr. Scott Barbour, an orthopedic surgeon in Atlanta, reflected the comments the other doctors made about how the medical system has been able to handle the coronavirus without being overwhelmed, but also noted that the reported mortality rates from the coronavirus might be off.

“The vast majority of the people that contract this disease are asymptomatic or so minimally symptomatic that they’re not even aware that they’re sick. And so the denominator in our calculation of mortality rate is far greater than we think,” he said. “The risk of dying from COVID is relatively small when we consider these facts.”

Gold, an emergency medicine specialist based in Los Angeles, led the letter on behalf of a new organization called A Doctor a Day.

A Doctor a Day has not yet formally launched but sent the letter, with hundreds of signatures from physicians nationwide, to the White House on Tuesday. Gold and the group’s co-founder, Barke, said they began the organization to advocate for patients against the government-imposed coronavirus shutdowns by elevating the voices of doctors who felt that the negative externalities of the shutdowns outweigh the potential downside of letting people resume their normal business.

To gather signatures for the letter, Gold and Barke partnered with the Association of American Physicians and Surgeons (AAPS), a doctors’ group that advocates for less government interference in the relationship between doctors and patients, and notably has taken part in legal challenges against the Affordable Care Act and advocated to allow doctors to use hydroxychloroquine on themselves and their patients.

Gold, in a conversation with Fox News, lamented that the debate around hydroxychloroquine has become politicized, noting that it is taken as a preventative measure for other diseases and that the potentially harmful effects of the drug mainly affect people with heart issues.

The drug is approved to treat malaria, lupus and rheumatoid arthritis, but the Food and Drug Administration has said that “hydroxychloroquine and chloroquine have not been shown to be safe and effective for treating or preventing COVID-19.”

The FDA has also warned health professionals that the drug should not be used to treat COVID-19 outside of hospital or research settings.

Gold said she has direct knowledge of physicians who are taking hydroxychloroquine and said that although “we will see” about its efficacy as it is studied more, there have been some indicators that it could be effective at preventing or mitigating COVID-19 and she could therefore understand why doctors might take the drug themselves or prescribe it to their patients.

There is also other research that appears to indicate hydroxychloroquine is not an effective treatment for the coronavirus, which has largely informed the consensus that the risks of the drug outweigh the potential benefits.

Gold, who is a member of the national leadership council for the Save Our Country Coalition — an assortment of conservative groups that aim “to bring about a quick, safe and responsible reopening of US society” — also said she was concerned that her message about the harms of shutdowns is becoming politicized. She said that she agreed with the general principles of the coalition and decided to sign on when asked, but hasn’t done much work with it and is considering asking to have her name removed because people are largely associating her message on reopening the country with a conservative political point of view.

“I haven’t done anything other than that,” she said. “It’s causing a big misunderstanding about what I’m doing so I actually think I’m just going to take my name off because it’s not really supposed to be political.”

Gold also said she is not associated with the Trump reelection campaign in any way, referring to her inclusion in an Associated Press story about the Trump campaign’s efforts to recruit doctors to support the president’s message on lifting coronavirus restrictions. The AP story details a call organized CNP Action, also part of the Save Our Country Coalition, which involved a senior Trump campaign staffer and was aimed at recruiting “extremely pro-Trump” doctors to make television appearances calling for the reopening of the economy as quickly as possible.

Fauci says extended stay-home orders could cause ‘irreparable damage’

Just recently Dr. Fauci changed his view on stay-home orders. Dom Calicchio reported that stay-home orders that extend too long could cause the U.S. “irreparable damage,” Dr. Anthony Fauci finally warned Friday.

Strict crackdowns on large gatherings and other orders, such as for home quarantines, were needed when the coronavirus first hit the nation, but those rules can now begin to be lifted in many parts of the country, Fauci said during an interview on CNBC.

“I don’t want people to think that any of us feel that staying locked down for a prolonged period of time is the way to go,” the member of the White House coronavirus task force said.

“But now is the time, depending upon where you are and what your situation is, to begin to seriously look at reopening the economy, reopening the country to try to get back to some degree of normal.” He warned, however, against reckless reopenings and called for the use of “very significant precautions” as restrictions are lifted.

Fauci told CNBC that staying closed for too long could cause “irreparable damage.” He said the US had to institute severe measures because #Covid19 cases were exploding “But now is the time, depending upon where you are and what your situation is” to open.

“In general, I think most of the country is doing it in a prudent way,” he said. “There are obviously some situations where people might be jumping over that. I just say, ‘Please, proceed with caution if you’re going to do that.’”

Fauci’s comments came one day after two top Republicans – Sen. Rand Paul of Kentucky and Rep. Andy Biggs of Arizona – wrote in an op-ed that Fauci’s initial safety recommendations had “emasculated” the nation’s health care system and “ruined” its economy.

“Fauci and company have relied on models that were later found to be deficient. He even has suggested that he can’t rely, on any of the models, especially if the underlying assumptions are wrong,” the pair wrote in USA Today. “Yet, Fauci persists in advocating policies that have emasculated the medical care system and ruined the economy.”

They also pointed to Fauci’s testimony last week before a Senate committee that opening too soon would “result in needless suffering and death.”

“What about the countless stories of needless suffering and death produced by Fauci’s one-size-fits-all approach to public health?” Paul and Biggs asked.

They called for policies based on trusting the risk assessment of the American people rather than a federal government mandate.

Earlier Friday, Fauci said it was “conceivable” that the U.S. could begin to distribute a coronavirus vaccine by December. “Back in January of this year when we started the phase 1 trial, I said it would likely be between a year and 18 months before we would have a vaccine,” Fauci said during an interview on NPR. “I think that schedule is still intact.

“I think it is conceivable,” he continued, “if we don’t run into things that are, as they say, unanticipated setbacks, that we could have a vaccine that we could be beginning to deploy at the end of this calendar year, December 2020, or into January, 2021.”

My question is what does the future of medicine look like going forward from this pandemic and how do we plan for a better healthcare system and assist in the recovery of our economy?

More on that in future posts.