Coronavirus

[dfwatt]

Medical malpractice happens. It is most concerning when it is deliberate and sadly a lot of hospitals if not most just cover it up. About 15 years ago a a Cardiologist at our local hospital who was the department chief suspected that one of the other Cardiologists was performing unnecessary stents on patients. He went over several of the cases and found several of those that what the guy was doing was documenting cases as having blockages over 90% when films showed much less blockage. Insurance companies don't review films and just assume the doctor wasn't lying. So no one would catch it unless they knew what they were looking for. So the Department chief went to the hospital administrators about it and they did nothing. So then he went public and sent letters to each of the patients he had documented it for. Guess who was forced to resign? The hospital had to refund Medicare all the payments it received for the unnecessary procedures. It actually made the local paper but patients continued to be referred to this creep and he is still practising at that hospital and the other local hospital because he brings in business.

Unnecessary procedures or procedures where patients are simply misinformed about the risks and benefits are actually the standard of care in this country in some areas. We have a procedure Centric Care system because prevention doesn't pay but high-tech intervention on the other hand pays big. Sadly this means we are not willing to cover primary care for somebody with minimal resources with bad essential hypertension, but after they blow up their kidneys from decades of it and they need dialysis and then eventually kidney replacement, all at six-figure price tags, we'll cover that.

It's the definition of lunacy in a sense that we're not willing to spend on prevention at the front end to save literally billions if not trillions at the back end. We spend probably about 5 cents on the Dollar on prevention and about seventy to even eighty cents on the dollar in relationship to diseases of aging that could have been prevented or delayed significantly. In other words, take the classic example of Alzheimer's disease which is my principal area of expertise, if you delay the onset of cognitive decline to someone's middle 80s, they die with mild cognitive impairment but they're never hospitalized or institutionalized because of serious levels of dementia. Their family is spared that trauma and they are too. But our system really neglects prevention in a primary sense and focuses on the cash cows which are high technology care and high technology intervention and first-line drugs, payment incentives which are of course running the system.

 

[bkp_duke]

I wonder what the medical professionals think of this. Disturbing if accurate.

This is what you get when non-doctors are in charge of room assignments. At EVERY hospital I ever worked at there was a "bed boss" - which is usually a NURSE in ADMINISTRATION that is in charge of bed assignments. These are supposed to be based upon diagnosis, and supposed to be clustered to prevent hospital-acquired infections.

To me, this screams of poor hospital management, which rarely is at the physician level (we are just grunts this day and age). Bean counters run everything in hospitals now.


I won't get into this particular nurse's lack of biological knowledge. I could spend a page on that. But the overall hospital error is egregious.

 

[bkp_duke]

How about criminal stupidity?

Its funny you mention that. I was thinking JUST yesterday about the following . . .

I truly believe that the impeachment proceedings against Trump for the Russian collusion stuff was a bunch of BS. But I would happily get behind impeachment for "criminal negligence" for his pandemic response.

I know we are talking about the GA governor, but same principle applies.

 

[bkp_duke]

Medical malpractice happens. It is most concerning when it is deliberate and sadly a lot of hospitals if not most just cover it up. About 15 years ago a Cardiologist at our local hospital who was the department chief suspected that one of the other Cardiologists was performing unnecessary stents on patients. He went over several of the cases and found several of those that what the guy was doing was documenting cases as having blockages over 90% when films showed much less blockage. Insurance companies don't review films and just assume the doctor wasn't lying. So no one would catch it unless they knew what they were looking for. So the Department chief went to the hospital administrators about it and they did nothing. So then he went public and sent letters to each of the patients he had documented it for. Guess who was forced to resign? The hospital had to refund Medicare all the payments it received for the unnecessary procedures. It actually made the local paper but patients continued to be referred to this creep and he is still practicing at that hospital and the other local hospital because he brings in business.

There is a risk for abuse of this system for "proceedure based" physicians. That physician should be reported to the Cardiology Board, and the hospital to CMS. Both of those referrals would carry the most weight possible. Physician Boards are still honorable and have the best interest of the patient in mind, and CMS is no joke.

 

[dfwatt]

These are really important questions the answers to which, if we had them, would allow much better tailoring of our response.

The only problem is how to get the data. Infecting people to gather it would be unethical, completely irresponsible, that level of field data is not worth killing for. But these questions are important to fund research on. For some things we might be able to code up detailed computer simulations that would provide some insight. Or perhaps we could simply test for droplet spread with some sort of tracer without going all the way to results with infectious diseases contracted. I hope this research is currently on going.

For instance 6 ft is a current target social isolation. It would be helpful to know how critical that is. How high and completely do plexiglass barriers need to be for less spacing with similar results?

Common sense is probably enough in the absence of detailed tests. Virus appears to be airborne-lite, focus on preventing droplet transfer. We are not flying completely blind. But given the huge impact of public health interventions more data that would support more tailoring of responses is a worthy goal.

This guy continues to float the balloon of this incredibly unethical probe of getting patients deliberately infected to test his flake theories. He should be on ignore and we should not respond to his nonsense anymore.

 

[dfwatt]

Its funny you mention that. I was thinking JUST yesterday about the following . . .

I truly believe that the impeachment proceedings against Trump for the Russian collusion stuff was a bunch of BS. But I would happily get behind impeachment for "criminal negligence" for his pandemic response.

I know we are talking about the GA governor, but same principle applies.

We'll have to agree to disagree on the question of whether coordinating with a foreign power's hacking of our elections is a disqualifying offense for the presidency (even if it does not rise to the level of criminal conspiracy), we certainly agree on the criminal level of negligence and denial and misinformation about covid-19 demonstrated by the idiot in the white house and all of the followers of his Cult of Personality in Governor's offices around the country. The results are Criminal and we are on Pace to have over 200,000 deaths by the election and if we don't change course 300,000 deaths by the end of the year. The fact that we can even talk about such possible numbers says how far out in the weeds the United States really is. And if we don't do something to remove the people who are responsible for this we are all complicit in those hundreds of thousands of deaths. This is a wake-up call unlike any wake up call we've had perhaps since the Cuban Missile Crisis.

 

[bkp_duke]

We'll have to agree to disagree on the question of whether coordinating with a foreign power's hacking of our elections is a disqualifying offense for the presidency (even if it does not rise to the level of criminal conspiracy), we certainly agree on the criminal level of negligence and denial and misinformation about covid-19 demonstrated by the idiot in the white house and all of the followers of his Cult of Personality in Governor's offices around the country. The results are Criminal and we are on Pace to have over 200,000 deaths by the election and if we don't change course 300,000 deaths by the end of the year.

For the record, I think the dems failed to PROVE there was any kind of coordination. If they could have made the proof, great, but even their star witness would not say that.

 

[bkp_duke]

We'll have to agree to disagree on the question of whether coordinating with a foreign power's hacking of our elections is a disqualifying offense for the presidency (even if it does not rise to the level of criminal conspiracy), we certainly agree on the criminal level of negligence and denial and misinformation about covid-19 demonstrated by the idiot in the white house and all of the followers of his Cult of Personality in Governor's offices around the country. The results are Criminal and we are on Pace to have over 200,000 deaths by the election and if we don't change course 300,000 deaths by the end of the year.

200-300k is optimistic, I would say.

Where are all the people saying "this is just another flu"?

 

[madodel]

There is a risk for abuse of this system for "proceedure based" physicians. That physician should be reported to the Cardiology Board, and the hospital to CMS. Both of those referrals would carry the most weight possible. Physician Boards are still honorable and have the best interest of the patient in mind, and CMS is no joke.

The FBI actually came to the hospital and the doctor's office to investigate. The hospital just wanted it to go away. So nothing came of it other than the hospital and probably the doctor having to refund Medicare for whatever was billed for the cases. He should have been charged with fraud and criminal assault. My wife thought that the FBI probably thought the actions were too technical for anyone to understand especially since the patients had blockages, just not severe enough to require a stent. Had they had no blockages it would have been clear cut fraud. So this sociopath got away with it. Probably still does it. The real problem is no one actually cares as long as it can be covered up. And anyone uncovering it will be the one who gets screwed.

 

[bkp_duke]

The FBI actually came to the hospital and the doctor's office to investigate. The hospital just wanted it to go away. So nothing came of it other than the hospital and probably the doctor having to refund Medicare for whatever was billed for the cases. He should have been charged with fraud and criminal assault. My wife thought that the FBI probably thought the actions were too technical for anyone to understand especially since the patients had blockages, just not severe enough to require a stent. Had they had no blockages it would have been clear cut fraud. So this sociopath got away with it. Probably still does it. The real problem is no one actually cares as long as it can be covered up. And anyone uncovering it will be the one who gets screwed.

What does she thinking about a Cardiology Board investigation? I would imagine it's not too technical for them.

 

[dfwatt]

200-300k is optimistic, I would say.

Where are all the people saying "this is just another flu"?

Ioannidis is still out there defending his cooked data antibody study. Sad. I used to think he was good.

 

[dfwatt]

The FBI actually came to the hospital and the doctor's office to investigate. The hospital just wanted it to go away. So nothing came of it other than the hospital and probably the doctor having to refund Medicare for whatever was billed for the cases. He should have been charged with fraud and criminal assault. My wife thought that the FBI probably thought the actions were too technical for anyone to understand especially since the patients had blockages, just not severe enough to require a stent. Had they had no blockages it would have been clear cut fraud. So this sociopath got away with it. Probably still does it. The real problem is no one actually cares as long as it can be covered up. And anyone uncovering it will be the one who gets screwed.

Sadly, this is all totally believable. And probably happens more than we know or would care to know.

 

[Daniel in SD]

It seems kids are not immune but are resistent to catching covid19, the effect start to disappear at about 16yrs and by the 20s is gone.

I suspect this is because they don't bother testing people under 18, they just end up quarantining with their COVID positive parents anyway. Spain's seroprevalence study found 3.8% of people 0-19 had antibodies vs. 4.6% of the general population.
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)31483-5.pdf

 

[madodel]

What does she thinking about a Cardiology Board investigation? I would imagine it's not too technical for them.

It was 15+ years ago. She kept thinking the FBI would do something and then it just disappeared. Can't even find the newspaper article online any more. As I recall the entire stink that was made was not about this guy performing unnecessary procedures for his own gain but that the Chief of Cardiology violated HIPPA rules by directly contacting another doctor's patients.

 

[dfwatt]

It was 15+ years ago. She kept thinking the FBI would do something and then it just disappeared. Can't even find the newspaper article online any more. As I recall the entire stink that was made was not about this guy performing unnecessary procedures for his own gain but that the Chief of Cardiology violated HIPPA rules by directly contacting another doctor's patients.

I suspect that stent-happy cardiologists have been finally marginalized by the recent findings that show stents are not the way to go. It was amazing that it took us that long to discover that but it always struck me as a version of shoveling s*** against the tide to stick a foreign object in an artery to keep it open that's being occluded by an active immune process without even considering whether or not you're going to block that inflammatory process. It was a Boston area company Boston Scientific that spent millions and probably made hundreds of millions on a drug alluding stent. I remember all the hype and all the disinformation that they engaged in to push their product on the cardiologists. Okay , this is starting to sound like a rant so I'll stop here!

 

[dfwatt]

Makers of a novel antipsychotic medicine announced a stock split and a tripling of their stock price.

This follows in the wake of:
FDA Approves Intra-Cellular Therapies’ Novel Antipsychotic, CAPLYTA® (lumateperone) for the Treatment of Psychosis in Adults
December 23, 2019 at 6:59 AM EST
PDF Version
NEW YORK, Dec. 23, 2019 (GLOBE NEWSWIRE) -- Intra-Cellular Therapies, Inc. (Nasdaq:ITCI), a biopharmaceutical company focused on the development of therapeutics for central nervous system (CNS) disorders, today announced that CAPLYTA® (lumateperone) has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of schizophrenia in adults. The Company expects to initiate the commercial launch of CAPLYTA in late Q1 2020.

When asked to defend the stock split and the enormous increase in their stock by skeptical investors, Intra-Cellular Therapeutics mentioned evidence for a hugely increased market for their new drug, specifically, recent data showing that 38% of the American population is in fact completely psychotic. This is the percentage of Americans that believe that President Trump is doing a good to excellent job in relationship to the covid-19 pandemic. The company's Media Communications Director spoke excitedly about "how we had no idea that there was this much refractory psychosis right under our noses."

 

[deonb]

In other words, take the classic example of Alzheimer's disease which is my principal area of expertise, if you delay the onset of cognitive decline to someone's middle 80s...

How do you do that?

 

[dfwatt]

How do you do that?

All the so-called healthy lifestyle factors of course regular exercise, avoidance of a pro-inflammatory western diet pattern, a good night's sleep, and, the lifestyle factor that has just as much clinical effect as the other three classic ones, decent social support. In other words social isolation or severe forms of social stress looks like it's as big a risk factor for Alzheimer's disease as being sedentary, or being obese and having a poor diet. Indeed it's fascinating to see how all these lifestyle factors converge on a bunch of cellular phenotypes of aging and either augment protective processes or inhibit destructive ones in a broad and diffuse way at the deep level of cell signals. If anybody's interested in a book chapter on this they can PM me and I'll send it to them. Warning: it's pretty technical, but it's not impossible to understand if you have some biological science background. A recent variable that's coming to focus has been the evidence that folks may develop Alzheimer's disease in the context of chronic and even subclinical viral infection or other types of chronic infection. All this of course raises the concern about covid-19 being a pro neurodegenerative influence over the long-term because of inflammatory stress on the brain. But it's too early and we have too little data to ring in any version of an alarm on that subject. But it is a question.

It surprises people to hear about the protective effects of social support and good relationships but when you look at the cell signals that are affected by the stress axis and by the conjoined effects of inflammation and stress axis activation, it's clear that having good and supportive relationships actually intercept many of the same factors that are regulated by healthy lifestyle variables as classically conceived. This collection of Lifestyle factors of course does not constitute bulletproof protection (everybody wants guarantees) but there is no bullet proof protection for that matter from cancer, coronary artery disease, or any other disease of aging. But prevention is the way to go particularly given our failure to develop any disease-modifying Therapeutics in Alzheimer's disease. That failure is another long and interesting story that I won't get into here. If somebody wants a scientific summary of that they can PM me and I'll send them one of my recent talks.

 

[AlanSubie4Life]

For the record, I think the dems failed to PROVE there was any kind of coordination. If they could have made the proof, great, but even their star witness would not say that.

The impeachment articles were for abuse of power and obstruction of Congress. I think both points were proved very clearly and it was entirely consistent with the R’s core principles (yeah they are kind of buried these days) to vote for conviction. But they chose what they thought was the easy way (life comes at you fast!). I think they should have added maladministration. Yet, here we are with a raging pandemic and a president who continues to abuse power, maladminister, and obstruct. And we are all currently suffering the consequences of that incompetence.

/End of my overtly political discussion in this coronavirus thread

 

[bkp_duke]

The impeachment articles were for abuse of power and obstruction of Congress. I think both points were proved very clearly and it was entirely consistent with the R’s core principles (yeah they are kind of buried these days) to vote for conviction. But they chose what they thought was the easy way (life comes at you fast!). I think they should have added maladministration. Yet, here we are with a raging pandemic and a president who continues to abuse power, maladminister, and obstruct. And we are all currently suffering the consequences of that incompetence.

/End of my overtly political discussion in this coronavirus thread

The most vague articles in the history of any impeachment. The impeachment then was a complete theater for the dem base, because they knew they had nothing substantial like with Nixon (recordings, etc.). It's also why, unlike ALL other impeachments in history, it was the most party line vote ever.