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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schools have unhealthy buildings with outdated HVAC systems.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.
Voices—Hospitals can't lose sight of infection control as COVID
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
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.
Courier Journal. Jan. 30, 2023.
55. 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.
54. 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,
53. 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,
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,
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.
https://kentuckygazette.com/opinion-with-only-28-of-kentuckians-boosted-against-covid-19-variants-could-pose-a-big-health-risk/ References Download
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.
On Health, BMC, Sept 28, 2022.
48. Success and failures in MRSA infection control during the COVID-19
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.
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
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.
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.
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.
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
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.
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
Courier Jounal. Apr. 7, 2022.
40. As another variant
emerges in Europe, it's too soon to let down guard against COVID.
It 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
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.
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.
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.
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.
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
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.
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.
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.
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,
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
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.
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.
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
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
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.
Courier Journal. July 19, 2021.
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
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.
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.
23. Kavanagh KT. Why the
COVID-19 6-foot rule isn't enough and how to return to a more normal
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
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,
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
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.
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.
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.
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.
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.
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.
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.
15. With the coronavirus
mutating and vaccinations behind schedule, here's what we must do
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.
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.
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.
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.
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.
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.
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
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.
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.
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:.
3. The United States has squandered resources it needs to fight
"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).
2. The Untimely Reporting of Drug-Resistant Outbreaks in the United
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).
1. Coronavirus is the biggest challenge our healthcare system has
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).
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