Public health can be hazardous to your personal health

In the 1970s and into the '80s, we learned a lot about medical crisis management from the TV series M*A*S*H.  Dr. Hawkeye Pierce exemplified the best in battlefield surgery, artfully wielding the medical resources at his disposal while the clock ticked away unrecoverable minutes measuring the fine line between life and death.

We could use Dr. Pierce today, but instead, we get a 2020 version of Dr. Charles Emerson Winchester III, an advocate of the philosophy: "I do one thing at a time, I do it very well, and then I move on."  Tick-tock, Dr. Winchester — and Dr. Fauci.

The American public health community led by Dr. Anthony Fauci do first-rate work, but they act as scientists, not physicians.  The controlled double-blind randomized clinical trial may be the gold standard of medical science, but in no way does it represent the mainstream of medical history.  Controlled studies are a luxury we cannot always afford.

The true history of medicine is trial and error.  We are here today because our ancestors discovered nutritious foods, used clean water, nourished the ill with their best version of chicken soup, and petted tame wolves, not saber-toothed cats.  Others tried alternatives, often with sad results.  Over the eons, knowledge accrued through countless experiments, both natural and scientific — a practice yet ongoing.

When today's medical trials fall short of scientific proof, they are appropriately deemed anecdotal; when a series of related medical trials accrue and show similar results, the amassing evidence somehow remains accused of being anecdotal.  Scientific rigor becomes scientific ignorance.  Repeated experiments, however imprecise, create a body of evidence not to be ignored.  We may be facing a novel virus, but we do have extensive knowledge of infectious disease, coronaviruses, and antiviral treatments.

Convalescent plasma recruited from recovered patients can provide antibodies for those yet uninfected.  Antivirals such as Remdesivir, a failed Ebola treatment, show promise against coronaviruses.  Arthritis drugs such as Actemra can be effective against the dangers of pneumonia brought on by the body's dangerous immune response.

The most immediately promising — and contentious — coronavirus treatment employs the pairing of hydroxychloroquine and azithromycin, an odd coupling of an antimalarial and antibiotic to create a potent antiviral.  While its formal testing is in early stages, clinical results from respected infectious disease specialists such as Didier Raoult and Stephen Smith, among others, have compelled a number of hospitals and numerous Drs. Pierce worldwide to promote it to a first-line treatment.

Hydroxychloroquine is also suspected of conferring resistance to coronavirus.  Persons treated for its value as an antimalarial or anti-inflammatory appear to have acquired a degree of immunity, coaxing medical practitioners to gradually adopt it as a prophylactic against infection.

Research into all forms of infectious agents, whether viral or bacterial, shows that the best "magic bullet" actually may be magic bullets — plural.  The probability of any individual drug defeating a novel or resistant infectious agent is dramatically improved by attack with more than a single mechanism of action.  Hydroxychloroquine and azithromycin possess different antiviral properties, a one-two punch that may overwhelm their target.  Chloroquine's anti-inflammatory properties may add a valuable bonus against associated pneumonia.  The potential power and efficacy of hydroxychloroquine — azithromycin broke free of its anecdotal stage shortly after the arrival of its coronavirus foe.

The prevailing notion that this virus has caught us all flatfooted and unprepared does serious injustice to the medical community.  Oddly, the public health sector that has fostered the underlying scientific foundation for coronavirus treatment has shunned the growing evidence at hand like an annoying stepchild.  If you want a solid future of national health, Dr. Fauci may indeed be your guy.  But if you suspect you have contracted COVID-19 — and you want a future at all — call Dr. Pierce. 

Dean Kedenburg is an anthropologist in the hamlet of Leucadia, California.

In the 1970s and into the '80s, we learned a lot about medical crisis management from the TV series M*A*S*H.  Dr. Hawkeye Pierce exemplified the best in battlefield surgery, artfully wielding the medical resources at his disposal while the clock ticked away unrecoverable minutes measuring the fine line between life and death.

We could use Dr. Pierce today, but instead, we get a 2020 version of Dr. Charles Emerson Winchester III, an advocate of the philosophy: "I do one thing at a time, I do it very well, and then I move on."  Tick-tock, Dr. Winchester — and Dr. Fauci.

The American public health community led by Dr. Anthony Fauci do first-rate work, but they act as scientists, not physicians.  The controlled double-blind randomized clinical trial may be the gold standard of medical science, but in no way does it represent the mainstream of medical history.  Controlled studies are a luxury we cannot always afford.

The true history of medicine is trial and error.  We are here today because our ancestors discovered nutritious foods, used clean water, nourished the ill with their best version of chicken soup, and petted tame wolves, not saber-toothed cats.  Others tried alternatives, often with sad results.  Over the eons, knowledge accrued through countless experiments, both natural and scientific — a practice yet ongoing.

When today's medical trials fall short of scientific proof, they are appropriately deemed anecdotal; when a series of related medical trials accrue and show similar results, the amassing evidence somehow remains accused of being anecdotal.  Scientific rigor becomes scientific ignorance.  Repeated experiments, however imprecise, create a body of evidence not to be ignored.  We may be facing a novel virus, but we do have extensive knowledge of infectious disease, coronaviruses, and antiviral treatments.

Convalescent plasma recruited from recovered patients can provide antibodies for those yet uninfected.  Antivirals such as Remdesivir, a failed Ebola treatment, show promise against coronaviruses.  Arthritis drugs such as Actemra can be effective against the dangers of pneumonia brought on by the body's dangerous immune response.

The most immediately promising — and contentious — coronavirus treatment employs the pairing of hydroxychloroquine and azithromycin, an odd coupling of an antimalarial and antibiotic to create a potent antiviral.  While its formal testing is in early stages, clinical results from respected infectious disease specialists such as Didier Raoult and Stephen Smith, among others, have compelled a number of hospitals and numerous Drs. Pierce worldwide to promote it to a first-line treatment.

Hydroxychloroquine is also suspected of conferring resistance to coronavirus.  Persons treated for its value as an antimalarial or anti-inflammatory appear to have acquired a degree of immunity, coaxing medical practitioners to gradually adopt it as a prophylactic against infection.

Research into all forms of infectious agents, whether viral or bacterial, shows that the best "magic bullet" actually may be magic bullets — plural.  The probability of any individual drug defeating a novel or resistant infectious agent is dramatically improved by attack with more than a single mechanism of action.  Hydroxychloroquine and azithromycin possess different antiviral properties, a one-two punch that may overwhelm their target.  Chloroquine's anti-inflammatory properties may add a valuable bonus against associated pneumonia.  The potential power and efficacy of hydroxychloroquine — azithromycin broke free of its anecdotal stage shortly after the arrival of its coronavirus foe.

The prevailing notion that this virus has caught us all flatfooted and unprepared does serious injustice to the medical community.  Oddly, the public health sector that has fostered the underlying scientific foundation for coronavirus treatment has shunned the growing evidence at hand like an annoying stepchild.  If you want a solid future of national health, Dr. Fauci may indeed be your guy.  But if you suspect you have contracted COVID-19 — and you want a future at all — call Dr. Pierce. 

Dean Kedenburg is an anthropologist in the hamlet of Leucadia, California.