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.