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     -- Long COVID's Impact on Patients, Worders & Society   
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     -- Frontline Worker Safety in the Age of COVID-19: A Global Perspective    Download White Paper
     -- COVID-19 Lessons Learned: A Global Perspective     Download White Paper

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Major OpEds & Journal Articles/Letters   

68.  A potential discovery of highly fatal SARS coronavirus?
It’s time for a reality check. We must take this recent preprint seriously, and our government needs to take proactive measures to prepare for future pandemics. This entails implementing strategies such as source control through improved ventilation systems and the utilization of N95 masks or respirators. While considerable efforts have been made to emphasize individual responsibility in combating pandemics, the reality is that collective action led by public health authorities is indispensable. Relying solely on individual actions will not suffice to safeguard against future threats posed by dangerous pathogens. References  Kevin MD. March 23, 2024.  

67. COVID denialism allows other infectious diseases to spread. We must make public health a priority.
"Falling vaccination rates are being driven by anti-science, and The Centers for Disease Control and Prevention only needs to look in the mirror to discover one of the driving forces. The anti-science rhetoric governmental institutions are spewing regarding COVID-19 is causing far reaching and enduring damage to public health, fueling conspiracy theorists and anti-vaxxers. Many in the mainstream public do not truly understand the intricate details of science, but they know when they are being gaslighted." We need to stop believing we live in a world of rainbows and unicorns. COVID-19 is currently filling over 22,000 hospital beds and resulting in more than 200 deaths each week. In addition, long COVID is ravaging our entire adult population with 6.8% afflicted with the disease, a number which appears to be increasing. Society must know the true downside and risks of spreading this virus and determine the number of chronic disability and premature deaths that we can tolerate..." References  Courier Journal. March 13, 2024  
66.  Wake up! We are still in a pandemic and Vaccines are our best defense against long COVID
"The chance of becoming severely sick from COVID when attending a January indoor function is far too great not to take preventative measures. And once you become sick, do not count on developing any long-term protective immunity to this rapidly changing, immune evasive virus. Infections also tear down not build immunity to other infections...We need to wake up as a society before we reach a point of no return, or before the damage to our frontal lobes from repeated viral infections reaches a point where we are unable to form a consensus and effectively respond to this pandemic...We need to wake up as a society before we reach a point of no return, or before the damage to our frontal lobes from repeated viral infections reaches a point where we are unable to form a consensus and effectively respond to this pandemic. " References. Courier Journal. Jan. 8, 2024. 

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65. Is Nosocomial SARS-CoV-2 Still Worth Preventing? 
"... it is not difficult to imagine hospitals maintaining infection control practices to prevent the spread of SARS-CoV-2. Maintenance is imperative to protect all patients and health care staff. For the immunocompromised, access to healthcare is being restricted which is not only bad medicine but appears to be in conflict with the Americans with Disability Act (ADA). "  JAMA Network. Nov. 13, 2023.  View Comment     
64. Commentary: Charleston airport needs to improve its air quality
"Besides the concern about the spread of infectious disease — and not just COVID; I do not wish to spend thousands of dollars on a trip and be down for several days with even a cold — there is also the concern regarding cognition and worker performance. It should be noted that HEPA filters and UVC upper-room lighting do not lower carbon dioxide levels. Charleston International Airport needs to upgrade its indoor ventilation and heating and air conditioning systems. This requires more than just an upgrade of filters, because the increase in resistance to produce adequate airflow often requires new HVAC units, which may also require electrical upgrades. In addition, lowering the CO2 level by increasing the mix of outside air is imperative for both worker and traveler safety." References  Post and Courier. Oct. 31, 2023.

63. COVID is closing Kentucky schools – again. Embracing disinformation paralyzes our response. The myth that children do not have to worry about COVID, along with other respiratory diseases, is based on misinformation.
Unfortunately, too many of our schools have unhealthy buildings with outdated HVAC systems. This will adversely impact our children’s learning, along with placing them at risk for acquiring respiratory diseases (RSV, flu and even colds). I felt the spending of COVID funds on outdoor sports and running tracks, as opposed to improvements in indoor air quality and COVID mitigation strategies, exemplified Kentucky’s embrace of disinformation and inability to safeguard the lives and well-being of our children. Let’s make Kentucky the national leader in providing a safe educational environment for our children. The first and easiest steps will be to upgrade school ventilation and to respect parents who are masking their children. References  Courier Journal. Sept. 6, 2023.  

62.  Industry Voices—Hospitals can't lose sight of infection control as COVID recedes
Earlier this month, a news article from the United Kingdom reported that more than 2600 National Health Service staff have missed work due to Long COVID, some up to two years. The vast majority of those impacted were nurses. Two days later, the Journal of Infection Control and Hospital Epidemiology reported that 27.4% of Brazilian healthcare workers who were diagnosed with COVID-19 developed long COVID. The best defense against long COVID is to not get infected in the first place. Unless we commit to a reliable and robust measurement system of hospital-acquired infections, we will continue to have a stressed workforce and need to rely on data generated in other countries. If this does not occur, the United States will take a back seat in public health and healthcare safety and will lose its leadership position in the world.
References Fierce Healthcare. June 23, 2023.  

61.  Industry Voices—The case for hospitals to invest in cleaner air
The American Society of Heating, Refrigeration, and Air-conditioning Engineers (ASHRAE) recommends an indoor CO2 level of 870 ppm or below. To achieve this, a minimum ventilation rate of 10 liters per second per person is needed. Lowering CO2 improves cognition: Higher CO2 levels can also cause drowsiness and affect concentration. Joseph Allen, et al., have demonstrated that compared to CO2 levels of 550 ppm, cognitive function was 15% lower at a level of 945 ppm and 50% lower at a level of 1400 ppm. For “strategy” (the ability to plan, sequence and prioritize actions) these scores were 16% and 78% lower, respectively. “On average, a 400 ppm increase in CO2 was associated with a 21% decrease in a typical participant’s cognitive scores across all domains …” New draft ASHRAE recommendations released in May 2023 address “Control of Infectious Aerosols.” Equivalent outdoor airflow in healthcare waiting rooms should be 60 liters per second per person (L/s/p), 45 L/s/p in common treatment areas and 90 L/s/p in healthcare patient rooms. Compared to the purchasing of N95 masks, the economic investment in clean air is much lower and should easily be offset by the advantages of maintaining a healthy workforce and increasing the safety of healthcare provided to patients. References  Fierce Healthcare. May 15, 2023.  
60.  Frontline Worker Safety in the Age of COVID-19: A Global Perspective
The third annual Health Watch USA(sm) webinar conference assembled 16 speakers from 4 continents who shared information regarding frontline worker safety in the age of COVID-19. The U.S. Bureau of Labor Statistics reported a nearly 4000% increase in workplace illness in 2020 compared with 2019. It is estimated that 2% of the U.S. workforce is not working because of long COVID. In addition, the impact is growing with each surge. After the acute illness, patients are often described as recovered, when in fact many have only survived and are coping with the multisystem impacts of long COVID. Long COVID, including its late cognitive, cardiovascular, embolic, and diabetic complications, disproportionately impacts frontline workers, many of whom are of lower socioeconomic status and represented by ethnic minorities.
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59.  Industry Voices—As healthcare's labor shortages worsen, masking remains critical
"Staffing shortages have created healthcare worker burnout and skyrocketed hiring prices. A vicious feedback loop ensued. N95 masks are one of the keys to the optimal maintenance of a healthy healthcare workforce and breaking this cycle. The expense of these masks pales in comparison to the expenses paid by hospitals to hire agency replacement workers. The benefits of high-quality masks extend far beyond SARS-CoV-2, since they will help prevent illnesses from other common airborne pathogens, decreasing sick leave and allowing the facility to maintain the provision of high-quality services. " References  Fierce Healthcare. Apr. 7, 2023.    

58.  Industry Voices—Amid a return to normalcy, COVID remains a threat.
The Federal Reserve Board raising interest rates will not cure the bird flu, nor will it cure COVID. The infections have a lasting negative impact on our workforce, shackling our healthcare system with chronically sick long COVID patients with far too few healthcare staff to service them. Banks are collapsing; our economy is obviously not overheating. Our current economic strategy is like telling someone to run with a broken leg and work through the pain. References  Fierce Healthcare.  Mar. 27, 2023.   
 57. Comment regarding Household Transmission of Influenza A Viruses in 2021-2022
I found the magnitude of the increase in influenza infections to be surprisingly high and not supportive of the Immune Debt hypothesis. The authors observed a 150% increase in transmission. This is far greater than a theoretical Immune Debt caused by a 1 year lack of exposure to influenza. According to the CDC, the average number of symptomatic influenza cases each year approximates 10% of our population. Thus, one should also consider the possibility of Post COVID-19 Immunodysfunction or hypofunction.  JAMA Network. Mar. 1, 2023.

56. Who gets better COVID protection? CEOs or the frontline workers they employ? Opinion
What does the capitalistic business magazine, Forbes, and the World Socialist Web Site have in common? Answer: Both are pointing out the glaring double standard in COVID-19 precautions given to business CEOs and world business leaders at the DAVOS World Economic Forum, compared to those given to frontline workers which many of them employ. With the dangers of delayed heart disease, memory and disorders cognition, along with post-COVID immune dysfunction, we are dealing with a dangerous pathogen and I have repeatedly given the advice for business owners to upgrade their airflow, patrons to use portable CO2 monitors to estimate air quality and to test before gatherings. If it is good enough for billionaires and Fortune 500 CEOs it is good enough for me. References Courier Journal. Jan. 30, 2023. 
55.  Despite misinformation, we can do more to protect against Covid, RSV and flu | Opinion
Much of the current COVID-19 misinformation has its genesis from the newly concocted explanation of “Immune Debt.” Mounting evidence indicates this is not the case. A more concerning process may be taking place. In Africa and Southeast Asia, masks and social mitigation measures have been used for decades to blunt the epidemics of SARS, MERS, and Ebola without any observed ill effects. The other more ominous possibility is “immune theft” resulting from an immunodysfunction caused by previous COVID-19 infections. A non-peer reviewed preprint recently reported that children who contracted RSV were twice as likely to have had a previous COVID-19 infection than those who did not develop an RSV infection. Common sense measures need to be taken during this winter surge. And The United States also had a large RSV spike last year. Thus, the "Immune Debt" explanation does not fit. For patrons, high-quality N95 masks should be worn when one enters indoor venues. For business, to the extent possible, make available curbside pickup and online purchasing options. References  Lexington Herald Leader. Jan. 6, 2023. 
54.  Why 'herd immunity' is as outdated as 'the earth is flat' when it comes to COVID: Opinion
This concept was formulated before science knew what viruses and mutations were. In actuality, many biological systems are highly dynamic and constantly adapting. With the exception of smallpox, no pathogen has ever been eradicated from the earth and with smallpox, eradication was achieved with a highly effective long-lasting vaccine. Our goal must be to decrease pathogen spread. We need to embrace vaccinations, the use of N95 masks in crowded venues, along with home delivery, curbside pickup and outside dining. Indoor air quality must be improved to the point where it is safer indoors than it is outdoors. References Courier Journal. Jan. 4, 2023.  
53.  Re: Long covid outcomes at one year after mild SARS-CoV-2 infection: nationwide cohort study
Another way of stating the results is that in very young unvaccinated adults (median age 25 years) who have mild disease, if one has cognitive impairment during the acute illness, this symptom will probably persist (81% of the time), if one has dyspnea or weakness, well over a third will have persistent symptoms, if one has heart palpitations about a third will have persistence of this symptom. BMJ. Jan. 1, 2023. 
52.  There is no such thing as 'herd immunity.' Why the ongoing dangers of COVID-19 are real
We all need to recognize the dangers of COVID-19 and the risks it imposes to our long-term health and our country’s workforce. Long COVID occurs in approximately 30% to 35% of cases. It commonly occurs with even mild disease and with reinfections. Thus, testing, masking, avoiding indoor crowded settings along with keeping vaccinations and boosters up to date are the best strategies we have to stay safe during times of high viral spread. Above all, we need to have clear and comprehensive public health messaging. We must be willing to make a few compromises in the way we live, for the safety of others and ourselves. References Courier Journal. Nov. 11, 2022.
51.  These holidays, we still need to think about COVID
With the upcoming holidays and family gatherings along with the public largely ignoring masking, testing and vaccinations, we may well be in for a holiday surge of COVID-19; adding to the increasing cases in RSV and seasonal flu. Masking, testing and vaccinations to flu and COVID are in themselves good steps, but taken together will give the best possible protection. Everyone should be tested immediately before the event, which some research has shown can decrease spread by 40%. Second, ask those attending a family gathering to not enter high risk settings and to wear an N95 mask in public a week before the event.  Lexington Herald leader.  Nov. 21, 2021.   References  Download OpEd PDF
50.  Opinion: With only 28% of Kentuckians boosted against COVID-19, variants could pose a big health risk
Cases of COVID-19 are surging in Europe, there is not just one variant of concern but what appears to be a “soup” of highly infectious variants. In the United States these include the BA.5, BA.4.6, BA.2.75, BF.7, BQ.1 and BQ. 1.1 and in Southeast Asia, the XBB variant. Variant “soup” is highly problematic, since it just takes one variant that is able to evade your immunological history to cause an acute infection. “the original sin of the COVID-19 response is the failure to recognize airborne transmission as the dominant mode of transmission. …” Industry needs to upgrade indoor ventilation and ideally install germicidal UV-C lighting. Kentucky Gazette. Nov. 16, 2022.  References  Download OpEd PDF
49.  COVID-19 Risk Adjustment, Driving Transformation or Normalizing Deviance? It is Our Choice
During the COVID-19 pandemic, the U.S. healthcare system neared collapse, in large part due to lean staffing and meager stockpiles of supplies. However, instead of transformation, it appears policymakers have assumed that facilities can do little to prevent safety lapses in the presence of COVID-19, and the Centers for Medicare and Medicaid (CMS) have decided to “risk” adjust quality metrics used in financial incentives. Risk adjustment should only be applied when effective strategies do not exist to prevent the occurrence of adverse outcomes. The question remains: Are we going to meet the challenge, build the needed infrastructure and strengthen our healthcare system to adapt to the new normal, or are we going to normalize deviance with continued lean staffing and just-in-time supply chains? I would choose the former and use financial incentives to drive the change.  References  On Health, BMC, Sept 28, 2022.   
VHA MRSA Infection Rates During COVID-19 Pandemic48. Success and failures in MRSA infection control during the COVID-19 pandemic
Private sector facilities in the United States have experienced a resurgence of Methicillin-resistant Staphylococcus aureus (MRSA) hospital-onset infections during the COVID-19 pandemic, which eliminated all gains that were achieved over the last decade. The third quarter of 2021, the Standardized Infection Ratio for hospital onset MRSA bloodstream infections was 1.17, well above the baseline value of 1.0. In contrast, the Veterans Health Administration (VHA) has been able to maintain its mitigation efforts and low rates of MRSA hospital-onset infections through the second quarter of fiscal year 2022 (Mar. 31, 2022), the most recent available data. The difference may be explained not only by the VHA’s use of uniform mitigating policies which rely on active surveillance and contact precautions, but also on the VAH’s ability to maintain adequate staffing during the pandemic. Future research into MRSA mitigation is warranted and this data supports the need for healthcare system transformation. Antimicrobial Research and Infection Control. Sept. 24, 2022.  
47.  How a new phase of fighting COVID requires the public to pay: Opinion
Due to lack of congressional funding, the Biden administration announced plans to curtail the funding of COVID-19 tests, treatments and vaccines shifting the financing and burden of the epidemic onto the public and private market. Along with Kentucky’s recent devastating natural disasters, curtailing federal payment on vaccines, tests and treatments is another stressor which risks the health and well-being of Kentuckians. As calls for a national public healthcare system are becoming louder, this is a step in the opposite direction. The best advice is to take advantage of the vaccines, ordering of tests and the bivalent BA.5 booster which will be available in early September before federal coverage for all is suspended. References  Courier Journal. Sept. 2, 2022.   
46.  We’re facing a triple threat of COVID, monkeypox and polio. Let’s take them seriously  
At the same time as COVID-19 the United States is experiencing a surge in monkeypox, whose main mechanism of spread is from close contact. Needless to say, having intimate contact with strangers will readily spread disease. Having multiple contacts, exponentially fuels a pandemic. With monkeypox, there is no “safe sex.” Many feel that because rates of COVID-19 have dropped the virus has become endemic, but we are still having 500 deaths per day in the nation. And cases of Long COVID continue to mount, even in those who are reinfected or develop infections after vaccination. Current rates of cases are too high to be sustained for eternity. References  Lexington Herald Leader.  Aug. 17, 2022.  
45.  How patient risks of harm in the hospital have increased during the pandemic: Opinion
Facilities appear to be responding by trying to water down regulations and to lessen the efficiency and impact of quality monitoring. And we received from the CDC were watered-down regulations, with not having specific recommendations to increase ventilation, admission COVID testing at the “discretion of the facility” and the encouragement, but not mandating, the use of N95 masks. All of the above has resulted in many staff not feeling safe, worsening the chronic nursing staff shortage. The CDC must set the highest standards for the world to emulate, not standards that are pliable for our profit-driven health care systems.  References  Courier Journal. July 11, 2022.

44.  Kentuckians are convinced that COVID is over, but they are wrong.
OpEd: “Herd immunity” may help end a surge, but the virus quickly adapts and strikes again. As new variants continue to rapidly emerge, the guidance actually becomes simpler: All immunity is waning, and one needs to keep your immunity as strong as possible. This means to stay up to date with your vaccinations and boosters, even if you have had a previous infection. We all need to wear high-quality N95 masks during times of high viral spread. I am not sure how to motivate Kentucky’s population to do so. At the very least we need to use our vote to express political feelings, and our love for our neighbors to dictate how we act in public.  References  Lexington Herald Leader, June 29, 2022.
43.  Does COVID make you dumber? Here's how you lose IQ points when you're infected
Last night I awoke during a nightmare. We were in a COVID-19 cognitive feedback loop, where repeated infections were causing a progressive loss of intelligence which was making us more likely to undertake risky behavior. Sort of like the planet of the apes, but instead of the apes getting smarter, we were getting dumber. This apocalyptic thinking was spurred by a New York Times report detailing healthy individuals enduring multiple infections because of waning natural and vaccine immunity. And cognitive loss with COVID-19 is a real concern.  References  Courier Journal.  May 31, 2022.    
42.  We may not have to wear masks, but COVID is still lurking out there
Masks have again entered the public spotlight with a Florida federal judge ruling prohibiting the CDC from issuing mask mandates regarding public transportation. Mid-flight passengers cheered, oblivious to the fact that the virus could care less. Currently, we are witnessing the emergence of a new and even more infectious variant in central New York, BA.2.12.1. Now is not the time to be promoting spread around the country with maskless airline travelers. Dosage counts. If a single virus penetrates a mask, it is unlikely to cause an infection, but if someone is exposed to 1000s of viruses, that is another story.  References  Lexington Herald Leader.  Apr. 30, 2022.   
41.  What the US must learn from its handling of the COVID-19 pandemic: Opinion
As stated by researchers in Nature: “This Swedish laissez-faire strategy has had a large human cost for the Swedish society”. emails revealed: “they (State Epidemiologists) at least speculated on the use of children to acquire herd immunity,” but at the same time were publicly stating children “played a negligible role” in spreading the disease and did not become ill. And the elderly fared even worse, where many were given morphine instead of needed and available oxygen, “effectively ending their lives." Reuters described a European Union document that found that “Russian media … deployed a “significant disinformation campaign” against the West to worsen the impact of the coronavirus, generate panic and sow distrust…” As a nation, we need a Federal Government which does not sugarcoat the facts of the pandemic and a public that gathers its information from a multitude of historically reliable national and international sources.  References  Courier Jounal.  Apr. 7, 2022.  
40.  As another variant emerges in Europe, it's too soon to let down guard against COVID.
t seems most of the nation has declared the pandemic all but over. In Kentucky, as of March 22, NYTs data showed the 14 day case average was down by 25%. However, Eastern Kentucky is telling a different story. In the United Kingdom, this resurgence started approximately two weeks after COVID-19 restrictions were lifted. The BA2 Variant is highly infectious, possibly as much as measles. Predicting severity of illness is difficult, since the vast majority of individuals have varying immunity to the virus. However, Long COVID can occur in 10% to 30% of cases. Complaints regarding cognitive function occur in approximately 70% of patients with long COVID. We must respect others, some of whom we wear a mask to protect, but above all, get vaccinated along with obtaining boosters when indicated.  References  Lexington Herald Leader. Mar. 22, 2022.       
39.  Kentucky COVID-19 bills are based on campaign talking points, not reality: Opinion
The toll of this pandemic has been enormous. Kentucky has had well over 13,000 deaths from COVID-19 and FAIR Health estimates, as calculated by insurance company allowables, Kentucky has spent over $1 billion on COVID-19 hospital treatment alone, not counting outpatient or chronic rehabilitation costs. Let’s quit getting our information from social media sites. This is like reading the emails in your spam folder. ...for the safety of all Kentuckians, we need to have clear, accurate messaging. References  Courier Journal.  Mar. 6, 2022.  
38.  Disinformation is still hurting in Kentucky’s battle against COVID-19
Immunity elicited by boosters markedly diminishes after 6 months, but vaccines are our best bridge until antiviral therapeutics become widely available and also to keep our facilities from being overrun. Pfizer and Moderna are both reformulating a vaccine for the Omicron variant and plan to have it available before Summer. For now, let’s just take one month at a time and use the tools which are available to us. The disinformation which some are spewing is nothing short of parroting the propaganda playbook of our communists’ adversaries. It is dividing and weakening our country. We as a country must do better.  References  Lexington Herald Leader. Feb. 11, 2022.   
37.  Why the Biden administration needs to take decisive action on COVID-19 | Opinion    
We are now enduring our fifth wave caused by a new variant “Omicron,” having immune escape properties and by some estimates over three times as infectious as the Delta Variant. We can expect continued surges in the future caused by a variety of different variants. Herd immunity and returning to “Normal” is no longer an option. As a country, we need to rally around a transformative plan which will take our country in a new direction. To this end, reenactment of the Coronavirus Task Force along with creation of a National Public Health System would be the first steps to accomplish this imperative. The United States Department of Veterans Affairs’ fourth mission of responding to health emergencies in the United States, may be able to serve as a foundation to build a national public health system. References  Courier Journal. Dec. 27, 2021.  
36.  Kentucky’s nursing shortage not about supply but retention in tough working conditions  
I am not surprised that Kentucky is facing a nursing crisis with a projected need of an additional 16,000 nurses by 2024. This is a problem of retention not production of nurses. A problem which has been decades in the making. If we wish to maintain a viable healthcare system, rather than a crippled understaffed delivery system which triages care, we need to slow down the spread of COVID-19. We need to curtail spending COVID-19 relief funds on quasi-related projects and focus on changing our society to live with this endemic virus. This means investing in proper infrastructure including improvements in building ventilation, the provision of high-quality protective gear and the frequent testing for all employees. For me, I religiously follow a no-mask, no tip rule.  Lexington Herald Leader.  References  Dec. 16, 2021. 
35.  Why we must listen to science and get vaccinated to beat COVID-19 | Opinion
I am not sure why our citizens continue to listen to those who have stated the pandemic was a hoax and medical personnel were diagnosing cases for money. Some of these same leaders also predicted the attainment of herd immunity after each COVID-19 surge.
Many around the world are envious of the COVID-19 resources available in the United States and perplexed why we do not fully utilize them. For the safety of our loved ones, let’s become vaccinated, wear masks and utilize home testing. All of these modalities are inexpensive and readily available.  Courier Journal. Dec. 1, 2021.  References 
34.  Your ‘right’ not to vaccinate delayed my cancer treatment
Over the past few weeks my writing was placed on hiatus, since I was finally able to obtain needed cancer surgery. The surgery had been previously delayed because a bunch of misguided souls were exercising their 'right' to not become vaccinated. And then exercised their right to receive protracted medical care by filling regional ICU’s and hospitals; denying prompt medical treatment to many with serious illnesses.
And some of those so-called libertarians who advocate freedom from Government actually want to use the Government to shackle the free market by
prohibiting employers from implementing worker and patron safety measures. The era of Authoritarian Libertarianism, justified by pseudoscience, has been
born. In health care, exposing the most vulnerable to a dangerous pathogen is unconscionable. I would state, the health care vaccine mandate has been 100% effective, because it eliminated patient exposure to individuals, who did not care enough about those who have entrusted their lives to them, to become vaccinated. Courier Journal. Oct. 23, 2021.  References   Download Article PDF   
33.  Kentucky's failure to unite against COVID-19 is like 'making a pact with the devil'
Natural immunity does not work well with Ebola and rabies. Those who will point out that Ebola and rabies are animal viruses and are more dangerous because they do not depend upon mankind for survival need to remember SARS-CoV-2 is also an animal virus and has multiple animal hosts. SARS-CoV-2 will not miraculously disappear. In the short term, it is unlikely to become less severe. This virus has gotten meaner with each iteration. It does not need us, so it does not have to play nice.
We need to create the safest school and workplace environments possible. Kentuckians not coming together to fight this virus with all their might is nothing more than making a pact with the devil.   References  Courier Journal  Sept. 17, 2021.      
32.  The only way for us to fight COVID-19 is with a 'layered' approach. Here's what you can do
Vaccines are a vital layer of armor but as a recent Israeli study has illustrated not a COVID-19 cure in themselves. As stated in a previous opinion column, vaccine immunity is starting to wane, necessitating the implementation of added interventions and plans for administering boosters. We must plan to live with the continued waves of this virus by implementing layered approaches, including keeping current with vaccinations and boosters, frequent testing (twice weekly) of all frontline workers and students in schools, wearing high-quality, well-fitted masks, preferably a KN95 or N95 mask, and enacting strategies to combat an airborne virus, including upgrading of indoor sanitization and complete air exchanges. But of utmost importance, we cannot solely be centered on protecting ourselves. We must also protect others in the community and drive down community spread. Remember, we are all members of the same community so protecting others, will also protect ourselves.  References  Courier Journal. Sept. 8, 2021.   
31.  COVID-19 lessons learned: a global perspective
On June 15, 2021, infectious disease authorities from around the world participated in a joint webinar to share experiences and lessons learned in combatting the COVID-19 pandemic. One of the overriding goals of the conference “COVID-19 Lessons Learned: A Global Perspective” was to provide documentation of worldwide COVID-19 response strategies, in order to combat the plethora of misinformation and conspiracy theories that are being actively disseminated. This misinformation is having a profound negative impact on controlling the pandemic in many countries. Misinformation which was addressed in the conference included challenging the seriousness of COVID-19 infections, a refusal to recognize aerosolization as the major mechanism of spread, a belief that schools can be opened safely without implementation of extensive control strategies, and that masks and vaccines are not effective. A second goal was the identification of common strategies between nations. Common strategies included the implementation of a range of closures, mask mandates, travel bans and the need for expanded testing. But of utmost importance there was recognition of the need to implement a coordinated national strategy, which is depoliticized and led by scientists.  ARIC.  Aug. 26, 2021.   
30.   How the CDC's missteps left Americans vulnerable to COVID-19's delta variant
Unfortunately, the hospitalization of Jesse Jackson, who was fully vaccinated, and the death of former Kentucky legislator Brent Yonts from COVID-19 are not outliers. It is in line with the Israeli data on vaccine effectiveness and is the culmination of a long string of failures by the Centers for Disease Control and Prevention in generating timely data and promptly informing the public regarding the risks of COVID-19.
The continued narrative that breakthrough vaccine infections are uncommon is not true. When they do occur, certain groups are at risk of hospitalizations and deaths. As immunity wanes, we all will enter this category.  Thus, we will need to receive a booster. For now, wear a medical grade, KN95, or a well-fitted N95 mask, avoid indoor settings and above all keep current with your COVID-19 vaccinations.   References  Courier Journal.  Aug. 26, 2021.    
29.  COVID-19 is ravaging our unprotected children. Opening schools now is dangerous
Currently, we are confronting a variant that is more than twice as infectious as last year’s wild-type virus; it is more deadly and has an increased propensity to infect children. Kentucky’s community spread is extremely high with a test positivity rate of over 10%. To open schools at this time and expect our children to be safe is dangerous cult thinking. Unfortunately, we have done nothing to prepare for continued waves of COVID-19. We have squandered coronavirus funds and just hoped the virus will go away. However, at this point, stopping SARS-CoV-2 will also require a marked change in the way we live, along with a massive infrastructure investment and a sustained commitment to the safety and welfare of others.  References  Courier Journal. Aug. 10, 2021.    
28.  The delta variant is the biggest public health threat we have faced. Here's how to beat it
We cannot solely vaccinate our way out of this. We must also implement stringent public health strategies to slow down the spread and mutation of this virus, including universal access to N-95 masks and upgrading building ventilation. In that way, our pharmaceutical development and production can catch up with the emerging variants. The new mRNA vaccines are a medical miracle, and we can develop a new vaccine within weeks. The challenge is in producing and distributing hundreds of millions of doses and placing them into arms. With the (Veterans Health) Administrations’s large infrastructure and fourth mission mandate, it is the obvious vehicle to implement a nationwide public health care system.  References  Courier Journal. Aug. 4, 2021.
27.  Why we need a worldwide perspective about wearing masks, especially when traveling
For many, they appear to be stuck in the stage of denial and anger. And one of the manifestations of this is the anger being displayed on air travel; most confrontations are over the use of masks.
There should be little question that one of the highest risk settings for acquiring COVID-19 are crowded transportation hubs and vehicles, especially where passengers can come in contact with international travelers.
Several countries, such as Australia and Singapore, have practically closed their borders to travelers.  As long as the United States’ borders remain relatively open and we are dealing with highly contagious variants, the least we can do is to require travelers to wear masks. References  Courier Journal.  July 19, 2021.    YouTube Video: 
26.  We can't will away COVID-19, and the delta variant is spreading rapidly. Get vaccinated
Watching our nation’s Fourth of July celebration one could only conclude that we have decided to will COVID-19 away and ignore its presence. Many do not want to trust science and argue over the validity and meaning of the data, but determining what will happen is actually quite easy. Just look at the United Kingdom. Currently, the U.K. is spiking cases and Boris Johnson predicted there could be 50,000 cases by July 19, Both Gov. Andy Beshear and Sen. Mitch McConnell agree that everyone who can should become vaccinated. And when those two agree on something, one should listen.  Courier Journal.  July 8, 2021. Courier Journal. References
25.  With COVID-19 variants lurking, we must prepare for the worst
We do not have an available booster for the next variant. One of the problems is that there are several different ones and unlike the flu, last year’s virus did not go away. Comparing the length of protection an infection with SARS or MERS affords is not applicable to COVID-19 with the immune escape variants. The evolutionary success of mutations is dependent upon increasing transmissibility or allowing the virus to escape immunity. SARS-CoV-2 (the virus which causes COVID-19) is doing both. In the case of the United States, we (need to) expand genomic testing of immune escape variants to early on detect community spread, and for all to receive vaccines to the wild type virus to boost their immunity to a level which will prevent disease, hopefully even mild to moderate disease, by the immune escape variants. We have the knowledge to avoid another devastation by this virus. Simply become vaccinated.  References  Courier Journal. June 3, 2021.   
24.  Rand Paul's statement about the COVID vaccine can be summed up in one word: Reprehensible
The recent statement by Sen. Rand Paul that he does not plan to be vaccinated until more citizens become reinfected with COVID-19 and are “dying in large numbers or being hospitalized or getting very sick” was nothing short of reprehensible. As a leader, he should have the foresight to ward off catastrophes, not react to them after they have already happened. We all should be out of this pandemic by now and returning to a more normal life. Case rates are plummeting in the nation, but only slowly falling in Kentucky. In many respects, the COVID-19 pandemic has ended, and what we are faced with is a massive pandemic of misinformation, being largely ignited by foreign adversaries and whose flames are being fanned by some of our own leaders.  Courier Journal.  May 25, 2021.  References  
23.  Kavanagh KT. Why the COVID-19 6-foot rule isn't enough and how to return to a more normal life.
The 6-foot rule no longer applies; the virus is airborne. In poorly ventilated buildings, 60 feet is as safe as 6 feet away. These aerosols can be produced by talking, shouting and singing.
We need to reopen the state smartly. As a prerequisite, all public venues should be required to meet safe ventilation standards for airborne contagions. The public needs to embrace vaccinations and we need to be prepared for other waves of new variants. Hopefully, if we can lower the case rate in our state and manage small outbreaks with rapid and effective case tracking, only then will we be able to return to a more normal life.  Courier Journal.  May 13, 2021.  References
22.  COVID-19: Here are the four most common myths and how to keep yourself and others safe

  • Myth 1: Any type of masks will work. With these highly infectious variants, this is no longer true.

  • Myth 2: You are safe indoors, if you wear a mask plus are 6 feet away from someone.

  • Myth 3: If you survive, you recover and only the old do not survive. Too many do not worry about COVID-19, citing the extremely low chances of them dying of the acute illness.

  • Myth 4: If you are vaccinated you do not need to wear a mask; if you have to wear a mask then vaccines do not work.

During this pandemic we must all weigh the risks and benefits to ourselves regarding public health advice. Almost all activities have risks. But in our decision of how we engage in activities, even those that are necessary such as seeking medical care, we should not place others or our community at an undue risk of acquiring COVID-19. And above all get vaccinated.  Courier Journal, Apr. 29, 2021. References  

21.  With young people and sports, COVID-19 must be our main opponent
With the looming new variants, our society needs to have a paradigm shift in thinking; we must respect the dangers of nature and this ever-evolving natural predator. Businesses need to markedly upgrade ventilation systems; we all need to obtain the vaccine (which is highly effective against the wild-type and current UK variant); and we need to obtain the booster for the “EeK” variants once it is available. Until then we must stop spreading the virus, making it more likely that the more dangerous variants will take hold in our communities and even worse, increases the likelihood a totally vaccine-evading mutation will emerge.   Courier Journal.  Apr. 15, 2021.  References  
20.  What stands in the way of ending COVID-19? Only variants and anti-vaxxers
And these roadblocks are highly related. Those who do not become vaccinated, will spread the virus and promote emergence of variants. Ironically, the same group of individuals who are against vaccinations also tend to not want to wear masks. Herd immunity will not protect them since, they tend to meet and clump together which will spread the virus. There is now more than six months of safety data with COVID-19 vaccines and so far, the benefit has been great and severe reactions extremely rare. If you are afraid of the vaccine but for the safety of others receive it anyway, then you are displaying the compassion and bravery that our nation was built upon. We all need to become vaccinated to achieve herd immunity and return our society to a new and better normal. Courier Journal. Mar. 25, 2021.  References 


19.  ‘We are so close.’ Let’s not play Russian roulette with our nursing homes and COVID.
We are so close to stopping this virus from spreading, so let’s not play Russian roulette with our grandparents and with others who are at high risk for severe COVID-19 infections. We have already lost over 500,000 souls to COVID-19 and we are on the verge of stopping this pandemic. Let’s undertake strict public health strategies for just a few more weeks and allow our race with vaccinations win out over the spread of variants.  Lexington Herald Leader.  Mar. 20, 2021.   References   
18.  The COVID-19 pandemic has shown the dangers of distorting science for political ends
On Feb. 15, 12 prominent scientists, sent a letter to the White House and CDC pointing out that current policies appear to be minimizing the importance of aerosolization and are not providing adequate protection of frontline workers. And we are still following advisements designed for stop-gap measures in an acute crisis, such as resterilization of N95 masks. I am not sure if I am most disturbed by the deficiencies discussed in the letter or that these scientists are now out of the key inner circle, having to resort to sending a letter. We must break this downward spiral in our society by not distorting science for political ends and by giving the truth to the public. Only then will we have the knowledge and willingness to invest the needed resources to address this and future pandemics. Courier Journal. Mar. 4, 2021.  References
17.  Schools can be reopened safely amid COVID, but only if we take overdue steps
Political debate is one thing, but spinning science and placing our children at risk is unacceptable. Statements that research shows “schools are safer than the community“ or that we should take the “default position of opening schools” are being grossly misinterpreted. “Safer” is not “Safe.” It depends upon the rate of community transmission, and “default” means to do something if there is not a reason to otherwise not do it. .. Instead, we need to focus on transformation and making the needed investments in our society to effectively eliminate this virus and then to snuff out outbreaks. And this includes schools. Smaller class sizes and healthier buildings are something we should have done long ago, regardless of the COVID-19 pandemic. School-age children have always been known to have an increased risk of transmitting infections from school and all these transmissions are potentially preventable.   Courier Journal.  Feb. 19, 2021.  References

16.  Dangerous COVID-19 variants lurk, but there are signs of hope.
We are fighting not only a deadly virus, but an inability of our nation to unite to confront this deadly adversary, being kept apart by “fake news” and an alternate reality being inflamed by a misplaced trust in false idols. Even more formidable strains of the virus already exist. The P1 in Brazil and the 501Y.V2 in South Africa are even more concerning. They may evade monoclonal antibodies, make the vaccines less effective and cause reinfections. We all need to receive vaccinations when vaccines become available. We now have many months of safety data which should capture the vast majority of adverse events. So far, both vaccines have been found to be effective and very safe, certainly safer than developing COVID-19. Some recall the Tuskegee experiments and are concerned, but this is much different. With this virus, our only choice is to get the vaccine or be an experimental “control.” I for one will choose the vaccine.  Courier Journal.  Jan. 29, 2021.  References
15.  With the coronavirus mutating and vaccinations behind schedule, here's what we must do now
The news media is filled with articles regarding the new UK coronavirus mutation, which modeling has shown to be 56% more infectious. This mutation appears to be widespread in the United States, possibly emerging as early as October and now is spreading in multiple states. Similar to the original virus, this one has spread undetected because of inadequate testing. The United States is not leading but is 43rd in the world for genetic sequencing to detect new strains of the virus....Remember the Louisville Zoo’s snow leopards. They are particularly good at enforcing social distancing, not so much at wearing masks. They caught COVID-19. You need to do both.  USA Today.  Jan. 9, 2021.  References 

Courier Journal:
Yahoo News:

Kaiser Healthcare News Morning Briefing: 

14.  In Battling COVID-19, Government Needs to Engage, Not Fight With Religious Communities
Public health strategists should realize these rulings set a template for a unified national strategy that is not perverted by economic or political interests. New York City, the genesis of the Supreme Court Case, closed schools and allowed bars and restaurants to remain open, which made little sense. And many in Kentucky question the wisdom of closing schools with sporting events remaining open. All of this is creating unnecessary public confusion, eroding faith in our public health institutions and most importantly ineffectively controlling the spread of COVID-19. Courier Journal. Dec. 4 2020.  References  


13.  We can see a light at the end of the COVID tunnel, but we still have to be diligent
We can now see a light at the end of the tunnel but let’s not brick up the end. We must slow down the transmission of this virus, so nature’s lab does not outpace our pharmaceutical giants. If a safe and effective vaccine is available, please take the vaccine and encourage others to receive it. And wear a mask along with social distancing.  Lexington Herald Leader. Nov 20, 2020.  References
12.  Distortion of Science to Inhibit the Adoption of Infectious Disease Strategies.
Distortion of science for political and economic ends has prevented the allocation of needed resources to stop the spread of dangerous pathogens. This places all of society as a whole at risk, but exacting an insufferable toll of death and disability on our front-line healthcare workers, along with our most vulnerable populations. COVID-19 has demonstrated how dangerous this scenario has become..... Whether one deals with MRSA or COVID-19, screening and decolonization or self-isolation of healthcare workers is of utmost importance. Their health, the health of their families along with their patients depend upon it.  BioMed Central.  Nov. 13, 2020.  References  
11.  Will the COVID-19 Pandemic Transform Health Care ?
Many lessons have been learned from COVID-19. We have learned that case definitions can be rapidly created and a reporting system which comprises all types of healthcare facilities can be implemented. The same needs to be done for other dangerous pathogens, including the CDC’s Urgent and Serious Threats, and strategies need to be standardized across all types of facilities. SARS-CoV-2 does not vary its lethality or infectivity based upon the facility type or region of the country.  BioMed Central.  Nov. 13, 2020.   References 
10.  COVID-19: through the eyes through the front line, an international perspective
COVID-19 is continuing to ravage the globe. In many Western Countries, the populace has not embraced public health advice which has resulted in a resurgence of the COVID-19 virus.
This vulnerable population of frontline workers are faced with a choice of going to work with inadequate PPE or placing food on their families’ table. In the United States, official recommendations seem to be ever changing, based more upon supply and test availability, than on science. We must rely on science and learn from the lessons of past pandemics or we will relive, even to a greater degree, the deaths and devastations experienced by our ancestors over 100 years ago.  Antimicrobial Resistance and Infection Control.  Nov. 7, 2020. 

9.  To successfully deal with COVID-19, we need to transform our way of life
It is imperative that we need to take our head out of the sand and unite as a nation. Successfully dealing and living with viruses is the new norm. We need to adapt and need to invest in our infrastructure and transform our society. New Zealand, Australia, Taiwan, China and South Korea have done this, so can the United States.  Courier Journal.  Nov. 5, 2020.   References  
8.  Our nation needs to learn how to live safely with the coronavirus
As our society continues to live in a way that defies public health logic, one can only conclude the infectivity and lethality of this virus is being severely underappreciated by our leaders. An underappreciation exemplified by Kentucky Sen. Rand Paul’s recent push for a policy of opening all schools and having only those at risk wear masks.
We need to approach this pandemic not with third-world nation strategies but by expanding rapid testing and case identification, along with transforming our infrastructure and society to allow us to safely live with this virus.   Courier Journal.  Aug. 26, 2020. 

7.  On COVID-19, the U.S. is turning into a dangerous cult of bad information
Some of us formed into online cliques and developed a Jonestown cult mentality in our approach to American life. Added to the toxic mix, foreign agitation placed us on the precipice of one of the greatest ordeals which our society may endure – COVID-19. A study from Carnegie Mellon University found almost half the tweets regarding the coronavirus are likely bots with a playbook similar to Chinese and Russian disinformation campaigns. Reuters reported similar findings, describing a European Union document which concluded Russia implemented an online misinformation campaign, in multiple languages, which was making the EU’s response to the epidemic difficult.   Lexington Herald Leader.  July 8, 2020.   References  

6.  Opinion: If we don't come together as a nation, the coronavirus will win the battle
Currently, society is struggling on two fronts, both for social justice and at the same time to control a raging epidemic. The epidemic of COVID-19 may be with us for a long time. And those who try to minimize it are doing so by placing front-line workers and economically disadvantaged populations at risk. We are opening our economy, but we need to do so safely, and we need to learn to live with this virus. That means wearing masks in public and in stores, social distancing and protecting, not fighting others. While we fight for social justice, it is imperative that at the same time we need to slow the spread of this virus, so our technology and vaccine development can catch up. Courier Journal.  June 6, 2020.  References  


5.  Healthcare system's basic infrastructure left it unprepared for COVID-19
Hospitals are receiving massive bailouts based upon their Medicare billings. However, this will primarily shunt money to large healthcare systems as opposed to frontline hospitals. Similar, to everyday citizens’ stimulus checks, hospital bailouts should be based upon need. Non-profits with high net assets should not receive as much funds as frontline hospitals with negative assets. If for-profit facilities or private equity firms receive a bailout, it should be paid back with interest or the Government should acquire an equity position in the company. And all of this should be predicated on not furloughing workers."   Lexington Herald Leader.  April 27, 2020.   References  
4.  There's No Excuse for Lean Healthcare Systems — Especially during COVID-19
"There is no excuse for running a system which is lean on hospital rooms, supplies and staff. Net-profits and assets are desirable, but not at the expense of public safety. Hospital staff are being asked to see patients under draconian conditions and at the same time they do not have an adequate economic and healthcare safety net. Healthcare workers do not need paid sick leave, they need adequate PPE and worker’s compensation benefits, if they become infected. IPs are placing both themselves and their families’ lives at grave risk under the crisis management CDC infectious disease recommendations. That is the very least we can do for them."  Med Page Today (non-redacted version).  April 20, 2020: References

3. The United States has squandered resources it needs to fight coronavirus
"The United States is on the verge of being ravaged by an invader which we have far too little resources to confront. New estimates from the United Kingdom are predicting 2.2 million deaths in the United States from an unmitigated coronavirus (COVID-19) epidemic. If our healthcare system is overrun, this care will not be available to all. In Italy, there are reports of those over 80 not being placed on ventilators. In addition, critical care survivors, including the young, may well develop pulmonary fibrosis, a disabling chronic lung disease."  Lexington Herald Leader.  Mar. 24, 2020 (Online).  References
2. The Untimely Reporting of Drug-Resistant Outbreaks in the United States.
Over the course of the last few decades, the United States has fallen into the dark abyss of secrecy: if truth is inconvenient, just cover it up and don't disclose it. The United States needs to implement mandatory real-time public reporting of the CDC's dangerous biological threats. The Center For Disease Dynamics, Economics & Policy. Mar. 3, 2020 (Online).  References
1. Coronavirus is the biggest challenge our healthcare system has faced.
Is Kentucky prepared? In January, I concluded an OpEd with an alarmist statement: "The epidemic of antibiotic resistant organisms may be the final solution to global warming." We are currently on the precipice of a massive pandemic from the coronavirus (COVID-19). Initial data from China has documented massive economic disruption with a 25 percent drop in carbon emissions. A sobering observation, but of even more concern when one considers the United States does not have the authoritarian structure and a culture of population control which exists in the Chinese government. According to the CDC, the unknown is when, not if, the epidemic will hit the United States and "severe disruption" of everyday life may occur. Lexington Herald Leader. Feb. 27, 2020 (Online).  References 


Republican Leaders and Governors -- Public Wearing Masks

This webpage is for guidance only, always consult your healthcare provider and the CDC Website for information before making decisions relating to the coronavirus.