Dr Dubrick in Salem

This will be my final post on my physician practice website. I will be actually blocking it because it seems to mostly serve as a source of investigation and criticism for those who have problems with some of my ideas, medical or not.

Salem Hospital IL will soon be announcing a newly employed physician at the site where I formerly worked for them. The community really needs such a person and I sincerely hope that they work out.

I have repeatedly applied over the last two years at local facilities for a position without success, most recently again in the last two weeks. Even offers for part-time and temporary work at significantly reduced wages have been unsuccessful. All facilities have been aware of my availability for some time now and none have reached out either, even when the need approached the desperate.

Unfortunately this now leads to the result, as I approach age 71 and seeing no likely source of medical work ever again, I will not be renewing my medical license in July 2022. There are absolutely no personal health or quality of care reasons that necessitate this despite rumors you may have heard.

This is the best I can answer to those I meet in town every day who ask me to explain the inexplicable. There are economic, structural, and even some personal reasons of spite that have led to this, I think, but there is little reason to dwell on them here. It's over.

Emotionally, the toughest thing for me is the realization that I still have a lot to offer to people who really need it but there is no way to activate that any longer. I have a strong sense of simply being obsolete. That happens in a private medical economy. If someone cannot make enough money off of you or feels their bureaucratic position in a corporate structure might be threatened, employment becomes impossible. The same thing happens to local factory workers.

I suppose it is also possible there are better people for the tasks now and I simply need to face my own unworthiness and inferiority. People have plainly told me that at times, though not with the best of intentions usually.

I plan to stay in the Salem area. This is home now. I might possibly get a job somewhere else in Illinois but it is not worth the risk, cost, and effort to make a move at this point in my life. Many of you feel trapped in the same way, I am sure.

I want to thank all of you again for your support and patronage over the years. I am very sorry I have let you down by my insufficiencies. I did try my best.

My final professional advice to you is to get COVID-boosted if you have not done so. It could mean saving your own life. There are people here in Salem who do not care, for their own selfish reasons, if they carelessly transmit the virus to you as you become vulnerable again. Incredibly, our own township hospital has been deficient in organizing and promoting the booster. There are actually people on the Hospital Board who oppose mass covid vaccination and are willing to tolerate unvaccinated staff there, although I doubt that is true for most top management.

The following excerpt from an NBC news article describes the need for boosters over age 65.

"Approximately 1 in 3 Americans 65 and older who completed their initial vaccination round still have not received a first booster shot, according to the Centers for Disease Control and Prevention. The numbers have dismayed researchers, who note this age group continues to be at the highest risk for serious illness and death from Covid-19...

People 65 and older account for about 75 percent of U.S. Covid deaths. And some risk persists, even for seniors who have completed an initial two-dose series of the Moderna or Pfizer vaccine or gotten one dose of the Johnson & Johnson vaccine. Among older people who died of Covid in January, 31 percent had completed a first vaccination round but had not been boosted, according to a KFF analysis of CDC data.

The failure to boost more of this group has resulted in the loss of tens of thousands of lives, said Dr. Eric Topol, founder and director of the Scripps Research Translational Institute...

Although the initial one- or two-dose vaccination course is effective at preventing hospitalization and death, immunity fades over time. Boosters, which renew that protection, are especially important for older people now that Covid cases are rising again, more transmissible omicron subvariants are proliferating, and Americans are dropping their masks, Topol said.

Some older people, who were prioritized for initial vaccination in January 2021, are now more than a year from their last shot. Adding to the confusion: The CDC defines “fully vaccinated” as people who have completed an initial one- or two-dose course even though a first booster is considered crucial to extending Covid immunity.

Numerous studies have confirmed that the first booster shot is a critical weapon against Covid. A study of older veterans published in April found that those who received a third dose of an mRNA vaccine were as much as 79 percent less likely to die from Covid than those who received only two shots.

A central question for scientists championing boosters is why rates have stalled among people 65 and older. Surveys have found politics and misinformation play a role in vaccine hesitancy in the population at large, but that’s not been the case among older people, who have the highest initial vaccination rate of any age group. More than 90 percent of older Americans had completed an initial one- or two-dose course as of May 8.

By contrast, 69 percent of those vaccinated older Americans have gotten their first booster shot.

Overall, fewer than half of eligible Americans of all ages have received a booster.

The discrepancy for seniors is likely due to changes in the way the federal government has distributed vaccines, said David Grabowski, a professor of health care policy at Harvard Medical School. Although the Biden administration coordinated vaccine delivery to nursing homes, football stadiums and other targeted venues early last year, the federal government has played a far less central role in delivering boosters, Grabowski noted.

Today, nursing homes are largely responsible for boosting their residents, relying on pharmacies they traditionally hire to administer flu shots, Grabowski said. And outside of nursing homes, people generally must find their own boosters, either through clinics, local pharmacies, or primary care providers.

Dr. Thomas Frieden, a former CDC director, said that, in theory, shifting responsibility for ongoing Covid immunization from government-sponsored clinics to individual providers might seem logical, given the privatized design of U.S. health care. In reality, Frieden said, that approach is not working because “our primary health care system is life-threateningly anemic” and not set up to readily take on a public health mission."

The only reason that I, as a doctor, can get away with re-publishing the article below is that I am retired and no longer have to fear employment retaliation by the local hospitals.

"Hospital costs are the real US healthcare scandal
Medical monopolies have allowed inflation to get out of hand, but American politicians are not paying attention"

The author below raises excellent points, although I think the pharm cost scandal is a really big problem, too. Additional problems of oversized local hospital organizations include 1) monopsony control over local wages, driving them below market; 2) use of restrictive physician covenants in the fashion of predatory competition; 3) oversized pressure on local governments to reduce regulatory and tax burdens; and 4) increased consumer time and costs to access centralized healthcare and network mandates, which is especially hazardous in emergency and OB situations.

Here is a classic example of the predatory use of restrictive covenants. When I tried to sell my practice last year a local hospital offered me take-it-or-leave-it $1,700 for my patients roster and $5,000 to not practice any longer in Downstate Illinois. This organization has massively transitioned to using nearly entirely nurse-practitioners in primary care. They just don't want any physician competition to disrupt that and I declined to co-operate with that. But, since they control the local market, it also prevented me from getting any value out of my practice. They know that, and thus the hardball. It's like Rockefeller pushing out the smaller competitors.

Dr Nisarg Patel JULY 27 2021, Financial Times

"The parallels between banks’ skyscrapers in downtown Manhattan and today’s hospital behemoths are striking: sparkling glass windows, vast marble lobbies and expensively maintained greenery, with skyrocketing executive bonuses and global brand recognition to boot. Similarly, they have both been large-scale recipients of federal support. As hospitals struggled with Covid-19 last summer, the country’s largest and richest health networks absorbed billions of dollars of stimulus. The picture is reminiscent of Wall Street in 2008: much of America’s healthcare sector has become too big to heal.

A confluence of political arm-twisting, corporate collusion and quasi-monopoly power within some of America’s best-known medical institutions has sent the industry to record levels of spending. Over the past 20 years, the price of US hospital services has increased by more than 200 per cent, compared with average inflation of 60 per cent. Yet large hospital networks, which contribute three times more than drug prices to total US healthcare spending, have largely remained out of public and political scrutiny.

Unpaid medical bills, totalling an estimated $140bn last year, already make up America’s largest type of debt owed to collection agencies. As the US attempts to recover from the pandemic, the unabated rise of healthcare prices threatens to plunge more patients into financial despair.

Today, more than 80 per cent of US hospital markets are “highly concentrated” and hospitals with established regional monopolies are able to increase the price of care year after year. Rising prices have trickled down to patients through higher insurance premiums. The pandemic hasn’t bucked this trend: hospital bills for Covid-19 ran into the hundreds of thousands per patient....

"Large health providers argue that mergers increase operational efficiency, improve care co-ordination and lead to better outcomes for patients. But evidence for these claims remains scarce. Harvard economists showed that job growth in healthcare directly increased prices but did not improve health outcomes.

Health economists have proposed three approaches that could make healthcare services markets more competitive, improving patient care. The first is federal: reform Medicare payment policies that currently encourage consolidation; reduce the documentation burden for independent physicians; and make quality and cost data publicly available and easy to interpret.

The second is market-driven: encourage investment in independent primary care and specialist practices; in clinics located in stores; and in urgent care facilities, with outpatient surgical centres for specialised procedures.

The final approach is judicial: limit anti-competitive behaviour by blocking dangerous mergers. An example is the seven-year price cap and third-party oversight set on the Beth Israel Deaconess Medical Center and Lahey Health merger in 2018, which created the second largest hospital network in Massachusetts. On July 10, the Biden administration called for revision of federal merger guidelines to increase scrutiny of hospital consolidation.

Health system consolidation and the resulting price increases have become a runaway train. Unless we decisively establish safeguards against the monopolistic tendencies of hospitals, we risk allowing the industry to let America’s sickest citizens foot the bill."

f you input Marion Co here, you will see that covid19 transmission risk has now converted to "High" with 60% of adults not fully vaccinated. 30+% over age 65 remain unvaccinated. https://covid.cdc.gov/covid-data-tracker/ -view

COVID Data Tracker CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

All fair and true here...

The unfair blame on primary care physicians Physicians need to work together to preserve our profession as one we would want our children to pursue. The future of health and health care is at stake.

Congratulations to Alex Nazarian and the Salem Township Board on promoting him to his appointment as the new CEO there. It was instantly obvious he was the best choice. He is a talented, honest, forthright man who was instrumental in the Hospital's fiscal turnaround under the trying conditions of covid19 - no small feat. As far as I could tell, that was largely due to real skill in finding reimbursements left seemingly underattended by the hospital leadership prior to his arrival.
Departing Kendra Taylor showed real skill when recognizing and becoming increasingly depending on his talents. Ms Taylor herself deserves much credit for abandoning and reversing the catastrophically incompetent leadership of her former CEO. I truly could never understand why the Hospital Board put up with a full three years of his misbehavior and mismanagement. The judgment capacities of the Board as then populated are justly called into question. That former cost the Hospital and its affiliated foundation millions of dollars, eventually forcing it to the brink of bankruptcy and depleting its reserves - while conducting an aimless and pointless war with its chief primary care doctors, promoting a series of costly internal and largely unrevealed legal settlements to push out all those who remotely threatened his executive status, seeing the Hospital census collapse to nearly zero even during a robust influenza epidemic, hiring a series of expensive consultants to perform and inform the job he was supposed to be handling himself, and within a few short days some years ago disastrously undermining community confidence in the local institution with the abrupt, vindictive firing of Dr G Jha (subsequently wisely reversed at no small cost to the Hospital). The background events to these decisions were poorly reported in local media and the Hospital Board proved intent on obscuring the costs of its poor oversight in those days. Much of this story remains unrevealed and untold.
I am now retired from medical practice. I haven't been to a Salem Hospital meeting since the covid onset last March. I have notified the Hospital of my intent not to renew privileges. In short, I have little personal at stake any longer in the internal medical politics and economics there, other than as a concerned citizen who wants to keep Salem as a good place to live.
I do not know Mr Nazarian well. My own interactions with him were limited to a handful of medical staff meetings. We had some economic differences on the costs and necessities of certain quality measures, but our differences always seemed to me to be respectful and productive. I have nothing but admiration for his overall financial acumen and sincerity.
At least until now, Mr Nazarian's skills have largely proved to be financial, though he does also promote a friendly and cooperative workplace with an engaging and cooperative personality. In this, he largely reflects his mentorship as a prior employee of the Carle health systems located in Champaign, IL. Carle has always been known to pursue an aggressive growth strategy centered around profit-seeking - often at the expense of attending to community needs and in particular in being startlingly cold-hearted to the plights of individuals with poor income and large health needs. The Carle organization grabbed up the paying customers in Central Illinois, leaving other more charitable organizations and physicians to take up the slack regarding community needs, often necessarily inadequately.
The question now is whether that emphasis on purely financial affairs will completely fulfill the mission of this publicly funded hospital, whose Board is entirely appointed (according to its charter) by the elected Salem TOWNSHIP Board. The Hospital must rest on a sound financial footing, of course. This is certain - and Ms Taylor and Mr Nazarian have done much to re-establish that. But something is else is also required of a Hospital so founded and committed in its idealistic origins.
What has recently been missing at STH, and what the public should now as a matter of right clamor for, are 1) assessment and addressing of community needs left unattended by purely financially-driven hospital policies over the last six years; 2) establishment of an effective internal quality review system long overdue to reestablish community confidence in its healthcare operations; 3) openness and transparency about its financial costs and decision-making, consistent with its role as a semi-public body; and 4) re-insertion of medical advice into the weighings of the Hospital decision process. (It won't involve me. I'm out of that loop now.)
A further financial issue left unattended by the prior two hospital CEO's was the extremely low pay rates for its nonprofessional and purely technical staff. While it might be argued that such is needed for rural Hospital fiscal solvency, it also means that this very dominant city employer leaves a train of employee poverty in its wake. A further consequence is that the best, the brightest, and the most reliable soon move on after their entry-level mentorship here.
Much of the difficulties have derived from the approach taken by the Board as appointed a few years ago by a very Republican Township Board requiring that, "The Hospital should be run like a business." This is wrong as stated. In fact, the Hospital should indeed be run in as business-like manner as possible - but it is not a private entity selling shoes, motorcycles, and the like. Every one of its billing statements is attached to a real person with real pain and real mortality. The Hospital business is different in this regard. Hospital inadequacies result not merely in consumer product dissatisfaction but also in real pain and suffering. That is why we have the tort system left as one of the few restraints on socially irresponsible Hospital corporate decision-making. Increasingly, hospital decisions everywhere are boiled down to the questions, "Will we get sued for this?" and "Even if so, can we bear the cost?"
The Board as then re-constituted actively sought to remove all physician leadership and input into its processes. The CEO former to Ms Taylor decisively instigated this purge. A comparison of the Hospital leaderships as listed on its bronze plaques compared to the recent rosters gives away what the game was.
The Hospital does have a flourishing paperwork quality documentation system that appears to pass accreditation reliably. However, it is a meaningless rote system designed to cover tracks and ignore systemic and egregious issues. The situation got worse when its semi-independent quality supervisor was terminated a few years ago without effective replacement. The Hospital now engages merely in risk cost management, not in actual risk reduction. I was a medical quality officer at a much larger hospital for many years before coming to Salem. Here at Salem, I was shocked to see some striking problems left unremedied and even diverted from proper documentation that would routinely be picked up and addressed in an otherwise effective health quality management system. Putting it plainly, the public simply does not know, nor was informed, how badly certain situations had evolved. My guess is that even otherwise well-intentioned Board members have been left obtuse about the matters.
The Hospital has been very proud of its Medicare patient satisfaction ratings and has publicized them often as a marker of quality. Nonetheless, when seeing them, I have often thought to myself: "Oh boy, if these people only knew what was really going on..." I can tell you that I was not the only semi-insider who felt that way.
The last item about re-inserting elements of medical control might seem particularly controversial to some. However, I don't say this by way of insisting that physician wealth-seeking should dominate Hospital decisions, as it so often did in so many places in the past. That medical input is required yet because, as a matter of health safety and professional counsel, financial and business-oriented hospital managers sometimes need to be told, "NO, you just can't do that to real people with sickness and suffering." The input of all health personnel and the public in general is needed to fully accomplish this - yet still, physicians are the only ones with enough clout and expertise to convincingly carry the day when this is required.
Former Board President Dick Haney used to often say, "I know when my doctors are happy, the Hospital is on the right track." He also knew it was not just a matter of physician dollars, and with good reason. Hospital founders like the late Dr Rubio were equally if not more concerned with delivering good quality and universal healthcare in Salem.

COVID19 IS MOSTLY BECOMING A DISEASE OF REPUBLICANS AND THEY ARE THE MAIN VECTOR FOR CHILDREN NOW. WHATEVER YOUR POLITICS, PLEASE GET VACCINATED.

J Hunter, Daily Kos Staff, 6/14/21

Vying for least surprising news of the day are two extremely unsurprising news stories, both about the pandemic. Try to contain your non-surprise, please, no matter how difficult it may get.

The first story is from The Washington Post, and uses data to again confirm the bloomin' obvious: States with high vaccination rates are now seeing fewer COVID-19 cases, while places with lower vaccinates are seeing pandemic infections "holding steady or increasing."

Yep. The vaccines are working—but only among the people that actually, you know, get them. The Post was able to determine that in counties with at least 40% of residents vaccinated, COVID-19 infection rates that were "low" and "going down." In counties with fewer than 20% of residents vaccinated, "not only are there higher case rates, but the number of cases there also is growing."

In the second story, we see the predictable effects of the first. From NBC we learn that people coming into local hospitals with severe COVID-19 symptoms are almost all Americans who haven't been vaccinated, from unvaccinated adults to children too young to be eligible for any of the current vaccines. So-called "breakthrough" cases of COVID-19 in vaccinated individuals are both rare and seldom require hospital treatment—except among immunosuppressed patients, for whom vaccines not may generate sufficient or long-lasting immune response.

From this, we can deduce several things. If you're vaccinated, you have very low odds of contracting COVID-19 and very low odds of it becoming severe enough to require emergency medical care. If you're not vaccinated, you're either just as likely or more likely to catch COVID-19 right now as you were through much of the rest of the pandemic.

And if you do get it, you're going to be the vector by which other Americans get sick and possibly die. The virus is spreading among children because children can't get the vaccine yet. The virus is killing immunocompromised patients because people who haven't been vaccinated are spreading it to them.

Once again, then, we're seeing the predicted real-world results from a buffoonish and incompetent Dear Leader figure attempting to pretend his way out of a world health crisis while stoking paranoia about actual health professionals and safety measures. We previously learned that masks have indeed been working quite well at stopping pandemic spread, thus turning Donald Trump's anti-mask fetishes into another way for his party to kill off its own voters.

The COVID-19 pandemic is getting closer and closer to becoming a primarily Republican disease in this country. It can never be a fully Republican disease because the virus does not verify voting status, when traveling from one person's cough to the next person's lungs. But in places with high vaccination rates, herd immunity may soon come close to eradicating the virus by giving it few places to viably spread.

In pockets of vaccine resistance, meanwhile, whether it be Q-styled conspiracists, avid Trump supporters who still believe the pandemic is a hoax, or deplorables whose principle objection to getting vaccinated is that it appears to be what the liberals and book-learners want them to do, Americans are going to continue to die.

There's still good news even in those pockets, however. The good news is that every percentage of vaccinated adults translates to fewer hospital services needed in an area, even in deep-red communities, so local hospitals will be far less susceptible to becoming overwhelmed this fall than during the pandemic's first year. There will be plenty of ventilators and oxygen, and if there is not then there will still be more resources to take patients out from Republican-dominated locales and drive them to places that have the pandemic better under control.

That's assuming a lot, though. A complicating factor here may well be the "delta" virus variant, the virus mutation that first took hold in India and is now threatening to become the dominant strain elsewhere. It seems 10% of all U.S. COVID cases are now of the delta variant, and it is expected to become the majority strain "at some point." Delta appears to be both more contagious and more deadly than other strains, making herd immunity a more challenging bar to reach.

It's these mutations that continue to threaten a full unraveling of all pandemic progress made so far. The longer the virus is allowed to stew inside unvaccinated populations, the more genetic variants will be naturally produced; the more produced, the more likely it becomes that any one of them will be able to evade current vaccines and reinfect even the vaccinated. The virus may this summer be reduced to a predominantly Republican illness, but it's not assured to stay that way.

So we know the vaccines work. We know masks work. We know social distancing works. We know even if the vaccines let an infection through, it will almost never require hospital intervention. And we know that it's unvaccinated people who will be letting the virus spread despite all that.

What's next, then? It's unclear. I still say that if we can convince Republican-leaning communities that "antifa" is trying to keep the vaccine from them, flag-waving patriots will be demanding to be needle stuck ten, twenty, or thirty times. You'll have Greg Abbott supporters hoarding spare vaccine in their cheeks like squirrels.

It's either that plan or darting people from helicopters, and ... oof. You may say that's a dumb idea, but it still beats nine tenths of what the Trump team came up with.

Let's kill this rumor right now. https://www.abc10.com/article/news/verify/coronavirus-verify/vaccinated-people-cant-shed-covid-19-vaccine-spike-proteins/536-a6ab4dff-1656-4bf3-b8f9-a9a73bcb621d?utm_campaign=snd-autopilot

No, vaccinated people can’t shed COVID-19 vaccine spike proteins Experts say there is no evidence to suggest that vaccinated people pose any harm or threat to unvaccinated people.

Medical records for my past patients are available through Salem Medical Center on Hawthorne Dr in Salem IL, next to Doctors & Nurses Rehab. Many people know that as Dr Hahs' s office. Call them at 548-4545 during regular business hours. By default, all my past patients have eligibility to enroll there for continuing care.

And here is the potential bad news about recombinant covid19 variants emerging in GB.
"There’s a country where Covid-19 is fast becoming Covid-21. I’m not kidding, and if you think it’s hyperbole, if you’re rolling your eyes, or if you think I’m exaggerating, you are badly mistaken. My lovely gentle doctor wife who’s working around the clock on a Covid ward says: “Don’t be a moron. Your doctors are literally sacrificing themselves for you and your family’s health. You need to take this seriously.”
This country that I’m talking about has already bred its own mutant strain of Covid, thanks to an incompetent and often nonexistent government and social response to the pandemic. That mutant strain is both more transmissible and more deadly, it appears. Enough to have caused a massive surge in both infections and deaths — which finally, finally moved said country to respond a little more properly, the way it should have from the beginning…and yet masks still aren’t mandatory.
Now, though, in this country, mutant strains from around the world appear to be merging and converging. Re-read that sentence until you get chills, because you should get chills reading it. This country’s existing mutant strain itself seems to be acquiring mutations from other mutant strains from other countries. It has developed a particularly troublesome and dangerous mutation that lets the virus’s spike protein hook into and attach itself much more strongly and stickily to cells that it infects. And so this mutation is vaccine resistant.
Virologists suggest that what’s happening here is that all these strains have evolved to the same place — but a much simpler and more likely explanation is that the first mutant strain inherited the mutation from the second. Either way, though, that’s just analysis — it doesn’t matter so much. What does?
In the country I’m talking about, Covid-21 is now developing. Mutant strains from around the world are merging there, swapping mutations, or pushing one another to evolve faster and faster, in a kind of genetic arms race of lethality. Those mutant strains are converging — to form one that’s a) more infectious b) more deadly and c) vaccine resistant.
That’s Covid-21.
I know the above sounds like a plot line for a sci-fi movie. If only. It is all, unfortunately, fatally real. And unless you want to spend the rest of your life in lockdown, contending with an even worse form of Covid, you should take this seriously. (My lovely doctor wife who’s working on a Covid ward interjects: “this is extremely dire…we may never recover as a society if people don’t start getting how real this is.”)
Now, there’s a certain kind of person — perhaps a white American — who’ll scoff at all this. This kind of person thinks they know everything, only they have been wrong about most things for the last decade, and longer than that. They will call the above hyperbolic and an exaggeration and so forth. Don’t take my word for it. Here’s James J James, the former Director of the AMA’s Center for Disaster Preparedness discussing Covid-21 as a “syndemic”, or a cluster of pandemics.
Listen to the doctors, my friend. They are extremely concerned, and you should be too. So let me continue my story.
Have you figured out which country I’m talking about? The one that’s the world’s top contender for incubating Covid-21? I’ll give you three guesses. Go ahead. What did you pick? I’d bet: a poor country, like Pakistan, a war-torn state, like Yemen, or an authoritarian state, like North Korea — or maybe all three. All of that’s eminently logical, and you’d be dead wrong.
The country where Covid-19 is becoming Covid-21 is Britain. That’s right, the dreary isle. It’s not a poor country, one ravaged by war, or an authoritarian state — it’s a rich democracy. And yet right before discerning eyes, mutant strains are merging, to form the next mega-strain of Covid.
In Britain, the British Strain appears to merging with the South African and Brazilian Strains. Does that sound a little terrifying? It should.
Because if it’s unleashed, will cause utter havoc for who knows how long. It will have added a pandemic to a pandemic. We haven’t even vaccinated the world against Covid-19 yet. So what happens now that Britain’s breeding Covid-21?
What happens if this process reaches its culmination? It spreads across most of Britain. That much is already on the cards. Why? Well, how did Britain end up being the country that’s incubating Covid-21?
Because even though it’s a rich democracy, it’s also a country of staggeringly stupid people at this point. When Covid hit, it’s government trumpeted “herd immunity” in the absence of a vaccine — a recipe for mass death — and then quickly backtracked, and did…a whole lot of nothing. It put in place lockdowns that weren’t lockdowns — nail salons and gyms and schools stayed open — for PR reasons. Naturally, Covid engulfed the country like wildfire, to the point that Britain had the worst Covid outcomes in Europe, by a long way.
But Britain made another key mistake, which was even dumber than all the ones above. It kept borders wide open, and did no Covid checks. Heathrow became a notorious hotspot suspicious by every Londoner of super-spreading, packed with arrivals from around the world, waiting for hours in immigration lines.
Open borders. No checks. Fake lockdowns. What did all that add up to? Variants from around the world met in Britain. And they began to merge and or compete. They swapped genes and mutations. And an evolutionary arms race was born. That is why the British Strain and the South African and Brazilian Strains appear to be merging.
Of course that’s what was going to happen in a nation that didn’t close its borders and lock down its streets — especially a little island where people from around the world meet in tiny, densely packed neighborhoods. Britain was the world’s perfect Covid incubator, just waiting to happen — and that is why it should have taken extraordinary precautions not to be. Instead, it did…not much, and not nearly enough.
If you think I’m done, just wait — I’m about to tell you the worst part of the story. How fantastically idiotic is today’s Britain? You’d think that understanding all the above, Brits and their government would be panicking. Instead, the British government has done just the opposite: it’s “delayed” the second dose of vaccines. The scientists who made the vaccine recommend 3–4 weeks. The British government — which is made of politicians, not scientists — has decided on 12. What the? There’s a good reason the scientists who made the vaccines recommend the second dose at a max of 3–4 weeks: after that, in animal tests, an immune response doesn’t develop.
Translation: Britain now has merging mutant strains of Covid, which are already on the way to becoming Covid 21. That’d be worrying enough, but it also has an inept, unscientific, politically compromised half-way vaccination program that’s literally the perfect petri dish for fuelling an evolutionary arms race: one that doesn’t wipe viruses out, but just causes them to become resistant at light speed. Bang! This is literally the worst case scenario for human beings — and the best case scenario for a virus.
The British government is gambling desperately, foolishly, incredibly dangerously, with the lives of its people. They are currently guinea pigs in the world’s largest and most dangerous social experiment. You’d think that might have provoked some level of backlash — do you want your life to be gambled with? Instead, the British government enjoys fairly stable approval ratings. All of that tells us two things. One, the British government is either malicious, incompetent, or foolish, more so than any other in the world. Two, British people are really, really horrifically dumb.
But the stakes here are not about Britain. It’s now a virtual certainty that variants fuelling the evolutionary push toward Covid-21 infect the whole country, because it’s simply too late. The British Strain is the dominant one in most parts of the country, obviously — and the South African and Brazilian Strains are now spreading in clusters, all of which, even more obviously, is how these strains are merging. The stakes here are about the world.
The world is shattering under the strain of Covid-19. Debt loads are being pushed to massive levels. Societies like America have been ripped apart. The poor world has no realistic way of getting vaccines yet. The rich world is bickering over them. What do you think a new strain of Covid is going to do?
Can the world survive another year, two, three in lockdown? Can the economy’s shuttered shops? Culture’s empty theatres and clubs? Society’s distanced norms of isolation? Can you?
I doubt it. And I think the world knows it, because nobody is as incredibly stupid as Britain right now on the face of planet Earth. I think when — not if, but when — Britain breeds Covid-21, the world will have to quarantine it hard, making sure not a single person is allowed to enter. And in Britain, a failed vaccination program will mean that Covid goes thermonuclear.
Covid-21 is the biggest short term risk to our civilisation. I wish I could say: we didn’t have to worry about it. But we do." https://eand.co/the-country-where-covid-19-is-becoming-covid-21-690155e2f93

The Country Where Covid-19 is Becoming Covid-21 The Country Where the World’s Mutant Strains are Colliding — and an Even Worse Form of Covid is Being Born