COVID: Thoughts on Medical Fallibility in Times of Pandemic
The biggest critique I received for my last article “COVID: Hydroxychloroquine (HCQ) and America’s Frontline Doctors” was:
1) I was giving cover for those who want to use HCQ as an excuse to not practice basic pandemic safety guidelines.
2) The scientific consensus just doesn’t believe that HCQ really works against COVID.
To the former let me be clear and reiterate what I stated initially. HCQ is not a panacea. There is no evidence or logical reason to believe that it will cure COVID and HCQ will not save our country or enough of our loved ones if we do not use what the scientific evidence (and common sense) absolutely shows can help us turn the tide against COVID-19. We must continue to practice basic social distancing and mask-wearing. Especially in large crowds and indoors and even more so in cities/states where there is a larger proportion of positive cases.
Regarding the latter argument that scientific consensus and studies published in the best journals do not seem to show any benefit to HCQ. This is true, there is very little (if any) scientific evidence that HCQ helps. But, who remembers the beginning of the pandemic when we were told that not only was public mask-wearing not beneficial but instead was likely to cause far more harm to the wearer? That was the message from the CDC, WHO, and almost all American medical professionals. I remember my friends and family asking
me about wearing masks and I scoffed and explained that if they don’t wear masks correctly and don’t change them frequently, they were far more likely to contaminate themselves and contract COVID. Did I have strong evidence of that? No, but that’s what “the experts” continued to hammer home and there was some evidence offered up at the time that this was the case. The bottom line is we were intentionally misled albeit likely with good intentions. There was a shortage of masks and PPE (personal protective equipment) in the hospital settings and there was genuine (and accurate - as we have subsequently seen) fear that an all-out rush on masks would severely limit the availability for healthcare workers.
In non-pandemic times, the scientific method and medical consensus work extremely well to ferret out the non-truths and propagate up the most accurate information available. The studies are thorough and well-powered. Time can run its course and show the correct answers.
In times of pandemic, everything goes into hyperdrive. Considerations such as the risk of national panic, and ethics of utilitarianism (where the ends justify the means) and the need to find fast solutions lead to blanket statements that often cannot be backed up with great evidence. Authorities should have stated “masks are likely to help the general public, but they are an absolute necessity in the hospital. Due to the shortage please use cloth masks” and then found some way to ensure hospitals had what they needed. Whereas everyone quickly came out against HCQ when it was trumpeted as a cure-all without good data, we should have said, we just don’t know enough yet. Let’s continue to study it in the best method possible and doctors can consider prescribing it under safe and reasonable circumstances.
I for one have learned my lesson, I cannot just blindly follow medical consensus in a pandemic. These are unique times and require a certain amount of critical thinking. We need to read the studies, consider the risks, and weigh the alternative options. I have been humbled enough to know that I cannot speak in blanket statements in times of pandemic. That is not to say that medicine is wrong or doctors are bad. Far from it.
In times of pandemic, extra caution and critical reasoning are required by both the general public and healthcare providers. The scientific process just cannot work fast enough to give us all the answers we so desperately need. The saying, “Trust but verify” is apt here. Trust the medical advice in general but verify it with the actual data and common-sense safety precautions.