Let NJ Kids Go Back to School – Don’t Cave to Unions

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While millions of Americans, including doctors and nurses, truck drivers, grocery store workers, and many more, are working at jobs that expose them to potential SARS-Cov-2 infection, unions that represent one group at lower risk are fighting to not have to go back to work.

Is it dangerous to send teachers back in to the classroom? It turns out that it is significantly more dangerous to NOT send them back to teach.

“The greater risk to our society is to have schools closed,” warns CDC Director Dr. Robert Redfield, July 7, 2020:

And even the American Academy of Pediatrics, the principal medical society representing 67,000 pediatricians, concluded that it is not safe for children to be denied full-time classroom instruction:

“With the above principles in mind, the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school. The importance of in-person learning is well-documented, and there is already evidence of the negative impacts on children because of school closures in the spring of 2020. Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality.”

Source:
https://committeetounleashprosperity.com/wp-content/uploads/2020/07/CTUP_NotSafeToKeepSchoolsClosed_Study-1.pdf

It is clearly unsafe to prevent kids from school. But what about safety for teachers? Yes it is. The Foundation for Research on Equal Opportunity reports:

“In Europe, reopening schools has not led to a rise in COVID-19 cases. Denmark reopened schools on April 15, the first Western country to do so. But “you cannot see any negative effects from the reopening of schools,” said Peter Andersen of the Danish Serum Institute. Norway reopened schools on April 20, and cases there continue to trend downward. Austria reopened schools on May 18, and has not seen an increase in infections. Similar trends hold in Germany and Finland. A study of 541 students in northern France found zero cases of an infection transmitting from student to teacher.”https://freopp.org/reopening-americas-schools-and-colleges-during-covid-19-bdb35e3e32c4

You know how critical public and private schools are to the entire fabric of society in New Jersey and across the country. Public school teachers unions are sending the message that teachers are no more important than Walmart workers. The NJEA “reopening plan,“ is “Orwellian speak” for how to close your school using an impossible-to-achieve checklist.

The Union is also distributing action steps for union leaders to use to bind the districts up with minutia like proving when they “calibrated dampers.”

There are many common sense solutions to improving ventilation in classrooms, like opening windows and using inexpensive fans. But the unions do not seem interested in solutions as much as stalling and obstruction.

So folks, do not cave to the Union’s propaganda. Send teachers and kids back to school.

The Tale of Two Drugs: A Case for Allowing Patients Right-to-Try #HCQ #hydroxychloroquine for #COVID19 #Coronavirus Prophylaxis

Nowadays Gilead’s Truvada, PrEP (Pre-Exposure Prophylaxis) for HIV, is considered essentially a right for anyone who wants it. Medicaid covers it in many if not every state as does Medicare Part D. TV ads for it are ubiquitous. This is a drug that reportedly costs $2000 per patient per month and it’s the most prescribed specialty drug in the state of California and perhaps other states too.

But meanwhile HCQ PrEP for COVID at $10 a month is not meaningfully allowed in many states even if patients want to pay out of pocket.

Wait there’s more:

Truvada, is available without a prescription from a physician in California:
https://abcnews.go.com/Health/hiv-prevention-drugs-prescription-california/story?id=66132808

Oregon and Colorado are considering following California’s lead:
https://www.poz.com/article/prep-may-available-without-docs-prescription-two-states

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FALSE EQUIVALENCE: Government lockdown vs Coronavirus

Authors:  Parvez Dara, MD, MBA and Craig M. Wax, DO

There is a powerful force in humans that drives their destinies. This force asserts itself in the form of Liberty. In the Declaration of Independence, the statement “Life, Liberty and the Pursuit of Happiness,” is the most powerful of those liberating words ever written. The absence of subjugation to power and the right to act, speak, or think as one wants, are the tenets of what makes us all Americans. When these basic rights are threatened, the ire of freedom loving people is raised.

 The current COVID-19 pandemic seems to have roiled the tranquil waters. In this chaos many a voice seems to invoke falsehoods and render them as truths. There is a false equivalency between disparate ideas that rule the minds of the policy makers and in attempting to rule the minds of the citizens.

 Let us look at the past 6 weeks and gather reality from this recent past. As the pandemic broke across the Pacific and Atlantic shores simultaneously there was a sense of urgency and panic. The urgency was implied by some very poor models that were based on hypotheticals that failed to materialize. Large quantities of beds were made available and larger numbers of ventilators were built to respond to a threat that never materialized. Most of the beds remained empty and ventilators are being diverted to other countries.

 Yet, the virus continues to move through the United State from both coasts into the middle taking thousands of lives in its wake. The tally of the infections and deaths has become the daily mantra of the experts. In fact, some seem to thrive in reporting such numbers, and take delight in the fact that the worst is seemingly yet to come. Even in the face of a slow and steady decline, these experts continue to feed the beast of public fear. Caught in the trap are politicians that have a lesser sense of what is real. The louder the drumbeat, the more deference is paid to the experts. Policies are made to counter this beast of an epidemic. No one seems to pause and reflect for a moment as to what is at stake with each policy or mandate they conjure. No one!

 One such policy is the “lockdown” of private commerce in its many forms. Closure of hotels, airlines, shops and even short distance travel is frowned upon. So much so, that drones have been utilized by police precincts to command and control and command citizen movements through virtual means. In West Texas, the police SWAT Team was summoned to close down a bar. The loudest voices seem to be repeating the phrase, “We must flatten the curve.” By that they mean they imply,  “Social distancing,” from one another and, “shelter at home,” the spread of the virus will be contained, and the healthcare system will not be overburdened. Meanwhile dubious policies take flight; Prisoners are released while law abiding citizens are imprisoned for walking with their children.

 But within this “shelter in place” and other such terms, is a sinister mechanism that has raised its ugly head and seems to hover over us as the Sword of Damocles. The thinking goes that if private businesses are opened too soon, then we will have many hundreds of thousands of more deaths. That specter shakes the core of any human being. But time is passing, and more and more information is being revealed. The virus seems to not like living under sunlight and moist air. Yet even armed with this knowledge, the powerful governing forces have shut down parks and beaches, albeit a few have been reluctantly opened due to pressure from citizen protests. Small businesses still are forced to remain closed. Among small businesses,  physician office closures  are having a deleterious effect on medical care of the infirmed and ailing fellow citizens. There are estimates of over 6,000 early deaths among cancer patients alone, with 80,000 missed diagnoses of cancer. Other specialties are also seeing fewer patients with heart disease, diabetes, lung disease and kidney disease. All these patients have been furloughed from healthcare due to fears of hospitalization and close contact with others for fear of contracting COVID-19. How many people will die from such an action?  The number will most certtainly exceed deaths from COVID-19.

 False equivalency exists between the control of the virus and the shelter in place concept.  Although shelter in place may have, “flattened the curve,” it still remains in dispute given the data from Sweden, certain states, and other parts of the world, where shelter in place was not undertaken by  government force. The essence of this virus suggests that it will find “parity” with its surroundings and eventually die off. “Parity,” here means herd immunity. Scientists have since the beginning said that it will take infection of 70% or more of the population for the virus to finally die off. But some epidemiologists have models that suggest only 25-30% of infected population shuts the virus down. Further evidence suggests that between 40% to as much as 65% of the deaths were from Nursing Home patients. In fact, the Swedish Health Minister stated  that the increased deaths in Sweden were from poor infection control in nursing homes. The incomprehensibility of some enforced policies of moving patients with COVID-19 into the nursing homes in New York, New Jersey and California are counterfactual to scientific reality. Governors’ policies directly increased morbidity and loss of life. It would therefore be prudent to allow the country to open for business and people over 65 years of age with co-morbidities might continue, “physical distancing,” as preventative measure against the virus. The younger population meanwhile can begin the process of normal living with recommended good hygiene standards. The herd will get itself immunized and the virus will become a distant memory, and limit further economic, emotional and health damage caused by the capricious government lockdown.

 While Aristotle suggested that desire can be subjugated to reason and Plato stated that all desire must be postponed for a higher ideal, the current ideal threatens the economic welfare of everyday workers in every country, as the economic collapse continues from these unbridled restrictions. Socrates meanwhile argued, “that happiness and personal growth were a major purpose of life, and a central goal of education.” If that is true, and it is, then the current actions by some governors are a direct assault on individual human liberty and freedom to pursue happiness.

 It is therefore imperative that Governors exerting undue force of their incomprehensible logic, should undo their dictates and open the civil activities of daily life, so that for the time being those aged 18 to 60 years of age can work and provide for their families. Government subsidies cannot sustain life as has been evidenced throughout history. The United States Constitution states, “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.”

 As the New Hampshire flag and automobile license moniker states, “Live Free or Die.” Let us throw off the chains of government lockdown and assume our rightful individual rights and responsibilities. We must demand our freedom to continue to live under that banner of liberty.

#PriorAuthorization Should be Illegal

They harm patients and steal valuable resources for third-party profit. 

A recent example:

A patient needed an MRI. The physician spoke to @evicorehc @Aetna @MedicareGov to get #Precertification.

Dr. M called back for a “peer to peer” and approved the procedure.

A half-hour later the doctor was called by Vanessa V, who said “the peer to peer was for educational purposes only. The procedure was denied and, since it was a Medicare Advantage patient, no appeal was possible.”

The doctor then spoke with supervisor Christine H. at Evicore and she echoed the same. The doctor explained to Christine that she was practicing medicine without a license, harming the patient, and consuming valuable patient care resources.

The doctor demanded approval for the MRI and hung up. 

 #free2care #nomiddlemen #disintermediate #healthcare  #medicare

Personal Health is a Personal Responsibility to Enable National Health

By Paul Kempen, MD, PhD

It really amazes me as a physician and health care expert,  that while the government and general population EXPECT doctors, Nurses-yes ALL hospital employees down to the janitor (Health care workers=HCW)- to go to work  EVERY day to care for severely and clearly infected patients, the expectation that  the general population cannot even perform daily tasks in low risk environments seems severely misplaced. Being out of doors has of recent note, apparently even become “illegal”.  We have seen the country “closed for business” and production capabilities, lives and personal welfare, decimated. If all HCWs are able to work in clearly infected environments, why are citizens unable to protect themselves in low risk environments? Why are there not clear and effective educational and production mechanisms for ensuring regular daily living activities promoted in all media at this time? I have NEVER seen a public educational clip on HOW to correctly wear a mask-but  have repeatedly seen “experts” without and improperly wearing masks. Are factories and businesses still (really) unable to provide PPE and distancing between workers? WHY? If we can put a man on the moon……….we cannot provide education and PPE?

 Of course, the LACK of Personal Protective Equipment (PPE) has been the serious issue. Government/CDC/WHO “Expert Action” has been unable to address to date THE singular outstanding shortage of N95 masks and hand disinfectant, or provided ACCURATE and specific instruction/education on PERSONAL protective measures. Instead, concentrating on ventilator production (to TREAT disease) and “Testing” to identify infections remains “the answer”. In Medicine, we typically test to identify infection based on symptoms-as a healthy, negative tested individual is not protected by the test and can become infected by those providing tests to hundreds per hour!

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The overwhelming mismanagement of the COVID-19 Crisis

By Paul Kempen, MD, PhD

We saw SARS and MERS as severe Corona infections in the past, and COVID19 is also known as SARS-2:

The 2002–2004 SARS outbreak was an epidemic involving severe acute respiratory syndrome (SARS) caused by SARS-CoV. The outbreak was first identified in FoshanGuangdong, China in November 2002. Over 8,000 people from 29 different countries and territories were infected, and at least 774 died worldwide. We watched it in Torono, Canada, just across the border.

Middle East Respiratory Syndrome (MERS) is an illness caused by a virus (more specifically, a coronavirus) called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Most MERS patients developed severe respiratory illness with symptoms of fever, cough and shortness of breath. About 3 or 4 out of every 10 patients reported with MERS have died. Health officials first reported the disease in Saudi Arabia in September 2012.  https://www.cdc.gov/coronavirus/mers/about/index.html

The past epidemics didn’t kill enough Americans to create enough interest in solving the problem. The current SARS or COVID19 pandemic was first documented on January 10, 2020, while the name itself identifies the pandemic as starting in 2019. We are now 3 months INTO the epidemic, with an anticipated death rate of 5% and are still only reacting! Instead of closing down the country, we should have been ramping up industry to provide for THIS EXPECTED pandemic and providing the PPE, drugs material and manpower. The current plan to “self-quarantine” serves only to spread out the ultimate number of infections over time,  to allow the available facilities to be able to “cope” with the expected severe infections. But please remember, that the USA has been reducing total numbers of hospital beds and closing hospitals for decades. It will also remain to be seen if this COVID19 pandemic will equal or exceed the deaths from those yearly Flu season’s infections (epidemics) which KILL 30-60 THOUSAND each year in the USA.

Oddly enough, we never have seen this sort of  PPE response to the flu in  spite of the significant mortality-so why are we treating COVID19 as if it were EBOLA, when it is a respiratory infection just like the FLU? Or will we now be responding to flu seasons like the Covid-shutting down the country, especially if the flu actually kills more people than the covid virus? Why are nurses suddenly utilizing PPE with such high level of protection, exceeding that required for flu season? Why are we seeing nurses crying on TV that “they never signed up for this”. “This” comes EVERY YEAR! The vast majority of flu and COVID patients do NOT die, as many have minimal or no symptoms, especially the young and healthy. Yes, be safe, but in which “War” did this country shut down the industries? Most workers in industry are easily 6 feet from each other.

The LAST place anyone should be going now-if they are healthy, is to a HOSPITAL -why join the infected if YOU are not-stay home!!! All this wasted “news” on testing has been counter-productive. A Test does not save anyone, it does not insure citizens are not infective for a number of reasons-more importantly, you could BECOME infected getting the test in a hospital. Getting yourself tested in your car from a person who is reaching into test hundreds of patients an hour is not someone I want to encounter as they may be infected. Why risk to “see” if I am infected driving up and opening my mouth and possibly GETTING the virus (my test will be negative and I will be positive a day later).  The emphasis on daily declarations of the total number of “cases” rather than DEATHS serves to maintain the hysteria in the population, facilitating and exploiting the fear, to force all citizens to comply with whatever the “Current recommendation” is issued,  being true or false. Testing only provides access for numerators and denominators in the tracking of epidemiology-but this is also an effective way to scare the populace into “following orders”. No person without symptoms needs testing as a matter of acute care. The overwhelming of facilities with hysterical people wanting testing and treatment for “possible” (not probable or symptomatic disease) is counterproductive, helping to spread the disease and tying up those health care workers and facilities need to care for the sick.

The CDC has failed us by stating “civilians should not wear masks”, and should be reversing this statement soon,  because it is WRONG. If it is useful to doctors and nurses, why would it not be true for citizens out in public? Sure, the statement was a political based decision and NOT a doctor-patient decision. The CDC wanted to conserve PPE. Sure, the epidemiologists also have “recommended” for decades to change your face mask after EVERY use before the Covid hit (i.e. every time you leave the operating room)-but no one does this in real life because THAT too is wasteful and excessive. Now we are reusing and prolonged using of PPE because of a shortage, which after 3 months since the first warning, should NOT have occurred.

We as health care professionals-Doctors KNOW what masks do and this is important and is NOT being disseminated via the news. Surgical masks contain YOUR secretions during normal operations from falling into the wound. N95 masks are not the same and prevent other’s aerosol infections from being transmitted to you! A Mask is NOT “a mask”. There are different types, uses and functions. Hand made cloth masks are NOT N95 and protect those around you from your secretions but do not reliably protect you from theirs. Everyone should be wearing surgical masks in public, and “high risk” civilians should have N95 if they NEED to leave their homes to go to the doctor or grocery store. People should not need to reuse masks, but they could be disinfected with rubbing alcohol 70% in a plastic bag overnight and air dried (or even baked at 200 degrees) prior to reuse.

I have YET to see any information on the “NEWS” to explain the use of masks to the public to date. Yet, every hospital health care worker must comply with OSHA guidelines and submit to an “N95 Fitting session” to LEARN how to use this type of “duckbill” N95 mask for PPE!  Because of the misinformation presented on the “daily news” it is high time for these issues to be presented. It is high time for EVERY person appearing on TV to WEAR a surgical mask, whenever there are more than 2 people present! We need the RIGHT messaging sent out to the population and the right example projected!

I have personally Worked on the USNS Comfort twice during missions to South America, once after the Haiti earthquake. ALL patients were screened for Tuberculosis-a  severe respiratory infection- to insure no one with TB was brought onto the ship, because of the danger of widespread infection once on board. The current presence and use of these warship hospitals appear to me to be primarily one of “reassurance” or some political statement in this pre-election period. In this PANdemic however, the likelihood that COVID patients will NOT become apparent onboard-even if they bring only “non-covid tested patients onboard to “relieve landside facilities” is highly unlikely.,  After the 800 workers and first 800 patients are brought onboard, the infection may become apparent after days.  Testing is not able to exclude latent infection and the COVID is extremely infectious-especially if the patients are coming from a high risk zone=i.e. a HOSPITAL. The size of patient bays on those ships is small, the ventilation is “common” and cross infection will be a given, after the first Covid infection manifests onboard. Our experience with quarantine on cruise ships and COVID is,  well…….. nobody is going on a cruise until Covid is over! The resources (personnel and materials) of these two hospital ships would be better placed landside, in a converted mall or convention center with adequate space and ventilation. The shortage is one of material and personnel-NOT floating sardine cans,  which are known to be at risk for dissemination of respiratory infections. These military health care workers should be used landside in this “War on Covid”. We need an army and not a navy today.

The government has made many decisions to allow “compassionate care” approval of drugs. It has been STANDARD PRACTICE to allow doctors to prescribe medicine for “off label” use-prescription for  conditions other than those formally studied and allowed to be advertised under FDA “labeled” guidelines. Almost ALL use of drugs in children was initiated as “off label” for decades. IN the face of an epidemic, the use of hydroxychloroquine had been curtailed and in spite of information from as early as 2004,  suggesting effectiveness in slowing viral reproduction in SARS as a treatment and therapy. Of course the scientists at the CDC “want further study”………….but people are DYING NOW. But the political agenda is to now build thousands of ventilators, instead of releasing drugs. The drugs are quickly and easily marketed, are very low risk in the young and healthy, but alias, as generics these drugs were unlikely to find the financial incentives noted with complex machine products. They may well be able to specifically prevent and treat the disease,  as opposed to fight the symptoms of disease (with ventilators). SARS is not new-it has been there for study for over a DECADE. The lessons of the flu season (epidemics) EVERY YEAR are the same as COVID. Are we learning or even asking these questions? Why not?

Many questions remain in this War and cannot be answered until addressed, unlike most of the preceding matters discussed. Because the young, healthy population is resistant to severe symptoms, should they be restricted from service in this war? Should the elderly and infirm?  Should ALL TV persons be WEARING MASKS to promote the “war effort”? When will educational, instead of hysterical “news” be screened to teach the population what is TRUE and effective? Why are the drugs not in high priority production and dissemination for prescription by physicians to PATIENTS who desire them?

COVID19 is a form of virus (Corona), one which usually causes about 20% of the yearly common colds.  We have not developed testing or immunization for corona virus in the past BECAUSE it is benign. Are children and non-geriatric people less affected, because of their yearly exposures to the similar, yet innocuous corona virus? We know that immunizations for Smallpox, polio and other viral disease prevented these serious diseases by inoculations of similar and less deadly live virus. Infections are typically one pathogen and competition with others may reduce pathogen’s  disease-we know eugenic bacteria exist in the bowel and if destroyed by antibiotics, allow pathogens to become deadly there.  Should we be passing out “Common cold virus” now to compete and possibly prevent severe COVID? Can it “compete” in cell cultures or animals/humans? Should we stop publishing daily “Corvid cases” on the news channels-sticking to deaths and promulgation of useful information like safe and correct mask use for all?

It is time for medical and not political decision making. We should be anticipating needs for now AND the next decade, and not be awaiting each crisis.

Pau Kempen, MD, PhD

213 Vista Dr
Weirton, WV 26062

412 860 6827

“Gee, Jim, I wish I would have run for congress after graduating high school like you! I could have saved myself 12 years of grinding medical education to become an expert in health care like you and your many colleagues in congress!”                                                       From a late night joke on TV

Head of China CDC: 

“The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact.”

https://www.sciencemag.org/news/2020/03/not-wearing-masks-protect-against-coronavirus-big-mistake-top-chinese-scientist-says

A physician in Michigan sent this to me last night. 

And separately these Korean modelers concluded that these strategies were working:

“To early end of the COVID-19 epidemic, efforts to reduce the spread of the virus such as social distancing and mask wearing are absolutely crucial with the participation of the public, along with the policy of reducing the transmission period by finding and isolating patients as quickly as possible through efforts by the quarantine authorities.”

https://www.e-epih.org/journal/view.php?doi=10.4178/epih.e2020011

“Estimating the reproductive number and the outbreak size of Novel Coronavirus disease (COVID-19) using mathematical model in Republic of Korea

Sunhwa Choi Choi  , Moran Ki ,  Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea, Goyang, Korea

COVID-19 Mortality Statistics

By Kelly Victory, M.D., President, Victory Health, LLC.

Like essentially every American with a pulse, I have spent countless hours over the past weeks listening to both politicians and “experts” reporting the “data” and “statistics” on COVID19. Most people now appreciate that testing has been spotty at best and fraught with false negatives, and that therefore, we have likely woefully under-estimate the true number of cases of the virus. 

That said, one of the numbers most frequently reported (daily) — and the one piece of data most commonly cited as a veritable certainty — is the number of deaths from COVID. Well here’s the sobering reality: The numbers being reported by the CDC are wrong. In fact, they are very, very wrong – and here’s why:

We now know that the vast majority (likely greater than 80%) of individuals who contract COVID-19 have minimal if any symptoms. A small percentage (perhaps 5%) go on to have severe illness and may ultimately require supplemental oxygen and/or hospitalization.  Physicians — including the CDC’s own Dr. Anthony Fauci — agree that if and when death occurs as a result of COVID-19, it happens due to “overwhelming cytokine storm and resulting pneumonia and/or ARDS.” In layman‘s terms, people who die from COVID-19 die from pneumonia or from Acute Respiratory Distress Syndrome (ARDS) which is a “pneumonia equivalent“.

In doing a deep dive analysis of the data on the CDC website, I found that only 40% of the patients who have reportedly died of COVID19 actually had evidence of pneumonia. Hmmm.  Only 40%! So, what was the actual cause of death in the majority — the other 60%?? Presumably, it was complications from underlying medical conditions including diabetes, cardiovascular disease, cancer, infection unrelated to COVID19, etc. — In other words, not from COVID-19 at all!

Furthermore, buried in the fine print, I found that in order to be reported as a “death from COVID19”, the patient need not have actually tested positive for the virus; they only needed to have “clinical signs and symptoms consistent with COVID19”. For those who haven’t been bludgeoned with the non-stop public service announcements on the topic, that means fever, cough, headaches, body aches and possibly shortness of breath — symptoms remarkably similar to Influenza and a number of other viral illnesses. 

Given that the “experts” —and the politicians relying heavily on their advice — are making potentially life-altering decisions based on the “growing number of deaths from this virus”, Americans deserve to know what those numbers actually are. Therefore, any patient whose death is being attributed to COVID19 should be required to have documented evidence of both pneumonia and a positive test for COVID19. Anything less represents a continued gross mis-representation of the facts.

https://pjmedia.com/trending/no-the-united-states-does-not-lead-the-world-in-coronavirus-cases-or-deaths/

PETITION: Tell NJ Governor to Rescind Order Blocking Patient Access to Hydroxychloroquine (609) 292-6000

NEW ACTION ITEM: Sign the petition to NJ Governor Murphy to repeal his prohibition of physician prescriptions for patients impacted by the #COVID19 #Coronavirus #Pandemic.

https://www.change.org/p/phil-murphy-covid-19-nj-gov-murphy-cease-your-prohibition-of-physician-prescriptions

After you sign the petition: Call New Jersey’s governor Murphy (609) 292-6000 to rescind his rule restricting early treatment of COVID-19 coronavirus patients. His rule is dangerous and likely would make people sicker and worsen the death toll. Call him, email or web page contact him and demand he reverse his rule. Let doctors be doctors.

Email: constituent.relations@nj.gov

https://www.nj.gov/governor/contact/

Join the physicians who are speaking out! The below letter from physicians explains the urgency for this request.


Doctor’s Letter to Governor

Dear Governor Murphy,

Based on the current circumstances of an extremely contagious deadly COVID19 virus that is creating chaos in our state and the world, your order to restrict physicians from writing prescriptions to treat their patients with Hydroxychloroquine (HCQ), we believe, is contrary to the best practices of medical care. We, as perhaps you, believe in the sanctity of the patient-physician relationship in personalized individual management and care, and that it must lie in the knowledge and wisdom between those two entities and not artificially imposed by others.

Your administration’s order of restriction to use HCQ, prevents patients’ access to a potential life-saving medicine, especially when administered in the early phase of the disease. (1) Creating such a mandate may risk the lives of many New Jersey residents.

Timely access to these medications may mean the difference between life or death for patients facing the battle of their lives. We respectfully suggest that working with New Jersey’s robust pharmaceutical industry to increase the supply of these drugs, both for NJ and the rest of America would benefit the residents of New Jersey and across the country.

Early treatment is crucial for keeping patients out of the hospital and off ventilators. Delaying treatment results in the opposite, more sick patients ending up in overburdened facilities.
HCQ prevents the virus from gaining access to the human cell and in doing so it prevents the infection. Additionally, in those patients who already have infection in their system, HCQ prevents access to the cellular structure called Endoplasmic Reticulum where it replicates. Preventing such replication, reduces the viral load and hence allows the human immune system to fight off the infection. Without this drug, many valuable human lives will be cut short with such an order as proposed and promulgated by your administration. (2)

Other State Governors of Nevada and Michigan formulated similar mechanisms of restrictions to the use of Hydroxychloroquine but seeing the burgeoning loss of life quickly reversed course. If restriction is to prevent hoarding of the medication, then perhaps using the Texas model of limiting the drug dosing for 10 days (20 pills) might be more appropriate. It prevents harm to our vulnerable, sick and infirmed patients. (3)

HCQ has many decades of history as used in the care of patients with Malaria and Rheumatoid Arthritis. Knowing its very low toxicity and it poses very little if any threat to the patient, clinicians in New York, Kansas, elsewhere are reportedly preventing deaths and ARDS/ventilator dependent long ICU stays. Waiting for placebo-controlled trials is not a wartime battlefield strategy, given the urgency of treatment.

As physicians it is our duty to treat patients with the best available therapy and available evidence to circumvent disease at its earliest phase, so as to prevent the loss of life and any future morbidity. It is with that wisdom and acquired knowledge that we respectfully ask you to reconsider this restrictive mandate.

That these drugs are effective against COVID-19 has been proven in laboratory experiments. (4) And now evidence is mounting that these drugs are working to decrease viral load in patients. Decreased viral loads means patients not only avoid the hospital but are less infectious to others.(1) There is growing evidence that early administration even in mild cases of COVID-19 prevents progression to worse disease, likely attenuating the need for ventilators and ICU beds and improves symptoms. (5) This will decrease the burden on the healthcare system and upon the doctors and nurses that bear the ultimately responsibility of the patient’s care.

The information available from across the world suggests that the prudent course of action is not to put hurdles in the path of patient care by restricting most valuable medications that can protect a human life. In fact, India is officially recommending health care professionals and family members of sick patients prophylactically take HCQ. (6) The New York Times reports of a recent study: “Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug.” (7)

We respectfully ask that you review this decision, given the influence of such overwhelming evidence to the contrary. It is with great respect and urgency that we ask you to reconsider this decision that can potentially cause a significant loss of life in the state of New Jersey. Each patient care decision is unique to an individual and their own personal situation and value system. Patients and their physicians must carefully weigh the risks and benefits of every potential intervention. The confidential patient-physician relationship must be held sacrosanct for this purpose.

Best health,

Craig M. Wax DO, Family Medicine
Parvez Dara, MD, Hematology/Oncology
Jim Thomas, MD, Interventional Radiology
Theresa Thomas, MD
Joeseph J. Fallon, Jr., MD, Endocrinology
Carl J. Minniti Jr., MD Medical Oncology & Hematology
Charles Dietzek, DO Vascular Surgery
Indrani Sen Hightower, MD, Neurology
Alieta Eck, MD, Family Medicine
Kelly Victory, MD, Trauma and Emergency Medicine,
Disaster Preparedness and Response
Christine Saba, MD, Pediatrics
Kim Legg Corba, DO, Family Medicine
Marion Mass, MD, Pediatrics
Katerina Lindley, DO, Family Medicine
Theresa Thomas, MD, Internal Medicine
Thomas W Kendall, MD
Family Medicine
Robert Campbell MD
Anesthesiology
Pain Management
Jane Hughes, MD, Ophthalmology
Kris Held, MD, Ophthalmology
Michael J. A. Robb, M.D., Oto-Neurology

Marilyn M. Singleton, MD, Anesthesiology

Kenneth A. Fisher, M.D. Nephrologist

Marlene J. Wust-Smith, M.D., Pediatrician

Leah Huston, MD, Emergency Medicine

Karladine Graves, DO, Family Medicine

Elaina George, MD, Ear Nose Throat

Scott Stevens, MD, Ophthalmology

N. Lois Adams, B. Pharm, MBA, CRPh

Joel L. Strom, D.D.S.,M.S., General Dentistry
Independent Physicians for Patient Independence

References:

  1. Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial
  2. COVID-19 Drug Therapy – Potential Options
  3. Gov. Whitner reverses course on coronavirus drugs
  4. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
  5. Efficacy of hydroxychloroquine in patients with COVID-19
  6. Recommendation for empiric use of hydroxy-chloroquine for prophylaxis of SARS-CoV-2 infection
  7. Malaria Drug Helps Virus Patients Improve, in Small Study

https://www.senatenj.com/index.php/pennacchio/growing-number-of-doctors-agree-with-senator-pennacchio/47292

ALERT: Opportunity to Help ALL patients access Direct Care with latest Coronavirus aid bill

Update 3/22/2020: It appears that the flawed language has been removed from consideration! Now it is time to ask the Senate to ADD good language from S. 3112, the Personalized Care Act.

Please contact your Senators ASAP with the following request: Please include S. 3112, the Personalized Care Act in the upcoming bill to address the Coronavirus epidemic. Allow all patients to use Health Savings Accounts for direct care arrangements with their trusted doctors, without unnecessary red tape and limits on patients’ options.

Phone numbers for all Senators and the email addresses of their healthcare legislative staff can be found at: bit.ly/senfull2020

Empowering patients to access low cost, high quality medical care, from independent physicians is more urgent than ever!


Tell Congress to Remove Flawed Direct Primary Care Language from Emergency Legislation

Dear AAPS Members and Friends,

Earlier this week we alerted you to provisions in the House coronavirus relief bill that are harmful to small medical practices and all small businesses.  The bill was made slightly less bad before it ultimately passed and was signed by the President.

You can read more about the changes and impact for small businesses here:

https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/senate-to-vote-soon-on-coronavirus-paid-leave-mandate.aspx

Now the Senate is working on a third bill related to the ongoing situation with COVID-19. 

A 247-page draft of the bill is now online here:
https://www.republicanleader.senate.gov/imo/media/doc/CARES%20Act%20Final%20-%20Mar%202020.pdf

It has a number of health policy related items tucked into it, for instance a temporary suspension of Medicare sequestration payment reductions.  It also has provisions easing FDA regulations that may impede timely care, and requires that “each provider of a diagnostic test for COVID-19 shall make public the cash price for such test on a public internet website of such provider.”

One immediate concern about the latest bill is that it contains flawed language (Sec. 4403) intended to fix the incompatibility of Health Savings Accounts and Direct Primary Care caused by current IRS law and policy.

A solution for this problem is needed, but the Senate language mirrors problematic policies from past versions of related legislation.

For instance:

1. The bill caps patients’ “aggregate” direct primary care fees at $150/month. Most DPC fees are well under that amount but imposing price controls on care paid for from HSAs would be a dangerous precedent.  And the cap also limits the flexibility of physicians and patients to tailor agreements based on individual patient needs. 

2. The bill limits DPC agreements to “primary care practitioners as defined in section 1833(x)(2)(A) of the Social Security Act.” It also imposes other limits on the types of care that can be included in agreements. These limitations are unwise and also improperly limits the options of patients and physicians.

3. The bill adds DPC to the the section of IRS code that lists types of insurance eligible for payment from HSAs. Labeling DPC as a type of insurance, or type of coverage, is not the right way to correct the flaws in the IRS code and increases the risk of overregulation of innovative DPC practices.

Here’s what you can do:

1) Ask your Senators to remove Section 4403:

Please call your Senators ASAP and ask them to“Remove Sec. 4403 from the 3rd coronavirus bill and replace it with S. 3112, the Personalized Care Act.  Sec. 4403 overregulates innovative direct care arrangements that are increasing patient access to low cost, high quality medical care. This flawed language will do more harm than good. Congress instead should enact S. 3112 and allow all patients to use Health Savings Accounts for direct care arrangements without unnecessary limits on patients’ options.”  

You can find your Senators’ phone numbers at: 
https://www.senate.gov/general/contact_information/senators_cfm.cfm

Alternatively, you may phone the United States Capitol switchboard at (202) 224-3121. A switchboard operator will connect you directly with the Senate office you request.

2) Next call your House members and tell them the same thing!

Contact info at https://www.house.gov/representatives or Capitol switchboard at (202) 224-3121

3) Finally call President Trump to warn him about this bad provision and ask him to demand Congress remove it:

White House Phone #:  (202) 456-1111.

White House Contact Form: https://www.whitehouse.gov/contact/

Please share this alert and encourage others to call. Thank you!

Independent physicians plan to battle #coronavirus #COVID19, tackle Homeland security and ensure patient freedom and choice

By Craig M. Wax DO

CORONA VIRUS COVID19 – INDEPENDENT & EMPLOYED PHYSICIANS NEED:

Click here for printable PDF you can send to your Members of Congress.

Independent testing sites and protocols with universal precautions

Guidelines for Medicare and insurance companies to pay for telemedicine (Audio and Video) to screen patients from their homes (Full fee schedule)

1. Temporary regs x 6 months and return to in-person standard of care

  • Eliminate insurance red tape: prior authorizations (Rx) and precertification (procedures)
  • Eliminate insurance networks to allow all physician to aid all patients
  • Support for independent physician practices to remain viable
  • Running a highly regulated business with employed staff in an epidemic
  • Regulatory, legal, contractual, taxes, overhead, need to pay staff despite changing model from in person medicine to audio and video telemedicine
  • Safety for physicians and staff to continue to provide medical care
  • Issue all physicians all protective gear if they are to see patients in their offices
  • Physician direct Rx dispense (only legal in certain states, not NJ, NY,MA, TX…)
  • Eliminating mandatory eRX as it limits physician and patient options.
  • Suspend federal law to allow Medicaid non-par physician to Rx and order tests
  • Suspend MACRA MIPS and all “quality measures”
  • Suspend or eliminate MOC (maintenance of certification) and OCC (Osteopathic Certification) mandates imposed by hospital and insurance companies (currently blocks patient access)
  • Any available physician who completed MD and DO school and two steps of USMLE or NBOME should be eligible to practice.  There’s a population of trained physicians who can’t secure a residency slot due to inadequate number of US slots (Missouri state model). They have more training and experience than NPs and PAs.

HOMELAND SECURITY AND CORONAVIRUS COVID 19

  1. Chinese Government Endangered the World1
  2. COVID 19 cases began November but covered up through end of December
  3. China Rx – China is contractor and subcontractor for most pharmaceuticals,2,3,4

World pharmaceutical, protective equipment and technology supply chain compromised.

             D.  Critical Rx and Supply Shortages 2

              F.  COVID19 potential treatments:  Chloroquine and hydrocycholoquine (Plaquenil)5

                        1. generic and inexpensive

                        2. not FDA approved for COVID19 virus treatment

                        3. no complete controlled studies, beginning use abroad and domestic

                        4. Dosage and indications unclear to get benefit and avoid toxicity

CORONA VIRUS – COVID 19

1https://foreignpolicy.com/2020/02/15/coronavirus-xi-jinping-chinas-incompetence-endangered-the-world/
2,https://thehill.com/policy/healthcare/484276-coronavirus-outbreak-could-cause-shortages-of-150-drugs-report

3China Rx, Gibson, Rosemary

5 https://www.moaa.org/Content/Publications-and-Media/News-Articles/2019-News-Articles/Made-in-China–How-U-S–Dependence-on-Chinese-Medicines-and-Components-Could-Pose-a-Security-Threat

5https://wattsupwiththat.com/2020/03/17/an-effective-treatment-for-coronavirus-covid-19-has-been-found-in-a-common-anti-malarial-drug/

How to Increase Access to Medical Care and Lower the Cost

Through Competition and Choice

A.   Unleash the Power of the Free Market in the Healthcare Sector

  • Expand patients’ freedom and choice in the use of health savings account dollars, especially as payment for direct primary care and other models of coverage, such as periodic-fee, membership subscription services.[1] [2]
  • Codify the use of Association Health Plans (AHPs) and Short-Term Limited Duration Insurance (STLDI) as affordable, portable alternatives to current models of coverage.[3]
  • Allow Medicaid patients to use provided monies as a voucher to purchase periodic fee services.
  • Repeal the “Safe Harbor” protections of 42 U.S.C. 1320a-7b(b)(3)(C) for kickbacks to PBMs and GPOs. [4]
  • Repeal the ACA’s prohibition of physician-owned hospitals.[5]
  • Solve “surprise billing” via the arbitration model already working in New York and Texas. Benchmark rate-setting is tantamount to price controls, an anti-free market mechanism with an abysmal track record.

B.   Repeal Onerous, Unnecessary Mandates

  • Remove Electronic Health Record (EHR) and Merit-Based Incentive Payment System (MIPS) mandates for practices having fewer than 50 physicians.
  • Streamline and reform the prior-authorization requirement in Medicare Advantage and other third-party markets.[6]

C.    Mandate Transparency 

  • Codify the measures in the Administration’s two executive orders on transparency.[7] [8]
  • Direct a study by the GAO of the accounting of PBMs ( already a bill), and eventually the GPOs.[9]
  • Mandate transparency regarding the training of all levels of medical practitioner.[10]
  • Make fully transparent the funding that flows FROM pharmacy “channel companies” (such as PBMs, GPOs, and distributors) TO advocacy groups, physicians, and think tanks. This transparency should be retroactive, so as to establish histories of possible conflicts of interest, as called for on page 33 of the white paper referenced in footnote 4.

Bridge to better healthcare:

Reducing Cost and Waste in American Medicine: A physician-led roadmap

IDEAL HEALTHCARE – Freemarket competition to improve quality, decrease price and provide choice for patients

CBO report shows full Obamacare repeal is better than partial, The Hill

https://thehill.com/blogs/pundits-blog/healthcare/317269-obamacare-cbo-report-shows-full-repeal-is-better-than-partial

We should replace Obamacare with a universal tax credit – Forbes, John Goodman

https://www.forbes.com/sites/johngoodman/2015/04/01/why-we-should-replace-obamacare-with-a-universal-health-tax-credit/#735c226529b5

IP4PI Principles for Individual Choice in Healthcare – Independent Physicians for Patient Independence

https://ip4pi.wordpress.com/2017/01/08/mr-trump-here-are-14-solutions-for-ultimate-citizen-consumer-healthcare-choice/


[1] Rep. Roy’s bill: https://www.congress.gov/bill/116th-congress/house-bill/5596?s=1&r=1

[2] Sen. Cruz’s bill: https://www.congress.gov/bill/116th-congress/senate-bill/3112?s=1&r=5

[3] https://www.whitehouse.gov/presidential-actions/presidential-executive-order-promoting-healthcare-choice-competition-across-united-states/

[4] See Appendix B in the white paper: Reducing Cost and Waste: A Physician-Led Roadmap to Patient-Centered Medical Care for a legislative proposal yet to be introduced.

[5] Sen. Lankford’s bill: “Patient Access to Higher Quality Health Care Act of 2019

[6] Rep. DelBene’s bill: https://www.congress.gov/bill/116th-congress/house-bill/3107

[7] https://www.whitehouse.gov/presidential-actions/executive-order-improving-price-quality-transparency-american-healthcare-put-patients-first/

[8] https://www.hhs.gov/about/news/2019/11/15/trump-administration-announces-historic-price-transparency-and-lower-healthcare-costs-for-all-americans.html

[9] Rep. Marshall’s bill: https://www.congress.gov/bill/116th-congress/house-bill/3223?q=%7B%22search%22%3A%5B%22hr3223%22%5D%7D&s=1&r=1

[10] Rep. Bucshon’s bill https://www.congress.gov/bill/115th-congress/house-bill/3928/all-info