Editor:
Mark Mosley, MD has made an impassioned call for physicians to unite with one voice to create a clear message for patients regarding COVID-19. (REM. 2021;43[12]:26; https://bit.ly/3Dc0LN1.)
He suggested that science strongly supports the effectiveness of masks and the safety and effectiveness of vaccines, but has no evidence to support current therapeutics. I have appreciated Dr. Mosley’s perspective on many issues in the past, but this article was unconvincing. The references do not support his arguments or were incomplete. Researchers around the world are working hard to contribute to knowledge about the treatment of COVID-19. These individuals are not charlatans, as he suggested; many are highly respected doctors and scientists who risk their careers to emphasize information they believe is suppressed.
In my opinion, the science is clearly not settled on the prevention, vaccination and treatment of COVID-19. A number of currently available early treatment options that significantly reduce morbidity could be initiated for discharged patients. Large-scale trials are unlikely to be published for generic therapies, but the sum of many smaller studies strongly supports their use (Cochrane). (https://c19early.com/; https://earlycovidcare.org/; https://bit.ly/3sHAogh.)
We have been trained to do no harm first and always consider risk versus benefit when counseling or treating a patient. I suggest that the modern practice of evidence-based medicine reinforces the need for clinicians to review the literature independently rather than depending on others. A new disease prompts advice from many people, including medical and government organizations. This does not absolve medical practitioners from obtaining informed consent for new therapies or providing a patient with what they believe to be the optimal treatment. If emergency physicians routinely adopt practice guidelines developed by other well-meaning experts, then what is our goal? All I see is a future where we will be replaced by technicians and individualized care will be excluded.
James Mateer, MD
Delafield, Wis.
