May 3, 2020: US Death Toll

As our Baby Boom population ages, and there are so few children behind, should we not eventually see a steep rise in death percentages in the coming years?

In the same vein as what Missy reported, I saw this yesterday at Gateway Pundit. Clearly a strongly right-wing site, but I don’t know of any credible charges of misreporting on their part. I hope this works, for some reason GP makes it very difficult to copy their url’s on a phone:
‪Coronavirus Death Counts Reported by Media Outpace Actual Deaths Reported Per CDC By Nearly 29,000 https://www.thegatewaypundit.com/2020/05/coronavirus-death-counts-reported-media-outpace-actual-deaths-reported-per-cdc-nearly-29000

Don– thanks. The Buzzfeed author doesn’t seem to be saying the CDC is the problem, but rather the NCHS. She doesn’t really talk about Worldometer like the GP guy did. However, I spoke with a friend whose job involves quite a bit of data collection and analysis, and he pointed out that Worldometer uses estimates for current day whereas CDC updates pretty frequently. He had it narrowed down to a gap of only a couple of thousand between WM and CDC.
So it appears the GP guy was pretty far off base. I should have checked it more before posting.

It seems that the most effective reduction of the virus spread has been with early travel restrictions. Australia and New Zealand who both used used early and aggressive travel have had a much lower infection level of infections than countries with delayed or less aggressive restrictions.

Likewise restricting the admission of infected persons into nursing homes and rehabilitation facilities in Florida seems be a significant factor for reduced mortality. The extremely high mortality in New York City may be attributable to forcing nursing homes and rehabilitation centers to admit infected patients.

The CDC still wants hydroxychloroquine only used for hospitalized patients who are enrolled in a controlled study. It seems that the best use of this medication is with early stages of the infection, hopefully to prevent hospitalization or the need for a ventilator. Other nations are using this medication as a prophylactic for health care workers and those with exposure contacts, our nation is having a controlled study.. Also this is a generic medication that can be manufactured quickly and cheaply. Also much of the cardiac side effects may be more attributed to the use of azithromycin with hydroxychloaquine, but for doxycycline (which has similar antibiotic and anti-inflammatory effects with less cardiac side effects) can be substituted for azithromycin,

There are also case reports of hyperbaric oxygen therapy (breathing 100% oxygen in a pressurized chamber) reversing acute hypoxia without using a ventilator; most required from 1-5 treatments until compression treatments are no longer needed. Unlike the studies requiring multiple doses over time, the hyperbaric medicine cases demonstrated observational improvement such as respiratory rates going from 50 breaths per minute to 25 with increased measured oxygen levels observed upon reaching the treatment depth and not increasing again until several hours after the treatment. Like hydroxychloroquine this is a relatively inexpensive treatment requiring a compression chamber and oxygen with few contraindications and rare adverse side effects.

What is concerning for me is that the concept of “evidence based medicine” may favor a utilitarian approach verse an egalitarian approach to medicine. I think that the Roman Catholic Church and Thomas Aquinas would favor an egalitarian perspective.

For example the egalitarian physician would base treatment upon an obligation to provide the maximum benefit for the patient and use therapy where the potential benefit exceeds risk.

The utilitarian approach is to withhold treatment for the general population until there are studies proving that the treatment has benefited those treated for the study.

Perhaps with a sudden event with high morbidity and mortality that will quickly pass should favor the egalitarian approach. Expensive treatment for chronic low mortality diseases that develop over long periods of time should favor the utilitarian approach. Should something with observational benefit such as the hyperbaric oxygen therapy require evidence of benefit from a multi center, double blinded, prospective study while in the midsts of a pandemic with high mortality rates that may pass before studies are completed, interpreted and reviewed?

In this case is the utilitarian principle being applied honestly? For example the “experts” seem to favor flawed the flawed VA study that used an inexpensive generic medication in a manner different then the way it was proven to be effective in other studies.

It also seems odd that favoring the utilitarian approach did not want to wait until until there were controlled studies proving that a lock down would be effective So a governor can restrict treatment for individuals in the state because there is insufficient evidence that it will help; yet the same governor can be shut down the state’s economy without out considering any evidence of benefit or risk.

Question Everything Because They Politicize Everything.

Who benefits from exaggerating (and sending infected persons into nursing homes) perceived China Murder Virus impacts?

Antibody Testing Indicates We’ve Been Lied To: Nearly everything they’ve told us about models, rates of infection, deaths, and recoveries was inaccurate. The first four days of NY testing showed that a minimum 13.9% of New Yorkers had COVID-19 late-stage antibodies – that’s 128,205 per 1,000,000, or 2,500,000.

Cuomo’s China Murder Responses Were The Worst. Taiwan has 400 infections and six deaths for a population of 23 million. New York state, slightly fewer people, has about 300,000 cases and over 22,000 deaths. One, Taiwan wasn’t run by Andrew Cuomo or Bill De Blasio.

DJH

Donald as a lawyer may have some experience with malpractice law suits.

My experience is that the best way to prevent a law suite is to take the time with the patient and family to explain what you think is going on, then what you plan to do, what you expect to happen and what could go wrong. It also helps to let the family know as soon as something goes wrong and not to delay telling bad news.. What is most frustrating for me is when a non participating family member parachutes in from out of town looking for someone to blame.

A problem with evidence based medicine is that there is evidence for and against almost anything you do or don’t do. In that case it usually results in a duel between the experts hired by the opposing lawyers.

Most primary care physician that I know who have been sued tell me that it is difficult to predict who will sue and many suits were unexpected.

In most situations when something bad happens there is not a rush to hire a lawyer. Often lawsuits are more personal than professional and family’s are less inclined to sue someone they like.

Of course what saves most physicians in a law suits is good documentation about what you asked the patient, what you found on exam, what you were thinking, what you did. When something goes wrong document what happened, why you think it happened, what you did and why. Even doing the wrong thing can be defended if one can explain why it was done and if the intention was correct.