Opinion: More Bad News on Tap for Marshall’s Shaun Kelehan

By George Smith  — October 15, 2021

Shaun Bobbi Kelehan of Marshall has not had a good couple of years.

The former Marshall doctor and former owner of Marshall’s Access Family Health clinic on Alamo Boulevard surrendered his medical license earlier this year rather than having the state Medical Board revoke it foe cause. He was also an owner and a physician at a clinic in Longview; additionally, he is a partner in clinics in Tyler and the Austin area. Access Family Health was an expanding network of boutique health clinics throughout Texas before being sold earlier this year.

In rapid-fire order in the last four years, Kelehan:

*  Was hit with a 2017 criminal investigation by the Marshall Police Department that found evidence of sexual assault and improper use of medication on a patient. Despite video and audio evidence in which he admitted the acts, Kelehan was no-billed on any charges by a Gregg County grand jury (with  special prosecutor after Harrison County Prosecutor Coke Solomon recused himself, citing he was a patient of Kelehan. The audio and video confessions were not played for the grand jury; special prosecutor ——– of Longview said he “jury did not request they be played.”

*  Had his practice of medicine drastically curtailed by the medical board, including an order that stated he could no longer administer medical treatment to male patients; could not prescribe prescription drugs to male patients; doctor’s Physician Assistants (PA) at his clinics could not see male patients; female patients can only be seen at his clinics; and he could not provide telemedicine sessions.

*  Was the main subject of a front-page investigative story in the Austin American-Statesman about patient abuse by Texas doctors.

*  Was informed with the revelation that a second alleged victim to sexual assault had complained, which prompted the medical board to schedule a second disciplinary hearing.

*  Abruptly volunteered to surrender his medical license; the board accepted his resignation without comment.


*  Announced his retirement and that his entire business interests had been sold.

 His troubles did not end there.

 On October 1, Dallas attorney Mark Perrin with The Perrin Law Firm in Dallas filed a civil suit in Harrison County (District 7 Court) alleging Kelehan deliberately over-medicated and sexually abused former Marshall resident Steven Trey Wood.

Wood is seeking monetary damages in “excess of $1 million.” Additionally, the suit requests Wood receive “exemplary damages, costs of suit, prejudgment interest at the maximum rate allowed by law”, plus “other and further relief…to which Plaintiff shows himself entitled.”

A request for comment from Kelehan was emailed but no response was received by deadline.

Wood, a former outstanding Marshall High School athlete, is an admitted alcoholic and drug abuser, spent two years in the Texas penal system for robbing a drug dealer, and has been in detox and rehab facilities numerous times.

The allegations in the lawsuit include:

*  On at least two occasions, according to statements from the alleged victim, and from videotapes of Kelehan, the former doctor “rendered Wood unconscious with the express intent or having sexual relations”.  In one of the alleged attacks, according to the prior testimony, Woods “woke up” to find Kelehan’s penis in his mouth.  (Note: The attacks allegedly occurred at Dr. Kelehan’s residence at 303 Henley Perry Drive and at his guest house, the historic Trammel’s Trace log cabin, which is adjacent to the residence. The cabin, the oldest house in Harrison County, received the first Texas historical building medallion in the county in 1962, and in 1965 received a Texas Historical Marker.)

*  That Kelehan, despite having a personal and professional relationship with Wood, and knowing his dependence on drugs, provided him with narcotics, opiates and benezodiaszepines (anti-anxiety). The lawsuit charges that Kelehan “enabled” and ‘exacerbated” Wood’s addiction.

*  Wood was provided drugs through prescriptions and sometimes “without a prescription”, with some coming from a “container in (Kelehan’s) home that contained medications that had been returned by patients.

*  Kelehan’s providing drugs to Wood “took an even more nefarious turn”, including two occasions the former doctor drugged Wood with Seroquel (sleeping agent), Librium (anti-anxiety and acute alcohol withdrawal) and/or Klonopin” (sleeping agent). The suit emphatically asserts Kelehan administered the  prescription medication without a prescription and  “with full knowledge” of Wood’s drug addiction and what affect the drugs would have on him, (and) that he gave Wood “the drugs for the purpose of incapacitating him.”

*  After giving the drugs to Wood, Kelehan sexually assaulted him in his guest house. In the audio and video recordings Wood obtained following a request by the Marshall police investigator, Kellehan admitted to the sexual encounter, plus another nonconsensual earlier sexual encounter to which  Wood has testified he did not remember.

*  Kelehan “took steps to fraudulently conceal wrongful actions” from Wood.

*  The lawsuit also alleges Kelehan’s former company Access Family Health is also responsible for the abuse charged by Wood as the company “failed to properly supervise or train” Kelehan.

And, there is still more to the story.

A reporter, attempting to get a copy of the filed lawsuit made six calls to the Harrison County Courthouse, including to the office of District Judge Brad Morin, District Clerk Sherry Griffis and District Attorney Reid McCain.

 In succession, the reporter was told: 1. The case was sealed; 2. contact the district attorney; 3. the case could not be located; 4. a deputy clerk would check with the clerk and call back; 5. the deputy called and said the “case being sealed was a mistake” and it was unsealed and ready for viewing. (The reporter had already received an email copy from the Perrin Law Firm.)

The reporter, having covered court cases for more than 40 years asked or stated at each juncture of the find-the-case hunt:

“Who sealed the case?”

“Why was it sealed?”

“The plaintiff’s attorney did not know it was sealed. How could that be?”

“What does the district attorney have to do with a civil case?”

“How can a case be accidentally sealed? Doesn’t a judge have to perform that function?”

No answers to any of the questions were obtained.

The case was filed in the district clerk’s office at 4 p.m. Friday, Oct. 1, and acknowledged as received by Giffis.

 And, the criminal part of the story may not be over.

 An investigation of Woods’ complaint against Kelehan, based on the series of unusual legal twists and turns of the case, is continuing, according to a state law enforcement official. The official, who requested anonymity due to an “ongoing investigation”, said criminal charges could still be filed in the case, or, based on the events that transpired in this case, it could be taken to a grand jury.”

 The official said, “You have a police investigation, which ended up in charges being filed; you have confessions, on both audio and video; you have a grand jury no-billing a case in which the jurors did not get all the pertinent information, via a decision by the special prosecutor.

“Then,” the official said, “you have a sealed civil suit that no one seems to know about, including the plaintiff’s attorney, and after a question pops up about the case, it’s magically no longer sealed.

“These events could lead to a reopening and expansion of the original case.”


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A Primer on What We Know About Mixing and Matching Covid Vaccines (STAT News):(J. Harris: Readable and meeting ongoing currently.)

”… If you get a booster jab that is of the same brand as your previous jab or jabs, you are getting a homologous booster. In the United States, most people who have been vaccinated have had homologous vaccine series and homologous boosters….If your original series of vaccines or the booster were from different manufacturers, you have what’s called a heterologous vaccine series or a heterologous boost…Kathryn Edwards, a vaccines researcher at Vanderbilt University, suggested the United States should probably look at whether specific brands of booster doses should be targeted at certain populations — or more specifically, if certain people should be steered away from certain vaccines when it comes time for them to get boosters. With concerns about myocarditis in young males associated with mRNA vaccines and clotting problems reported mainly with younger women who got one of the viral vectored vaccines, such as the J&J, maybe it’s time to think about who gets which type of Covid vaccine, Edwards said…A number of countries — the United States among them — do not consider people who received two different brands of vaccines fully vaccinated, even if the person’s home country does. This means someone who got an mRNA vaccine as a second dose after receiving an AstraZeneca shot as a priming dose is not deemed fully vaccinated and is not eligible to travel to the U.S. or other countries with the same rule…the kind of immune response one gets from Covid vaccines is determined by the first dose… “And so it kind of locks you into a repertoire and a pattern of antibody, T-cell balances that carry on through subsequent boosters…Complaints about reactogenicity [discomfort after injection etc] were even greater among people who got mixed vaccine brands, the Com-CoV trial reported…Who then has that responsibility to bring forward a recommendation to mix and match? …”

Tracking the FDA advisory panel meeting on Moderna’s Covid vaccine booster

(J. Harris: FDA vaccine meeting almost live.)

Anchorage approves a mask mandate after two weeks of intense debate.

The order requires everyone to wear a mask or face covering in public indoor spaces, with limited exemptions for younger children and for religious or medical reasons.

An F.D.A. analysis suggests that J.&J. has not presented robust evidence for booster shots.

Transmission of SARS-CoV-2 After COVID-19 Screening and Mitigation

(Short, readable school/Covid article.)

Conclusions and Relevance  Despite the implementation of several mitigation measures, the incidence of COVID-19 among children attending primary school in this study was comparable to that observed among teachers and parents. Transmission tree reconstruction suggests that most transmission events originated from within the school. Additional measures should be considered to reduce the transmission of SARS-CoV-2 at school, including intensified testing.



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1. MOLNUPIRAVIR EUA REQUEST Merck and Ridgeback Biotherapeutics on October 11 submitted an application with the US FDA for Emergency Use Authorization (EUA) of molnupiravir, an investigation oral antiviral medication, for the treatment of mild-to-moderate COVID-19 in adults at high risk of severe disease. Notably, if authorized by the FDA, the drug would be the first COVID-19 treatment to be administered orally, as all other authorized or approved medications are delivered intravenously or via injection. The companies’ submission is based on a Phase 3 clinical trial interim analysis showing molnupiravir reduced the risk of hospitalization or death by about half when compared with people who received a placebo. The data are not yet published or peer-reviewed. An effective therapeutic that is taken by people recovering at home could relieve some pressure on hospitals, particularly in areas with low vaccination rates. 

Two Indian generic drug manufacturers last week requested permission to end late-stage clinical trials of generic versions of molnupiravir, after the drug did not show “significant efficacy” among people with moderate COVID-19 disease. A Merck spokesperson noted that the Indian studies defined moderate disease differently than the FDA and included patients with more severe disease. The Indian companies are continuing to research the treatment among people with mild COVID-19.

2. ITALY’S GREEN PASS From October 15 through the end of 2021, Italian workers will be required to present a digital or printed “Green Pass” certificate upon entering their workplace, demonstrating that they have recovered from COVID-19 in the last six months, received a negative COVID-19 rapid antigen test result in the last 48 hours, received a negative COVID-19 molecular test result in the last 72 hours, or have been at least partially vaccinated. Workers who do not comply with the new mandate risk fines or suspension. Both civil and violent protests have broken out in response to the September 16 announcement regarding the new mandate in Italy, including reported clashes over the weekend between neo-fascists or other individuals associated with the far right and police. Some employees and policymakers are concerned that a rise in vaccinations may not occur, instead leading to worker shortages due to a lack of available tests. 

The Green Pass already is required in Italy in order to access schools and universities, utilize public transport, participate in gatherings related to civil or religious ceremonies, visit medical facilities or long-term care facilities, access certain public gathering events or spaces, and pass through areas with higher COVID-19 risk—so-called “red” or “orange” zones. The Green Pass also is recognized by the European Union to help travelers avoid COVID-19 travel restrictions. 

Federal vaccine mandates can override Texas’ sweeping new ban, experts say.

”…Courts in the United States have a long history of upholding vaccine mandates,… and of ruling that protecting public health takes precedence over personal choice….The right of the government to impose vaccine mandates has been established at least since 1905, when the Supreme Court ruled that Cambridge, Mass., could require adults there to be vaccinated against smallpox. Later court cases set the legal groundwork for vaccine mandates in schools, health care and other fields…”

(J. Harris:  We Texans don’t like Other Folks telling us what to do, especially not Federal Folks, and mostly, Local Folks don’t like State Folks telling us what to do either. We Texans have had a good long run being our own bosses—EXCEPT where PUBLIC HEALTH is concerned. Even as hardheaded and conservative as I am, I want the Federal Folks to manage and protect the public where certain, mostly communicable diseases, are concerned. States and Counties cannot handle this matter. 

 In addition, Texas’ failure to fully participate in federal Medicaid programs has led to several years of substandard medical care for a significant number of less fortunate and rural Texans and forced the closure or significant modification of many Texas hospitals, emergency rooms, and clinics in rural and small-town Texas. The private, local, personal medical care that most of us grew up with no longer exists, and it is unlikely ever to be resurrected. If you have an accessible physician who knows your name and is competent, you’re fortunate. If you have reasonable access to a “Mission Directed” hospital, you’re fortunate — especially if the hospital has pockets deep enough to survive the occasional pandemic or famine…. But the long-lingering question as to whether good medical care is a right or a privilege is being answered, as it should be.)



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NYT: “… Since January of last year, at least 1 in 7 people who live in the United States have been infected, and at least 1 in 464 people have died…”

Implications of suboptimal COVID-19 vaccination coverage in Florida and Texas

(J. Harris: Short, readable, believable article that is worth the read.)

”…Here, we estimate the deaths, hospital admissions, and infections that could have been averted if Florida and Texas had matched the average vaccination pace of the top-performing states and vaccinated 74·0% of their adult populations by the end of July….By Aug 31, the enhanced vaccination in Florida would have reduced hospital admissions by 61 327 (95% CrI 49 723–73 501) and deaths by 16235 (13 243–19 473)….The reduction in hospital admissions in Texas during the same period would have been 37 587 (95% CrI 31 575–44 659) and the reduction in deaths would have been 6353 (5227–7501). Collectively, these two states could have averted more than 95 000 hospital admissions and 22 000 deaths had they reached the vaccination coverage achieved by the top five states and continued at the same pace until Aug 31, 2021….”

Antithrombotic Therapy for Outpatients With COVID-19

”… currently, the use of aspirin or apixaban for symptomatic but stable ambulatory patients with COVID-19 does not seem justifiable.

(J. Harris: Apixaban is an oral anticoagulant or blood thinner similar to but perhaps better and safer than Coumadin. It is new to me but thought by some to be safer than the older blood thinners.)


New Clues Emerge About Whether Vaccines Can Help Fight Long Covid (Wall Street Journal) Millions of people suffer from symptoms of long Covid, doctors estimate. Now, early research is offering some clues about whether vaccinations might help. When the vaccines first came out, some people who had suffered from debilitating symptoms for months after their initial Covid-19 infections told their doctors they felt better after getting vaccinated. The response intrigued scientists. Now, emerging research suggests that vaccines may help reduce symptoms in some people.

COVID-19: Clinical and Public Health Implications of SARS-CoV-2 Immunology

(J. Harris: Up to date forum and access to previous Annals of Internal Medicine videos.)

”…To address new questions that are emerging about immunity, the duration of protection that follows acute infection and vaccination, and the need for booster doses of vaccine, the most recent forum, held on 8 October 2021, focused on the immunology of SARS-CoV-2 and clinical and public health implications of the virus’s immune behavior…that evidence is currently not sufficient to support antibody measurement in making clinical decisions for individual persons. While many people are seeking antibody tests through a variety of channels and using the results to guide their health decisions, we do not yet know the level of antibody associated with definitive protection……”

Texas Gov. Greg Abbott bans any COVID-19 vaccine mandates — including for private employers

(J. Harris: Do some politicians have trouble sleeping at night? Do they keep up with the body counts? Certain aspects of Public Health require mandates. Period.)


Mary Gold (front center) and some of her new “best friends” now say that they are not sure that they will have enough room in the spring for Milton The Tomato and his wheeling and dealing tomato buddies. Ms Gold said, ” Those inconsiderate tomatoes take up too much space, are frequently sick and wormey, and use up all the water. Maybe they shouldn’t come back? Futhermore,  the Okra! For goodness sakes, the deer come by to nibble on their stalks every night lately. It’s hard to get any rest.”


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Question of the day


By George Smith  — October 8, 2021

Question of the day: “What Is Critical Race Theory, and Why Is It Under Attack?”*

 “Is ‘critical race theory’ a way of understanding how American racism has shaped public policy, or a divisive discourse that pits people of color against white people? Liberals and conservatives are in sharp disagreement.

 “The topic has exploded in the public arena this spring—especially in K-12, where numerous state legislatures are debating bills seeking to ban its use in the classroom.

 “In truth, the divides are not nearly as neat as they may seem. The events of the last decade have increased public awareness about things like housing segregation, the impacts of criminal justice policy in the 1990s, and the legacy of enslavement on Black Americans. But there is much less consensus on what the government’s role should be in righting these past wrongs. Add children and schooling into the mix and the debate becomes especially volatile.”

 My opinion is just that, an opinion, but is based on the reality that “history is history” and should be made available and studied and discussed in open forums. Truth — telling it and being able to listen to it, to discuss it, is important.

 History is full of good, bad, ugly, wretched, horrifying and evil deeds by humans, organizations and governments.

 Educational facilities should be charged with relating these truths so the bad/evil/mean events are understood and not repeated.


 — White settlers, assisted by the military, took land from Native Americans? Historical fact.

 — Taxicans absconding with a humongous tract of land from Mexico because it suited the white man’s purpose and dream? History.

 — Slavery as a beloved institution is part of this country’s recent past? Real down-and-dirty historical fact.

 — Continually unfairly persecuting people of color and treating them as second-class citizens for more than 250 years? It’s a fact.

 Why not teach history? Why not teach all of it, from the events that brought forth angelic hurrahs to the festering boils of depravity, the evil deeds of humans throughout history?

 There are those who want to cover up the bilious behavior of certain individuals snd groups, including factions of the federal government, like they never happened.

 In one of my college classes, I asked students various questions aimed at testing their historical knowledge of the building of this social fabric of this county.

 How did the western expansion of  predominantly white settlers affect the lives of Native Americans?

 Did shavery have any good attributes?

 What do you know about the Trail of Tears?

 Tell me about the Meadow Mountain Massacre.

 What were “carpetbaggers” and how did their actions affect the South after the Civil War?

 What caused the rise of the KKK? Why is it still active today?

 You know…history questions, important questions to assist putting current events into perspective.

 If we do not learn about history, ALL history, it’s hard to develop a strong, intuitive, moral compass that creates a need to right the wrongs upchucked by our ancestors.

 Did your know that in Germany, students are taken on field trips to historical sites preserved to show each generation  the depths of  human sorrow and depravity… they visit Nazi concentration  mcamps where more than 6,000,000 hunan beings were exterminated. Think a school district would bus students to the site of a lynching of a black man by a white mob as a life and history lesson?

 History must be taught…all of it. Historical fact cannot be changed because it is just thst—fact!

To attempt to hide historical fact, is intellectually fraud. We are better than that. Aren’t we?

 *Education Week provide background information for this article)


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While ICU’s in the area are busy, it is not due to an influx of Covid patients on ventilators. 



(J. Harris: Worth the read and is encouraging. This Delta waning infection pattern has been noted in several other countries like India and England.)

2. The view from Sweden

”If you look at the mortality statistics, compared with Norway, Finland and Denmark, Sweden fared much worse. The pandemic highlighted weaknesses in care in the nursing homes. Compared to many other European countries, however, Sweden has done similarly or better, and not much worse….Vaccination is entirely voluntary in Sweden. Nearly 80 percent of the population ages 16 and older are fully vaccinated. The most vulnerable population is at about 95 percent…Sweden has a very different mask culture compared with the U.S. and other European countries. It was reluctant to recommend masks for a long time. Even after the public health authority urged people to start using masks in public transport, people didn’t always follow the recommendation. You weren’t likely to get yelled at for not wearing a mask… the biggest vectors of transmission were the home and the workplace. Those places accounted for between 20 and 30 percent of infections. Ten percent were public places like subways…”


1. Covid-19 Booster Shots Have Outpaced the US Rate of New Vaccinations. And the Millions Still Unvaccinated Could Trigger ‘Future Waves,’ Expert Warns (CNN Health) The US is making headway in its battle against Covid-19 — with infection and hospitalization rates on the decline after a surge fueled by the highly transmissible Delta variant. But with the number of Americans getting booster shots surpassing those who are initiating vaccination, experts warn more is needed to continue the progress. The country has averaged more than 101,200 new cases a day over the last week — down 41% from a peak in a Delta-driven wave reached in mid-September, according to Johns Hopkins University data.

2. COVID-19 Testing and a Path out of the Pandemic (Clinical Chemistry) For the US, COVID-19 testing is here to stay. The White House’s “Path out of the Pandemic” announcement on September 10, 2021 calls for increased access to COVID-19 testing and testing programs, including for schools and for employees of businesses larger than 100 people who are not vaccinated.(1) To increase the availability of tests, the Defense Production Act has been invoked by the Administration to increase manufacturing, free pharmacy testing has been expanded, and home rapid antigen tests will be sold at reduced prices by major retailers. This plan is a welcomed ramp-up of testing capacity which will help address current shortages of tests and long delays in getting test results. It will be important, however, for the US government to not only address the current demands for testing but to anticipate what testing needs are likely for the future, and plan for them. Testing needs are increasing and will change—though not disappear—when cases of COVID-19 eventually decline.



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Opinion: We know this on our heart

 Opinion: We know this on our heart

By George Smith  — October 2, 2021


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1. LONG COVID Ongoing studies are helping to better characterize and determine the prevalence of so-called long COVID, also known as post-acute sequelae of SARS CoV-2 infection (PASC). In a study published in PLOS Medicine, researchers led by scientists with the University of Oxford conducted a retrospective cohort study based on linked electronic health records (EHRs) data from 81 million patients including 273,618 COVID-19 survivors, primarily in the US, and included 114,449 patients with influenza as a control. The researchers found that nearly 37% of COVID-19 patients studied reported having at least 1 or more features of long COVID between 3 and 6 months after their initial diagnosis, a higher percentage than the 10%-30% reported in previous studies and significantly higher than after influenza. The most commonly reported symptoms included abnormal breathing; fatigue; chest, throat, or other pain; headache; abdominal symptoms; and anxiety or depression. While lingering symptoms occurred more frequently among people who had more severe acute COVID-19, including those who were hospitalized, and older individuals, the researchers stressed that people who had mild disease and children and young adult survivors also experienced long COVID

In a study published September 29 in JAMA Network Open, researchers interviewed 2,433 COVID-19 patients who were discharged from 2 hospitals in Wuhan, China, between February 12 and April 10, 2020. Notably, 45% of patients reported at least 1 symptom at 1-year follow-up, with the most common symptoms being fatigue, sweating, chest tightness, anxiety, and muscle pain. Patients who experienced more severe COVID-19 cases and who were older were more likely to have at least 3 lingering symptoms. In yet another study, posted to the preprint server medRxiv, researchers found that SARS-CoV-2 infection, even mild cases, could reduce gray matter thickness in the brain, possibly contributing to long-term neurological damage. Taken together, the studies highlight the fact that the health impacts from COVID-19 extend far beyond the acute phase, and contribute more knowledge about the risk of long COVID, for both unvaccinated and vaccinated individuals, that could help identify those at greatest risk, plan necessary ongoing health services support, and help develop treatments for the condition.



California plans to add the Covid vaccine as a requirement to attend school as early as next fall.

(J. Harris: I agree with this mandate; Covid is at least as important to prevent as Measles and Chicken Pox, although probably less lethal than Polio and Diptheria.)

And last but not leased: CHEER UP. WE’RE GETTING THERE.

School photos:


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J. HARRIS: While Delta is washing out of our area — finally —  it’s not gone. Notice that we have only 15 ICU BEDS currently available in our area, and there are still 192 sick people on ventilators, mostly with Covid. However, even the NYT is relaxing a bit with a science article about A beet, of all things. (Milton sent it to me.)It would be especially tragic to get Clovid now, with plentiful vaccinations and some new treatments looming. Be Careful. Keep your mask handy.


”…Merck said an independent board of experts monitoring its study data had recommended that its trial be stopped early because the drug’s benefit to patients had proved so convincing. The company said that the Food and Drug Administration had agreed with that decision…The federal government has placed advance orders for 1.7 million courses of Merck’s drug, at a price of about $700 per patient. That is about one-third of the current cost of a monoclonal antibody treatment…It may be initially approved for the limited group of patients who are eligible to receive monoclonal antibody treatments: possibly older people and those with medical conditions that put them at high risk for bad outcomes from Covid. But experts said they expected that the drug might eventually be used more widely, in many people who test positive for the virus…If authorized, Merck’s drug would be the second antiviral treatment for Covid. The first, remdesivir, must be infused and has lost favor among clinicians as studies have suggested that it offers only modest benefit for Covid patients.

22 Pregnant Women Died From COVID-19 in August

”…The US Centers for Disease Control and Prevention (CDC) issued a Health Advisory on September 29, 2021, recommending urgent action to increase COVID-19 vaccination among pregnant women, recently pregnant (including those who are lactating), women trying to become pregnant now, or who might become pregnant in the future…”

WHAT CAN AND SHOULD WE DO TO PREVENT ANOTHER PANDEMIC? READ THIS ARTICLE BY ED YONG (J.Harris: Mr Yong has consistently written the most complete and compelling articles about COVID-19 available. He will get a Pulitzer Prize for his body of work — of which this article might be the best. Click the above. Our health system can be fixed.)

”…Delta was [IS] an audition for the next pandemic, and one that America flubbed. How can a country hope to stay 10 steps ahead of tomorrow’s viruses when it can’t stay one step ahead of today’s?…With every new pathogen—cholera in the 1830s, HIV in the 1980s—Americans rediscover the weaknesses in the country’s health system, briefly attempt to address the problem, and then “let our interest lapse when the immediate crisis seems to be over,… The result is a Sisyphean cycle of panic and neglect that is now spinning in its third century. Progress is always undone; promise, always unfulfilled…More Americans have been killed by the new coronavirus than the influenza pandemic of 1918, despite a century of intervening medical advancement….the U.S. must also address its deep social weaknesses—a health-care system that millions can’t access, a public-health system that’s been rotting for decades, and extreme inequities that leave large swaths of society susceptible to a new virus…America’s historical modus operandi has been to “give responsibility to the local public-health department but no power, money, or infrastructure to make change,..When a doctor saves a patient, that person is grateful. When an epidemiologist prevents someone from catching a virus, that person never knows…It’s very hard to achieve effective containment when the people you’re working with don’t think you care about them…”




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 1. PRIOR INFECTION & IMMUNE PROTECTION “As we have discussed previously, protection conferred by vaccination has been demonstrated to be better than protection conferred via natural SARS-CoV-2 infection. Two recent studies, however, provide further analysis of the immune response during and following SARS-CoV-2 infection, including possible protection against re-infection. A study from Japan, published in the Journal of Medical Virology, analyzed the IgG and IgM responses against 2 SARS-CoV-2 proteins (N and S1) in 231 COVID-19 patients. The researchers found that mild cases exhibited stronger immune responses (IgM and IgG) against both proteins early after symptom onset than severe or critical cases. As the disease progressed, the IgM and IgG responses increased in severe and critical cases higher and more rapidly than for mild cases. Additionally, the immune responses remained elevated for longer periods of time in patients with severe or critical disease, while they declined more rapidly for patients with mild disease. ELISA analysis demonstrated that a significantly higher proportion of severe and critical patients remained seropositive at 22 days after symptom onset than for mild patients for the S1 protein but not the N protein. The researchers note that lower immune response among mild cases could potentially signal lower levels of neutralizing antibodies and a shorter period of conferred immune protection against re-infection. Further analysis is needed to better characterize the duration and strength of protection, including the role of the innate immune response and memory B and T cells, and any association with disease severity during the initial infection.”

(J. Harris: So get a vaccination and later boosters even if you have had Covid, in my opinion.)

2. SOUTHERN US BLACK COMMUNITIES Rural communities in the US South are disproportionately impacted by the COVID-19 pandemic, most likely due to disparities in social determinants of health such as employment and access to healthcare. In the region’s predominantly Black communities, the pandemic has exacerbated ongoing medical and financial inequities. In a photojournalism report, titled “Distanced: Pandemic stories of Black life in the rural South,” STAT News examines the challenges these communities face and how they have found strength in the midst of this unprecedented public health emergency. Although the racial gap in COVID-19-related deaths seems to have shrunk in recent months, data can obscure the nuances in disparities; for example, Black people are less likely to live into older age, when COVID-19 is most lethal. Even when controlling for individual factors such as economic status, housing, education levels, preexisting health conditions, and occupation, researchers warn that structural racism contributes to demographic disparities in COVID-19 deaths, and the recent wave of cases due to the Delta variant have worsened these imbalances. 


Covid Is killing rural Americans at twice the rate of people in urban areas

”…Rural Americans are dying of Covid at more than twice the rate of their urban counterparts — a divide that health experts say is likely to widen as access to medical care shrinks for a population that tends to be older, sicker, heavier, poorer and less vaccinated…Roughly 41 percent of rural America was vaccinated as of Sept. 23, compared with about 53 percent of urban America, [HARRISON COUNTY 33%]…the overload of Covid patients in hospitals has undermined a basic tenet of rural health care infrastructure: the ability to transfer patients out of rural hospitals to higher levels of specialty care at regional or urban health centers…Access to medical care has long bedeviled swaths of rural America — since 2005, 181 rural hospitals have closed. A 2020 KHN analysis found that more than half of U.S. counties, many of them largely rural, don’t have a hospital with intensive care unit beds….As travel nurse companies attract more nurses, the nurses left behind shouldering their work become more burned out — and eventually quit….”

Mask Mistakes You’re Making Now

(J. Harris: A slide show from Webb MD)

Twiter to Ban Vaccine Misinformation

A Daily Pill to Treat Covid Could Be Just Months Away, Scientists Say

”…a short-term regimen of daily pills that can fight the virus early after diagnosis and conceivably prevent symptoms from developing after exposure…Antivirals are already essential treatments for other viral infections, including hepatitis C and HIV. One of the best known is Tamiflu, the widely prescribed pill that can shorten the duration of influenza and reduce the risk of hospitalization if given quickly…They work by interfering with the virus’s ability to replicate in human cells….The top contender is a medication from Merck & Co. and Ridgeback Biotherapeutics called molnupiravir, …Two others include a candidate from Pfizer, known as PF-07321332, and AT-527, an antiviral produced by Roche and Atea Pharmaceuticals.In the case of molnupiravir, the enzyme that copies the viral genetic material is forced to make so many mistakes that the virus can’t reproduce. That, in turn, reduces the patient’s viral load, shortening infection time and preventing the kind of dangerous immune response that can cause serious illness or death…Like the monoclonal antibodies, antiviral pills would be no substitute for vaccination,”



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