COVID-19: Will the Vaccine Save Prisoners?

Jane Orient, MD — Dec. 12, 2020

I hope a loved one is not incarcerated, but all of us need to be concerned about prison health, for humanitarian reasons and also because prisons are breeding grounds for contagious diseases.

The Pfizer vaccine for COVID-19 is expected to arrive in hundreds of sites next week under an Emergency use Authorization (EUA) from the Food and Drug Administration. In Arizona, it will be administered, by appointment only, in centralized drive-thru locations (“pods”) to persons on the 1A allocation list. That includes healthcare workers and nursing home residents—not prisoners.

More than half the inmates at the Arizona State Prison Complex in Yuma test positive for COVID. Staff are getting certified to administer vaccine, when it becomes available, but the vaccine is already too late for more than half. The not-yet-positive inmates are housed separately and required to wear cloth masks when outside their cells. But inside or outside their cells, they are breathing the same air.

Orofecal spread of coronavirus is possible. Virus lives in the GI tract and wastewater for days or weeks. Virus has been isolated from restroom exhaust fans. In one study of environmental contamination, the air sampler had to be quarantined twice despite wearing full protective gear. If virus is aerosolized from flushing toilets, the prison mask policy will be of limited value.

So, what can we do to protect both prisoners and staff? A disproportionate number are minorities, the population most severely affected by the disease.

On Dec 8, the Senate held a second hearing about early treatment for COVID. While none of the witnesses said anything related to politics, or anything critical about vaccination or public health mitigation measures, Sen. Chuck Schumer (D-N.Y.) attacked the hearing, Chairman Ron Johnson (R-Wis.), and witnesses as being political, “anti-science,” and “anti-vaxx”—before a word was said.

There is apparently an Anti-Early-Treatment movement, which confuses being pro-treatment with being “anti-vaxx.” It has specifically discouraged use of hydroxychloroquine (HCQ), but official guidance from the National Institutes of Health (NIH) recommends no treatment for outpatients—except for the recent addition of mostly unavailable new monoclonal antibodies.

In contrast to official therapeutic nihilism, testimony at the hearing provided great hope about ivermectin, which has been called “a miracle drug,” having saved millions from terrible parasitic diseases in Africa and other developing areas. In more than 30 studies completed to date, all studies show effectiveness for COVID-19 in early and late disease and for pre-exposure and post-exposure prophylaxis (PrEP and PEP in HIV/AIDS parlance), as the graphic below shows.

There have been no large-scale randomized controlled trials (RCTs) for use in COVID-19 because of difficulty in obtaining funding. The research money goes to novel drugs and vaccines with huge profit potential. But safety has been shown with nearly 4 billion doses taken by humans since 1981.

Prisoners could be offered the choice to take one dose of ivermectin today and a follow-up dose in perhaps a week. Or they can wait to get infected soon and vaccinated whenever.

If you would like to discuss these issues, contact me at [email protected] or (520) 323-3110.

Jane M. Orient, M.D., Executive Director, Association of American Physicians and Surgeons

Thinking Out Loud: Pravda

We have a mentally challenged, corrupt vapid zombie running for President of our democratic republic. The media refuse to report about it. Not to mention that the real presidential candidate is a despicable corrupt politician in her own right.

The First Amendment’s freedom of the press and speech clause enhances our freedoms through flooding the “marketplace of ideas” with unlimited information. There was a time when the law wrestled with censorship of hard-core pornography. Now the media are censoring political viewpoints.

Although media outlets are not government entities, the charge of the media is to relay information, not indoctrinate. In a few short years our media — the voice of the people — have devolved into Pravda. For those who don’t remember the Soviet Union (USSR), Pravda (meaning “truth”) was the USSR’s Communist Party newspaper that disseminated only Party-approved information.

Yesterday the Senate Committee on Commerce, Science, and Transportation grilled the CEOs of Google, Twitter, and Facebook regarding their bias against conservative posts. Predictably, some Democratic legislators seemed to think the censorship of conservatives was acceptable. Sen. Ed Markey (D-Mass.) indeed wanted more — against conservatives only!

Suppression of free speech is a step in the long march to socialism. With socialism the state owns and operates all capital. It seems antithetical that some corporate shills (including big tech, print and television media) support Joe Biden, the Communist Chinese puppet. Think again. Biden’s platform includes re-instituting regulations, raising the minimum wage, and levying high taxes. Such policies tend to drive smaller companies out of business. With the competition eliminated, the surviving big corporations assume they will be the “chosen ones” for the government-owned means of production. After all, the government deemed the big boys “essential,” thus allowed them to operate at full throttle during the Covid lockdowns.

Remember who is really essential: you. Speak up and speak out while you still can.

“As to the evil which results from a censorship, it is impossible to measure it, for it is impossible to tell where it ends.” Jeremy Bentham, English philosopher (1748-1832)

Mission Possible: Saving Freedom in Medical Care

by Marilyn M. Singleton, MD, JD

In the original Mission: Impossible series, against all odds, through brilliant strategizing the good guys thwart stealth communist plots to undermine democracies. In trying to provide affordable, quality, personalized medical care, independent physicians face seemingly insurmountable obstacles: digging out from under piles of electronic paperwork, breaking free of third-party red tape, dodging hospital buyouts, and shielding patients from data mining and privacy intrusions.

But the biggest obstacle to great medical care is the socialist brigade rallying around Medicare for All, the proposed federally financed program that boasts no premiums, deductibles or copays, and medical, dental, vision and hearing benefits. What could possibly go wrong? As they say, show me the money. The Congressional Budget Office estimates the federal government will spend about $1 trillion on healthcare programs in 2018. A detailed Mercatus Center analysis concluded that Medicare-for-All would add $32.6 trillion to federal expenditures during its first 10 years.

Currently, payroll taxes and income tax on Social Security benefits fund Medicare’s Part A Hospital Insurance Trust Fund. The Centers for Medicare and Medicaid (CMS) estimates this fund will be depleted in 2026. General tax revenues and beneficiary premiums fund medical services coverage (Part B). Medicare for All would be financed by current Medicare funds – minus the insurance premiums – and would be supplemented by the ever-popular “taxing the rich.” Beware: the definition of “the rich” will be ratcheted down to encompass more taxpayers.

Then there is the coercive nature of Medicare. A beneficiary’s opting out of Medicare Part A means forfeiting all past and future Social Security benefits. Medicare for All makes it clear that no straying from the herd is allowed: neither private insurers nor employers can offer insurance that competes with the government.

Fortunately, more choices are becoming available for potential patients. The House of Representatives recently passed two packages of expansions of Health Savings Accounts (HSAs) (H.R. 6199H.R. 6311). To name a few benefits, the contribution limit for an HSA nearly doubled to $6,650 for individuals and to $13,300 for families. HSAs would be allowed to pay for direct primary care (DPC) monthly fees. Best yet, anyone would be able to purchase a lower-premium catastrophic plan — removing the ACA’s under age 30 restriction. And purchasers of “bronze” and catastrophic (“copper”) plans would be able to contribute to an HSA.

Improving HSAs is not a trivial goal. HSAs are portable. HSA contributions reduce taxable income, money in the account grows tax-free, and money can be withdrawn tax-free to cover qualified medical expenses. The Employee Benefits Institute estimates that a person saving in an HSA for 40 years, assuming a 2.5% return, could accumulate up to $360,000.

The Executive Branch acted on CMS’s report that lower-cost alternatives were necessary given the rising premiums responsible for the decline in the purchase of unsubsidized ACA plans. The Administration created new rules for short-term limited duration (STLD) insurance policies, which are not bound by the ACA’s restrictive mandates.

STLD plans, defined by the Obama administration as less than three-months duration, can be up to 12 months duration and can include an option for guaranteed renewal up to 36 months. Californians may be out of luck if the proposed consumer protection legislation prohibiting STLD policies makes it to the governor’s desk.

According to CMS, in the fourth quarter of 2016 the average monthly premium for individuals for a STLD policy was approximately $124, compared with $393 for an unsubsidized ACA-compliant plan with comparable $5,000 deductibles. That is an annual savings of $3,228. Even adding $50 per month for a direct primary care practice, an individual saves $2,628 a year. With DPC, all primary care services, including chronic disease management and access to low-priced commonly used medications are included in the upfront price.

The HSA bills and the new STLD rules are an antidote to the erosion of our freedom to contract under the guise of protecting us from “junk” insurance. Medicare-for-All is not the cure for health care ills. Once the central planners lure the masses into dependence on “free” stuff, abuse of power ensues. Voluntary participation by physicians becomes mandatory. When the money tree withers, the non-negotiable provider payments are slashed, and services to patients are rationed.

To mitigate the unacceptable, sometimes fatal wait times in the Veterans Administration health system a bipartisan Congress looked to the backbone of great medicine: private practice physicians. Independent medical practices will lead the way to achieving great affordable medical care through competition and consumer choice.


Dr. Marilyn M. Singleton, MD, JD is a board-certified anesthesiologist and member of the Association of American Physicians and Surgeons (AAPS).

Dr. Marilyn Singleton ran for Congress in California’s 13th District in 2012, fighting to give its 700,000 citizens the right to control their own lives.

While still working in the operating room, Dr. Marilyn Singleton attended UC Berkeley Law School, focusing on constitutional law and administrative law. She also interned at the National Health Law Program and has practiced both insurance and health law.

Dr. Marilyn Singleton has taught specialized classes dealing with issues such as the recognition of elder abuse and constitutional law for non-lawyers. She also speaks out about her concerns with Obamacare, the apology law and death panels.

Congressional candidate Dr. Marilyn Singleton presented her views on challenging the political elite to physicians at the Association of American Physicians and Surgeons annual meeting in 2012.

Follow Dr. Marilyn Singleton on Twitter @MSingletonMDJD

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