Episode 143: We Were So, So, So, So Right about COVID
The Paradocs Podcast with Eric Larson
Release Date: 08/27/2021
Episode 154: Rethinking Vaccine Mandates and the Omicron Variant with Dr. Monica Gandhi
The Paradocs Podcast with Eric Larson
Vaccine mandates, mask mandates, boosters, and variants have been a constant source of debate and controversy with the pandemic. My guest today is Dr. Monica Gandhi, an expert in immunology and infectious disease who runs the HIV clinic at UCSF. She has been a fairly prominent voice in support of the mask and vaccine mandates in her home state of California and city of San Francisco. She returns from her visit in June for SARS-CoV-2 in which she guessed that it wouldn't evade the vaccine or prior infection (spoiler alert: she was right). Do Vaccine Mandates Make Sense? Dr. Gandhi is...
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Episode 153: Crowd Health is Go Fund Me for Health Care on Nitro with CEO Andy Schoonover
The Paradocs Podcast with Eric Larson
What happens when you take Go Fund Me and put it into an ecosystem of likeminded folks who want to build a community to care for each other's health care expenses? You get which draws upon some of the concepts of crowd funding for one time health care expenses within its community. By taking people from all over the country and putting them into a community where there are expectations of caring for others, Crowd Health offers a solution to paying for health care expenses without breaking the bank. Is Crowd Health Insurance? If you've been paying attention to the US health care...
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Episode 152: The COVID Drawdown
The Paradocs Podcast with Eric Larson
Today we are going to discuss the COVID drawdown. Essentially, this is what must inevitably happen for us to return to lives of normalcy where we have typical interactions with others at family gatherings, sporting events, concerts, and business meetings. Unless we are prepared to radically change the way we live our lives and choose isolation (which probably has far greater physical and mental health detriments) then we have to consider how the drawdown occurs and what conditions ned to be present for it to happen. What HaS TO HAPPEN FOR THE DRAWDOWN TO OCCUR? We've talked to...
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Episode 151: Health Care for Those Who Don't Earn High Wages with Dr. David Berg
The Paradocs Podcast with Eric Larson
One of the scariest times for many workers is being presented with a bill for medical services. Even if they have insurance "coverage", the deductible or co-pay might be more than they can afford. For hourly workers in entry level jobs or low skilled positions, medical bankruptcy is a real fear. While barely making ends meet an additional bill for an ER visit or doctor's office stop can send you to collections and destroy your credit. Unfortunately, a lot of Americans are in this exact spot as they earn a living working these low paying jobs but have little medical security even if...
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Episode 150: Make Sure Your Health Insurance Broker is Working for You and not the Insurance Company with David Contorno.
The Paradocs Podcast with Eric Larson
When you run a business, one person you usually meet and hire is a health insurance broker. In theory, these brokers work with the employers to secure the best deals for health insurance to meet the company's health care objectives. However, in practice, the brokers serve as a sales force for the insurance companies who lavish them with bonuses, trips, and gifts. The seedy underbelly of the health insurance broker industry is that they are really not working to save money or get deals for their clients - the checks are written by the insurance carriers and that's who they answer to. Who do...
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Episode 149: Is Asymptomatic Spread of SARS-CoV-2 a Thing? with Daniel Halperin, PhD
The Paradocs Podcast with Eric Larson
Not only has the COVID pandemic politicized our country - it has led to a lot of misinformation and a shutdown of communication. For instance, is there really asymptomatic spread of COVID? Or just pre-symptomatic and symptomatic spread? That might seem like splitting hairs but it can have a profound effect on policy for quarantining and testing. We've talked about this before on the show as well as general discussions on COVID policy which can be found , , and . 12 Myths and 12 Facts About COVID-19 If there is one certainty during this confusing pandemic it is that there are plenty of...
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Episode 148: Urgent Care as Primary Care with Dr. Juliet Breeze of Next Level Medical
The Paradocs Podcast with Eric Larson
There are a lot of urgent care clinics all over the country. But few of them, to my knowledge, also operate as regular primary care clinics. But that is exactly what is happening today in the Houston, Texas area with the emergence of Next Level Medical. If you think about it, it makes perfect sense to leverage all the facilities needed for a primary care clinic - exam rooms, physicians, etc. and use it to deliver regular and sometimes non-urgent care. We've discussed before that lower the cost of care with transparency so this seems like the next logical step with urgent care. We...
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Episode 147: Has the Pandemic Led to Infants Losing IQ? - with Sean Deoni, PhD
The Paradocs Podcast with Eric Larson
The COVID pandemic has brought on all sorts of changes to the way we live our lives. From wearing masks, working from home, stay at home orders, and restrictions on social interactions, the virus has caused untold disruption to the way our society functions. Although the changes COVID has brought to our schools and the lives of our school age children, it is perhaps less appreciated what changes have occurred for our infants. It is a well known fact that our environment and meaningful stimulation is necessary for normal intelligence and brain development. Infants are completely...
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Episode 146: Explaining COVID in 11 Minutes with Dr. Eric Larson
The Paradocs Podcast with Eric Larson
Imagine yourself in California at a clearing in a large forest. And it’s on fire. There are three groups of people standing before you. A large group is screaming and running around pointing at the fire. They’re yelling that we need to do something, anything we can to stop the fire. Meanwhile, there is another group (not as large) with their backs to the fire. They are mocking and ridiculing the group running around panicking. They tell them to calm down and to stop ordering people around. They insist there isn’t anything wrong at all. Of course, the largest group of people are...
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Episode 145: Surgery without Insurance with Dr. Keith Smith
The Paradocs Podcast with Eric Larson
A lot has happened since we last met with Dr. Keith Smith from the back in 2018. . We also spoke about how the system was rigged to enrich the hospital systems, insurance carriers, and PBMs (what's new right?). So what's happened since then and how has the center done with the pandemic? Is the Surgery Center of Oklahoma Thriving or Just Surviving? Not surprisingly, Dr. Smith says that the center is doing just fine and has increased its market share from other states. Additionally, the international community from Canada is now being allowed to come back into the US for their...
info_outlineIn April, 2020, serendipitously, my high school classmate reached out to me after one of my podcast episodes where I was talking about mask usage. I was incorrect in one of my assumptions with the use of masks and the spread of particles which he pointed out. I then read his blog post about COVID and how it pertained to his home state of Montana and recognized that the way he looked at the pandemic was completely different than most. He came on the show for episode 086 and with today's episode will have been on five times. The perspective Dr. Graham brings to COVID is one with a clear insight about where we will end up. And if you know where you are going, it is much easier to figure out the best way to get there.
COVID Is Endemic
The greatest insight we spoke about way back at the beginning of this pandemic was that this virus, SARS-CoV-2, would become endemic. There was no chance of eradicating it no matter what type of vaccine was developed. The virus would be ubiquitous throughout the world with individuals always having a risk of exposure and infection. There would be no place to run or hide from the virus. And now we have animal reservoirs (animals that can become infected and spread the virus to other animals or humans) which means that even if you miraculously eliminated the virus from every human on the planet, it would pop up again as soon as it found new people who don't have immunity are born or their immunity wanes.
How Do We Approach Endemic Viruses Differently?
Endemicity is the key point to our discussion and one which has broad reaching policy implications. Your approach for controlling the spread of the virus and expectations completely change your strategies. It is why I've personally found the strategies promoted (and currently being promoted at this writing) so frustrating. Our current strategy is pointedly directed at preventing any and all transmissions of SARS-CoV-2. Whether that is using masks, distancing, restrictions on social gatherings, vaccine mandates, travel bans, or economic lockdowns we have been attacking this viral pandemic in exactly the wrong way.
For an endemic virus, we recognize that we will all get infected multiple times throughout our lifetimes. Although we develop lasting T cell immunity to coronaviruses it does not completely prevent infections. That means that people will continue to contract and spread the virus but not get terribly sick. For the vast majority of people, these reinfections will be mild not requiring hospitalization. However, just because you don't require hospitalization it still might be a miserable few days similar to when you get the flu.
If You Promote Masks, Promote Ones That Work
We discussed mitigation measures and the colossal failure of any country, state, or city to successfully stop the spread of COVID-19 with either masks, lockdowns, or distancing. One important point was that we ned to be honest with people and if we are going to force kids to wear masks we should at least have them use masks that have some chance of making a difference. The use of cloth masks is pointless when you have a bunch of kids in an enclosed place for long periods of time. Ultimately, even good N95s probably wouldn't work very well because the kids wouldn't have good seals on them anyway.
Dr. David Graham is an infectious disease specialist and the author of the book, From Killer to Common Cold: Herd Protection and the Transitional Phase of COVID-19. He is also the author of FIPhysician.com where he is a practitioner and advocate for early financial independence and retirement.
show notes
Episode 143: Today's show
Episode 086: Dr. Graham's first appearance
Episode 096: How we transition from pandemic to endemic
Episode 101: From Killer to Common Cold - We discuss Dr. Graham's book
Episode 114: We're in the transitional phase right now.
Financial Independence for Physicians: Dr. Graham's blog where he writes about the FIRE movement and also occasionally COVID.
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