Something Has to Change: Rethinking Our COVID-19 Strategy
September 2, 2021
Ricardo Maldonado, M.D.
By Ricardo Maldonado, M.D.
Friends, we are at war! Even though you are unable to see the casualties every day, please know that we are in the fight of our lives.
How much longer are we going to ignore it? What if I told you we had over 600,000 casualties overseas. Plus, half of our soldiers are disarmed. That’s basically our situation in our homeland right now as COVID casualties have surpassed 640,000, and yet, about half of our Alabama residents remain unvaccinated. They are not armed for the battle we ALL face.
When I moved from the northeast (New York/New Jersey) to the south (North Carolina) for my infectious disease training, friends at Morristown Hospital where I was finishing my Internal Medicine residency, warned me, ‘If you go the south, you will never come back.’ They were right.
Southerners are the friendliest people! They have the strongest faith, love college sports, love outdoor activities, and, are very patriotic and tough. When I moved to the south in 2004, I immediately fell in love with it, and have now lived in east Alabama almost 12 years.
I love the south and its people. It’s a great place to raise a family. I always thought, if a crisis happens and America goes to war, I am 200 percent sure I am in the right place.
America has been at war for 18 months now. It’s not your typical war, but it’s definitely still a war. We have lost 642,000 innocent people and that number will continue to climb in the weeks ahead.
Please pray for our healthcare team as we continue to battle COVID-19. Having a strong faith in God is very important to me. In fact, I believe God called me into this sacred profession of being a physician where I took an oath to “First, do no harm.”
COVID-19 is the toughest thing I’ve faced in my career. Many times over the past 18 months have brought me to my knees pleading with God to help heal my patients. This Delta variant is extremely contagious and deadly, and our best defense is vaccination.
Did you know mobile morgues were sent to south Alabama last week in preparation for above normal deaths due to COVID-19? That’s worrisome, but what is happening away from hospitals is beyond bizarre for us who deal with COVID every day. The lack of awareness, or willingness to understand the situation, by almost half of the state looks like we are in a fog of war—this is a term used to describe confusion of direction, location, and perspective on a battlefield.
I am as tired as all other physicians, respiratory therapists, nurses and the entire hospital family, in general. Should we just give up and let people die? Should we continue to let them make poor decisions and keep filling up our ICU beds and/or a mobile morgue? No! Like Sir Winston Churchill famously said during WWII, ’We shall never surrender.’
So, I am asking everyone to stop right now and use a strategy to help us get over this fog of war. It is called a Tactical Pause. We must take a deliberate pause in this war against COVID-19.
I want everyone who has not been vaccinated yet to pause and listen for just a minute. Does it make sense not to trust frontline doctors until you cannot breathe, and you are dying? It would be like not trusting your military general until you get shot and start bleeding out—that is too late.
If you have been skeptical about the vaccine, the pandemic and/or the treatments we have, I ask that you please do our hospital employees a favor. Please step back, take a breath, evaluate the situation, and consider some changes to help us accomplish the mission.
There is a reason why the situation in Alabama is among the worst in the whole country. What we are doing is not working!
The myths and lies propagated for political reasons—on both sides—are leaving us disarmed at just the time when the enemy has us surrounded. Politics should not have a place in this crisis.
I am not asking to change your political views or your faith. All I am asking is for you to truly think about who to trust when it comes to COVID-19.
Infectious disease experts have trained continually throughout their professional careers to fight infections and pandemics. We know how to understand and interpret research papers and studies. We can go through medical information quickly and differentiate between what is a good study and what is a bad study.
Trying to do that yourself is like trying to put together complicated artillery equipment when the enemy is pointing their guns at us. It’s time to let the experts guide you.
During this time of reflection, please allow me to address certain concerns and/or false information:
1. COVID-19 is not bad; it only kills 1 percent. Do you think 1 out of 100 is good? Would you raffle your life with those odds? One in a hundred chances of dying is awful. That would be over 3.3 million deaths in the U.S. alone. The argument is just plain wrong.
2. Masks and vaccines are for scared people. COVID-19 can kill anyone, even healthy people. I had COVID-19 in August 2020. I had mild symptoms for a day. If I had not needed to get tested for my job, I probably wouldn’t have been tested. I am not scared of COVID-19, but I am fully vaccinated because it decreases the chances of transmitting the virus to others and decreases the chances of hospitalization. My wish is that people would look at who all have chosen to be vaccinated (95 percent of physicians and almost every political leader) and know that we would not choose the vaccine if we felt there was any concern. Please join me in leading by example, so that together we can save the lives of friends and family.
3. Vaccines for COVID-19 should not be mandatory (My body, my choice). I agree, vaccines should not have to be mandatory, but I say that because it is safe and effective. Anyone with a sense of responsibility for themselves, their families and their communities should do it. There should be no need for mandates.
4. God made us perfect, including our immune system. We are indeed made in the image of God, but we live in an imperfect world. As human beings, we are all flawed. As such, we need a combination of God’s help and the best available resources to cope with the imperfections of this world. Our immune systems are not perfect and that is why we have antibiotics and vaccines. They are the reason we live longer than our ancestors.
5. I will trust my health and my family’s health to God. I also trust God and ask for His protection and guidance daily to help fight Covid-19. During 2020, we all prayed for deliverance from this modern-day plague. I believe the vaccines for COVID-19 are the answer to our prayers. With help from God (the “Divine Physician”), the vaccines, and the COVID infusions, we will defeat this terrible virus. This partnership sustains me and our healthcare team, and gives us hope.
6. I am tougher than this virus. This virus has killed more people than any illness in our lifetime. If you are lucky enough/healthy enough to only have a mild illness—and act like everything is normal—you could be spreading it to someone that it may kill. Please use your toughness and courage to think and care about others in our community. That is real strength and power.
7. I have a friend who took hydroxychloroquine (HCQ) or ivermectin and after 5 days, he was fine. It works! No, it doesn’t. Many patients will get better without any treatment (remember the 90-99 percent survival rate?). Those patients will survive COVID-19 because they were going to survive COVID-19 anyway, like over 90 percent do. It was not the ivermectin he took, or your friend relying solely on vitamins. The only way to know if a medication works is to do a thorough study that can be interpreted by experts.
8. COVID-19 is easy to treat with hydroxychloroquine (HCQ) and ivermectin: We tried hydroxychloroquine at the beginning of the pandemic as we were desperate to find something to treat COVID-19. Our experience was expectedly bad as we learned later on from studies that it did not show any benefit.
Ivermectin was used extensively in countries where it is almost free and is an over-the-counter medication (like in my home country of Peru). So, how did that work for them? They had the highest death rates in the world. Sorry, but HCQ or ivermectin will NOT save your life. If your physician is still promoting the use of those drugs instead of promoting a safe and effective vaccine, you should start questioning this advice.
Let me assure you that there’s plenty of excellent information about the safety of vaccines—including the COVID-19 vaccines. Please understand that if everyone was vaccinated, our ICU would not be full of COVID-19 patients, including parents of young children. The vaccines are not perfect, but they are very good, and are the best option we have right now. There is also good information about monoclonal antibodies helping in early cases, but availability is an issue.
Trust me, COVID-19 vaccines and monoclonal antibody infusions—in that order—are the best weapons we have. Trying to rely on ivermectin and hydroxychloroquine is like bringing nail clippers to a war as your weapon of choice.
Please, we beg you, put on your real warrior gear and weapons. In other words, please get vaccinated now. Then, if you have a breakthrough case, know that we are using monoclonal antibody infusions for those who meet the criteria. These have proven to be very effective in greatly reducing COVID-19 hospitalizations, but we are not able to give to everyone due to limited quantities, limited appointments and limited staff.
So, please drop the nail clippers as your weapon as we need you truly armed for battle. Please listen to the medical experts here and at other trusted institutions, such as UAB, Cleveland Clinic and Johns Hopkins. We have done the homework for you and will continue to learn and guide you through this pandemic.
We are surrounded, so our tactical pause needs to end quickly. It’s time to fight back. And don’t forget your other protective equipment—face masks. These are needed whenever you are close to other people who might be at risk and/or unvaccinated. Please wear it, not because you are scared, but because you and I care about others. This stopped being about ourselves a long time ago. Hopefully soon, when cases start going down, we can have a more normal life and masks can again be optional.
Please, my Southern friends. We are supposed to be good at fighting enemies—not ourselves. Let’s do it the right way.
Ricardo Maldonado, M.D. is an Infectious Diseases specialist and is the sole practitioner with East Alabama Infectious Disease. He joined the medical staff at EAMC in 2009. Dr. Maldonado is leading the clinical response to COVID-19 at East Alabama Medical Center.
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