It is week 3 since the return of normal commerce and culture to the Commonwealth of Pennsylvania. It is wonderful to freely socialize, shake hands, and gasp, even hug family and friends that have been absent for so long.

In fact, the only place where I have to wear a mask is during work, at our VA hospital where the Federal Government still requires face covering.

There are some sad sequelae from the pandemic. For instance, in my case, I had close friends who avoided contact with me for the entire pandemic. Hopefully, this was because of my job, which involved caring for Covid-stricken veterans. Last November, I was infected and recovered. Recently it became clear that these friends still shun me, even though they are vaccinated. They claim it is because I am not.

I have written before about this. When vaccines were first available, doses were limited, I felt ethically, that since I had been infected and very likely was immune, I ought to hold back until more vulnerable people had been immunized. Now with vaccines widely available, I continue to hesitate. Because of this, some people choose to keep their distance.

My reasons for not being vaccinated basically fall into 2 categories:

#1. At least for now, I don’t believe it’s necessary for recovered patient’s to be immunized.

#2. I have concerns over the technology of the new vaccines and the reports of scary side effects, including roughly 11,000 vaccine-linked deaths reported in the CDC’s Vaccine Adverse Effect Reporting System (VAERS).

I have been watching the literature closely regarding the question of the post-recovery immunity of COVID-19 patients. Early on, there were several studies looking at antibody levels post-recovery. The consensus seems to be that antibody levels are quite high immediately post-infection. There was a point where they appeared to fall which was an early concern, but it now appears that they plateau at a healthy level. So far, since the first infections were seen, this continues to be true.

 A recent study out of New York University looked at the characteristics of the immune response in recovered patients, versus those who are vaccinated. It concluded that “Both the natural infection and mRNA vaccination-induced robust innate and adaptive responses but the authors noticed material differences in the two cohorts”. It was noted that the Pfizer vaccine activated fewer portions of the immune system, whereas natural immunity had a broader response.

Getting any of the vaccines basically exposes you to one small protein on the virus, the “S” or spike protein. This makes up a small percentage of the antibody “targets” on the virus. It does currently confer immunity.  Should the spike protein mutate sufficiently ( which does happen), then these mRNA vaccines could well be rendered ineffective. Natural immunity exposes your body to the whole virus. This includes many more antibody targets creating redundancy to protect from new strains.

In April 2021 researchers from the Israel Institute of Technology, The Hebrew University of Jerusalem, and Sheba Medical Center studied the effectiveness of immunity derived from the Pfizer vaccine, versus natural immunity in recovered patients. They found that in terms of percentage effectiveness they were essentially equal in terms of recurrence and hospitalization. They tried to compare deaths, but there were no deaths in the natural immunity arm of the study.

Even more convincing was COVID 19 data from May 2021, to the present, compiled by the Israeli Health Ministry to analyze their most recent outbreak (delta variant). It also compared those who were vaccinated to unvaccinated patients who had recovered from Covid. The data suggests that in Israel you were 6.7 times more likely to be reinfected if you were merely vaccinated, versus recovered from infection. From this data, Israel is trying to decide whether another round of boosters will be necessary.

Even the NIH appears to support post-recovery immunity. In this article from their website, they describe a study done in the La Jolla Institute for Immunology in California that was actually funded by Dr. Fauci’s own agency, the NIAID. Here’s a quote from the article dated 1/21/2021 “our studies showed that natural infection induced a strong response, and this study now shows that the responses last,” Weiskopf says. “We are hopeful that a similar pattern of responses lasting over time will also emerge for the vaccine-induced responses.”

Of course, I am also aware of the availability of cheap, available and effective anti-Covid therapy in the form of ivermectin, and hydroxychloroquine. I have had a rather dramatic reversal of my own Covid symptoms last November after taking the latter medication.

Given all of this evidence, and the controversies surrounding the vaccine, I have elected to pass for now. If natural immunity is shown to wane in the future, I would of course be vaccinated, especially as I’m aware that there are several conventional inactivated-virus type immunizations in the pipeline.

This is not meant to be a rant against vaccination. What I wish to get across, is that the products currently offered are not completely benign and still not FDA approved. The decision to be vaccinated should be based on your risks of serious illness, versus the risk of vaccine complications. A 75-year-old obese diabetic should certainly get the “jabs”. An 18-year-old healthy college student… probably not.

As I have written in the past, I feel it’s important for people to do their own research before acquiescing to the government’s recommendations. There is a larger agenda here, one that likely involves unhealthy relationships between government health officials, and big Pharma.

I’ll keep my own counsel for now.

As always I would Be honored if you’d share.

Header Image: Elizabeth’s View( Samsung Galaxy S 20 5G UW)

It has been a year and 10 weeks since our lives were fundamentally altered by a pathogen we are coming to realize was a veritable bioweapon cooked up and sloppily released by the CCP, with monies from the NIH. I am happy to say that we do appear to be emerging into a post-Covid world with decreasing cases and increasing vaccinations.

You may remember that my last post back on May 7 was titled “They’re all lying to us”. Given subsequent developments, it appears this is more true than even I believed. From my point of view, it looks like certain people should be indicted for perjury. It also appears that whatever sliver of credibility was retained by the so-called “mainstream media” should be doused in gasoline and burned to cinders.

Here in Pennsylvania, it’s definitely beginning to feel as though the pandemic is ending. There were 2 public questions on the ballot in the recent primary that were designed to limit the governor’s emergency declaration powers. Both passed easily. Gov. Wolfe has announced the end of pandemic restrictions as of late May, but given the new rules, they may actually have expired already.

I point this out because there is no longer any incentive to spin the pandemic so as to minimize Government restrictions. That’s over.

In a matter of 2 weeks, we have seen a huge shift in mainstream opinion on the origins of the virus. Since my last article, the dogma that the SARs Cov-2 virus spread through a “wet market” has all but collapsed. It is increasingly acknowledged that the likely source of this virus was a P4 lab run by the Chinese Communist Party.

At the onset of the illness in Wuhan, after initial intra-virology community disclosures, the Chinese prohibited all information from being released by the Wuhan lab. Shortly afterward, Chinese health authorities descended on a “fish market” in the town. This was done to create the myth that bats sold as “bushmeat” were the source of the infection.

They were ably assisted in this deception by the World Health Organization, the CDC, and by the NIH and NIAID (Dr. Fauci’s organization).

The selling of the “natural source theory” of the bat virus origins was going swimmingly, until last spring, when both Republican Senator Tom Cotton and then-President Trump, claimed to be privy to intelligence suggesting that the virus originated in the Wuhan Lab.

I’m sure you’ll remember what happened next.

Here is a wonderful compilation of the press reaction to those statements:

Let us just say that terms like debunked, discredited, dismissed, hoax and crackpot, all came into common press usage in the weeks afterward. This treatment was also the response to the extremely well-documented report published at that time by Joshua Phillips of the Epoch Times.

So, now it’s May 2021. Within a few weeks, multiple well-established journalists publish reports, supporting, very credibly, the lab origin theory. Suddenly, with Donald Trump banished, the press has changed its tune.

With the press embargo apparently lifted, information starts to flow, Suddenly we find out that in November 2019, 3 workers in the Wuhan lab became ill with symptoms consistent with the virus, so much so that they were transported to a hospital.

We know from the Phillips report, that even the Chinese government investigation found that the first four victims of coronavirus were known to have had nothing to do with the “wet market”.

We have also learned, that in early 2020 both the Australian and Thailand intelligence services, reported to the US on a possible release at the Wuhan site.

Suddenly the Trump and Cotton statements start to make sense. This also explains why the Trump CDC head, Robert Redfield, also supports a lab origin for the virus.

Apparently now, quite suddenly, so does Dr. Fauci. He spent over a year decrying the possibility rather vehemently and mocking those who espouse it. Suddenly this week, he has quietly alluded to the possibility and now suggests an investigation into the matter. I have no words that would express adequately my disgust.

As Tucker Carlson pointed out in a recent opening segment, if the virus was engineered or just accidentally released from the lab, then this is the single worst (by far) man-made disaster in human history. That would make the people that diverted, dissembled, and outright lied to withhold the truth major world-class villains.

One more thought: Donald Trump’s endorsement of the lab origin theory was enough to set the national press on an organized effort to discredit the concept. Now with their dream of his defeat realized, they are suddenly completely reversing their opinion.

What else did Trump endorse? He endorsed hydroxychloroquine, which prompted the same exact response from the press, as well as Dr. Fauci, despite all manner of data, from anecdotal, to peer-reviewed that supported its use, early on, in the disease course.

If this effort to discredit the medication was to “get Trump”, then those who were involved in the effort may be responsible for thousands of patients who may have experienced severe illness or even death, because early treatment was withheld.

I want to remind you that these lies hurt people of all political stripes, not just conservatives. The elite media’s manipulation of the facts potentially harmed even their own loyal consumers. No one should ever trust them again.

In a just world, those public officials and associates who for political reasons, distorted and withheld information needed to address this pandemic would be investigated, and if necessary, indicted and tried. The journalists and pundits who supported the effort would be mocked, shamed, and hopefully fired. Their employers would be sued into bankruptcy by the victims and their families.

The lesson we should learn from this is simple. There is essentially no ethics left in either government, “big tech” or the media. Do your own research(on DuckDuckGo not on Google). If Facebook suppresses a viewpoint, find out more about it.

Stop parroting the orthodoxy on social media. Those posts may not age well.

Form your own opinion. Don’t be afraid if it conflicts with the viewpoint of your particular political or identity group.

In these increasingly weird times… it could save your life.

As always, I’d be honored if you’d share.

Header image: Blueberry blossoms (Fujifilm X100V)

It has a been year and 7 weeks since our lives were truncated by the ruling elites, on account of a virus from China. Here in the US, vaccinations are being made available to a greater portion of the population, and more and more states, including my own, are easing their grip on our lifestyle.

This is our second spring under regulation, and it seems that this year, warming temperature have definitely brought out a lush growth of Covid 19 fatigue. Given our circumstances, I think it is justified.

I for one have absolutely had it with the policy people at the CDC. The new masking guidelines, giving us permission to gather outside without masks, only if it with household members or people known to be vaccinated, is ludicrous on its face. It will obviously be universally ignored. Don’t get me started about Dr. Fauci and his wildly meandering utterances. Someone needs to put a stop to his media appearances.

Especially since he bears some responsibility for our situation.

I have been perusing the internet for more Covid news. I recently encountered Sharyl Attkisson’s report on the origins of Covid on one of the compilation sites. I posted it earlier this week on Facebook. Based on multiple sources and documents both conclude that the virus was likely engineered in a Wuhan virology lab and then escaped out into the population. This was a lab had been noted by multiple organizations to have poor containment policies. This “gain of function” research was being done in cooperation with virologists at the University of North Carolina. And… it was funded by the NIH. Yes, our NIH.

Just to clarify: “gain of function” in this care means modifying an animal virus …to infect humans.

Regarding coronavirus, “big tech” continues to lie and distort. Earlier in the week when I posted Attkinsson’s report, it was quickly followed by a disclaimer from Facebook.

 Her report reminded me of a video from April of 2020 written by Joshua Phillips of the Epoch Times, a right of center publication. Reflexively I searched the video to review it. The list of citations Google provided me only included articles ridiculing the theory of the lab origins of the virus and the Phillips documentary. Reading over the list of titles would tend to make one convinced that this was a “crackpot” theory, and move on.

I then searched for the article on the unbiased search engine DuckDuckGo and immediately found the Phillips video as one of the first citations. Watching it again reminded me of how incredibly well researched and persuasive it is. Invest the time, it’s definitely worth it.

https://www.ntd.com/coronavirusfilm.html

What makes this dismissive Google search so infuriating, is that this is no longer a “crackpot” theory. It has been proposed and investigated and promoted by Josh Rogin of the Washington Post,  Robert Redfield, the former CDC director. Add in the Lawrence Livermore Laboratory, the institution most responsible for our nation’s bioterrorism defense. They apparently did a secret investigation in the spring of last year and raised the same concerns. Make no mistake: Google is lying, probably on China’s behalf.

So here is another wrinkle to this story. When asked about Dr. Redfield’s opinion, Dr. Fauci attempted to shoot down, continuing to claim that the virus passed from a bat species (found nowhere near Wuhan Province) to humans directly. Well here’s the thing: The gain of function coronavirus research going on at Wuhan was being done in cooperation with the University of North Carolina, through several NIH grants including one ultimately sourced to the National Institute of Allergy and Infectious Disease.

Apparently the leader of that organization, who has been called “the godfather of gain of function research” was forced to move this portion of the research to the Wuhan lab at China, when in 2014 the Obama administration declared a moratorium on these practices. The work went on even though multiple scientists in virology circles warned against continuing. It was performed in a lab that were the subjective multiple memos by the US State Department questioning the lack of safety protocols.

Who is the “godfather”? That would be Anthony Fauci.

This may explain a lot. For instance, imagine you’re the beloved Dr Fauci, in early January 2020, and you hear about a viral outbreak, specifically respiratory, in Wuhan China, in the same city you’re sponsoring gain of function research on respiratory viruses.

I’m pretty sure that was a holy sh*t moment for the good doctor.

Fortunately, there happens to be a “wet” market a few blocks from the lab. That made a good cover story for all involved including our NIH/NIAID people as well as the Chinese Communist Party. Neither party would confess that particular sin.

In the early going it made sense for Dr. Fauci to downplay the seriousness of the outbreak. He probably hoped that it would remain confined to East Asia and fade quickly (like SARS1). On January 21, 2020, at the onset of the outbreak in an interview, he stated: “This is not a major threat to the people of the United States and this is not something that the citizens of the United States should be worried about right now,”. At the same time, he reassured us that they were “taking it seriously”.

As late as March 8, 2020, Dr. Fauci stated “there’s no reason to be walking around with a mask.”

Unfortunately, this was not SARS1 and by late March had begun to spread throughout the globe including the United States. And the overzealous, inconsistent, mask-loving Covid-scold Fauci was born.

Maybe he is just cautious by nature.

Or maybe it’s guilt.

And then there’s this, published yesterday.

https://thebulletin.org/2021/05/the-origin-of-covid-did-people-or-nature-open-pandoras-box-at-wuhan/

I am very uncomfortable feeling this way, but it’s becoming clearer by the day.

They’re lying to us. They have been all along.

As always, I would be honored if you would share this post

Header Image : The Barrrens Awaken (Sony RX100 Mark III)

It is week 55 of curve-flattening Soviet-style regulation spawned and nurtured by our Governors. Despite our increasingly recovered and/or vaccinated population, there continues to be devotion to the illogical rituals that cannot protect us from an increasingly impotent pathogen. The anxiety goes on, prodded when necessary by our “betters” who continue to stoke terror among their vassals.

A flagrant example could be observed in the behavior of our new CDC director Dr. Rochelle Walensky. She comes to the job seemingly well-qualified, having been a former head of the infectious disease department at Massachusetts General Hospital. Credentials, however, can be misleading.

Speaking at a Coronavirus task force briefing on March 29th, she spoke about her “feeling of impending doom”. She monologed about the horrors she experienced caring for patients presumably in the early stages of the pandemic.

Her voice cracking, she spoke of her experiences worrying about the availability of ventilators and PPE’s, and horrified about the extra morgue set up at her hospital. She forgets to mention, that these issues never really germinated. Looking frightened she blubbered: “Right now I’m scared” alluding to the possibility of a fourth surge.

Unbelievably, she admitted this was just her feeling and not based on data. She urged the country to continue with current measures. “We’re so close now”. Wait a minute. If we are “so close”, then why the “impending doom”?

I assume she was reacting to multiple states that shortly before, had decided to partially or completely eliminate their coronavirus restrictions.

I have never heard more unprofessional statements from a director at this level. Her histrionic comments were grossly inappropriate, and I think disqualifying. Her words seemed to be an absolutely shameless attempt to reinforce fear within the populace.

At one time I thought I understood the rationale for this behavior. Provoking panic would help to destroy the Trump economy, leading to his replacement. Now, with the orange man gone, the motivation now would seem to be about control, and in some cases, profit.

There is a video available by a fellow by the name of James O’Keefe who runs an investigative outfit called Project Veritas. Their M.O. is to infiltrate largely liberal organizations and do hidden camera interviews exposing their actual agendas. This week he released a video of a CNN technical director, apparently in a tavern, speaking off the cuff.

A big part of this conversation was about Covid. He implied that they were deliberately hyping the situation because it was good for ratings.

He asserts that the powers that be at CNN are worried that there will be eventually “Covid fatigue” and that the fear will dissipate. When it does, they’re ready with their next “focused issue” which, they have decided will be “climate change”. This was specifically chosen as a fear generator because the CNN leadership feels it will have a longer lifespan than the current focus on the pandemic.

In essence, they will use the threat of “global warming” will be used to drive viewership.

They’re doing this, as he puts it, because “Fear sells”. All this from an editor at CNN “the most trusted name in news”.

Meanwhile, perusing the data for the individual states on the Time magazine website, it appears that throughout the country, even in former hotspots such as California, cases, and deaths have dropped precipitously.

Here in Pennsylvania, our numbers are down significantly from December and are oscillating week by week. In Texas, more than 3 weeks after the state opened up, their case numbers continue to fall.

My prediction is, that regardless of our control measures, we are likely to see the numbers in the northeast to be relatively stable until fall. People in the south, however, driven indoors by the heat are likely to see a summer surge, similar to last year. Hopefully, as we begin to approach some level of herd immunity, the morbidity and mortality numbers will be blunted.

I want to acknowledge our governor’s resonable decision to reopen the economy in the last week. Hopefully, the executive branch realizes the lack of linkage between the degree of restrictions, and the “case” numbers (positive PCR tests).

Currently, the available vaccines are a topic of interest. in the last several months, I’ve seen commentary from several molecular biologists who have been concerned that the mRNA vaccines (Pfizer and Moderna) have the potential not only to code for the coronavirus spike protein but actually become incorporated in the host DNA. There is some thought that this may be one reason why people have been seen to test positive by PCR, even after they’ve been immunized.

I’ve now encountered a paper in preprint (not yet peer-reviewed) from Harvard and MIT scientists. They have shown, in cell culture that mRNA in vaccines actually will incorporate into an exposed cell’s DNA. This could lead to a variety of problems including autoimmune disease and an over-aggressive immune response after future Sars Cov-2 exposure. Though I don’t think this scant data justifies abandoning the Pfizer and Moderna products, it certainly bears further investigation.

Now, the Johnson & Johnson vaccine has been put “on hold”. This due to some incidence of abnormal blood clotting, particularly in young women. These incidences involved clotting in the brain, and the legs, and involve a mechanism that means the traditional anticoagulants such as heparin can actually make things worse. Still, it’s a very small number of incidents in the large population of vaccinated patients. It’s important in this situation to tease out the women that are on birth control, particularly those that smoke, as they have an independent risk for clotting.

So what should we make of this? For myself, having been infected, I consider myself immunized and not currently seeking the vaccine. There is plenty of literature to support this position. If I were compelled to be vaccinated (which I would deeply resent) I would probably go with the J and J inoculation as I am not currently a young woman.

Meanwhile, it’s time to go out, have a few beverages and reconnect with friends. Maybe I’ll cook some barbeque.

Be careful… but have fun.

As always, I’d be honored if you’d share

Header Image : Random Daffidils (Samsung Galaxy S20)

It’s hard to believe, but it’s been 1 full year since rising COVID-19 infections inspired the policy of “3 weeks to flatten the curve”. In that period of time, we have been living our lives subject to the whims of our public servants. They have wielded, what many would consider unconstitutional power. They have imposed draconian, and often capricious rules and regulations, ostensibly to protect us from an increasingly manageable viral infection.

One year ago, I remember feeling a fair amount of anxiety. We assumed that no one was immune to this novel virus. We did understand that mortality increased with increasing age. I remember the nervous joking in the room as I taught a course for my non-pulmonary colleagues on how to run ventilators. This was set up out of concern that I and my fellow pulmonologists, all of us in our 60s, might fall ill, or worse, and be unavailable.

Yikes.

Caution was certainly warranted at that stage. We were hearing reports out of Italy of legions of sick people and overwhelmed hospital facilities. New York City was starting to have problems. Here in Pennsylvania, we had our first reported case. This was the point where Governor Wolfe shut down schools, and most businesses, other than those deemed “essential”.

 Nonessential businesses, including haircare salons, bars, restaurants car dealers, and other retailers were either fully or partially shuttered. Because of unemployment benefits that were offered, many people out of fear of the virus chose not to work. This affected many of the businesses allowed to open. It was a circumstance unprecedented in our lifetime. I think most people accepted the restrictions as necessary. Many of us, however, assumed that the disease and the lockdown would disappear by late spring.

As I have written before, we are in an entirely different place in March 2021. First off we know much more about this virus. We know that something like 40% of the population (based on blood bank studies from blood drawn before the pandemic) have pre-existing T-cell immunity. This is probably due to previous exposures to other Coronaviruses.

We have much better therapeutics including two inexpensive generic regimens that appear to have activity against the virus (ivermectin, and HCQ/azithromycin. Mortality rates are falling, and hospitals are non-stressed. Importantly, caregivers and most of the elderly population have been immunized.

I think my biggest fear now, is that even though it is only been a year, I see signs that people remain devoted to the illogical dogma that has been cultivated by media hype and governmental overreaction. If they cling to this. we may struggle to return to an open, welcoming society.

I’m concerned about the psychology of this. People tell me that their memories of our pre-Covid lifestyle are fading into the mists, as we grow ever more habituated to the lockdown life. We have been steeped in the belief that both family, friends and strangers, are potential vectors for Covid and must be kept at a distance. Greeting kisses and embraces for many are unthinkable. When people do gather, there is a wariness in personal interactions that I do not remember prior years. I see this, even in those who have recovered or have been immunized.

We need to get over this mentality. If you have recovered from the illness, or have been vaccinated, you are at best immune from further infection, and at worst, unlikely to become very sick if reinfected. You certainly do not need a mask. The fact that public health organizations will not admit this, suggests to me an inappropriate zeal for control.

I for one, welcome the relaxation of regulations scheduled for April 4 here in Pennsylvania. I am watching the data from states such as Texas where restrictions are almost completely eliminated. So far, after nine days there has been little change in their infection/mortality rates which continue to decline.

It should be clear I think to all of us, that going forward, that lockdowns are not a long-term strategy for dealing with this pandemic. If cases increase again sometime over the summer or in the fall, we need to recognize the virus may be endemic. We need to react to the disease burden, and not just positive PCR tests. Remember, people have been contracting coronaviruses for millennia, and a few become critically ill. A small number die. This is nothing new.

We should focus now on immunization and therapeutics, rather than curtailing our lives and liberty.

As always, I would be honored if you would share this post.

Header Image: Dying Spruces at Brady’s Lake ( Fujifilm XE3, XF 18-55mm f2.8-4).

It is week 51 of the Wuhan-sourced scourge to society and commerce. Here in Pennsylvania, as in much of the country, it is still meteorological winter. Covid regulations have been essentially the same as last July. Nonetheless, once again there have been steep declines in new cases for no obvious reason.  In our state, the number of cases, and the number of hospitalizations has plummeted since their peak and mid-December. Deaths are also falling in a slightly delayed fashion. PCR positivity is now 6.5% down from 15% earlier in the winter. Only 0.4% of emergency room visits are for Covid-like symptoms.

This is not only a pattern seen in Pennsylvania but throughout multiple states as well as most European countries.

There has been a scramble to explain the decline. Theories include the increasing number of vaccinations, the passing of the season, or the lack of availability of testing. Let me try to find an explanation.

Let’s talk about seasonality. Typical temperate winters put people in closer contact with each other as they tend to remain indoors. Vitamin D levels tend to go down which increases susceptibility. Finally. most lipid-encapsulated viruses tend to be more easily spread in cool, relatively dry conditions (and spread poorly when it is warm and humid). Problem is, that up to now this is been a fairly fierce winter, with little letup in cold temperatures as I write this. No, I don’t think the climate is the answer.

People like to tout the ongoing restrictions to life and liberty as a factor in the precipitate decline. This to me makes no sense. We have been under the same restrictions since last July, and if anything, people are weary of it all, and the adherence is starting to slip.

As to the availability of testing, I do not think that is a factor. One can be tested without a prescription, and there are many facxilities from which to choose. I have friends who have been tested 3 and 4 times because of travel, without any particular inconvenience. If testing is down, its because there is less demand.

I had high hopes to tout approaching “herd immunity” as a potential cause of improving conditions. To review: “herd”, or community immunity occurs when the percentage of the population with immunity to a particular disease, essentially blocks the spread and causes the disease to essentially “peter out”.

Let’s look at Pennsylvania. They’re roughly 12,400,000 people in the Commonwealth. There have been roughly 918,000 cases (mostly positive PCR tests) as I write this in late February. Remember, however, that the sensitivity of the PCR test causes large numbers of false positive cases. Thus, the number of actual infections leading to immunity is certainly less (probably considerably less). There have been roughly 917,000 patients who have received at least 1 dose of the vaccine, with roughly 500,000 “fully covered”.

So, let us add another number. A variety of groups have studied the presence of pre-existing T-cell immunity to COVID-19, often by assessing serum samples drawn prior to the pandemic. It’s been estimated that roughly 20-50% of people have some pre-existing immunity to this virus. Unfortunately, that number can’t be added to the vaccinated and infected people, as many of those people are probably represented among patients with either asymptomatic or minimally symptomatic infections, and some are already included in the numbers.

Another interesting statistic was a study from Sweden that looked at asymptomatic family members of known infections who were exposed but did not themselves gets sick. Though only 50% demonstrated antibodies to COVID-19, roughly 90% demonstrated the more prolonged T-cell immunity. My wife Cathy, for instance, may well fit in this category.

So, all this is complicated. Using the most optimistic estimate, let’s say there are roughly 1,800,000 2,000,000 people in Pennsylvania with full or partial immunity.

This would mean means that roughly 14.-16% of the population falls into this category. With the CDC currently estimating a herd immunity threshold for this Coronavirus at roughly 70%, it would appear that we are not nearly there yet.

However, there is some data that has flown under the radar. According to the CDC, back as far as February 2nd, roughly 78% of nursing facility residents (and 38% of the staff) have received at least 1 dose of a vaccine for Covid. As roughly 1/3 of total cases, and somewhere between 30 to 60% of fatalities, occurred among this vulnerable population, these numbers are significant. Soon the vast majority of the most susceptible should be relatively protected from this virus.

I was discussing the outbreak with a friend from Great Britain. He lives in London where since December 23, 2020, he is been under virtual house arrest. He is essentially trapped in his home. Venturing outside is legal only under very defined circumstances. Pubs and restaurants for him are a distant memory.

So how is this working? In Britain, after a summer lull, there were essentially two peaks in new cases, a smaller one occurring in early to mid-November, followed by a “saddle” and then a second higher and sharper peak in mid-January. There was a slight dip in the days after the lockdown began, but this also occurs over the Christmas holiday, an effect we also saw here in the states. Daily numbers of cases climbed even more steeply for roughly 3 weeks prior to peaking in mid-January. Given the incubation period of the coronavirus, if lockdowns are useful, numbers should fall in 5 to 10 days, not the three-plus weeks seen in Britain. Climate is also not an issue as the temperatures in Britain has been fairly flat from December through the end of February.

I guess my point here is that these outbreaks are on their own schedule and rhythm. Likely they are influenced in part by climate but even without a change in season, they seem to have a life cycle of their own. When you compare the timing of the Covid restrictions with the pattern of the outbreak, there is no pattern of response. In fact, the number of cases tends to accelerate afterward, before peaking and falling in a globally similar pattern.

We are now approaching a year of experience with this pathogen. In March of last year, SarsCoV-2 was a novel infection where it was assumed there was no inborn immunity. There were no known treatments and we had a poor understanding of how to manage those who became critically ill.

A year later we know far more about the disease. We know that the vast majority of patients exposed to the virus either remain asymptomatic or suffer a mild self-limited illness. There is evidence that many people in the population have some degree of pre-existing immunity. It appears that vitamin D and zinc supplementation are helpful as preventative measures. There are several antibody cocktails along with hydroxychloroquine/azithromycin, that are effective for early treatment. We have remdesivir and dexamethasone that are helpful for the critically ill.

Finally, the elderly and particularly nursing home residents, the population we are all trying to protect, are currently isolated and rapidly being immunized.

We are in a completely different situation than we were last March

If someone is sick, they need to quarantine. For the rest of us, it’s time to move towards a more normal life. I understand that some people are more nervous about the virus than others. Do what for you, feels comfortable.

Offer to greet your friends with a handshake, Offer your loved ones a hug. Gather together for celebrations.

Don’t let zealots divide us. Wear your mask where required, but do not obsess, as the rules are illogical and thus the benefit is dubious.

Don’t let fear steal away our culture, and our lives.

Shortly after writing this, Texas and Mississippi essentially ended their Covid restrictions but emphasized “personal responsibility”. Sounds about right.

As always, I would be honored if you share this with your friends.

Header Image : Melt (Sony RX 100 Mark III)

It is the 38^th week of our battle with the Wuhan modified “gain of function” Bat virus known as SARSCoV-2 and the cult of obedience it has spawned. Overall, in the United States, we are just coming out of our second peak of “cases” and hospitalizations. Deaths have also begun to fall. There are significant regional differences, however.

In Pennsylvania for instance, we are clearly past peak with daily “cases” roughly 2/3 of those seen in the third week of December. Hospitalizations have seen a similar decline. Deaths too are on the downslope but as always, are lagging the other indicators. This rise and fall of cases seems to be occurring independently of other factors. My sense is that there was little impact, for instance, from the tightening of restrictions over the holidays.  

Also notice that this outbreak is declining in the dead of winter. Last spring, when we assumed that the warming conditions were responsible for the reduction in cases but there’s no warming now. This further suggests that the virus is on its own schedule, not ours.

Still the current number of new “cases” is formidable, in most cases far higher than the spring. Thankfully there is generally far less hospital utilization.

I am disturbed by several developments. First is the sudden change of heart among governors and mayors who have had a miraculous epiphany and now realize that remaining in lockdown will destroy what’s left of their economies. Funny thing that with a new president inaugurated, that suddenly their positions have changed.

I am disturbed by this on multiple levels. With the possible exception of Illinois, where cases clearly have bottomed out, all of the involved states still have significant disease burdens. New York in particular has just probably rounded the curve. So, with numbers the same or worse than in late November and December but with the electors counted and accepted, now we can reopen our restaurants and businesses. Don’t get me wrong, I think this is the right decision. But it should absolutely destroy any remaining trust between our elected officials, and the citizens who have suffered under their capricious dictates.

Now let’s turn to the newest utterance from the venerable Anthony Fauci, who has essentially supported the wearing of two, yes count them, two masks. Asked by Savannah Guthrie on The Today Show as to the advisability of “doubling up” Dr. Fauci responded: “It likely does because this is a physical covering to prevent droplets and virus to get in. If you have a physical covering with one layer and you put another layer on it, it just makes common sense that it likely would be more effective”.

 Not so fast.

First off, “America’s doctor” is up to now been a devout adherent to empiric data, first noted when he rejected case reports suggesting hydroxychloroquine might be useful for the virus (it is). Now we’re going with common sense? I could find no empirical data to support that two masks are better than one.

Secondly, I think, the good Doctor is unfamiliar with the dynamics of respiratory devices. The more you increase the resistance of air penetration through the masking material, the more likely the air will seek an alternate route. Most of the masks currently in use fit poorly to the face and thus tend to leak. With 2 masks, during inhalation one is more likely to “entrain” air from around the mask and then reverse the process when exhaling. Thus, you will be inhaling and exhaling more unfiltered air. How is this helpful?

By coincidence I had a gentleman enter my clinic office today with 2 masks on, one paper, and one cloth. I could watch the sides of the masks flare as he breathed. It looked like a fish’s gills.

There is also the issue that we refer to in pulmonary medicine as “work of breathing”. For people who have reduced pulmonary reserve, increasing the airflow resistance with a second mask would likely result in significant increases in shortness of breath. I know this because I do have respiratory problems, and wearing a single mask makes it difficult for me during any exertion. Two masks for some could be extremely uncomfortable.

It’s also worth remembering that this is the same Dr. Fauci who suppressed the use of masks in the initial phases of the pandemic, so to preserve the limited supply of the PPE’s. I hope we have lots of supply now because his words could double facemask consumption.

My final point will be an “I told you so”. Very quietly on January 20, the World Health Organization released new guidelines for Covid testing. They finally addressed what we have known all along: that the PCR test has been incorrectly used, which has inflated the number of cases. They now recommend, a decrease in the amplification cycles (sound familiar?) and the use of other confirmatory evidence such as actual symptoms and a second, different diagnostic study, such as an antigen test,

Just how many “cases” have been diagnosed incorrectly is anyone’s guess; but let me try. I’m thinking…a lot (between 60 and 90% according to the August 29th New York Times article).

I received an email today from the Feds on the topic of COVID-19 immunization. the email explains that the vaccine does not confer immunity, but the antibodies and immunity derived, merely help those who are vaccinated to fight off the virus (We knew this, though). It states that “guidelines for masking, social distancing all remain in place and should be adhered to regardless of vaccination or antibody status”.

In other words, there is no end in sight for this truncated, stilted lifestyle that we have all been forced to adopt. Even if 100% of people are vaccinated, there will likely always be vulnerable people that need to be protected. You know, the same way it has been with influenza over the years.

The pandemic was real. But it was shamefully manipulated by people in power for their own benefit. Yes, people have died from this virus much as people have been dying from respiratory virus infections for centuries. But the illogical, emotion-based restrictions placed upon us, are also causing financial, educational, and emotional devastation which may have very long-term effects.

It’s time to leave the cult, and return to life.

As always, I would be honored if you would share this post.

Header image: St William’s at Raquette Lake (Fujifilm XE2, XF 18-55mm f2.8-4)

It is week 39 of the increasingly irrational response to the Sars-Cov-2 viral pandemic in Pennsylvania and elsewhere. It is a response, increasingly the province of emotions and politics rather than science and logic. In our Commonwealth, it involved an abrupt change in regulations that deliberately suppressed the festive winter holidays that help to keep us sane over the dark days of the solstice.

In this article I wish to pose some questions. I am neither a virologist nor an epidemiologist. I am merely an internist and pulmonary physician engaged in the menial tasks involved in actual patient care. But, I can read.

As many of you know, I contracted the virus shortly before Thanksgiving. Against the judgment of the experts in this country (but not elsewhere) I took a course of hydroxychloroquine and azithromycin that I had on hand from when such medications were deemed promising. Six hours later I had the most abrupt cessation of viral symptoms I had ever experienced. Anecdotal?… Sure.

 I decided to do a search to review the current data. I first searched on Google. This produced a list of articles emphasizing the negative aspects of the drug. Most of these references described its use in the hospital setting.

Out of curiosity, I then performed the same search in the increasingly popular DuckDuckGo search engine. Amazingly, it brought up a much more varied group of studies. For instance, It cited a review article from the Journal of New Microbes and Infections. Written in November 2020, the authors reviewed 43 articles written on hydroxychloroquine and COVID. Twenty-five of them showed clear clinical efficacy, 11 showed no efficacy, and 3 reported worsened outcomes. Most notably all of the articles examining hydroxychloroquine used early in the course of Covid 19 (outpatients) supported the use of the medication.

This should not be read as advocacy for use of the drug. My question involves why there is a discrepancy between the studies in the literature and the stance taken by the government and organized medicine. For instance, why did the AMA seemingly soften its recommendations against the use of the drug in late October on the eve of the election? And why is there such a difference between a search on Google and on this upstart search engine? I feel very manipulated.

Here in Pennsylvania, like much of the rest of the country, our positive tests skyrocketed in December. In the last several weeks it appears that the numbers may have peaked and are now in decline. Testing is also declining, hopefully, due to decreased demand. There was a small post-holiday bump (or perhaps an intra-holiday dip) Hospitalizations also seem to be on the downslope. Happily, even though the peak in positive tests/day was 7.5 times the peak in April, hospitalizations ended up being little more than twice those in the spring. Again the system has not been overwhelmed. According to the state, between 1 and 2% of emergency room visits are for “Covid-like illness”. Elective surgeries are still performed.

I have certainly advocated using the disease impact rather than just new cases, as the trigger for government action. Over December, there was a lot of talk about hospital occupancy being in the 90-100% range, with full ICUs. Clearly, some of that patient population is being treated for coronavirus, but given the low percentage of ER visits that are due to “Covid like illness,” it’s hardly the predominant admitting diagnosis.

What I don’t think people understand is how hospitals work. In Luzerne County Pennsylvania where I currently reside, there are 4 acute care hospitals, only 2 of which offer tertiary care level critical care. Twenty-Five years ago, there were 8. In the intervening years, the smaller hospitals either closed or were absorbed into the bigger systems. Their buildings tend to be used for outpatient and/or subacute care. Thus there has been a big decrease in acute care hospital beds.

Because of this, it is now commonplace, especially in winter for admitted patients, to be “stuck” in the emergency room for lack of any beds upstairs. (it happened to my father last February). This is financially beneficial to the hospital systems who obviously do not get paid to staff empty rooms. So the hospital bed situation we face now is not particularly unusual.

Another problem is that Covid patients tend to be admitted to ICU settings regardless of severity. This is because, in many hospitals, it is the critical care units where the “negative pressure” rooms are located. These rooms have airflow that is exhausted to the outside, not back into the unit itself, preventing viral spread. Another factor is nurse staffing, as ICUs often provide one to one nurse-patient ratios, which helps to deal with the arduous personal protection efforts inherent in their care.

I continue to hear people tell me that they have undergone testing for multiple reasons, most often not for symptoms. My own illness apparently provoked a flurry of testing among my asymptomatic friends. It is interesting that on our state’s “Covid dashboard” they report not “positive tests” but “positive PCR tests”.

I have written before about the PCR test before, quoting articles including a highly publicized report from the New York Times documenting the tests on reliability. PCR tests are designed to look for fragments of DNA/RNA. The test relies on amplification cycles to progressively increase its sensitivity. Up to 40 such cycles are utilized in routine testing for Covid RNA strands. Experts on the technique suggest that no more than 20 would be a better limit to prevent false positives. Why haven’t we fixed this?.

We could report the number of amplification cycles needed with the results, This would tend to put things in a better perspective. For instance, if a person tested positive after only 15 amplification cycles the likelihood that they are truly infected is much higher than if detection of the RNA required 30 or 35 cycles. It’s not clear why this information is withheld. Reporting is required in some states (Florida).

Speaking as a recovered patient I see many inconsistencies about the rules going forward. One question would be with masks. Apparently, the powers that be suggest I should continue to wear a mask even though: #1 I can no longer infect anyone, #2 I’m presumably relatively immune and not at risk of recurrent infection (at least until the next seasonal cycle), and #3 if I do get reinfected, I’m likely to weather it well. So why the mask? I suspect it has to do with emotional support for the more Covid frightened population and to encourage conformity. Neither of these reasons is particularly compelling, especially as I do have respiratory issues and the mask makes me short of breath.

Another related question would involve the vaccine. This has not had the cleanest release with reports of allergic reactions, and immune-related side effects, particularly after the second dose. Dr. Fauci says that even if you’re vaccinated, you should continue to socially distance and wear a mask because “you could still infect someone”. If that is so…

THEN WHY IN HELL SHOULD ANYONE SUBMIT TO VACCINATION?

Dr. Fauci also says that those who have been infected and recovered should also be immunized. So I ask myself: My immune system has been exposed to the entire virus with all of the related proteins. Why would my immunity be improved by being injected with a vaccine that ultimately replicates only the spike protein of the virus? And, as my B and T cells are already familiar with the spike protein, wouldn’t the side effects be worse?

I want to make myself clear here. I actually do think people should be vaccinated, both for their own protection, and to reduce the spread. Depending on how things evolve, I may choose to be vaccinated, perhaps next year once more data is available. But whether you are a survivor or have been immunized, I do think it’s time for you to drop the masks and the other rituals, that are ruining our quality of life.

I have one last concern. This virus isn’t going to go away. Once we reach herd immunity either through infection or vaccination are both, it will recede to the background. There’ll be occasional infections, but in an immunized population, they will be less consequential. Remember, any of the respiratory viruses have the potential to kill a vulnerable host.

What is going to happen perhaps next fall when respiratory viruses surge again? Will we continue to test for Covid, and begin to panic once again when positive PCRs start increasing? Hopefully, a reduced rate of hospitalizations in the newly immune will temper this effect. But I doubt it.

2020 was obviously a very difficult year particularly for those who lost loved ones to Covid. I have been lucky in that regard. The fact that that government, and healthcare profession appear to be manipulating data to achieve political aims as well as profit, is for me, a source of profound despair.

I used to believe.

I am now officially a skeptic.

As always, I would be honored if he would share this post.

Header image: Birch in December (Sony RX 100 III)

It is week 30 of the Chinese-sourced scourge that is the COVID pandemic. Throughout the country, cases are soaring. Everything is increasing including the percentage of positive PCR tests, the number of hospitalizations, and to a lesser extent deaths.  Happily, the ratio of hospitalizations to new cases remains significantly better than in spring.

This matters to me, as I too have become a statistic.

I was feeling fine until Saturday. I have had a very nice prime beef brisket in my freezer probably since the winter. With no possibility to socialize, it remained frozen. This week I decided to cook it, either to share with friends or freeze it for further use. Cooking a brisket at 225° can be an 18-hour event. I started it late at night and then tended to it periodically until morning. When I woke up Saturday morning feeling tired, it was no surprise.

I went to bed early that night and awakened on Sunday, nine hours later having apparently slept well. If anything I was more fatigued and began to notice muscle aches and pains, and a cough. I figured I had developed a more mundane viral infection, but realized as a practical matter I would have to be tested before going to work at the hospital on Monday. I ultimately had a rapid COVID test in our hospital emergency room Sunday morning which turned out to be positive.

I was uncomfortable most of Sunday, with fatigue caused undoubtedly by the interleukin levels provoked by the virus. In the late evening as I prepared for bed I had a sensation of flushing and brief nausea which cleared after about 10 minutes. 15 minutes later, I was no longer fatigued and felt better. Other than some minimal sporadic headaches, I have basically felt fine since.

Therapeutically, I have been taking zinc and vitamin D on a fairly regular basis. Back in March, I had obtained a course of hydroxychloroquine, and azithromycin; despite the conflicting data, I elected to take them in the morning right after I was diagnosed. I’m not sure whether they were helpful or not but I’ve experienced no unpleasant side effects.

I think the worst part of this has been the isolation. I’m lucky to live in a big old rambling Victorian, and it’s easy enough for my wife and me to isolate from each other. I have been basically existing in my office at the back of the home which has my computer, and a pullout couch (not particularly comfortable). There is an outside entrance so that I can go up to my shed/workshop in the back. I distance myself from my wife and wear a mask in her presence.

I don’t know why, but she seems pretty happy with the arrangement.

This is not meant in any way to trivialize the pandemic. I know that my friends working in other healthcare facilities are once again under stress. People are really sick.  I suspect, if my good fortune continues, it is because of the fact that for 37 years as a physician I have been quite intimate with the coronavirus family of viruses, and thus probably have some immunity. Obviously, others have not been so lucky.

With my newfound perspective, it is interesting to watch the states respond to this surge. I’m actually sympathetic to Governor Wolf in this situation, as his options are very, very limited. Hopefully, he understands that another shutdown like the one in March would truly devastate the economy, wiping out the businesses that barely survived the restrictions in the spring. The new Pennsylvania restrictions tighten up on interstate travelers except those that have to travel every day (which kind of makes this moot) and increased mask-wearing to include certain outdoor circumstances, and indoors when your family has a visitor.

Governments, after all, have to be seen to do something about crises. But as I’ve said before, it’s becoming more and more clear that this virus is on its own schedule. It’s likely to run its course, at least until there’s a viable vaccine. This will hopefully be soon. Happily, the current surge means that a lot of people’s immune systems are becoming familiar with this coronavirus, and will hopefully have relative immunity to it. I suspect over the years it will join the rest of the coronavirus family, as merely a periodic irritant.

Meanwhile, I’ll continue my exile, and maybe even wallow in self-pity.

At least there’s brisket.

As always, I’d be honored if you’d share this post.

Header image: View from Elba (Sony RX100 Mark 3)

It has been 29 weeks or 8 calendar months since we locked down our society to battle the scourge of COVID 19. Nationally, we are clearly in the third run of new cases. The graphs from the Atlantic’s COVID Project reveal escalating peaks with July higher than April’s, and this new peak already exceeding July’s peak.

Interestingly, there are also 3 peaks of hospitalization, though so far they are roughly equal in size. Considering the ratio of cases to hospitalizations, it appears that a significantly lower percentage of people require admission. There is a small surge in deaths, though nowhere near as many as in April (so far).

Here in Pennsylvania, the pattern is slightly different. We had a large peak in new cases in April and a comparatively tiny peak in July.

Cases are now heading upward again in Pennsylvania with daily rates roughly double that in the spring. There have been however roughly 3 times a number of tests done compared to April however suggesting a lower positivity rate. Despite doubling the new cases the rate of hospitalization remains about 40% of what it was in the spring. Deaths have not yet surged since the summer numbers.

As mentioned, 2 weeks ago, my hospital is seeing sporadic cases of COVID, but we now have an excellent treatment protocol including remdesivir, convalescent plasma, and when necessary, steroids. I think it’s worth saying that there is much less fear among the doctors and staff this time around. Other hospital systems in town are also admitting COVID patients once again. Unlike the spring, the hospitals are now better prepared, so that elective surgeries and other procedures are still going on.

There is also recent news of a COVID strain affecting mink populations in Denmark. This virus can apparently pass from humans to mink, and then back to humans. To my knowledge, this is the first mammal with whom there is a back-and-forth spread of the virus. Still, there is no evidence that this is a more virulent strain, or that the mutation, will render it resistant to vaccines.

Speaking of vaccines, of course, the big news this week other than the election, was the announcement by Pfizer that the preliminary results of their COVID vaccine suggest a 90% effectiveness, and that immunization might be available as early as late December. This is wonderful news.

One wrinkle in this however is that Pfizer decided to try to decouple vaccine from the Trump “Warp Speed” program, instituted earlier in the year to try to speed along vaccine development. It clearly was a part of that program as evidenced by Pfizer’s contemporary press releases.

Though it’s easy to accuse them of perfidy, especially if you’re a Republican, I suspect this was actually an attempt to decrease public resistance to the inoculation.  Both “anti vaxxers” and some Democrats, expressed concern about the safety of a vaccine produced so rapidly.

There is of course a related reluctance to give any credit to the president. In this vein, Andrew Cuomo actually expressed regret that the vaccine was released during the Trump administration, rather than presumably waiting till late January?

Forgive me, but what a callous, pompous ass.

 Pfizer clearly wants to sell doses, and not have the vaccine sink into a political morass. I think any reasonable person is hopeful that it will be effective, no matter who gets the credit.

Trying to look on the bright side, the end of this mess may be in sight, as vaccination begins, and as a large number of positive tests means even more immunity throughout the community. In the meantime, we need to continue with masks, distancing, and protection of the vulnerable.

Oh, and I’d avoid Danish minks.

 Just to be safe.

As always, I’d be honored if you would share this post.

Header image: Path through the Barberry (Sony RX100 III)