Dr. Loh: COVID gets off on a technicality

We live in strange times. Over the last three decades in particular, our society has become increasingly polarized to the point that those who disagree with you are felt to be so out of touch with obvious reality that friends and even families have been torn asunder.

Where one sits along the information divide can now determine whether one is a friend or not-friend. Russia’s President Putin has an over 80% approval rate … in Russia, where data on the war in Ukraine, or “special military operation,” is tightly controlled, under penalty of imprisonment, and everything from the West is fake news. So the average Russian, without access to our uncontrolled and sometimes totally almost incredibly raucous press, can’t sort out fact from fiction since, in their world, they are the same.

So let’s have a little mental exercise involving one’s health. Let’s posit that you have a painful chronic condition and you have seen a number of healthcare providers to sort out what it is and what to do about it. You accept that you have the disease, but there is inconsistency on what the “experts” tell you to do about it. Some have said that surgery will cure or at least mitigate your pain and suffering, but you, understandably, do not want to have surgery if it can be avoided. Especially since those doctors cannot guarantee that you will be cured. Other consulting experts have said that you do not need surgery, which is much more appealing to you obviously, but leaves you wondering if that is the best recommendation.

What to do? Both sets of experts seem to have compelling arguments to justify their respective, though disparate, recommendations. In an attempt to resolve this issue, you ask your health plan to help you sort out the dilemma. After all, you are the one suffering, and they allegedly have the medical expertise. The health plan tells you, yes, they will help. They will assign to your case a designated specialist to review your condition. After some deliberation, their expert tells you that she has decided between whether or not to have surgery, which you really don’t want unless they can guarantee that you will be cured, or not have surgery, which is what you really prefer. The expert tells you what you want to hear … you do not need surgery.

Great. But then you wonder who exactly is this expert who made this decision for you, even though it’s the decision you wanted. Let’s say that when you look into this expert’s background, you learn that the American Medical Association, after reviewing the relevant experience of this individual, said that this expert was “not qualified.”

Even though it’s what you wanted to hear, would you be concerned that it nonetheless is the correct decision?

So this month, a federal judge in Florida voided the mandatory mask mandate on public transportation. TSA and the airlines promptly complied since the public pushback on masks, given the perception that the pandemic is on its last legs, has been intense. The White House, and most public health officials, were disappointed, but said they would abide until the CDC weighed in. The conservative 11th District Appellate Court may also look at this ruling, which has profound public health implications. The U.S. District Judge based her ruling on her opinion on a law called the Public Health Service Act of 1944 that the CDC improperly failed to justify its decision and follow proper rule making, and thus exceeded the CDC’s authority. Her ruling was not based on available science.

This 35-year-old Florida judge was given this lifetime federal appointment despite only having been a judge for eight years, far fewer years than average for appointees, and had never been a trial attorney. The American Bar Association, which reviews all federal judge candidates, reviewed her experience at the time the Trump Administration recommended her, and the ABA officially called her “not qualified.” She nonetheless received Senate approval in 2020 along a straight party line vote.

New omicron sub variants, called BA.2.12, BA.2.12.1, and omicron XE, have become dominant and are significantly more infectious than original omicron and about 25% more infectious the newer variant I wrote about only a couple of months ago, BA.2. These sublineages have picked up mutations that help them enter cells more rapidly, and, this is the yellow alert part, evade vaccine and even infection-boosted immunity according to virologists studying the COVID virus.

Case numbers are rising, but thus far it appears that hospitalizations and serious illness are dominantly in the unvaccinated, under-vaccinated, or those with higher risk based on co-morbidities. We need to watch hospitalization and mortality rates to track the significance of this “stealth” omicron variant, and those variants that will inevitably follow, since it is highly likely that the COVID virus will be with us for the foreseeable future.

The pandemic is not over, as much as we all wish it were. If you think you’re tired of this virus and the burden it has placed on your life, ask your medical acquaintances to gauge how tired they are of this virus. You’re tired. We’re tired. The virus is not tired.

Despite the federal judge throwing out the mask mandate based on jurisdiction, not on science, and even though many people have been happy to ignore the science and go on with their lives, I think it prudent that when in enclosed proximity to people of unknown vaccination status, that masks, social distancing, and hygienic precautions remain in play. Until the reconstituted CDC gives us the all clear, based on available evidence-based scientifically validated data, being cautious is preferable to being cavalier.

Irving Kent Loh, M.D., is a preventive cardiologist and the director of the Ventura Heart Institute in Thousand Oaks. Email him at drloh@venturaheart.com.

This article originally appeared on Ventura County Star: Dr. Loh: COVID gets off on a technicality