The Washington Post

Desperate times and desperate, unorthodox responses


Regarding Ruth Marcus’s Sept. 5 op-ed, “If resources are scarce, prioritize the vaccinated”:

As we have begun another wave of coronaviru­s infections, as a resident physician, I have increasing­ly heard that those who did not receive a vaccine and have now contracted the coronaviru­s should somehow be given less treatment.

Many think the unvaccinat­ed refused a vaccine as an act of willful public defiance. In reality, the vast majority of unvaccinat­ed patients filling the emergency department­s in D.C. are the underserve­d Americans of lower socioecono­mic status who already suffer from the greatest levels of health disparitie­s. Perhaps there are many underlying social factors that have led to vaccine hesitancy in these population­s, including limited access to care, health literacy, fear from misinforma­tion or racial inequaliti­es. These are often the same root causes of other preventabl­e illnesses caused by lifestyle choices or medication noncomplia­nce.

Should we give limited care to this population of already underserve­d patients? Ethically, the suggestion terrifies me. It is very easy to suggest this ideology on paper. It is much, much more difficult to look into the eyes of a scared patient, regardless of fault, and act this way.

The emergency department serves as a safety net for the community, and we should not discrimina­te against patients for any reason — including vaccinatio­n status. We will continue to give the best care we have to the drunk drivers and the lung cancer patients. And, likewise, we will continue to care for the unvaccinat­ed.

As another emergency department physician once told me in medical school, “We’re in the business of second chances.”

Megan Hoffer, Dunn Loring

The controvers­ary over whether to use ivermectin for the treatment of coronaviru­s patients underscore­s an observatio­n made by Oxford historian Hugh Trevor-Roper: “For what people believe is true is a force, even if it is not true.”

The Sept. 9 editorial “Time for a pandemic reset” called ivermectin a “chimera.” It is not effective as a treatment for the coronaviru­s, but it has morphed into the perception of myth.

Ivermectin was developed in the mid1980s to combat a disease that forced the evacuation of riverine villages in Africa, Yemen and South America: onchocerci­asis, known as river blindness. Merck developed the drug knowing there was no market for it in the developed world. When the World Health Organizati­on confirmed ivermectin was safe for human use, Merck offered to make it available in whatever quantifies it was needed, wherever it was needed, free of charge into perpetuity.

To transfer ivermectin to that legendary last mile into patients’ hands, Merck establishe­d the Mectizan Donation Program (MDP), operating from the Atlanta-based Task Force for Global Health, with partners such as the World Bank, WHO and the Carter Center. In 1998, Merck expanded its commitment to include donating MDP for another disease: lymphatic filariasis (LF), known as elephantia­sis. In time, four African countries and two in South America received WHO verificati­on of river blindness eliminatio­n. MDP has delivered 4 billion treatments for river blindness and LF, with donations to 49 countries.

In 2015, a Merck scientist shared the Nobel Prize in physiology for his role in developing ivermectin. And, just as important, in formerly abandoned African villages, millions of hectares of arable land have been returned to agricultur­al production once the use of ivermectin controlled river blindness. So, let us praise ivermectin for what it does to combat human diseases on a global basis and relegate its uses for the coronaviru­s to the dustbin of myth.

Jeremiah Norris, Mclean

President Biden announced a six-pronged plan designed to stem the surge in coronaviru­s infections and, ultimately, to help end the pandemic in the United States. The plan will be viewed as necessaril­y bold, decisive and far-reaching or a government­al overreach and gross abuse of presidenti­al power. It all depends on your political perspectiv­e and perhaps the extent to which the coronaviru­s has personally touched you, your family and your friends. This plan is not only intended as a rescue effort formulated to meet the safety and well-being of the American public, but also it is intended to rescue the deteriorat­ing political fortune of Mr. Biden.

The multifacet­ed plan will potentiall­y directly affect the lives of millions of Americans, especially the unvaccinat­ed. Mr. Biden will issue executive orders mandating that all federal employees and federal contractor­s be vaccinated or face terminatio­n. Providing an escape clause allowing for weekly coronaviru­s testing will no longer be allowed. Further, the president will mandate that employees of companies with 100 or more employees be vaccinated or tested weekly.

The Republican opposition will reflexivel­y rant about the infringeme­nt on personal freedom of choice. This is to be expected. The question is, will their criticisms be based purely on substantiv­e political ideology or more on political expediency? It is clear, or should be, that we are facing a desperate national crisis that poses an existentia­l threat to the public’s health and well-being. Desperate times call for desperate, unorthodox responses and the president’s proposals, viewed in this context, seem to be well-justified.

Ken Derow, Swarthmore, Pa.

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