COVID questions

The pandemic has given rise to a breed of inquisitive patients who want to know all about the infection

August 28, 2022 01:08 am | Updated 01:08 am IST

Often, patients find themselves under a deluge of material when they go looking for medical information online.

Often, patients find themselves under a deluge of material when they go looking for medical information online. | Photo Credit: Getty Images/iStockphoto

A patient asked me whether she may have ‘Corbevax’ as a ‘booster’. I said: “Why not, it’s available in India since August 12, 2022.” Seemingly unconvinced by my answer, she said that the WHO had not approved it. She then wanted to know whether COVID vaccines would protect her. I said: “Why not, because of the vaccines we are now able to move about freely.” Came the answer: “But, doctor, the highly cautious American President Joe Biden, British Queen Elizabeth II, and the young U.S. Surgeon-General Dr. Vivek Murthy got the infection after multiple vaccinations.”

To convince the patient of the goodness of the vaccines, I explained: “Occasionally, ‘breakthrough’ infections may occur, but the disease won’t be severe.” She then queried if ‘Paxlovid’ may be taken in the case of such infections. Surprised by her knowledge on COVID treatment, I again said: “Why not, it must be beneficial.” Betraying a tinge of derision, she said that Biden had ‘Paxlovid rebound’ infection. I didn’t say it out loud, but this is the problem in handling ‘Internet-educated’ patients.

After all these questions, the patient wanted to know whether it is safe to take ‘Covishield’ and ‘Covaxin’. I said: “Why not, we gave them to most of our eligible population with a good safety profile.” With an expression of amusement, she pointed out that many countries stopped using ‘Covishield’ (Oxford AstraZeneca) for some time due to dangerous blood clots, and that the WHO had suspended supply of ‘Covaxin’ through United Nations agencies. Even before I started to explain, she said three Canadian doctors “had died after taking COVID vaccine, all within a week in July 2022”. With clinical coolness, I countered that the deaths were stated to be not related to vaccination. With a wry smile, she made a sarcastic comment: “Yes, yes, it was stated that the death of our comedian movie actor Vivek, one day after being vaccinated, was also not related to the vaccine.” I decided not to get into the quagmire of controversies.

She then wondered if the vaccine was so dangerous that Novak Djokovic preferred to forego the French Open and Wimbledon titles rather than getting vaccinated. I curtly said: “There are stupid people who opposed measles vaccine and let their children die. Brazilian President Jair Bolsonaro said that COVID vaccines would convert people into crocodiles. Former U.S. President Donald Trump touted hydroxychloroquine and wondered why disinfectants are not injected into people.” The patient reinforced her stance saying that some recent reports said that polio was spreading in rich countries through the ‘Oral Polio Vaccine’. I said I didn’t know anything about it.

She was curious to know whether ‘Remdesivir’ had any role in treatment. I said, “Why not, in a few cases it may be beneficial.” She commented that the drug was grossly overused to the tune of ₹593 crore from June to December 2020 in India where the need might have been only a fraction of that amount. She asked me whether taking medicines was safe at all. Defensively, I said: “Why not, millions of lives are saved every day.” She remarked that the risk of being harmed during medical treatment is one in 300, while it is one in 1,000,000 in air travel, and that 750 older adults are hospitalised every day due to side effects of medicines in America alone.

Then she went on to question about the validity of studies on COVID published in medical journals. Meekly, I said: “Because of the evidence-based publications, millions of lives could be saved, and life on Earth could become almost normal within three years after the onset of the pandemic. We should say hallelujah.” With a winning smile, she cited the infamous articles that were published and retracted in famous journals like The Lancet and The New England Journal of Medicine using allegedly fraudulent and fabricated data generated by the Surgisphere. I said: “Of course, that’s an aberration, black sheep are there in every field from paleontology to nanotechnology.” She took a dig at my profession, saying that modern medicine is getting a taste of its own medicine.

Then she wanted to know about the utility of “lockdowns”. I said, “Lockdowns contained the disastrous spread of COVID and prevented a lot of deaths.” Unconvinced, she asked: “Did not the lockdowns indirectly kill a lot more non-COVID patients and would not they continue to kill more in the future as a fallout of the economic downslide?”

Finally, she asked me why I had spent so much of my time talking to her. I said: “At the age of 80, I am not ‘young and ambitious’ to build up practice; now, I usually give appointments for only two patients a day.” All the while, she was doing the questioning and I’d been answering her patiently. Now, it was my turn to ask her: “What’s your medical problem, madam?”

She replied that she had come only to get to know something about COVID and inquired about the consultation fee to be paid. I said: “You are not a patient and I didn’t treat you. You need not pay anything. Even if you are my patient, this is the ‘Pay What You Can Clinic’.”

She looked at me as if I were a fool kicking away a pot of gold, and then wanted to know more about the clinic, me and... COVID.

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