I worry about the coronavirus. It’s already killed more than 100,000 Americans. The recent protests have created a nerve-wracking public-health situation for the next weeks. I really worry about racism. Not only racism in police systems but more systemic racism in our culture. My friend Dr. Andrew Foy sent me this slide and post showing […]
Stopping COVID19 in Nursing Homes is No Easy Task
My city, Louisville KY, recently had a spike in COVID19 infections. It came from a handful of nursing homes. That nursing home and long-term care facilities account for large percentages of COVID19 cases has been well documented. In some cities, the majority of cases come from these facilities. These facts have sprouted platitudes about “protecting […]
More on COVID19 Testing and How This Virus Makes Us Use Our Noggins
My friend Anish Koka, a cardiologist, wrote a beautiful review of COVID testing over at the HealthCareBlog. The great pandemic is wreaking havoc, we are told, because the nation is not testing enough. The consensus from a diverse group that includes public health experts, economists, and silicon valley investors is that more testing will allow […]
COVID19 and Finding Effective Medical Therapies
This post introduces a column I wrote over at TheHeart.org | Medscape Cardiology — The good news is that most people infected with coronavirus don’t need a hospital or doctor. But some do. Some get very ill. The maddening thing is that doctors don’t have an effective treatment for the virus. There are no cures. […]
Will the Uncertainties of COVID Science Resurrect Blogs?
Health news was popular before the pandemic. Now, almost all news is health news. It’s not only a rapt audience contributing to the deluge of COVID19 news. Two other factors: 1) the availability of preprint servers, digital archives where a scientific paper can be published without formal peer-review and 2) the attention economy. Attention is […]
Like Minds on COVID19
At nearly the same time I posted yesterday, The Lancet published this editorial from Swedish epidemiologist Prof Johan Giesecke. Some excerpts: It has become clear that a hard lockdown does not protect old and frail people living in care homes—a population the lockdown was designed to protect. Neither does it decrease mortality from COVID-19, which […]
Can We Discuss Flatten-the-Curve in COVID19? My Eight Assertions
On Telehealth, an older couple asked me a tough question about COVID19. They asked whether this virus would either be gone or less dangerous in 6 months to a year. It was a curious question. I replied, Why do you ask? Doc, we have a big family with many children and grandchildren, most of whom […]
The Debacle of Hydroxychloroquine and Azithromycin for COVID19
I discussed the use of hydroxychloroquine and azithromycin for patients with COVID19 on my March 27th edition of This Week in Cardiology Podcast. This is an important topic not only because of the specifics of treating patients but also vital because it shows how easily human beings can be misled. Here is a an edited […]
2020 Mandrola Update
Many things have changed in my life. I still practice electrophysiology full-time in Louisville. I still write. And I still love endurance exercise. You haven’t seen many blog updates because my writing has taken different forms. One is academic writing. In 2019, I co-authored 21 academic papers. Here is a link to the papers on […]
Change and the Case for Being a Medical Conservative:
When my favorite podcaster, the economist Tyler Cowan, asked Dr. Ezekiel Emanuel what nonobvious advice he would give to medical students today, the answer surprised me. The famous bioethicist said: I do think that this is probably the most exciting time in American medicine in a century, since really about 1910, 1920. And it causes a […]
Questioning Your Doctor is Ok
I received a good question(s) from a reader: In your “Changing the culture” posting there is the comment: “Patients seeking medical treatment should not assume a prescribed therapy is beneficial just because a doctor says it is.”… How then does a patient evaluate a proposed treatment in a way that they aren’t thwarting a doctor from performing what may […]
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