After Brownstone Institute republished my last article on New York City emergency department data, friends made me aware of some pushback from a hospitalist on Twitter. Addressing criticism on every platform is not a wise use of time, but enough of my fellow “Team Reality” colleagues engaged the thread to motivate me to respond.
It's worthwhile for those reading this to go back and read through Burnett's series of tweets.
There are multiple examples of appeals to emotion, appeals to authority and other logical fallacies.
This alone lends itself to damaging his credibility.
But let's put that aside and have him come forth for an open debate on this. I'm certain that multiple people on 'team reality' would be up for this.
Most of these individuals like Burnett rarely, if ever, come out of their twitter echo chamber as once scrutinized their claims crumble. Frankly I think this guy is being dishonest through and through.
Someone might also want to clue this character to the fact that all PCR "diagnoses" (for the millionth time PCR is NOT a test) are inherently fraudulent.
Nov 17, 2022·edited Nov 17, 2022Liked by Jessica Hockett
"The real-time PCR test developed by CDC was cleared for use by diagnostic laboratories by FDA under an Emergency Use Authorization (EUA) on April 28, 2009, less than two weeks after identification of the new pandemic virus.
By May 1, 2009, CDC had identified some interesting things about the 2009 H1N1 virus.
Researchers had confirmed earlier testing that the 2009 H1N1 influenza virus was a quadruple-reassortant virus, meaning that it contained virus genes that originated from four different influenza virus sources. Some of the gene segments originated from North American swine influenza viruses, some gene segments originated from North American avian influenza viruses, one gene segment originated from a human influenza virus, and two gene segments were normally found in swine influenza viruses from Asia and in Europe. "
The PCR is very sensitive and will detect the presence of viral RNA (with PCR the virus is detected by targeting one or more gene fragments). The gene fragment might be detected and the virus “positively found”. But is this viral RNA active? That is, does the detected viral RNA have the capacity to reproduce or infect the person (virulence) or get transmitted to other people (infectivity)?
The Centre for Evidence-Based Medicine (CEBM) says[1, 2]:
“PCR detection of viruses is helpful so long as its accuracy can be understood: it offers the capacity to detect RNA in minute quantities, but whether that RNA represents infectious virus may not be clear.”
Culturing a virus as reference test
What are a reference test and a baseline? Many experiments in science are relative in the sense that they do not give absolute values or need to account for context dependent data. In this sense, it is typical of scientific instrumentation and measurements to require calibration or a baseline. The baseline and calibration allow the scientist to interpret the results. In this respect, the CEBM writes:
“Viral culture [acts] as reference test against which any diagnostic index test for viruses must be measured and calibrated, to understand the predictive properties of that test.”
Does a PCR “TRUE POSITIVE” mean INFECTIVITY OR VIRULENCE?
What does viral culture tell about PCR positives?
A PCR test might find the virus it was looking for. This results in a PCR positive, but a crucial question remains: is this virus active, i.e. infectious, or virulent? The PCR alone cannot answer this question. The CEBM explains why culturing the virus is needed to answer this question:
“In viral culture, viruses are injected in the laboratory cell lines to see if they cause cell damage and death, thus releasing a whole set of new viruses that can go on to infect other cells.”
That is, if the PCR detects the virus in the human sample, this detection might correspond to a virus that is now incapable of infecting cells and reproducing. Biologists can tell if the virus is infectious by injecting it into cells (culture cells). If these cells are not affected by the virus and the virus does not reproduce in them, then the PCR test found a virus that is no longer active.
The meaning is that the PCR positive is a non-infectious positive.
Highly recommend this video. While some of the language is technical there is quite a bit in there that calls into question the entirety of the Drosten PCR scandal that launched the pandemic and questions the validity of the PCR tests that held us hostage to the casedemic.
Of particular interest is at the 10:37 mark where you will hear McKernan speak to the fact that Drosten et al had to be working on this 2 months in advance as the work they produced in January is not something that can simply be done in a few weeks time.
Video: WTMWD #50: Kevin McKernan on the review of the Corman-Drosten PCR methodology that he co-authored.
Hello Allen, this is Dr. Burnett. I have offered Dr. Hockett the opportunity to engage in an open debate with me on this, she refused. I'm not really sure why she refused, perhaps you will do what she won't and engage me in an open discussion on this topic. Let me know.
It's troubling that you'd catch flak for digging into what researches with integrity should looking into as relating to the reported high # of deaths out of NYC at that time... what was it killing those people then that isn't killing others now? Don't they want to know? What happened to that Nurse who was reporting on all the ventilators that they needed? Where are those vents now?
Hello Dr. Hockett. This is Eric Burnett, the hospitalist you referenced in your blog post. I stand by my original statement that you didn’t understand the data you collected, nor did you put it in the appropriate clinical context. As such you arrived at several wrong conclusions. I have had this discussion live with people who initially supported your view point. I would be happy to engage you in a live discussion. Please let me know when you’re available and we can set something up at a time that works for both of us. Looking forward to it!
"although it serves no hospitals in New York City" and "most commonly community hospitals with 100–500 beds" - we already know spikes in COVID admission are episodic over time and by geographical region. Your lack of critical appraisal of this study suggests a strong flavour of confirmation bias.
“ Across the US, hospitals and emergency departments initially prepared for a wave of critically ill patients expected to overwhelm the health care system. However, at the height of the pandemic, emergency department visits and hospitalizations decreased sharply…”
Your evidence is a commentary? LOL. You do realize COVID is episodic in both time and location right? Not all emergency rooms experienced waves of COVID-19 patients at the same time.
Drs. Burnett and Laxton, I am impressed you entered the conversation. This is exactly what I have longed to see on Twitter but have to come to Substack to find - (mostly) polite engagement and debate. I am disappointed I missed this discussion and only now stumbling upon it.
Hello there. I have offered Dr. Hockett multiple opportunities to discuss this with me live, but it’s been radio silence. Dr. Laxton and I have written a response to her posts, which you can find here:
I know that another major hospital system in New York published quarterly data about admissions, discharges, etc in their financial statements that showed the hospitals weren't over run in spring 2020.
I'm glad the Brownstone Institute is running some of your articles. The BI has been a ray of sunshine in an otherwise dark world. As you probably know, they've published a couple of my articles as well.
Here's my latest - that wasn't published at the BI, but I think some of your readers might be intrigued by the theme - which is how "logic" has not been applied to our times.
On footnote 7, about the NAAT tests: someone appears to have confused "highly sensitive" with "highly accurate." The testing is very sensitive due to the amplification - but as with any test, when sensitivity increases, specificity decreases.
Correct. I need to look up the original version of that page. I wonder if that sentence was added after the public starting coming to some realizations about PCR testing
PCR testing was grossly misrepresented through the whole Covid scare. For what I've seen, it looks like many people were treating any detection below total number of cycles run, as a positive test. Whether in ignorance or deliberate misdirection, lots of people eagerly interpreted the total number of test cycles as a pass/fail point.
As a useful reference, here's a study in which the authors compiled PCR test results from different studies to find out how many healthy, asymptomatic adults have detectable viruses in them. The short answer is: very many of them, up to 30% or so.
Jartti T, Jartti L, Peltola V, Waris M, Ruuskanen O. Identification of respiratory viruses in asymptomatic subjects: asymptomatic respiratory viral infections. Pediatr Infect Dis J. 2008 Dec;27(12):1103-7. doi: 10.1097/INF.0b013e31817e695d. PMID: 18978518. https://pubmed.ncbi.nlm.nih.gov/18978518/
Thank you, many times over, for this link. And not just for the parts about Covid and PCR testing.
Years ago I read the arguments being made by Duesberg regarding HIV, and was treated very condescendingly for suggesting that he might be right. The contrast with Gallo's self-aggrandizing book on HIV could hardly be greater - Duesberg's arguments were reasonable and fact-based, while Gallo simply played the "expert" card.
Hello doctor Hockett, I am unclear why someone with your specialty feels they are a PCR expert. But I am getting a strong flavour of PCR-denialism from your conversation. PCR has been used to diagnosed many infectious diseases long before COVID-19 including influenza, malaria, PJP, chlamydia and gonorrhoea, RSV, confirm hepatitis B and C infections, monitor HIV viral loads. And please, do us all a favour and do not quote Kary Mullis as he has been grossly misrepresented (initially by HIV-deniers) and he unfortunately passed away before the SARS-CoV-2 PCR was developed.
I'm unclear why you believe someone has to be an expert to discuss something.
PCR tests are very sensitive. They detect genetic material but do not necessarily indicate the patient has an active or clinically-meaningful infection. With any test of any kind (medical or otherwise), a guiding principle is "Intended use by intended users." The results of PCR tests for SARS-CoV-2, run at very high cycle thresholds, have been mis-used throughout this pandemic-response.
I'm happy to hear your POV on how Kary Mullis has been misrepresented.
On a different but related note, even through I take issue with how University of Illinois has used its saliva SARS-CoV-2 PCR test, co-developer Martin Burke's response in an August 25, 2020 radio interview is relevant to this topic: https://www.youtube.com/watch?v=YpwjoC2aZqs
Host: "So speed is one thing. What about accuracy? Compare the accuracy of this test to the accuracy of other tests in the market."
Dr. Burke: "Great, yeah. So we've done a whole bunch of those types of comparisons. Bottom line: We feel very confident the test is highly accurate [and] has extremely low false positive rate. So if it's positive, it's positive, and allows us to be very confident that the information we have is actionable. The other thing I’ll tell you: it's not binary. So it doesn't just tell you yes or no. We actually get a readout on how many copies per milliliter per half a teaspoon of the virus are in your saliva, so you can make smart choices if someone you know has a lingering positivity that's left over from an old infection that looks very different than if someone now has like 10 billion copies per mill in their saliva. So we can make smart choices based on the data about who's really potentially a dangerous, you know, spreader and who's probably just a lingering positive and doesn't need to be isolated. So it actually gives us a lot of good information to make this kind of decision."
There are some questionable statements in this response, but Dr Burke is correct to characterize a PCR test result as not simply YES or NO, and to note that the tests can and do pick up old infections.
If you are unclear on how someone has to be an expert on a complicated diagnostic procedure, I'm unsure I can help you. As for Dr Burke - you mean that "Bottom line: we feel very confident the test is highly accurate [and] gas extremely low false positive rate. So if it's positive, it's positive, and allows us to be very confident that the information we have is actionable"? Yes, that is correct. Each person who tested positive was appropriately counted as a COVID-19 case. Even if we caught them later in disease shedding residual RNA, they should still be counted as a COVID-19 case, especially epidemiologically. When someone tests positive, we also review previous PCR tests, symptoms and Ct to see if they are currently sick. However, as you are heavily implying the PCR test also failed in the EDs - a patient who is symptomatic has a very high pre-test probability of COVID-19, a positive SARS-CoV-2 PCR would be absolutely diagnostic. Also, sensitivity and specificity do not always "trade off." If there is a lot of a disease circulating in the community, the chances of it being a false positive is extremely low. However, PCR skeptics like to pretend physicians do not evaluate the whole patient when interpreting a PCR test. And as I've already stated - for public health - it is important to isolate all PCR positive patients during a pandemic because 1) the high Ct value could be from catching the infection at the beginning and they could go on to develop symptomatic disease, 2) you do not have the resources (nor, in early 2020, did we have the research on Ct values for the SARS-CoV-2 PCR compared to viral cultures) to evaluate Ct values on every positive patient, 3) epidemiologically, a positive PCR test represents someone who was infected with SARS-CoV-2 and should be counted as a case (as long as they have not had a previous positive in the last 3 months) for determining IFR and other important epidemiological information.
The author has already given a thorough response, but I have a couple of things to add:
The PCR process is essentially a manufacturing process, replicating DNA or a fraction of DNA many times over - the increase being dependent on the number of cycles. This can be easily be billions of copies of viral DNA created.
The use of PCR testing has shown detectable viral DNA (or partial DNA) in a very large percentage of healthy, asymptomatic adults. Researchers have found DNA from rhinovirus, RSV, human coronaviruses - everything that infects humans. We have reason to think that if the amplification were run long enough, we could find viral DNA in everyone.
But there's a big difference between finding some viral DNA and being infected with something. If someone has DNA from a virus in them, but it's not replicating and not causing symptoms, why would we classify that person as infected?
One could, in theory, also determine rates of actual infection vs. PCR cycles to detect, and create a probability map - but this would simply tell us the probability of someone being infected, not if they actually are. Such a mapping could be useful as a screening tool (telling us who to spend time trying to diagnose, and who to ignore, based on probabilities) but this isn't how the PCR results are being used.
Instead some people seem to treat any detection, regardless of the amplification, as a positive result. If the lab stops the test at 40 cycles, those same people treat it as a negative result. This is ridiculous - positive vs. negative depends on when the lab got bored.
I'm not a PCR expert either, but it didn't take much research to see how the PCR process was being misused. But the simple fact is that few people bother to try and understand these details. Instead they take direction from the people above them, and those people do the same. In the end it only takes a few "thought leaders" to misguide an entire industry.
I will address this all in my response. But you really have no idea what you’re talking about. You mention patients running out of sedation and paralytics, do you know why that is? Did you ever think to ask someone why those things might have happened? You’ve created this fantasy world where EDs were empty yet there were hospitals full of vented patients without meds. And you fail to understand the link between ED visits and hospital capacity in a pandemic. I will be present all the data that portray what actually happened in nyc.
Respectfully, I’m not insulting you. You’ve continued to gaslight me and other HCW and complain about ad hominem attacks. Saying that you’re confused isn’t an insult, it’s a legitimate observation based upon your data analysis. Saying that your data analysis is flawed isn’t an insult against you personally. I know you’re probably very proud of your work and perhaps even view it as an extension of yourself. But it’s very obvious to anyone who actually works in a hospital that your analysis is flawed. Hopefully my post will allow you to see that.
Thanks for the advice. Trust me, I used your post as a template and break each claim down using actual data. It's very granular and goes into a tremendous amount of detail, detail that I don't think you even considered when you wrote your post. I hope you actually learn something from it.
Respectfully, everything I’ve posted is actual data, and I’ve already said repeatedly that this is all part of a ongoing independent INQUIRY. No dataset shows everything, which is why I’m doing this a bit at a time.
Your piece be better-received by people you hope will take it seriously if you refrain from insults & mischaracterizations.
Face it Eric- the medical "profession" is one of the least trusted at this moment in history. This is for good reason. Even before the "Covid" fraud doctors were not highly respected and over the past three years that low level of trust has sunk to near zero.
A historical footnote tells us we should not be shocked. Physicians represented the highest number of those from the professional class that joined the Nazi Party in the 1930's. Don't take that personally just a historical fact to reflect on.
People know what is happening and know what happened in the hospitals. The third leading cause of death leading into 2020 was iatrogenic deaths. Now if calculated honestly it would be number one due to what occurred over the past two and a half years.
There were many thousand murders in the hospitals over the past two and a half years. Some of these cases are now being litigated. More are coming.
Maybe this is a wake up call for you to get out of such a decaying profession and put your energies towards something more life affirming.
Your "profession" is now directly tied to and controlled by global markets and operates based on the demands of those financial conglomerates. You take your marching orders from the Pharma cartel via administrative dictates. If you don't adhere to those rules you will be dismissed.
The doctors aren't heroes Eric, far from it- neither are or were the nurses. The good ones stand out- they are the exception not the rule. In today's climate the good ones get out of the inhuman system that is "medical industry."
99% of people falsely certified as having 'died from covid' actually died from their preexisting conditions being exacerbated by mass medical malpractice and 'public health' despotism, the other 1% simply died of old age.
From the CDC itself 7/16/21: "Of the 540,667 hospitalized coronavirus patients included in the study, 80,174 died during the observation period (March 2020 to March 2021). A whopping 99.1% of the patients who died had at least one pre-existing condition, with just 740 having no prior condition on record.
Most patients who died from COVID had multiple pre-existing conditions, with just 2.6% suffering from only one condition, compared to 32.3% who had two to five preexisting conditions, 39.1% who had six to ten, and 25.1% who have more than ten pre-existing conditions."
Translation: No one has 'died from covid' as "Covid" is nothing more than a fraudulent PCR result plus a nebulous clinical re-branding of cold, "flu" and many other disease conditions.
No one is a hero for doing their job, even when it's hard.
Sully Sullenberger said something similar in a 60 Minutes interview about his landing on the Hudson River - he did what he was trained to do. Notably, he's never said anything to draw attention to himself. His actions and professionalism spoke for themselves.
Also, heroism/heroic acts is conferred by others - not sought after or the subject of government-propelled propaganda.
I maintain you have no idea what you’re talking about and your confidence on this subject is perplexing to me. I will let you know when I publish my critiques of your points. I doubt it will change your mind, you seem rather intransigent, but it will at least let others know how wrong you are.
The only advise I would give you on whatever you publish is that you stick to the data I’ve actually posted. By then, I may have posted other things, but so far, you keep trying to say things I didn’t say.
Again, I don't have an issue with the data, I have an issue with your interpretation of them and the conclusions you arrived at as a result. I've mentioned this several times.
So you don't dispute that hospitals were overwhelmed but still say that EDs weren't. So you'll forgive me if I don't believe you have an in depth understanding of how any of this works. Which is why I maintain that speaking to an actual HCW before posting might have done you a world of good.
The fact that you still don't get where I'm coming from is mindboggling.
You're attempting to re-write history here. You're gaslighting me and other HCW who worked on the frontlines of this pandemic, and you ask me why I'm taking it personally? Are you serious?
You are dismissing the experience of thousands of healthcare workers because your data analysis (which is very flawed and demonstrates a critical lack of understanding of how any of this works) doesn't fall in line with the testimony of HCW.
The fact that you don't understand that ED visits are directly linked to hospital bed capacity shows me that you are very, very confused about even the most basic facts of hospital operations. yet you still somehow feel emboldened to make these posts. You post them in an echo chamber and never get called out on it, you insulate yourself here and then when someone actually challenges you what do you do? You retreat to countless whataboutisms and change the subject. you refuse to actually engage them in a live debate, and just come up with a string of excuses.
Perhaps ask yourself the question "when my data conflicts with peoples experience perhaps I am the one who's wrong. Perhaps I don't understand the data and should ask for some help." your hubris here is something else.
You sat in the safety and comfort of your own living room, hundreds of miles from NYC, you looked at numbers on a screen and made assumptions on what life was like inside NYC hospitals. You have the audacity to gaslight HCW and then refuse to speak with them.
I'm not going to engage with someone who denies reality.
You're asserting that COVID diagnoses were fraudulent, you're 100% wrong. You're persisting in a delusional fantasy realm, being fed misinformation that you blindly swallow because it confirms your preconceived biases. That's a really sad way to live life.
I'm not going to write paragraphs explaining the COVID protocols employed in the spring of 2020. My guess is you will ignore anything I say because it's clear from your response you're not living in reality. I would likely be wasting my time. As I have told Jessica and you, I will be more than willing to have this conversation face to face, the fact that you both have refused to discuss this with me is very telling. Again, you're worried about stepping out of your echo chamber, which I can understand, being uncomfortable isn't fun. But why don't you act like an adult and say this to me face to face. You seem very confident in your assessment as you're stating it unequivocally. So what's holding you back?
I will address all of this and more in my written response.
Just gauging your understanding here: what are the criteria to intubate a patient in respiratory failure? For example when would you decide to intubate a patient presenting in the setting of acute hypoxemic respiratory failure from COVID?
What do you know about COVID ARDS? What do you know about the management of ARDS in general? What do you know about the non-pulmonary complications of critically ill COVID patients? For example: renal failure, hematologic complications such as DIC, neurologic complications from CVA, cardiac complications, and how they impact mortality?
These are all pieces of background information that you should probably understand before you start making assumptions about COVID mortality and labeling them as "vent-expedited deaths"
Again, I think these queries could have been answered if you bothered to talk to even a single physician who cared for COVID patients in the spring of 2020.
I have no medical opinion about when a patient should be intubated, as I'm not a medical doctor and have never claimed to be.
My understanding is that possible that patients who were acutely intubated but didn't need to be were managed on floor beds without adequate sedation or paralytic agents and could have consequently suffered iatrogenic lung injury and infection.
The number and magnitude of deaths in NYC hospitals between weeks 11 - 24, 2020 is a global outlier. Numerous researchers and analysts have posited that ventilator use may have played a very significant role. This isn't a "fringe" theory.
Nothing is stopping you from writing and posting your own detailed testimony. You could even start a Substack for that purpose, if you wanted. Easy to tweet from that. Not sure how it integrates with TikTok.
So what are you implying here? That the EDs were empty but the hospitals were full of dying patients? We were using bad protocols on patients that just teleported into the hospital? Where do you think the admitted patients came from, Jessica? I really do think you’re very confused about how all of this works, again confusion which could have been avoided if you actually talked to anyone who works in a hospital. I don’t want to engage in an endless back and forth in the comments. I will post my breakdown of your claims soon, I’m adding more data as we speak. Please, take me up on my offer to have this conversation face to face. It doesn’t have to be public if your concerned it may harm your reputation.
Again, you're looking at numbers without putting them in the appropriate context. This is where talking to someone who actually worked in a hospital in the spring of 2020 would have been helpful. But you seemed to have skipped that.
You continue with your attempts at gaslighting by claiming that we "felt" overwhelmed but somehow your data analysis doesn't confirm our feelings/experience. Jessica, this is gaslighting, plain and simple. You refuse to actually have a face to face discussion with anyone who actually lived through this. You hide behind the comments section of this substack rather than engage in an actual conversation.
You're assuming that a decline in ED visits meant that EDs were not overwhelmed. You do realize that the ED can become overwhelmed for a variety of reasons, right? An increase in the acuity of patients can quickly overwhelm the system, as high acuity patients require more resources. You do realize that non-acute ED visits declined during the spring of 2020 (visits for headaches, back pain, nausea, minor traumas, etc), while ED visits for COVID increased, right? You do realize that COVID patients presenting to the ED were very sick, ie the acuity of illness was very high. I can ask you what do you think would be more burdensome and overwhelming to an ED: 100 patients with minor traumas, or 40 critically ill patients?
You state there are many reasons we felt overwhelmed, yet not one of your suggestions are actually backed up with facts. You talk about protocols, but I don't think you've ever asked an actual NYC physician what those protocols were, how they were developed/implemented. Perhaps you could have asked an actual HCW why they said we were overwhelmed rather than just mused on it from the comfort of your living room. This is exactly why I am asking you to have this conversation with me face to face.
I would be more than happy to tell you my roles and responsibilities at my institution during the surge of 2020 (I will focus part of my written response on that). But again, this would be better discussed face to face. But briefly: as a hospitalist one of my roles is to admit patients from the ED to the various general medicine services. Because our hospital quickly ran out of beds to send admitted patients to they needed to board in the ED until such a time that a bed became available in the hospital. This means they were under my care, but still physically in the ED. The avg length of stay for some COVID patients exceeded 3 weeks, which is another reason our hospital became overwhelmed. I would take care of patients boarding in the ED, some of whom became critically ill as their disease progressed necessitating transfer to the ICU. In fact we needed to open up a pop-up ICU in our ED to care for critically ill patients in the emergency room. I would ask you why would we need to do this if we weren't inundated with sick patients?
On face value your entire series of posts amounts to a poor attempt at gaslighting HCW who worked tirelessly during an unprecedented pandemic. You keep saying we felt overwhelmed but you don't buy it, your data analysis says otherwise. Why won't you actually speak with a HCW and ask them directly? Why won't you ask them if your data analysis is in line with reality? I want to challenge you, Jessica, step out of your echo chamber, step out of your comfort zone, defend this data analysis, have an actual conversation with me. You seem very confident behind your keyboard, I wonder if that confidence will hold fast while speaking to me face to face.
Why are you making this personal? It's truly perplexing.
You don't like that I posted data without talking to healthcare workers? I'm sure you're aware of numerous studies that show hospital data without including qualitative responses from healthcare workers. I don't have to address everything all at once. We're all aware of myriad testimonies and news reports that highlight what some HCWs in NYC hospitals have said/experienced There is no suppression of those testimonies, and I am not ignoring it, as you allege. Indeed, such testimonies are a big reason to look at what the numbers do and don't show.
I never said I don't buy how some HCWs say they felt. In this comment section I said there are likely good explanations for it.
Yes, average stays for covid patients everywhere in 2020 were long.
I never said you didn't have sick people in the hospital. I spoke to the sheer number of ED visits, and some types of visits.
Your pop-up ICU in the ED would be included in the ICU bed data, yes?
When data conflict with people's experiences, the solution isn't to dismiss the data or elevate experience as King, irrespective of what data say.
I've already defended all data and analyses I've posted. I see no place where what you've said challenges the veracity of any observation about any graphed data I've posted.
I haven't spoken to individual bed capacity data yet, or to facility-level ED visit data. (The latter doesn't exist; the best that's available is by zip code.)
It's worthwhile for those reading this to go back and read through Burnett's series of tweets.
There are multiple examples of appeals to emotion, appeals to authority and other logical fallacies.
This alone lends itself to damaging his credibility.
But let's put that aside and have him come forth for an open debate on this. I'm certain that multiple people on 'team reality' would be up for this.
Most of these individuals like Burnett rarely, if ever, come out of their twitter echo chamber as once scrutinized their claims crumble. Frankly I think this guy is being dishonest through and through.
Someone might also want to clue this character to the fact that all PCR "diagnoses" (for the millionth time PCR is NOT a test) are inherently fraudulent.
"The real-time PCR test developed by CDC was cleared for use by diagnostic laboratories by FDA under an Emergency Use Authorization (EUA) on April 28, 2009, less than two weeks after identification of the new pandemic virus.
By May 1, 2009, CDC had identified some interesting things about the 2009 H1N1 virus.
Researchers had confirmed earlier testing that the 2009 H1N1 influenza virus was a quadruple-reassortant virus, meaning that it contained virus genes that originated from four different influenza virus sources. Some of the gene segments originated from North American swine influenza viruses, some gene segments originated from North American avian influenza viruses, one gene segment originated from a human influenza virus, and two gene segments were normally found in swine influenza viruses from Asia and in Europe. "
https://www.cdc.gov/h1n1flu/cdcresponse.htm
https://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm#prior
Here's termination of the EUA but they didn't terminate the use of the RT-PCR.. might have missed it.
https://www.cdc.gov/h1n1flu/eua/
"Termination of Declaration of Emergency Justifying EUA of Certain In Vitro Diagnostic Tests"
RT-PCR isn't mentioned explicitly that I see, could be wrong
a fun read:
https://www.cdc.gov/flu/pandemic-resources/reconstruction-1918-virus.html
Helpful links, will review.
Thanks.
All of this dates back even further than the swine flu scam. In any case go here:
https://cormandrostenreview.com/
The PCR is very sensitive and will detect the presence of viral RNA (with PCR the virus is detected by targeting one or more gene fragments). The gene fragment might be detected and the virus “positively found”. But is this viral RNA active? That is, does the detected viral RNA have the capacity to reproduce or infect the person (virulence) or get transmitted to other people (infectivity)?
The Centre for Evidence-Based Medicine (CEBM) says[1, 2]:
“PCR detection of viruses is helpful so long as its accuracy can be understood: it offers the capacity to detect RNA in minute quantities, but whether that RNA represents infectious virus may not be clear.”
Culturing a virus as reference test
What are a reference test and a baseline? Many experiments in science are relative in the sense that they do not give absolute values or need to account for context dependent data. In this sense, it is typical of scientific instrumentation and measurements to require calibration or a baseline. The baseline and calibration allow the scientist to interpret the results. In this respect, the CEBM writes:
“Viral culture [acts] as reference test against which any diagnostic index test for viruses must be measured and calibrated, to understand the predictive properties of that test.”
Does a PCR “TRUE POSITIVE” mean INFECTIVITY OR VIRULENCE?
What does viral culture tell about PCR positives?
A PCR test might find the virus it was looking for. This results in a PCR positive, but a crucial question remains: is this virus active, i.e. infectious, or virulent? The PCR alone cannot answer this question. The CEBM explains why culturing the virus is needed to answer this question:
“In viral culture, viruses are injected in the laboratory cell lines to see if they cause cell damage and death, thus releasing a whole set of new viruses that can go on to infect other cells.”
That is, if the PCR detects the virus in the human sample, this detection might correspond to a virus that is now incapable of infecting cells and reproducing. Biologists can tell if the virus is infectious by injecting it into cells (culture cells). If these cells are not affected by the virus and the virus does not reproduce in them, then the PCR test found a virus that is no longer active.
The meaning is that the PCR positive is a non-infectious positive.
https://www.cebm.net/covid-19/pcr-positives-what-do-they-mean/
Highly recommend this video. While some of the language is technical there is quite a bit in there that calls into question the entirety of the Drosten PCR scandal that launched the pandemic and questions the validity of the PCR tests that held us hostage to the casedemic.
Of particular interest is at the 10:37 mark where you will hear McKernan speak to the fact that Drosten et al had to be working on this 2 months in advance as the work they produced in January is not something that can simply be done in a few weeks time.
Video: WTMWD #50: Kevin McKernan on the review of the Corman-Drosten PCR methodology that he co-authored.
https://bretigne.typepad.com/on_the_banks/2020/12/wtmwd-50-kevin-.html?utm_campaign=shareaholic&utm_medium=twitter&utm_source=socialnetwork
Hello Allen, this is Dr. Burnett. I have offered Dr. Hockett the opportunity to engage in an open debate with me on this, she refused. I'm not really sure why she refused, perhaps you will do what she won't and engage me in an open discussion on this topic. Let me know.
Sure- do you want to do so through this exchange or do you have another preferable medium?
Sounds like you have a virus denier using "swine flu scam" - not worth engaging with. Also demonstrates multiple instances of sea-lioning.
It's troubling that you'd catch flak for digging into what researches with integrity should looking into as relating to the reported high # of deaths out of NYC at that time... what was it killing those people then that isn't killing others now? Don't they want to know? What happened to that Nurse who was reporting on all the ventilators that they needed? Where are those vents now?
I plead guilty to being an academically-trained researcher who has integrity. :)
Hello Dr. Hockett. This is Eric Burnett, the hospitalist you referenced in your blog post. I stand by my original statement that you didn’t understand the data you collected, nor did you put it in the appropriate clinical context. As such you arrived at several wrong conclusions. I have had this discussion live with people who initially supported your view point. I would be happy to engage you in a live discussion. Please let me know when you’re available and we can set something up at a time that works for both of us. Looking forward to it!
I did not collect the data. The city of New York did.
Feel free to address my points in writing - like you did originally - including anything you believe I’ve misinterpreted.
“Conversely, our results do not suggest access challenges at hospitals overrun with patients with COVID-19 as a major reason for admission declines."
https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00980
"although it serves no hospitals in New York City" and "most commonly community hospitals with 100–500 beds" - we already know spikes in COVID admission are episodic over time and by geographical region. Your lack of critical appraisal of this study suggests a strong flavour of confirmation bias.
“ Across the US, hospitals and emergency departments initially prepared for a wave of critically ill patients expected to overwhelm the health care system. However, at the height of the pandemic, emergency department visits and hospitalizations decreased sharply…”
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2783271
And yet, NYC hospitals saw 15K more hospital inpatient deaths between week 11 and week 22, versus 2019. All excess with Covid on the DC.
Fewer people coming in, but an insane number of deaths, ostensibly caused a virus that was *nowhere* until it was everywhere.
Takes a lot more faith than I have to believe that story.
Your evidence is a commentary? LOL. You do realize COVID is episodic in both time and location right? Not all emergency rooms experienced waves of COVID-19 patients at the same time.
What exactly is your claim about NYC hospitals?
For example, do you have an assertion as to what % full NYC ICUs were, systemwide, in spring 2020?
Oh no, you're not sea-lioning on me - acknowledge that this study you "liked" does not back up your assertions about New York. Thank you.
Drs. Burnett and Laxton, I am impressed you entered the conversation. This is exactly what I have longed to see on Twitter but have to come to Substack to find - (mostly) polite engagement and debate. I am disappointed I missed this discussion and only now stumbling upon it.
Hello there. I have offered Dr. Hockett multiple opportunities to discuss this with me live, but it’s been radio silence. Dr. Laxton and I have written a response to her posts, which you can find here:
https://sciencebasedmedicine.org/brownstone-uses-flawed-data-analysis-to-minimize-covid-in-nyc-an-nyc-hospitalists-perspective/
Let me know if you have any comments or questions.
Best,
Eric
I know that another major hospital system in New York published quarterly data about admissions, discharges, etc in their financial statements that showed the hospitals weren't over run in spring 2020.
Yes - that’s true of pretty much every hospital system in the country. I’ve yet to see an exception.
I'm glad the Brownstone Institute is running some of your articles. The BI has been a ray of sunshine in an otherwise dark world. As you probably know, they've published a couple of my articles as well.
Here's my latest - that wasn't published at the BI, but I think some of your readers might be intrigued by the theme - which is how "logic" has not been applied to our times.
https://billricejr.substack.com/p/what-if-bill-gates-was-an-epstein
On footnote 7, about the NAAT tests: someone appears to have confused "highly sensitive" with "highly accurate." The testing is very sensitive due to the amplification - but as with any test, when sensitivity increases, specificity decreases.
Correct. I need to look up the original version of that page. I wonder if that sentence was added after the public starting coming to some realizations about PCR testing
PCR testing was grossly misrepresented through the whole Covid scare. For what I've seen, it looks like many people were treating any detection below total number of cycles run, as a positive test. Whether in ignorance or deliberate misdirection, lots of people eagerly interpreted the total number of test cycles as a pass/fail point.
As a useful reference, here's a study in which the authors compiled PCR test results from different studies to find out how many healthy, asymptomatic adults have detectable viruses in them. The short answer is: very many of them, up to 30% or so.
Jartti T, Jartti L, Peltola V, Waris M, Ruuskanen O. Identification of respiratory viruses in asymptomatic subjects: asymptomatic respiratory viral infections. Pediatr Infect Dis J. 2008 Dec;27(12):1103-7. doi: 10.1097/INF.0b013e31817e695d. PMID: 18978518. https://pubmed.ncbi.nlm.nih.gov/18978518/
Yep. Along those lines, here’s an under-appreciated journalistic effort from early on in the pandemic-response https://www.uncoverdc.com/2020/04/07/was-the-covid-19-test-meant-to-detect-a-virus/
Thank you, many times over, for this link. And not just for the parts about Covid and PCR testing.
Years ago I read the arguments being made by Duesberg regarding HIV, and was treated very condescendingly for suggesting that he might be right. The contrast with Gallo's self-aggrandizing book on HIV could hardly be greater - Duesberg's arguments were reasonable and fact-based, while Gallo simply played the "expert" card.
You’re welcome!
Very easy to see how PCR testing has created and sustained certain illusions.
Never thought I’d live through a time like this.
Hello doctor Hockett, I am unclear why someone with your specialty feels they are a PCR expert. But I am getting a strong flavour of PCR-denialism from your conversation. PCR has been used to diagnosed many infectious diseases long before COVID-19 including influenza, malaria, PJP, chlamydia and gonorrhoea, RSV, confirm hepatitis B and C infections, monitor HIV viral loads. And please, do us all a favour and do not quote Kary Mullis as he has been grossly misrepresented (initially by HIV-deniers) and he unfortunately passed away before the SARS-CoV-2 PCR was developed.
I'm unclear why you believe someone has to be an expert to discuss something.
PCR tests are very sensitive. They detect genetic material but do not necessarily indicate the patient has an active or clinically-meaningful infection. With any test of any kind (medical or otherwise), a guiding principle is "Intended use by intended users." The results of PCR tests for SARS-CoV-2, run at very high cycle thresholds, have been mis-used throughout this pandemic-response.
I'm happy to hear your POV on how Kary Mullis has been misrepresented.
On a different but related note, even through I take issue with how University of Illinois has used its saliva SARS-CoV-2 PCR test, co-developer Martin Burke's response in an August 25, 2020 radio interview is relevant to this topic: https://www.youtube.com/watch?v=YpwjoC2aZqs
Host: "So speed is one thing. What about accuracy? Compare the accuracy of this test to the accuracy of other tests in the market."
Dr. Burke: "Great, yeah. So we've done a whole bunch of those types of comparisons. Bottom line: We feel very confident the test is highly accurate [and] has extremely low false positive rate. So if it's positive, it's positive, and allows us to be very confident that the information we have is actionable. The other thing I’ll tell you: it's not binary. So it doesn't just tell you yes or no. We actually get a readout on how many copies per milliliter per half a teaspoon of the virus are in your saliva, so you can make smart choices if someone you know has a lingering positivity that's left over from an old infection that looks very different than if someone now has like 10 billion copies per mill in their saliva. So we can make smart choices based on the data about who's really potentially a dangerous, you know, spreader and who's probably just a lingering positive and doesn't need to be isolated. So it actually gives us a lot of good information to make this kind of decision."
There are some questionable statements in this response, but Dr Burke is correct to characterize a PCR test result as not simply YES or NO, and to note that the tests can and do pick up old infections.
If you are unclear on how someone has to be an expert on a complicated diagnostic procedure, I'm unsure I can help you. As for Dr Burke - you mean that "Bottom line: we feel very confident the test is highly accurate [and] gas extremely low false positive rate. So if it's positive, it's positive, and allows us to be very confident that the information we have is actionable"? Yes, that is correct. Each person who tested positive was appropriately counted as a COVID-19 case. Even if we caught them later in disease shedding residual RNA, they should still be counted as a COVID-19 case, especially epidemiologically. When someone tests positive, we also review previous PCR tests, symptoms and Ct to see if they are currently sick. However, as you are heavily implying the PCR test also failed in the EDs - a patient who is symptomatic has a very high pre-test probability of COVID-19, a positive SARS-CoV-2 PCR would be absolutely diagnostic. Also, sensitivity and specificity do not always "trade off." If there is a lot of a disease circulating in the community, the chances of it being a false positive is extremely low. However, PCR skeptics like to pretend physicians do not evaluate the whole patient when interpreting a PCR test. And as I've already stated - for public health - it is important to isolate all PCR positive patients during a pandemic because 1) the high Ct value could be from catching the infection at the beginning and they could go on to develop symptomatic disease, 2) you do not have the resources (nor, in early 2020, did we have the research on Ct values for the SARS-CoV-2 PCR compared to viral cultures) to evaluate Ct values on every positive patient, 3) epidemiologically, a positive PCR test represents someone who was infected with SARS-CoV-2 and should be counted as a case (as long as they have not had a previous positive in the last 3 months) for determining IFR and other important epidemiological information.
The author has already given a thorough response, but I have a couple of things to add:
The PCR process is essentially a manufacturing process, replicating DNA or a fraction of DNA many times over - the increase being dependent on the number of cycles. This can be easily be billions of copies of viral DNA created.
The use of PCR testing has shown detectable viral DNA (or partial DNA) in a very large percentage of healthy, asymptomatic adults. Researchers have found DNA from rhinovirus, RSV, human coronaviruses - everything that infects humans. We have reason to think that if the amplification were run long enough, we could find viral DNA in everyone.
But there's a big difference between finding some viral DNA and being infected with something. If someone has DNA from a virus in them, but it's not replicating and not causing symptoms, why would we classify that person as infected?
One could, in theory, also determine rates of actual infection vs. PCR cycles to detect, and create a probability map - but this would simply tell us the probability of someone being infected, not if they actually are. Such a mapping could be useful as a screening tool (telling us who to spend time trying to diagnose, and who to ignore, based on probabilities) but this isn't how the PCR results are being used.
Instead some people seem to treat any detection, regardless of the amplification, as a positive result. If the lab stops the test at 40 cycles, those same people treat it as a negative result. This is ridiculous - positive vs. negative depends on when the lab got bored.
I'm not a PCR expert either, but it didn't take much research to see how the PCR process was being misused. But the simple fact is that few people bother to try and understand these details. Instead they take direction from the people above them, and those people do the same. In the end it only takes a few "thought leaders" to misguide an entire industry.
I will address this all in my response. But you really have no idea what you’re talking about. You mention patients running out of sedation and paralytics, do you know why that is? Did you ever think to ask someone why those things might have happened? You’ve created this fantasy world where EDs were empty yet there were hospitals full of vented patients without meds. And you fail to understand the link between ED visits and hospital capacity in a pandemic. I will be present all the data that portray what actually happened in nyc.
If you've had a chance to respond at length, in writing, I've missed it. It's been a busy week with the holidays, for sure, so no worries.
This is my latest NYC post, FYI.
https://woodhouse.substack.com/p/nycs-hospital-system-never-reached
Did those things happen?
ED visits were down. I don't have access to ED census. If you do, please post the data.
Respectfully, I’m not insulting you. You’ve continued to gaslight me and other HCW and complain about ad hominem attacks. Saying that you’re confused isn’t an insult, it’s a legitimate observation based upon your data analysis. Saying that your data analysis is flawed isn’t an insult against you personally. I know you’re probably very proud of your work and perhaps even view it as an extension of yourself. But it’s very obvious to anyone who actually works in a hospital that your analysis is flawed. Hopefully my post will allow you to see that.
Sigh...
Thanks for the advice. Trust me, I used your post as a template and break each claim down using actual data. It's very granular and goes into a tremendous amount of detail, detail that I don't think you even considered when you wrote your post. I hope you actually learn something from it.
Respectfully, everything I’ve posted is actual data, and I’ve already said repeatedly that this is all part of a ongoing independent INQUIRY. No dataset shows everything, which is why I’m doing this a bit at a time.
Your piece be better-received by people you hope will take it seriously if you refrain from insults & mischaracterizations.
Ad hominem = automatic DQ
Face it Eric- the medical "profession" is one of the least trusted at this moment in history. This is for good reason. Even before the "Covid" fraud doctors were not highly respected and over the past three years that low level of trust has sunk to near zero.
A historical footnote tells us we should not be shocked. Physicians represented the highest number of those from the professional class that joined the Nazi Party in the 1930's. Don't take that personally just a historical fact to reflect on.
People know what is happening and know what happened in the hospitals. The third leading cause of death leading into 2020 was iatrogenic deaths. Now if calculated honestly it would be number one due to what occurred over the past two and a half years.
There were many thousand murders in the hospitals over the past two and a half years. Some of these cases are now being litigated. More are coming.
Maybe this is a wake up call for you to get out of such a decaying profession and put your energies towards something more life affirming.
Your "profession" is now directly tied to and controlled by global markets and operates based on the demands of those financial conglomerates. You take your marching orders from the Pharma cartel via administrative dictates. If you don't adhere to those rules you will be dismissed.
The doctors aren't heroes Eric, far from it- neither are or were the nurses. The good ones stand out- they are the exception not the rule. In today's climate the good ones get out of the inhuman system that is "medical industry."
99% of people falsely certified as having 'died from covid' actually died from their preexisting conditions being exacerbated by mass medical malpractice and 'public health' despotism, the other 1% simply died of old age.
From the CDC itself 7/16/21: "Of the 540,667 hospitalized coronavirus patients included in the study, 80,174 died during the observation period (March 2020 to March 2021). A whopping 99.1% of the patients who died had at least one pre-existing condition, with just 740 having no prior condition on record.
Most patients who died from COVID had multiple pre-existing conditions, with just 2.6% suffering from only one condition, compared to 32.3% who had two to five preexisting conditions, 39.1% who had six to ten, and 25.1% who have more than ten pre-existing conditions."
Translation: No one has 'died from covid' as "Covid" is nothing more than a fraudulent PCR result plus a nebulous clinical re-branding of cold, "flu" and many other disease conditions.
No one is a hero for doing their job, even when it's hard.
Sully Sullenberger said something similar in a 60 Minutes interview about his landing on the Hudson River - he did what he was trained to do. Notably, he's never said anything to draw attention to himself. His actions and professionalism spoke for themselves.
Also, heroism/heroic acts is conferred by others - not sought after or the subject of government-propelled propaganda.
I maintain you have no idea what you’re talking about and your confidence on this subject is perplexing to me. I will let you know when I publish my critiques of your points. I doubt it will change your mind, you seem rather intransigent, but it will at least let others know how wrong you are.
The only advise I would give you on whatever you publish is that you stick to the data I’ve actually posted. By then, I may have posted other things, but so far, you keep trying to say things I didn’t say.
Be well.
Advice*
Again, I don't have an issue with the data, I have an issue with your interpretation of them and the conclusions you arrived at as a result. I've mentioned this several times.
So you don't dispute that hospitals were overwhelmed but still say that EDs weren't. So you'll forgive me if I don't believe you have an in depth understanding of how any of this works. Which is why I maintain that speaking to an actual HCW before posting might have done you a world of good.
I have not yet addressed hospital capacity.
Nothing you’ve said changes any interpretation of any graph I’ve posted.
You’ve gone beyond what I’ve posted, with counterclaims irrelevant to the data.
I was referring to Allen's comment, not yours. He is a complete COVID denier, but you do seem to like a lot of his comments.
The fact that you still don't get where I'm coming from is mindboggling.
You're attempting to re-write history here. You're gaslighting me and other HCW who worked on the frontlines of this pandemic, and you ask me why I'm taking it personally? Are you serious?
You are dismissing the experience of thousands of healthcare workers because your data analysis (which is very flawed and demonstrates a critical lack of understanding of how any of this works) doesn't fall in line with the testimony of HCW.
The fact that you don't understand that ED visits are directly linked to hospital bed capacity shows me that you are very, very confused about even the most basic facts of hospital operations. yet you still somehow feel emboldened to make these posts. You post them in an echo chamber and never get called out on it, you insulate yourself here and then when someone actually challenges you what do you do? You retreat to countless whataboutisms and change the subject. you refuse to actually engage them in a live debate, and just come up with a string of excuses.
Perhaps ask yourself the question "when my data conflicts with peoples experience perhaps I am the one who's wrong. Perhaps I don't understand the data and should ask for some help." your hubris here is something else.
You sat in the safety and comfort of your own living room, hundreds of miles from NYC, you looked at numbers on a screen and made assumptions on what life was like inside NYC hospitals. You have the audacity to gaslight HCW and then refuse to speak with them.
It’s not my data. It’s the city’s.
ED visits were down systemwide.
I am speaking with you.
I understand well they the primary entry point for hospital admissions is through the ED.
I'm not going to engage with someone who denies reality.
You're asserting that COVID diagnoses were fraudulent, you're 100% wrong. You're persisting in a delusional fantasy realm, being fed misinformation that you blindly swallow because it confirms your preconceived biases. That's a really sad way to live life.
I'm not going to write paragraphs explaining the COVID protocols employed in the spring of 2020. My guess is you will ignore anything I say because it's clear from your response you're not living in reality. I would likely be wasting my time. As I have told Jessica and you, I will be more than willing to have this conversation face to face, the fact that you both have refused to discuss this with me is very telling. Again, you're worried about stepping out of your echo chamber, which I can understand, being uncomfortable isn't fun. But why don't you act like an adult and say this to me face to face. You seem very confident in your assessment as you're stating it unequivocally. So what's holding you back?
Where did I make such an assertion, i.e., that Covid diagnoses were fraudulent?
I will address all of this and more in my written response.
Just gauging your understanding here: what are the criteria to intubate a patient in respiratory failure? For example when would you decide to intubate a patient presenting in the setting of acute hypoxemic respiratory failure from COVID?
What do you know about COVID ARDS? What do you know about the management of ARDS in general? What do you know about the non-pulmonary complications of critically ill COVID patients? For example: renal failure, hematologic complications such as DIC, neurologic complications from CVA, cardiac complications, and how they impact mortality?
These are all pieces of background information that you should probably understand before you start making assumptions about COVID mortality and labeling them as "vent-expedited deaths"
Again, I think these queries could have been answered if you bothered to talk to even a single physician who cared for COVID patients in the spring of 2020.
I have no medical opinion about when a patient should be intubated, as I'm not a medical doctor and have never claimed to be.
My understanding is that possible that patients who were acutely intubated but didn't need to be were managed on floor beds without adequate sedation or paralytic agents and could have consequently suffered iatrogenic lung injury and infection.
Regarding intubation, I haven't posted intubation data yet. I used other data to respond to Michael Senger's estimate of iatrogenic deaths in NYC April 2020. My post is here: https://woodhouse.substack.com/p/april-was-the-cruelest-month and his is here: https://michaelpsenger.substack.com/p/an-estimated-30000-americans-were
The number and magnitude of deaths in NYC hospitals between weeks 11 - 24, 2020 is a global outlier. Numerous researchers and analysts have posited that ventilator use may have played a very significant role. This isn't a "fringe" theory.
Nothing is stopping you from writing and posting your own detailed testimony. You could even start a Substack for that purpose, if you wanted. Easy to tweet from that. Not sure how it integrates with TikTok.
So what are you implying here? That the EDs were empty but the hospitals were full of dying patients? We were using bad protocols on patients that just teleported into the hospital? Where do you think the admitted patients came from, Jessica? I really do think you’re very confused about how all of this works, again confusion which could have been avoided if you actually talked to anyone who works in a hospital. I don’t want to engage in an endless back and forth in the comments. I will post my breakdown of your claims soon, I’m adding more data as we speak. Please, take me up on my offer to have this conversation face to face. It doesn’t have to be public if your concerned it may harm your reputation.
Again, you're looking at numbers without putting them in the appropriate context. This is where talking to someone who actually worked in a hospital in the spring of 2020 would have been helpful. But you seemed to have skipped that.
You continue with your attempts at gaslighting by claiming that we "felt" overwhelmed but somehow your data analysis doesn't confirm our feelings/experience. Jessica, this is gaslighting, plain and simple. You refuse to actually have a face to face discussion with anyone who actually lived through this. You hide behind the comments section of this substack rather than engage in an actual conversation.
You're assuming that a decline in ED visits meant that EDs were not overwhelmed. You do realize that the ED can become overwhelmed for a variety of reasons, right? An increase in the acuity of patients can quickly overwhelm the system, as high acuity patients require more resources. You do realize that non-acute ED visits declined during the spring of 2020 (visits for headaches, back pain, nausea, minor traumas, etc), while ED visits for COVID increased, right? You do realize that COVID patients presenting to the ED were very sick, ie the acuity of illness was very high. I can ask you what do you think would be more burdensome and overwhelming to an ED: 100 patients with minor traumas, or 40 critically ill patients?
You state there are many reasons we felt overwhelmed, yet not one of your suggestions are actually backed up with facts. You talk about protocols, but I don't think you've ever asked an actual NYC physician what those protocols were, how they were developed/implemented. Perhaps you could have asked an actual HCW why they said we were overwhelmed rather than just mused on it from the comfort of your living room. This is exactly why I am asking you to have this conversation with me face to face.
I would be more than happy to tell you my roles and responsibilities at my institution during the surge of 2020 (I will focus part of my written response on that). But again, this would be better discussed face to face. But briefly: as a hospitalist one of my roles is to admit patients from the ED to the various general medicine services. Because our hospital quickly ran out of beds to send admitted patients to they needed to board in the ED until such a time that a bed became available in the hospital. This means they were under my care, but still physically in the ED. The avg length of stay for some COVID patients exceeded 3 weeks, which is another reason our hospital became overwhelmed. I would take care of patients boarding in the ED, some of whom became critically ill as their disease progressed necessitating transfer to the ICU. In fact we needed to open up a pop-up ICU in our ED to care for critically ill patients in the emergency room. I would ask you why would we need to do this if we weren't inundated with sick patients?
On face value your entire series of posts amounts to a poor attempt at gaslighting HCW who worked tirelessly during an unprecedented pandemic. You keep saying we felt overwhelmed but you don't buy it, your data analysis says otherwise. Why won't you actually speak with a HCW and ask them directly? Why won't you ask them if your data analysis is in line with reality? I want to challenge you, Jessica, step out of your echo chamber, step out of your comfort zone, defend this data analysis, have an actual conversation with me. You seem very confident behind your keyboard, I wonder if that confidence will hold fast while speaking to me face to face.
Why are you making this personal? It's truly perplexing.
You don't like that I posted data without talking to healthcare workers? I'm sure you're aware of numerous studies that show hospital data without including qualitative responses from healthcare workers. I don't have to address everything all at once. We're all aware of myriad testimonies and news reports that highlight what some HCWs in NYC hospitals have said/experienced There is no suppression of those testimonies, and I am not ignoring it, as you allege. Indeed, such testimonies are a big reason to look at what the numbers do and don't show.
Where did I *muse* about HCWs workers? By referring to your public Facebook post? https://web.archive.org/web/20210602113834/https://www.dailymail.co.uk/news/article-8324257/New-York-City-doctor-pens-heartbreaking-post-endless-list-patients-died-COVID-19.html
I never said I don't buy how some HCWs say they felt. In this comment section I said there are likely good explanations for it.
Yes, average stays for covid patients everywhere in 2020 were long.
I never said you didn't have sick people in the hospital. I spoke to the sheer number of ED visits, and some types of visits.
Your pop-up ICU in the ED would be included in the ICU bed data, yes?
When data conflict with people's experiences, the solution isn't to dismiss the data or elevate experience as King, irrespective of what data say.
I've already defended all data and analyses I've posted. I see no place where what you've said challenges the veracity of any observation about any graphed data I've posted.
I haven't spoken to individual bed capacity data yet, or to facility-level ED visit data. (The latter doesn't exist; the best that's available is by zip code.)