Category: COVID-19

Is a Pandemic About “War” or “Natural Disaster???”

The answer actually matters. Check this out. Here we have a blogging cardiologist arguing that we should not be making the mistake of dealing with COVID as if we are in a war with the coronavirus. Wars give governments pervasive powers and often turn citizens against each other. Rather, we should deal with the pandemic as a natural disaster. Something that we expect citizens to ban together to deal with, rather than fragmenting into factions. And the government to focus on helping the citizenry, rather than issuing mandates.

Bottom Line. Interesting. Metaphors can have very important and pervasive psychological consequences. See how we have been (mis!)-handling COVID-19 for reference!

“No One is in Charge” of US Public Health

Check this out. What you will see is a summary statement on the COVID pandemic, and more generally on the state of public health in the United States, from a blogging psychiatrist.

Doubtless he is correct in his perception that millions of pious Jews prayed to God during the recent Days of Awe that He extinguish COVID-19. Sadly, the blogger has come to conclude that the results of the last 19 months have strongly suggested to him that “No one up there is listening or responding.”

Likewise, he opines that no one on earth is really running public health either. In the US, is it the CDC or the FDA? Nope! The President? Nope again! WHO? Nah! Tony Fauci seems like the answer that is closest to the truth, and despite his expertise and constant TV appearances, that’s just silly.

And what comes out of this? Constant confusion! My wife and I were very clear that, according to Biden’s pronouncement and what I heard from my Volunteers In Medicine physicians, everyone who got Pfizer #1 and #2 should get a booster shot eight months thereafter. Off we went to the pharmacy department of our local grocery store(!), and got the shots. No questions asked. Two weeks later, we find that the FDA is now only recommending the shot for the immunocompromised and those over 65 (Thankfully, Casey and I are in the latter group and not the former!), with the CDC yet to weigh in, the Moderna and J&J vaccine boosters still up for grabs, and Dr. Fauci labeling the FDA vote against universal boosters as “not the end of the story.”

Bottom Line. Both in the heavens and here on Earth, the fact that no one is really in charge of public health is a problem that has been brought into focus by the COVID-19 pandemic.

And now it needs to be fixed!

The Covid Vaccination Struggle and “Market Forces”

In my most recent round of 10 On Doctors’ MindsSMmonthly conversations with physicians about the impact of the pandemic on their private practices in primary care, cardiology, oncology, etc., I have been asked by several clients to talk about the impact of “market forces” on vaccination acceptance among their patients.

As I predicted in a previous post, the Pfizer vaccine receiving “FULL FDA APPROVAL” didn’t matter in a single practice with which I conversed. Patients simply have no idea of the difference between “Emergency Clearance” and “FDA Approval.”

For practices with large numbers of working patients, the possibility of a “VACCINE MANDATE” was predicted by my discussants to have a significant impact, although not without a lot of rancor as the picture above, on the left, would suggest.

By far, the best conversation I had on the topic of convincing patients to get vaccinated was with a cardiologist in the Bronx, who actually was the first US physician to contract COVID himself at the beginning of the pandemic. He tells skeptical patients that they are right.  The vaccine is a hoax, as is the pandemic. The 600,000 people who have reportedly died of COVID were actually taken to Area 51 in Nevada, where they are being kept against their will. Etc., etc.  At the end of this riff, he asks patients if they believe all of that. Most, not surprisingly, say “No!” His retort? “Then your only choice is to get the vaccine.” One patient shot back that he was going to have to “Evaluate the science further.” To which the cardiologist, obviously no shrinking violet, responded, “You’re a truck driver. How are you going to do that?” Sort of the current situation in a nutshell! 

But check this out. An ICU nurse’s graphic reminder that when you show up at the ER gasping for air, there are no more choices. Everything available for treatment, including intubation, will basically be forced upon you. No volition. No more “bodily autonomy.” 

Bottom Line. One thing that my discussants are telling me this month is that the only “market force” they have seen motivate a recalcitrant patient to get the vaccine is actually seeing someone close to them die of the disease. 

Question. How can we synthesize the impact of that horrendous but impactful experience and get it into widespread public distribution???

Love Vs. Vaccine Mandates

May we live in interesting times. Check this out. What you will see is my friend Jane Sarasohn-Kahn’s blog post which further develops a theme I wrote about recently. In my post, I talked about the PSA offered by Pope Francis, in which he described getting the COVID vaccine as “An act of love.” Here, Jane notes that the Catholic Health Association has mounted an entire campaign wrapped around the notion of getting vaccinated being a way to “Love thy neighbor.”

AND. As I wrote this on September 9th, a clearly perturbed President Biden announced that he was “out of patience” with the unvaccinated, and proceeded to issue a mandate for almost 100 million people to get vaccinated. Federal employees, those doing business with the Government, employees of large corporations, etc.

Bottom Line. An interesting juxtaposition of events. A message based on love and a Presidential mandate. Will these forces combine to get the hardcore unvaccinated to take the plunge? What will the percentage of success be? How quickly will all of this unfold?

Stay tuned!

Does “Confidence” Cause “Action???”

Here’s an interesting one. A recent Harris Poll indicated that formal FDA approval of Comirnaty increased respondents’, both vaccinated and unvaccinated respondents, “confidence” in the vaccine. Interesting thought in and of itself. Reading this left me to ponder how many people could outline, even at the 20,000-foot level, the differences in the hurdles that a vaccine has to clear in order to obtain “emergency approval” versus “FDA approval.” I certainly couldn’t and look at what I do for a living!

The plot thickens. According to this same article, about 50% of those who are unvaccinated are moved enough by this increase in confidence that they “probably” or “definitely” will be vaccinated, and about 60% of parents are now willing to get their children vaccinated. Color me skeptical on that one. Talking with patients on the topic of vaccination, I have heard religious objections. I have had patients say that they are afraid that the vaccine since it is “Messenger RNA,” will alter their genetic makeup. Or have a negative impact on their fertility. Then there are those who believe that the vaccine will “magnetize” them or allow the government to track their movements. Does “FDA approval” relieve them of these objections?

Bottom Line. Just as I had finished reading this piece, I was scheduled to do one of my On Doctors’ MindsSM conversations to get an update for our hundreds of subscribers as to what is happening in office-based practices as a result of the pandemic. This doctor, a more senior primary care physician in a rural practice in Pennsylvania, offered that about 60% of his patients had been vaccinated and that he saw little likelihood of any more doing so. He has tried hard to get the balance to get vaccinated, but to no avail.

Survey research results versus the opinion of a physician with 50 years of experience under his belt. Which do we believe? Oh, and other factors, like major corporations, government agencies and academic institutions now feeling empowered to issue vaccine mandates given FDA approval might well have a significant impact on the outcome here.

What will Cominarty’s approval translate into in terms of new patients journeying out to get the “Fauci Ouchie?” 

Stay tuned!

What’s in a Name???

Here’s an interesting one, the likes of which we have never seen before. When the Pfizer vaccine received final FDA approval, the company quickly rolled out a brand name for the product. Comirnaty. You can see the “creatives’” minds at work coming up with this one.  “Co” for COVID. “mirna” for the first authorized messenger RNA. “ty” for community. 

The only question is whether any of this marketing fluff will matter. Likely “the Pfizer vaccine” is a term heard, around the world, more frequently than the name of any other pharmaceutical product prior to its FDA approval.  As we have often discussed, habits are strong forces, and I scratch my head wondering whether anyone will take the time to learn the new “brand name,” and to substitute it for the terminology now entered on hundreds of millions of vaccination cards. Will the result be clarification or confusion?

Bottom Line. While I see why Pfizer felt the need to promote this name, I wonder how many times someone will say “Comirnaty,” get a quizzical look from a listener, and respond, “You know! The Pfizer vaccine!!!” 

Will Pfizer spend a lot of money to drive the new name home? Will it matter? It will be interesting to watch and see!!!

Are We Entering the “Dark Ages???”

Our friend the Country Doctor certainly thinks so. Check this out! What you will see is his riff on the current collective state of mind of the United States. A sort of shared craziness that has the country more afraid of a vaccine than the disease it has been developed to prevent. Over 600,000 Americans dead and counting, and still half our population is unvaccinated, and many of them proud of it. Science has become a nasty word in the minds of many. Terms like “mandate” fly right into the face of the LMA (“Leave Me Alone”) generation and have led to demonstrations and violence. Flight attendants are literally getting punched when they tell passengers to put on masks. The result? I have seen several FB posts that have suggested that this might well be Armageddon, the end of the world as forecast in Revelation. 

Bottom Line. I know, I know. Chicken Little speak. The sky is falling, the sky is falling!!! We typically make fun of people whose stock and trade is the prediction of the end of the world.  BUT. I think that the doctor has a point here that should be considered. Are things bad now? Arguably, yes. Are things likely to get worse? Maybe. What will that look like?

And most importantly, what can be done to get our collective consciousness back on a positive track? I think the good doctor is correct. If things get better, it will be due to “dumb luck or divine intervention.” It will NOT be due to everybody doing their parts! 

Pope Francis and the COVID-19 Vaccine

We have an interesting situation here on Hilton Head Island, SC. Reported statistics indicate that about 70% of Caucasians here are fully vaccinated.  And 40% is the number being bandied about for Blacks, while the estimated number for our LatinX citizenry is 20%. 

A couple of points here. First, the explanation for the White vs. Black disparity has been heard many times. From the Tuskegee Experiment (In which Black men were purposefully injected with syphilis and left untreated to “see what would happen”) on forward, Blacks have unfortunately been provided with many “good” reasons to distrust medicine, doctors, etc.

But what’s with the LatinX number? The marketing researcher in me would love to know what’s going on here, but there are likely many factors at work, and we are desperately short on time.  Since talking science has not made much of a change in this number or overcome whatever factors are at work, maybe a campaign based on the Pope’s recent PSA, in which he declared that receiving the vaccine is an “Act of Love,” might be more effective in persuading the largely Catholic LatinX population to get vaccinated. If the Pope and these bishops say they should do it, with many of them speaking in Spanish, some probably will.

Bottom Line. Over the decades I have been studying health psychology, I haven’t seen religion pop up very frequently in health-related conversations. Now might be a good time to use religion to support vaccination, especially since anti-vaxxers’ “religious objections” are heard frequently!

Ivermectin, the “New Hydroxychloroquine”

Check this out. What you will see is a piece describing how a major piece of the “scientific data” offered to support the use of ivermectin, an anti-parasitic drug used in veterinary medicine, in the treatment of COVID-19 in humans is quite likely fraudulent. Not just inconclusive or errant. Purposefully fraudulent.

As the story points out, we have seen this movie before. As with ivermectin, claims of data supporting the efficacy of hydroxychloroquine were last year’s quick fix for the pandemic. So, what’s going on here? In brief, the psychology behind all of this seems to be that we need a treatment for COVID-19 now, this drug may be worth a try, so it’s not a bad thing to conjure up some bogus supporting “data” to convince people to use it.

Bottom Line. Yeah, BUT!!! During a pandemic of a “novel” virus, with real scientists running around like crazy trying to figure out how to prevent and treat, about the last thing the world needs is another distraction like this. 

Stop it!

Tele-Urology

Check this out. What you will see is that Dr. Diana Londono, the urologist pictured above, offers a sort of fascinating array of services on her website. These include:

Treatment of Acute Symptoms

I offer same day, virtual, tele-video or

telephone appointments for urgent

urological conditions.

Funny. I usually think of such one-off telemedicine encounters as being the purview of Primary Care Physicians. Where I have seen telemedicine employed by specialists, it has usually been as a “follow-up.” All of which got me to thinking. What other specialties could profitably offer such appointments for “acute symptoms,” and what conditions would they cover?

Bottom Line. Clearly, the “right way” to employ telemedicine in the long run is still undetermined. It will be fascinating to see how all of this shakes out in years to come. The COVID-19 pandemic threw most physicians willy-nilly into telemedicine, and many found virtual visits to be less than satisfying. But telemedicine clearly has a place in the practice of medicine in 2021 and beyond.

What is that place? Stay tuned!