“I read a report that said 88% of adults trust their doctors — well, 100% of dead people don’t.”
― Stewart Stafford
|Lincoln Stoller, PhD, 2020. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0)
On July 27th an unofficial press conference was held on the steps of the Supreme Court in Washington, DC. A newly formed group called America’s Frontline Doctors, consisting of GPs, hospital doctors, and colleagues presented their perspective on the COVID-19 experience. Their underlying message was the SARS-CoV-2 virus was not as dangerous as we were being led to believe, and that effective preventative measures exist, if implemented correctly.
These were not politicians and did not represent a political movement, or party. They did not represent an institutional authority or government agency. Their remarks were not vetted or approved.
They were introduced by Congressman Ralph Norman of South Carolina, and they were part of a quickly organized conference that had convened over the weekend. Their message was not the same as what was being broadcast by either party, by the White House, or by the institutions approved by these parties. However, since the press conference, all the mainstream media organizations are now claiming the group was pushing the Trump party-line. I do not hear an advocacy for Trump’s message in this group’s statements.
Six doctors spoke. They did not speak in politically guarded statements. They made several statements that have been widely recognized as fact, and some that sounded overly optimistic.
They were correct in stating that false results about Hydroxychloroquine had been published and then quickly retracted, that the truth about medication effectiveness was not being told. There continues to be a much greater focus on critical care than on addressing the infection at it’s early stage. This is important and the mainstream media has not made this point as forcefully as it should. They also claimed that organizations are interfering with the dissemination of information—which is certainly true—and are making Hydroxychloroquine unavailable—which is a damning accusation.
I have been following the publications and information they were referring to for the last six weeks, ever since these issues came to light. I am publishing my own observations on the same issues in my book COVID-19: Illness & Illumination, of which you can download a free, digital copy by going to its book page at https://www.mindstrengthbalance.com/covid19book/. I concluded, even before this press conference, that a number of the criticisms these doctors are making are correct.
It has been 36 hours since the press conference and I have seen scant mention of it in the mainstream press. It was rebroadcast by the Trump administration and the videos of the presentation, posted on Facebook, YouTube, and Twitter, were quickly removed by those corporations on the basis of it being false information.
While the video of the press conference and an accurate record of what was presented are now hard to find—you can view the full video which I’ve copied above—there is an easily located uproar denigrating the group and their opinion using ad hominem and misstated information, but no engagement on the points that were made. It seems that what institutions want to disseminate as “the truth” is being defended by portraying as false, established facts that are contrary to the official version.
The mainstream media has excoriated the group and its claims. This is in spite of the fact that the group was clear in making claims based on the experience of its members, not on published information or official policy. In spite of this, supposedly accurate mainstream media outlets, including the Washington Post and The Rolling Stone, have misread their statements, engaged in ad hominem attacks, and been biased in their referencing of scientific research.
These responses have come as political commentary from the mainstream media, not from their science writers. This is par for the course, except that in this case the stakes are amplified a thousand fold. Here, the truth, the false truth, and ignorance are costing hundreds of lives each day.
This press conference is the most dramatic example I’ve seen of the failure of the political system, healthcare, and media to execute their roles. It is a clear and rare example of each of these institutional voices being misinformed or wrong, and the unofficial voice as being if not correct then justified in its basic message. It is a stunning example of the average viewing citizens being unable to think or act in their own best interests. At least, that’s where we stand now, 36 hours out.
The most vocal and emphatic of the group was Dr. Stella Immanuel, a middle-aged, very Nigerian doctor working in Houston, Texas. I say “very Nigerian” because she is pragmatic and uncompromising, traits that I associate with a culture that has to do what works when there are limited resources. This is exactly the kind of person we need in this situation, and she played that role.
She is also an angry, immigrant, black woman, speaking to an angry, racist country whose pervasive class and race inequities are currently being hung out to dry. On the one hand, it’s great to see the forces that her background represents taking a stand on the front lines. On the other hand, it’s only to be expected that her medical message will be drowned out by the hysteria of the moment, and so it has been, so far.
Dr Immanuel made two comments that have attracted the most attention, and a third comment, which she wanted to be heard as her primary message, that is being lost in the uproar. He first comment—or that which is being taken first—is that masks are not necessary. Her next most heard comment was that there is a cure. Her third comment, which is being lost, is that people don’t need to be afraid. All of these comments are being twisted out of context and misreported.
Her comment was not that masks are not useful, it was that they are not necessary. And she was not talking about rates of infection, she was talking about rates of death. Her point was that rates of infection now, which are rising dramatically, are being misunderstood and being equated with rates of death. This is a misconception as the rates of death are not rising in proportion to the increasing rates of infection. That is, the case fatality rate continues to fall.
The point is that it is unclear how much of the rising infection is due to increased testing and how much is due to increased spread. It has been repeatedly shown and discussed that actual infection rates were an order of magnitude higher than was originally reported because tests were not being done. What we are now seeing may not reflect new cases transmission, but existing cases due to previous transmission. While there has been a large increase in confirmed cases and a small increase in deaths, its cause is uncertain.
Immanuel’s implication was that masks are not effective because the virus has already spread and that spread is now being noted by expanding tests. Her point was that rather than focusing on stopping the spread, which we are not doing well with masks, we should focus on prophylaxis and treatments, the means for which we have. The bottom line is that Immanuel does not really know enough about the trends or their causes to be rendering a judgment. What she is offering is an educated, personal opinion.
Further, she condemned giving science the first say in clinical treatment because science moves slowly and clinical treatment must move quickly. This is irrefutable. This is why those responsible for clinical decisions need to have the autonomy, access to resources, and the authority to make those decisions. This is not appreciated by academics, administrators, and politicians concerned with certainty and long-term social trends, and who are not working with remediation first-hand.
It should be noted that there remain good reasons in support of the use of masks. Namely, they greatly reduce the quantity of virus expelled by someone who is contagious, and they might reduce the viral load inhaled by someone in their vicinity. The question of the degree to which this is important is a separate question, but it does not detract from the utility of wearing masks or the positive effect of social distancing.
These are not new issues. The conflict between public health, individual choice, patient rights, and doctors’ independence has dogged the health care field for a long time. What’s happening now is that there is an emergency, and what was a traffic jam before is now turning into a train wreck.
Immanuel was not speaking as a scientist, she was speaking as a doctor. She denigrated slow, official studies as being inappropriate for guidance in emergency situations. There is a good argument for this, in this case. No one who needed emergency treatment would delay or refuse it for lack of officially certified, academically approved, scientifically validated, peer-reviewed publication of statistically significant, confirmed, efficacious treatment. Doctors are not scientists, and emergency doctors need protocols with or without the scientific method. As a scientist and a therapist, I understand this.
Immanuel’s third point was that the virus has been tamed. If open access to information and medicine was available, people would not die, she claimed. This may be true or not and the issue should be heard. It would be important to know the number of doctors in her position who share her opinion.
These doctors were not politicians, so they did not speak in buzzwords and soundbites. Immanuel’s comment about masks was not aimed to denigrate the use of masks—which she repeatedly said she and her colleagues use—but in reaction to the singular focus on them. It was to say that masks should not be our only sense of defense, and that the fear that we’re doomed if not for social distancing is false information and an incorrect prescription.
Her comment that we have a cure appears to be partially substantiated by the experience of some doctors and some reports I’ve seen. A great furor arose around the claim that hydroxychloroquine, zinc, and Zithromax help cure or prevent COVID-19. There first was evidence that it did, then evidence that it didn’t and that evidence was shown to be egregiously false. Then arrived evidence that hydroxychloroquine failed to help. At that point the drug was stricken from further testing and was deemed a failure in the press.
However, these last findings are again misleading because they tested the drug in unuseful doses at improper times. They did not follow the indications put forward by those originally indicated the drug’s promising application. What was observed, and what was not tested, was that administration of hydroxychloroquine along with zinc and Zithromax–when administered early–lessened the severity of the symptoms. Indications were that administration of these drugs significantly reduced risks of infection and ensuing damage.
What was shown, in the last battery of tests, was that the drug failed to work when administered in a manner where it would be expected to fail. This is a useful result, but it is not the result that was needed. Unfortunately, those who are making decisions at an institutional level do not have the skill or insight, or perhaps patience and intelligence, to distinguish a correct answer from the useful answer.
Dr Immanuel’s claim was more aggressive. She claimed that this drug cocktail was rehabilitating seriously ill patients, and that small doses of hydroxychloroquine alone acted as a reliable preventative.
I don’t know of any tests to confirm these claims, but Immanuel was adamant that she was not basing her statements on such tests, but rather on her own experience. That experience should be easy to verify, and would be extremely interesting and important, but, given the censorship of her observation and the indifference to her claim, it appears that it will not be verified or examined.
Science and Medicine
Clinical medicine is not a science. It is an empirical exploration hampered by the imperative that no situation should be considered an experiment, and the reality that every situation is an experiment. There are some elements in clinical medicine that can be approached scientifically—clinical medicine can use scientific conclusions—but the clinical approach cannot test failure to the degree that’s needed to ensure a sound, scientific understanding.
At every step, clinical medicine attempts to minimize time, cost, suffering, and failure. One cannot succeed in science under these conditions. That’s why clinical medicine partners with other fields to find a scientific basis for its approach. These other fields include research medicine, pharmaceuticals research, biology, genetics, public health, epidemiology, and a host of diagnostic, instrumental, and related fields. In these supporting fields, progress can proceed scientifically, although—it must be recognized—novelty and innovation are not guided by any method. Intuition always plays a role in science, but it plays a primary role in clinical medicine.
What the Frontline Physicians were advocating was the necessity to grant clinical medicine the power to exercise its intuition and, in this, provide inspiration for others. The official response to this has been to shut them down.
After sending this post, I received a few vituperative responses and a slew of unsubscribes. One person chided me, the others were derogatory and personally offensive. For better or worse, I responded to these people to clarify that I was not acting to take sides but to open minds. All three responded reasonably—or as reasonably as one could expect—and made their grievances clear. This was good as it allowed me to edit this piece for greater clarity.
One respondent encouraged me to clarify my political allegiance and I considered that, but that is not what is needed nor relevant. I am not here to support one alliance or another, but to encourage insight and the exchange of potentially useful information.
A fourth reader showed this piece to his doctor friends, people who are involved in treating patients with COVID-19, and this is how they responded:
———- Forwarded message
Dear (My Friend),
We were aware of the doctors speaking out—since saw some of the videos and agree with them wholeheartedly. First of all, HCQ/ZPak/zinc given early work very early for coronavirus. And, the doctors should be upset that the FDA/Fauci and others got in the way of their prescribing it all of this time.
And, there was an article on Fauci having been a fan of HCQ for SARS in 2005. So, why the violent reaction to its use today? Clearly, they were looking to promote a vaccine and meds like Remdesivir which do not work. And, Fauci and company will benefit from Remdesivir’s sale as well as the vaccine profits. There are many studies that show HCQ is effective if taken with ZPak/Zinc. The only time the studies did not have good results is when they did not administer the Zpak and Zinc. The reason HCQ works is that HCQ pushes Zinc into the cells and most people are deficient of zinc so they have to take 30 mg a day for HCQ to be effective.
We have many doctor friends/colleagues who have had great response treating Covid with HCQ/ZPak/zinc if given in the first five days of the illness and that includes the elderly, those with comorbidities, diabetes/hypertension,asthma, etc. Several doctors are also using it prophylactically to prevent Covid. It is currently almost impossible to get a prescription and close to impossible to fill. Several friends of ours told us the only way they could fill it was to order from out of the country. This is terrible since it is the best treatment out there.
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