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There is a great book out this year by Bergstrom and West called Calling Bullsh*t: The art of skepticism in a data driven world. The authors explain how much more effort it takes to dismiss Bullsh*t both because the supporting facts are actually cherrypicked propositions and those spouting the BS have already made up their mind anyway and are not looking for truth or reality, thus they will just spout/create more BS to keep you chasing the rabbit.

I usually avoid discussing misinformation and unfounded conspiracy theories because they just pop up like weeds over and over and I don’t want to give fire to any oxygen when there is so much important science that still needs to be shared, interpreted, organized and disseminated. …

Operation Warp Speed is the federal government funded effort to rapidly develop vaccines and therapeutic modalities to treat, prevent, or minimize side effects of Covid through the Accelerating Covid-19 Therapeutic Interventions and Vaccines (ACTIV) protoocols. I serve as the site principal investigator for the ACTIV-4 trial at the University of South Florida, Tampa General Hospital. In this trial, we will randomize patients leaving the emergency department (ED) with a new diagnosis of Covid to receive apixaban [Eliquis], aspirin, or a placebo in order to see if we an reduce blood clots in Covid patients using medication. …

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Reminder: SSRIs are not ready for prime-time Covid treatment and there is only one promising exploratory study. This should not be routine clinical care at this time.

We are still seeing a lot of patients with Covid in the Emergency Department and most can be discharged home. Over the last 8 months, care pathways have advanced our ability to follow these patients (telemedicine, pulse oximeters, vital sign monitoring devices) but treatment options for the discharged mild/moderate patient have been limited. The monoclonal antibodies have now opened up some options but the criteria for use are strict and the data is limited. …

Bottom Line: The monoclonal antibodies are for non-hospitalized patients. One in every 20 people who get Eli Lilly Monoclonal Antibody and one in every 50 people who get Regeneron, may avoid a hospitalization.

Spike is a protein found on the outside of the Sars-CoV-2 viral particle. The Spike protein, also known as S-protein, is the key that unlocks the door to the human cells and allows the virus to gain access. Once inside the cell, the virus that causes Covid can take over genetic machinery and begin replicating. The door on the cell wall is a receptor named ACE2. There is a common class of medications called ACE-Inhibitors that help lower blood pressure (the “prils” like Lisinopril) and there was some thought early on in the pandemic that these medications might lower viral transmission (by keeping the door closed so that the virus couldn’t enter the cell). Unfortunately, lots of people on ACE-Inhibitors also became sick with Covid and targeting ACE2 didn’t pan out as a treatment option. That leaves the S-protein. …

Morbidity and Mortality Weekly Report (MMWR) is not exactly an exhilarating read. MMWR is where a strange case series of pneumonias by a rare bug was reported in 1981, eventually leading to the discovery of HIV.

The weekly publication does not have advertisers like Fox News and MSNBC. The motives of the technical scientific writers are to broadly inform practicing scientists, public health experts, and physicians about important trends in disease or emerging new diseases.

Michael Caputo, installed at HHS by President Trump, once worked for a Russia media company to improve Russian President Vladimir Putin’s reputation in the United States and also previously worked with convicted liar and “trickster” Roger Stone. …

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HHS Secretary Azar commenting on Convalescent Plasma. August 24, 2020

Convalescent plasma is not a new technology. The idea makes logical sense — find patients who have recovered from Covid-19, have those patients donate blood, isolate the plasma (the part of the blood that contains antibodies) and allow the recovered patient’s antibodies to be given to sick patients, boosting their immune response as they fight off the virus.

Patients have been receiving convalescent plasma for Covid since April 2020 as part of an expanded access program (EAP) that allows use of the potential treatment while still requiring data collection and close monitoring of patient safety. My institution has been a part of the Mayo Clinic (EAP) for use of convalescent plasma. …


Jason W. Wilson, MD, MA, FACEP

clinical emergency medicine physician, critical medical anthropologist

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