Word for the day: iatrogenic

The Greatest Lie Told During COVID

It’s a very, very long article, with a lot of assertions and conclusions that seem to me to be not necessarily supported by hard facts, but the section on aspirin and its possible role in the Spanish Flu pandemic is interesting (even if it’s one of those parts of the article that relies more on assumptions and guesses than hard data, and the discussion of high-pressure ventilators and COVID deaths is spot on. It has data, and even I can still remember three years ago noticing the shift from “by the time a COVID patient is put on a ventilator, it’s usually too late to save him” to “gee, maybe the reason people on ventilators are dying is because they’re on ventilators”. The mainstream press publicized the first, and buried the second.

In any event, here are a few excerpts:

Loosely put, iatrogenic death is when the doctor kills you. And there is a long and unpleasant history on that one from Benjamin Rush bleeding George Washington to death to killing “witchy” cats to stop a plague carried by the fleas of the very rats they were eating to (and especially) new “wonder drugs” that are poorly understood but that rapidly go into widespread use. 

And one of those drugs was aspirin.

Aspirin had just come into widespread availability in 1918 (and Bayer was rushing it to market for the pandemic). It was the new wowie-zowie drug and doctors (and especially militaries) all over the world fell in love with it. They prescribed it widely to those with Spanish flu. In doses ranging from 8 to 31 grams per day. Oopsie.

A typical aspirin today is 325mg and max dosing per day is ~4 grams. 

A toxic dose is 200-300mg/kg of weight. That’s about 20g for a 180 pound person. 

So 31g is “You’re going to die really, really fast and there is not a damn thing anyone can do to stop it once you take that dose.”

The author goes on (and on) with details on the great aspiring poisoning, but let’s move on to COVID ventilators.

…. It was not covid that did this killing. It was covid response and the derangement of medicine and medical and social practice.

Here’s a clear and classic example from early covid: ventilators. 

“Vent early, vent hard” was the suddenly ascendant treatment modality. It ran riot in New York and many other parts of the world. It was used not just to treat patients but to “protect doctors” under the misbegotten theory that an intubated patient would not spread covid and that “doctors needed to be protected.” 

There was a whole national campaign to build more ventilators with everything but Rosie the Riveter. Industries (even Tesla) diverted from what they were doing to make them. Patients were intubated when they should not have been. When this failed to work, they kept turning up the pressure on the vents. 

And this killed people wholesale.

Certain writers were yowling about this back in April 2020.

That’s not covid death.

That’s iatrogenic death.

Once the Big Apple figured out that vents were killing people in droves and switched to proning as others had done, this death rate dropped. But an awful lot of people had lost their lives by then. And, as in Spanish flu, this high death rate was used as a pretext for more aggressive and ill-considered actions that drove more iatrogenic death. It’s a vicious cycle and once it gets going, it’s self-feeding. Every time you inadvertently kill people out of ignorance or fear, it makes the purported pathogen look more deadly and drives you to new “reactions” and mis-calibrations where you once more kill people. Lather. Rinse. Repeat.

It’s not like this was unknown or unknowable. 

Every couple of years, a new one is trotted out in search of a clamorous crisis. It’s basically an evergreen meme. 

And it will be trotted out again.

Is any FWIW reader old enough (or old, and able to) remember the Great Hong Kong Flu pandemic? First identified in 1968 it swept the world, infecting everyone. The response in the U.S., in addition to not scrubbing the moon landing, was this:

600,000 hipies, sharing everything from water bottles to sexually transmitted diseases, but no Hong koing flu die-off

Former dean of the John’s Hopkins School of Medicine Donald Henderson had some choice ideas about this. Apart from being a co-author on what was previously a sort of compendium of standing pandemic policies and assessments(published in 2006) that laid out in painstaking detail how lockdowns, travel bans, school closures, etc. all fail and amount to superstitious panic reflexes.

He stressed the value of normalcy and allowing the systems of society to function and of bolstering, not undermining, faith that medical services are available and the general confidence of the public.

What a shame he died in 2016.