We have seen research show, with some screening/testing, that doing those things ONLY saves a marginal amount of lives and/or extends life by a short time. We know that those that are weaker and frailer will succumb to the effects of ANY illness.
What has medicine done to help those that have low immune systems? Has anything been done to help them become stronger in the intervening years? I would say, a full stop, no!
Maybe the more important reflection is "what will you do differently the next time"?
If there was a worse plan than leaving COVID management to unelected bureaucrats, Pharma management, politicians and academic experts while marginalizing minority opinions, I’d like to know what that would be. Maybe putting strippers in the decision tree; probably not even that.
I have always had a healthy mistrust of politicians/bureaucrats, and medical ‘experts’ with dozens of letters after their names but little clinical exposure: The worst among them being epidemiologists and public health department officials, with decision making power. I mean—-masks, distancing, and school closures? Really? The list of foolishness runs to multiple pages. Control and CYA were the unspoken watchwords. Period.
Thank you, COVID for confirming our worst suspicions about ‘experts’. and the social control experiment that was the ‘pandemic’.
There were no experts during the pandemic. No one had lived through or experienced the 1918 influenza pandemic. We were dealing with a novel respiratory virus, conducting mass vaccination of people during an active respiratory virus pandemic (never done before) using a novel vaccine platform. And yet we were told 95% vaccination rate would end the scourge. It didn’t. But people lost their jobs as data was spun to weave a narrative based on political science not evidence based science.
I worked within the DPH during the pandemic. There was no critical thinking. It was all turned over to the CDC to define. We were stupid and responded with emotion as you mention. And yet we still have not thoroughly looked at what worked and what didn’t so we will be doomed to repeat the same mistakes. For me as a physician I lost faith in the people who claimed to be experts and represented “the science.” They didn’t…
Why have we not seen apolitical cluster, randomized trials of community masking like at a church or gym? We apparently had an uptick in influenza cases this winter, but no studies on masking? A reproducibility crisis that has not changed the 20 years of studying non-pharmacologic, physical interventions to stop the spread of virus where community masking does little to nothing. Masks do not "kill" the virus may "re-aerosolize" fomites as is shown when healthcare workers don and doff PPE. I honestly cannot say whether community masking worsens transmission. They could be vectors of concentrated fomites. As an example, I keep asking for someone to study the trigger handle on the "disinfectant" spray bottle at the public gym as people are trying their best to "clean" their gym equipment by spraying a paper towel and wiping down the machine, but I never see anyone clean the trigger where everybody's pointer finger touches. After 20 people touch the same trigger without cleaning it and then touch their face, I wonder if that could be worse as I breathe in the internal disinfectant wafting in the air!!
I like the neologism "Carlinness" - much truth to how we set our norms. The answer to the conflicts that were caused by the pandemic response are freedom and honesty. We had too little of either. We were terribly led.
Great essay. If I had to pick one takeaway from the COVID experience it was frustration at the general lack of humility. It's good that Francis Collins now realizes he had blinders on, but where was that perspective at the time? All of us got some things wrong about COVID along the line, I certainly did (I was in private practice at the time). Despite that there was an attitude of certainty coming from the media as well as political and health leadership that was unwarranted, and "science" became defined as adhering to that certainty.
At first mistakes were forgivable as we didn't know much, but as time went by and we learned more there was still a rigidity of thought that was decidedly unscientific. The interventions that made sense when it was "two weeks to flatten the curve" persisted for years.
Thank you. While I was only little affected by Covid, this article resonated with me in regards to my (overly?) aggressive cancer treatment which left me with many unpleasant long term side effects.
I may finally be able to forgive my chemotherapy doctor.
Thanks for this essay, Adam. I was in the Emergency Department in NYC. A few of my colleagues died and several nearly died and I don’t have a count of patients that died. Many of my colleagues developed autoimmune diseases (from stress or COVID?) One emotion I haven’t lost is a feeling that we were betrayed by the institutions we relied on to prepare, guide, and protect us. I’m not sure I will ever move past that. On the other hand, I also have an odd feeling of gratitude. The experience taught me a lot about myself, about focusing on important things (my kids). Also there are ways in which I’m a better, more empathetic and more skilled, doctor. I have had at least two occasions when resuscitating a patient when I thought, “thanks to COVID I know exactly what to do here.”
Probably one of the best reflections on COVID I've read though that's probably because I mostly agree with your thoughts. I worked in a cancer hospital where people died alone and endured harsh treatments in isolation, but I think most people and decision-makers were genuinely trying their best.
I always try to remember that the divisiveness is deliberate, driven by those who benefit from stoking it. Another really sharp thinker on the pandemic is Prof Morris, who has dismantled many of the arguments made by the likes of Prasad - who I fear may have lost his ability to critically appraise the evidence and has simply chosen a side.
I think the pandemic exacerbated our growing vitriolic political divisions forever. It just gets worse and worse. I wasn’t too afraid in the beginning because I have some doctor friends who reassured me of just what you said. It’s a corona virus. It’ll be with us and we will develop some immunity either through a new vaccine or natural immunity. I only lost one friend to death. He died by suicide because he was forced to close his business. He had two gyms. I had only two friends hospitalized, and only one that had a long road back to health. I still worry about the mRNA technology. I worry that another pandemic will ruin our societal relationships and we now are unable to solve big problems together. But, I am grateful to you, Dr Cifu, because I found you and other medical professionals in my downtime looking for good advice. I first found Vinay Prasad which eventually led me to Sensible Medicine.
Thanks Dr Cifu. Though different in details my memories are very similar in general. I am sad for all the suffering (of various sorts) and grateful for the lessons (of various sorts)…
I appreciate you writing this. COVID drastically changed my view of government effectiveness and my trust in experts.
My mother-in-law died alone in a hospital here in LA because we weren't allowed to visit her.
In California we allowed essential businesses to remain open. Of course movie productions were deck essential businesses. And they could have catered meals for the crew, but the restaurants across the street had to remain closed.
What about wearing masks to walk to your table in a restaurant, but not while you were sitting down. That was just stupid!
Our public schools were closed for 18 months. At the time, I thought zoom schooling would work okay, but I found out my smart kids, and their friends, watched tiktok while sitting in front of their computers all day. And they became programmed to be afraid of other people so much so that they didn't want to leave the house. Sadly they still feel the need to wear a mask when they are on an airplane. They can't help themselves.
I'm am genuinely envious of your gratitude -- I'm still disillusioned.
I can appreciate your gratitude and I must admit you are truly fortunate to have not lost anyone close to you. Regrettably, I lost my husband to Covid-19 in 2021. Anytime Covid-19 is mentioned, I recollect the time I spent in the ICU with my husband. After he passed, I could still hear the peeping noise of the monitors in the ICU for weeks on end.
We have seen research show, with some screening/testing, that doing those things ONLY saves a marginal amount of lives and/or extends life by a short time. We know that those that are weaker and frailer will succumb to the effects of ANY illness.
What has medicine done to help those that have low immune systems? Has anything been done to help them become stronger in the intervening years? I would say, a full stop, no!
Maybe the more important reflection is "what will you do differently the next time"?
If there was a worse plan than leaving COVID management to unelected bureaucrats, Pharma management, politicians and academic experts while marginalizing minority opinions, I’d like to know what that would be. Maybe putting strippers in the decision tree; probably not even that.
I have always had a healthy mistrust of politicians/bureaucrats, and medical ‘experts’ with dozens of letters after their names but little clinical exposure: The worst among them being epidemiologists and public health department officials, with decision making power. I mean—-masks, distancing, and school closures? Really? The list of foolishness runs to multiple pages. Control and CYA were the unspoken watchwords. Period.
Thank you, COVID for confirming our worst suspicions about ‘experts’. and the social control experiment that was the ‘pandemic’.
Forgive and forget? I don’t think so.
There were no experts during the pandemic. No one had lived through or experienced the 1918 influenza pandemic. We were dealing with a novel respiratory virus, conducting mass vaccination of people during an active respiratory virus pandemic (never done before) using a novel vaccine platform. And yet we were told 95% vaccination rate would end the scourge. It didn’t. But people lost their jobs as data was spun to weave a narrative based on political science not evidence based science.
I worked within the DPH during the pandemic. There was no critical thinking. It was all turned over to the CDC to define. We were stupid and responded with emotion as you mention. And yet we still have not thoroughly looked at what worked and what didn’t so we will be doomed to repeat the same mistakes. For me as a physician I lost faith in the people who claimed to be experts and represented “the science.” They didn’t…
Why have we not seen apolitical cluster, randomized trials of community masking like at a church or gym? We apparently had an uptick in influenza cases this winter, but no studies on masking? A reproducibility crisis that has not changed the 20 years of studying non-pharmacologic, physical interventions to stop the spread of virus where community masking does little to nothing. Masks do not "kill" the virus may "re-aerosolize" fomites as is shown when healthcare workers don and doff PPE. I honestly cannot say whether community masking worsens transmission. They could be vectors of concentrated fomites. As an example, I keep asking for someone to study the trigger handle on the "disinfectant" spray bottle at the public gym as people are trying their best to "clean" their gym equipment by spraying a paper towel and wiping down the machine, but I never see anyone clean the trigger where everybody's pointer finger touches. After 20 people touch the same trigger without cleaning it and then touch their face, I wonder if that could be worse as I breathe in the internal disinfectant wafting in the air!!
I like the neologism "Carlinness" - much truth to how we set our norms. The answer to the conflicts that were caused by the pandemic response are freedom and honesty. We had too little of either. We were terribly led.
Gratitude, really? Maybe Stockholm syndrome, following the Coved era’s intense trauma with abusive relationships and coercive control scenarios.
Science was sold out by the DoD operation called Covid, table-topped in Event 201. Denial is no longer a viable strategy.
Great essay. If I had to pick one takeaway from the COVID experience it was frustration at the general lack of humility. It's good that Francis Collins now realizes he had blinders on, but where was that perspective at the time? All of us got some things wrong about COVID along the line, I certainly did (I was in private practice at the time). Despite that there was an attitude of certainty coming from the media as well as political and health leadership that was unwarranted, and "science" became defined as adhering to that certainty.
At first mistakes were forgivable as we didn't know much, but as time went by and we learned more there was still a rigidity of thought that was decidedly unscientific. The interventions that made sense when it was "two weeks to flatten the curve" persisted for years.
Thank you. While I was only little affected by Covid, this article resonated with me in regards to my (overly?) aggressive cancer treatment which left me with many unpleasant long term side effects.
I may finally be able to forgive my chemotherapy doctor.
Carlinness: nice to see fundamental attribution error mentioned in an essay about medicine.
Thanks for this essay, Adam. I was in the Emergency Department in NYC. A few of my colleagues died and several nearly died and I don’t have a count of patients that died. Many of my colleagues developed autoimmune diseases (from stress or COVID?) One emotion I haven’t lost is a feeling that we were betrayed by the institutions we relied on to prepare, guide, and protect us. I’m not sure I will ever move past that. On the other hand, I also have an odd feeling of gratitude. The experience taught me a lot about myself, about focusing on important things (my kids). Also there are ways in which I’m a better, more empathetic and more skilled, doctor. I have had at least two occasions when resuscitating a patient when I thought, “thanks to COVID I know exactly what to do here.”
Thanks Colleen.
I’d love you to write about it…🙏
Probably one of the best reflections on COVID I've read though that's probably because I mostly agree with your thoughts. I worked in a cancer hospital where people died alone and endured harsh treatments in isolation, but I think most people and decision-makers were genuinely trying their best.
I always try to remember that the divisiveness is deliberate, driven by those who benefit from stoking it. Another really sharp thinker on the pandemic is Prof Morris, who has dismantled many of the arguments made by the likes of Prasad - who I fear may have lost his ability to critically appraise the evidence and has simply chosen a side.
I think the pandemic exacerbated our growing vitriolic political divisions forever. It just gets worse and worse. I wasn’t too afraid in the beginning because I have some doctor friends who reassured me of just what you said. It’s a corona virus. It’ll be with us and we will develop some immunity either through a new vaccine or natural immunity. I only lost one friend to death. He died by suicide because he was forced to close his business. He had two gyms. I had only two friends hospitalized, and only one that had a long road back to health. I still worry about the mRNA technology. I worry that another pandemic will ruin our societal relationships and we now are unable to solve big problems together. But, I am grateful to you, Dr Cifu, because I found you and other medical professionals in my downtime looking for good advice. I first found Vinay Prasad which eventually led me to Sensible Medicine.
Thanks Dr Cifu. Though different in details my memories are very similar in general. I am sad for all the suffering (of various sorts) and grateful for the lessons (of various sorts)…
Appreciate much of your writing here but comparing Covid to the Black Death seems disingenuous.
I appreciate you writing this. COVID drastically changed my view of government effectiveness and my trust in experts.
My mother-in-law died alone in a hospital here in LA because we weren't allowed to visit her.
In California we allowed essential businesses to remain open. Of course movie productions were deck essential businesses. And they could have catered meals for the crew, but the restaurants across the street had to remain closed.
What about wearing masks to walk to your table in a restaurant, but not while you were sitting down. That was just stupid!
Our public schools were closed for 18 months. At the time, I thought zoom schooling would work okay, but I found out my smart kids, and their friends, watched tiktok while sitting in front of their computers all day. And they became programmed to be afraid of other people so much so that they didn't want to leave the house. Sadly they still feel the need to wear a mask when they are on an airplane. They can't help themselves.
I'm am genuinely envious of your gratitude -- I'm still disillusioned.
Thanks for the comment. Disillusioned is a perfect word for it.
I can appreciate your gratitude and I must admit you are truly fortunate to have not lost anyone close to you. Regrettably, I lost my husband to Covid-19 in 2021. Anytime Covid-19 is mentioned, I recollect the time I spent in the ICU with my husband. After he passed, I could still hear the peeping noise of the monitors in the ICU for weeks on end.
I am so sorry, Nancy.