Category: COVID-19

Make Lemonade! Or Maybe Even Lemoncello!!!

Check this out. You know the old expression. If life gives you lemons…

Watch the short video and you might join me in an ah-hah experience related to this old chestnut. Along comes the pandemic, and most U.S. restaurants immediately sink into deep trouble. Many don’t survive. The latest recovery package from the Feds earmarked over $22 Billion (Yes, with a B) to help restaurants to get back on their feet. Simply weathering the storm was a stretch objective. 

BUT. Denny’s had a different idea. They decided to make a profit from COVID-19. Not by taking advantage of people during these tough times, but by making creative use of public health measures, delivering food, etc., and reestablishing their brand’s positioning as America’s Diner. Smart move.

Bottom Line. As I continue to roll out my monthly On Doctors’ MindsSM conversations with physicians about their pandemic experiences, I keep encountering a missed opportunity for the nation’s pharmaceutical companies. Physicians were thrown into a tizzy in March and April of 2020. Their patient loads suddenly dropped to zero, they had to hasten into telemedicine, they were concerned for their own health AND they no longer had their good buddies, the Pharmaceutical Sales Representatives, to lean on. Doctor after doctor has told me how “disorganized” our industry has looked to them during the pandemic.  

What a great opportunity for a drug company to step forward and say, “We’re here for you, Doc!” Develop a strategy and tactics that delivers on this promise during the pandemic and you have a friend for life!

Or, you could just do what most drug companies did. Sit back and wait for all of this to be over and soon we can go back to the way things used to be. 

Wrong!

Loneliness Hurts The Most

What is the worst thing that the pandemic has done to us? Killing 500,000 Americans? Not good!  Screwing up major pieces of the U.S .economy? Also, not good!

BUT. Perhaps the worst thing that COVID has done to us is to increase loneliness, and even more pervasively, the fear of being alone.

Check this out. What you will see is the story of a doctor who learns that even though he has asked all of the right medical questions, he has not fully done his job if he has not made sure that he has done as much as possible to treat the patient’s loneliness. To find her missing cell phone and get it to her. To reconnect her with her family.

Bottom Line. Isolation. Quarantining. I talked to a 60-something “bag boy” at my Country Club today. I knew he had had Covid, and I asked him how he had made out with the disease. By way of response, he without hesitation told me that the worst part was being separated from his wife. At home. Quarantining in the bedroom. NOT in an ICU bed. Not on a ventilator. But still being alone.

Hopefully this will be a positive learning experience that comes out of the pandemic. The realization of just how important our connectivity with other people actually is, and how distressing it can be when that connectivity is taken from us!

A Physician Dilemma During A Pandemic

Check this out. What you will see is a blogging physician asking whether we really mean it when we say we support our “healthcare heroes.”

Here’s the deal. A public health physician ended his day with 10 doses of COVID vaccine left over. What to do? There was at the time no protocol for how to handle left-over doses. There was no known waiting list for him to contact. So, he decided to spend his own time to go search for patients who might benefit from the vaccine before it spoiled. Which he did after getting permission from his boss.  

Like the old proverb says, “No good deed goes unpunished.” He was promptly fired from his job for going “above and beyond,” and the District Attorney launched an investigation into whether he should actually be charged with stealing the vaccine. Oh, and the Texas Medical Board weighed in as well.  

Bottom Line. Good grief! How many thousands of situations like this have dotted the landscape in the last 4 months since the vaccine became available? Remember the guys who got trapped in a blizzard, and wandered up and down the highway administering vaccine to other trapped drivers before the juice went bad? Did they commit a crime?

Sure, Dr. Gokal got his job back, the Texas Medical Board backed off and the initial criminal charge against him was dismissed. BUT. The DA continues the witch hunt, and the aggravation for the doctor along the way must have been significant to say the least.  

SO. Besides the lip service of praising our “front line health care workers,” how about if we actually show them some respect in ways that really matter???

“Good Morning From Vietnam”

Older readers will recall Robin Williams’ memorable “Good morning, Vietnam” movie quote. I can still hear his enthusiastic rendition of this line as he portrayed a military radio announcer during the war. Captivating! May he rest in peace!!!

This is not that. But it IS a good morning in Vietnam. Check this out.  

What you will learn is that Vietnam, as of December 2020, had 1,465 laboratory confirmed cases of COVID-19 and 35 deaths. You will also see the stupid easy principles on which they relied to keep these numbers so laudably low. 1. Detect. 2. Contain. Period!  

It turns out that having had severe outbreaks of novel viruses in the past, the country had the experience, infrastructure and commitment to avoid it happening again. My manicurist, who was denied her annual return for a visit to her native Vietnam last year and this, has described all of this to me based on her personal experience. The URL I sent you to here does a more rigorous and thorough job of laying out the cookbook for success in pandemic control. 

Bottom Line. Thought question. Has the United States learned from COVID-19 these same kinds of lessons? You know, the ones that would keep over 500,000 Americans from dying the next time a pandemic comes knocking on our door?  

Sadly. I am guessing that the answer is “NO!”

Covid-Delayed Medical Care

Check this out.  What you will see is an article clearly outlining the kinds of medical procedures that are being postponed due to COVID-19 pandemic. As summarized in the article “Even with telemedicine, there were 6.9 million fewer mental health visits. Early childhood immunizations declined by 22%. And 31% of adults avoided preventive care in 2020.”

In the On Doctors’ MindsSM interviews I am conducting every month; I am repeatedly hearing Oncologists expressing concerns about the “stage shifting” that they are seeing in their practices. Translated, they are seeing patients initially presenting with more advanced cancers as the result of missed screenings through colonoscopies, mammograms, etc.  

One physician told me a really scary story in this regard. In 2019, a routine screening found one of his patients to have a PSA of 12. Not good. The doctor told the patient to come back in a few months to have that value rechecked. Along comes the pandemic and the patient cancels his recheck appointment, being too fearful of the virus to show up in the doctor’s office. In 2021, the patient finally got up the nerve to come in for the recheck.  His PSA? 127! His prostate cancer? Widely metastasized!  

Bottom Line. Doctors are telling me that it will take years for the total impact of postponement of care to be realized. . . BUT. This article points out a few “Red Alert” symptoms that cannot be ignored, even in the short term. Hint. If you have chest pains or shortness of breath, get to the hospital quick, even if there are patients upstairs being treated for COVID!  

Amazing that people have to have this pointed out to them, but Cardiologists are telling me that especially in the early days of the pandemic, when everybody was totally confused and fearful, their usually busy cardiac care units were silent and empty. Explanation? People were having “silent heart attacks,” ignoring their chest pains and just staying home. 

Bad idea!!!

Doctors As Dog Groomers

Check this out. What you will see is an exploration of the various jobs that the 21% of physicians for whom the pandemic brought furloughs or other reduction in hours/income have pursued in an effort to keep financially afloat. Dog groomer, warehouse worker, doll house decorator, etc. 

Keep in mind that this is the first time in memory that physicians in the U.S. have faced any widespread version of unemployment. Little wonder that 2020 has, as this article reports, led many doctors to consider leaving medicine altogether.

Bottom Line. As we have discussed in previous posts, this is a really strange time to be a physician. While doctors are increasingly valued and some specialties are working unconscionably long hours, others are out of work in whole or in part.  

How long will it take the medical community to restabilize itself after this multi-faceted onslaught? I am thinking “Years!”  

Straight Talk

Check this out.  What you will see is another take on the vaccine effectiveness confusion issue we discussed in the previous post. Here, the Astra-Zeneca Oxford vaccine, marketed in Europe, gets thrown under the same efficacy shortfall bus that yesterday we saw bedevil J&J in the U.S.  

Why? As this article says, “… the two (organizations) bear responsibility for confusing data reports and a general lack of transparency, resulting now in a mishmash of authorizations around the world.”

Nice work. The article further discusses the lack of willingness of the company representatives to provide clear answers to questions that have been posed in an attempt at clarification of the underlying issues.  

Bottom Line. As the title of the article suggests, “straight talk” might be the best way for AZ Oxford, and by implication for J&J, to get out of this morass of confusion.  

It usually is!

When Does 66% Equal 95%???

When Dr. Fauci talks about COVID vaccines, that’s when! We’ve all seen Tony on TV, repeatedly telling listeners to “Get any vaccine you can get when it is your turn to get vaccinated.” But check this out. What you will see is a new challenge for J&J. Developing a working vaccine was tough. Getting people to accept their vaccine is constituting yet another challenge.  

Here’s what is happening. First, you had the J&J vaccine tested in a different time frame and different geographic areas than the Pfizer and Moderna vaccines. That means it might well have been encountering different, more infectious variants, thus accounting for its lower efficacy.  

Then, you have the natural tendency, as described by Behavioral Economists, for people to try to simplify information on which they are basing decisions. Thus, a vaccine that is efficacious for 95% of patients is thought of as “working for everybody,” while a product that is 100% effective in preventing death but only 66% effective in preventing disease is thought of as “sometimes it works, and sometimes it doesn’t.”  

Bottom Line. Perhaps the biggest problem here has been the history of confusion and misinformation that has permeated the entire COVID-19 pandemic. People trying to sort out he specifics of vaccine effectiveness face a significant statistical challenge, and Fauci vouching that we “now have three effective vaccines” simply adds to the confusion.  

SO. J&J’s communication challenge here might well be almost as daunting as developing the vaccine to begin with!  

COVID-19 Vaccine’s Financial Windfall

Check this out. What you will see is Moderna being catapulted from $60 Million in sales in 2019 to $571 Million in the fourth quarter of 2020. One could argue that this meteoric growth is a triple miracle. Miracle number one? Simple. A company that nobody ever heard of beats heavy hitters like Merck and J&J to the discovery and approval of a vaccine. Miracle number two? That Moderna could arrange to manufacture the number of doses they are turning out. And miracle number three? That they could set up a corporation that could strike international deals and do the other things that a company needs to do to profit from miracles #1 and #2.

Bottom Line. AND. We are all very thankful for Moderna’s three miracles! Especially those who had invested early in their stock!!!

The Rise And Fall Of Doctor Google

The Rise And Fall Of Doctor Google

Check this out. What you will see is a complicated interplay of public perceptions of physicians and the doctors’ own self perceptions. Said what?

Here’s the deal. Prior to the pandemic, Americans were increasingly likely to trust medical advice found on Google and in the social media, and decreasingly likely to trust physicians. Scroll forward. COVID has brought a return of the perception that “the Doctor knows best.” Only problem is, now that they have been placed back on their pedestals, doctors are more than well aware of their limitations in preventing mortality and morbidity caused by the coronavirus. AND. They still have to deal with the administrative claptrap that was burning them out prior to the pandemic. AND. They are wrestling with new factors like telemedicine which were thrust upon them by the pandemic.

Bottom Line. It’s not an easy time to be a physician. Was it ever?