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Aaron Kheriaty, MD

@akheriaty

15 Sep

From the outset, this pandemic was an affront to the idea of unlimited Progress, our ability to dominate nature through science and technology, through our pragmatic ingenuity. But then nature (or perhaps science itself) threw a virus at us that we fundamentally couldn't control.

This is one reason why natural immunity cannot be acknowledged as a major contribution to herd immunity and the pathway out of the pandemic. For us to reassert the idea of Progress requires that the solution be of our own making--scientific progress must offer the sole fix.

So, in the name of Progress, we forbade socializing, forbade encountering others face-to-face, forbade working unless the work could be technologically mediated or was necessary for bare biological survival. For the first time since Antigone, we forbade burying our dead.

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Aaron Kheriaty, MD

@akheriaty

14 Sep

1/ The 1905 Jacobson v. Massachusetts SCOTUS ruling is often cited by proponents as the basis for compulsory vaccine mandates and other emergency pandemic mitigation public health measures. But Jacobson was a narrow ruling at the time and the precedent it set was modest.

2/ Justice Harlan’s decision in 1905 upheld the State’s, not Federal government's, power to impose a nominal fine ($5, the equivalent of $155 today adjusted for inflation) on a person who refused to be vaccinated against smallpox during an outbreak in Boston.

3/ Smallpox was more deadly than Covid, and State's action more modest than losing one's job or being excluded from attending school. But this is not the first time the Jacobson precedent has been misapplied in acts of expansive overreach. The most notorious example being...

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Aaron Kheriaty, MD

@akheriaty

13 Sep

In Washington v. Harper, a 1990 U.S. Supreme Court case, the Court found that a “forcible injection … into a nonconsenting person’s body represents a substantial interference with that person’s liberty[.]” 494 U.S. 210, 229 (1990).

The common law baseline from which this right developed was that “even the touching of one person by another without consent and without legal justification was a battery.” 497 U.S. at 278.

Furthermore, “[t]he Ninth Circuit has reaffirmed the Court’s recognition of fundamental rights to determine one’s own medical treatment, to refuse unwanted medical treatment, and a fundamental liberty interest in medical autonomy.”

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Aaron Kheriaty, MD

@akheriaty

12 Sep

1/ More on natural immunity for Covid-recovered individuals. Once multiple studies on a topic have been published, a meta-analysis is useful for drawing robust conclusions from the research as a whole.

2/ A meta-analysis combines the data from many studies selected for methodological quality and re-analyzes their pooled data comprehensively.

3/ This has the advantage of overcoming some of the limitations or weaknesses of smaller individual studies (after all, every study has methodological limitations and potential weaknesses).

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Aaron Kheriaty, MD

@akheriaty

12 Sep

1/ My response to the following claim: “Okay, yes, natural immunity is superior to vaccine immunity, but perhaps still vaccinating the Covid-recovered anyway can improve their immunity a bit more.”

2/ The Iargest population-based study comparing natural immunity and vaccine immunity actually analyzed this situation: giving a one-dose Pfizer vaccine booster to those previously infected and comparing these individuals to unvaccinated previously infected individuals.

3/ The previously infected went from 99.74% immunity before vaccination to 99.86% after vaccination, including *asymptomatic* reinfections. The differences here before and after vaccination are negligible and have no clinical relevance whatsoever.

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Aaron Kheriaty, MD

@akheriaty

8 Sep

1/ Keep in mind when you read "hospitalized with Covid" stats: everyone gets tested on admission to hospital. I recently treated a physically health young man with a positive Covid screening test but zero Covid symptoms. He was hospitalized for suicidality and self-harm.

2/ But he was considered a “Covid hospitalization” for the purposes of these metrics. It’s a way of inflating statistics: test everyone hospitalized, and anyone with a positive Covid test is “hospitalized with Covid” even if not "hospitalized for Covid". Same for death stats.

3/ Most of the children "hospitalized with Covid" this year were "hospitalized for RSV." Ask any pediatric ICU nurse.

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