Author Topic: Trust in medical expertise  (Read 4135 times)

Offline ckmk47

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Re: Trust in medical expertise
« Reply #20 on: August 25, 2021, 11:03:22 AM »
I personally know MD's that don't recommend the vaccine for recovered patients, pregnant women, and even people on a cocktail of other drugs.


A doctor I know from the front lines considers pregnancy a 'risk factor' for getting a bad case of covid, (especially in conjunction with other mild risk factors such as mildly obese)  and recommends that  pregnant women get the vaccine. (not the J&J)


For recovered patients, (even pregnant ones) as long as they still have antibodies, medically, they're home free.  Of course, they may need to be vaccinated for political reasons. 
Which brings us back to the discussion at hand.

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Re: Trust in medical expertise
« Reply #21 on: August 25, 2021, 11:08:30 AM »
yes and how they began prior to the interview you are referring to.
I don't pay attention to political bias comments. I posted that just give a JJ an idea who she is and what she has done.

The point is how one side (either side) will turn on dime when they something against their side.

Another example is Dr Fauci but I didn't want to go there.  :)

IMHO the main cause for distrust is political based. Very few are as informed as some of the posters here. They just go to their political corner.
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Offline biobook

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Re: Trust in medical expertise
« Reply #22 on: August 25, 2021, 11:28:09 AM »
Pretty sure this sums it up.

You know how science works.

Imagine not knowing how science works. It can look like a bunch of bafoons. And now you can understand how most of the world sees it.
This isn't a totally satisfying explanation.  We all encounter areas of knowledge where we're not experts and have to rely on advice from others - car mechanics, technology, halacha.  But usually, when we have questions about why we're getting particular advice, we question our own understanding - Can you explain that again?  That doesn't sound right to me because....  Is there another possible answer? etc.    We don't automatically denounce the advisor as a liar and conclude he can never be trusted.

If, as you suggest, the source of distrust is people's lack of knowledge about how science works, how do you think we might counter that?

Offline biobook

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Re: Trust in medical expertise
« Reply #23 on: August 25, 2021, 12:01:58 PM »

Data and research must start somewhere. It starts with ancedotal data. 
I agree that this is often the case. 

A well-known story in the history of vaccines is that it began with an anecdote.  The milkmaids in Berkeley, England were often hired to provide nursing care for patients with smallpox.  They claimed that they were immune to smallpox because they had already been infected with cowpox while milking the cows.  This gave Edward Jenner the idea that led to the development of vaccination.

When there's no available data, doctors rely on anecdotes because that's all they have (although they're more likely to call it "the art of medicine".)  You're probably aware that the original use of Viagra was to treat high blood pressure and angina, but anecdotes led to its other uses. 

But other anecdote-based medicine have led to less valuable medical treatments, such as bloodletting.  The use of HCQ to treat covid was also based on early anecdotes from China of people who had been taking HCQ for other purposes. With HCQ, many clinical studies followed that anecdote, and led to the conclusion that it's not among the most effective drugs for covid.

So anecdotes may serve as the first source of medical ideas, but as quickly as possible we want to investigate that idea and see how significant and generalizable it really is by collecting more data. 

Quote
So you can ask for data all you want. Facts on the ground dont lie. Medical professionals may lie or may just not be familiar with what is available or going on elsewhere. The CDC is the last to know.
The CDC is often among the first to know, because doctors around the country report to them.  But the CDC investigates before it makes public announcements, so you may well hear about what works on the ground before you hear CDC talk about it.

Quote
When medical professional tell you X, Y or Z and you know from personal experience over multiple cases that it is not true you distrust.
I can understand if you say "When medical professional tell you X, Y or Z and you know from personal experience over multiple cases that it is not true you disagree with them on that subject."  But why should that disagreement translate into distrust of everything they do and say? 

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Re: Trust in medical expertise
« Reply #24 on: August 25, 2021, 12:02:42 PM »
I recognize the limitations of this crazy situation make that difficult, but there are things that can help with that. First of all, avoiding as much as possible absolutes, rather saying over and over again we don't know, but this is what our best guess is. I have personally spoken to doctors about various aspects of COVID as it related to myself and family members, and paradoxically the ones who prefaced every statement with "we really don't know, but this is what we think and our educated guess about how to be safest given the currently available information" were the ones I trusted the most.



Smartest statement I have read here so far.

If medical professional would act with a bit more humility and stop with the absolutes of something they clearly dont know everything about, people would be more trusting.
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Offline biobook

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Re: Trust in medical expertise
« Reply #25 on: August 25, 2021, 12:06:27 PM »
When they dont talk about natural immunity that sows distrust.

When they discount T cells that sows distrust.

When they ignore facts that sows distrust
Could you expand on that, give examples?  Who is "they"? What is being discounted? Natural immunity and T cells have been talked about since April 2020, both in the world and on DDF.

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Re: Trust in medical expertise
« Reply #26 on: August 25, 2021, 12:19:59 PM »
Could you expand on that, give examples?  Who is "they"? What is being discounted? Natural immunity and T cells have been talked about since April 2020, both in the world and on DDF.

I am admittedly not really an expert on how all this works, so please excuse my ignorance in advance, and correct me if I'm wrong, but (and maybe this is an oversimplification) isn't the basic way in which they proved the vaccines worked by comparing infection rates amongst vaccinated vs. unvaccinated people? And hasn't the data been available for at least many months showing a tremendous lack of confirmed re-infection amongst those who previously had COVID? Wouldnt this "prove" the idea of natural immunity? Yet, within all the discussions of whether you need to continue wearing a mask if you're vaccinated, or needing a vaccination to travel or attend certain events etc., do you know of any government official or CDC official or any of the "leading" experts being quoted having said that we should extend that to those who have recovered from COVID (and at the very least have positive antibody tests)? To completely deny that there has been large-scale ignoring of the protection afforded by natural infection and recovery is at best disingenuous. I have noted in other posts, that there may well be good public policy reasons for doing so to some extent, but once that line between science and policy starts getting blurred, I think you can appreciate why people start to wonder. Again, Fauci and the CDC maybe very good at what they do behind the scenes to reach scientific and data-driven conclusions, but when they get out of their lane.....

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Re: Trust in medical expertise
« Reply #27 on: August 25, 2021, 12:24:17 PM »
Smartest statement I have read here so far.

If medical professional would act with a bit more humility and stop with the absolutes of something they clearly dont know everything about, people would be more trusting.

The vast majority of doctors I have heard from during COVID  have prefaced most of what they say with statements along the lines of "we think", "we are seeing many cases where", or "it seems like" and other similar statements to signify that it is being based on unclear data.
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Re: Trust in medical expertise
« Reply #28 on: August 25, 2021, 12:24:40 PM »
Feelings don't care about your facts

Offline hvaces42

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Re: Trust in medical expertise
« Reply #29 on: August 25, 2021, 12:25:55 PM »
I can understand if you say "When medical professional tell you X, Y or Z and you know from personal experience over multiple cases that it is not true you disagree with them on that subject."  But why should that disagreement translate into distrust of everything they do and say?
I dont disagree with your premise in day to day medical affairs. But if its COVID related, why would I agree with anything other than what my personal experience has told me?

Again, let me share my personal experience, which I agree is ancedotal. I had a mild case of COVID in March 2020. Lost taste and smell, had headaches and fatigue for a few weeks and BH done with it since after Pesach 2020. I had antibodies and "lost" them by August 2020 but have tested since with antibodies present but not enough to justify a positive according to the lab. 15 is considered positive I have 11.6 consistently. First my doctor told me I dont need the vaccine. Then he changed his mind and said I should get it. Then he said no again and then he said because of variants I should. So do I trust him or not?

I have been in confined quarters for lengthy periods of time, multiple times, unmasked, with patients who have been admitted to ICU and even intubated. (I know everyone laughs off exposure but thats really the only way you can get it...by being exposed) I feel pretty safe around COVID positive patients. So do I need the vaccine? I dont know. Do I trust my doctor, yes. He doesnt know if I need it or not. So is it distrust that stops me from taking the vaccine? Or am I disagreeing with the premise that I need a vaccine and my experience tells me that natural immunity seems to be working for me.

I am comfortable enough that if I or anyone close to me CV got sick, I know where to get treatment and I know what the protocol will be. Others that call my daughter for advice want data. I understand them. They would rather trust a local hospital then trust someone who doesnt have actual data in printed form.

Thats their form of distrust.  They havent seen what we have seen. I cant argue with 200 very sick patients who recovered. They dont trust. In my view I cannot understand their distrust. Why call and ask for advice if you have no intention of following it unless it fits into your preconceived notion of what is good information and what isnt?
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Re: Trust in medical expertise
« Reply #30 on: August 25, 2021, 12:27:16 PM »
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Re: Trust in medical expertise
« Reply #31 on: August 25, 2021, 12:29:03 PM »
This isn't a totally satisfying explanation.  We all encounter areas of knowledge where we're not experts and have to rely on advice from others - car mechanics, technology, halacha.  But usually, when we have questions about why we're getting particular advice, we question our own understanding - Can you explain that again?  That doesn't sound right to me because....  Is there another possible answer? etc.    We don't automatically denounce the advisor as a liar and conclude he can never be trusted.

If, as you suggest, the source of distrust is people's lack of knowledge about how science works, how do you think we might counter that?
Where did you see "We don't automatically denounce the advisor as a liar and conclude he can never be trusted."

Was it part of the previous conversation? I don't think most people are saying doctors are lying on purpose and can never be trusted. And if they are, I'd bet there is a good chance they already didn't like what doctors had to say before COVID started.
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Re: Trust in medical expertise
« Reply #32 on: August 25, 2021, 12:30:36 PM »
As stated in my quoted post, some of the distrust is deserved, some not. For example, there are snide comments in the Crown Heights thread about doctors who gave of their lives in the most superlative ways for nothing in return. Those revolt me personally. Then you had doctors who kicked and screamed about every violation of social distancing or large events only to encourage and participate in BLM protests.

Here are some facts:

The average frum NYer knows many people who died from covid. They also know an equal or larger amount of people who were mistreated in NY hospitals, were malnourished, and suffered the worst of conditions.

Our own nonprofit organizations were ahead of NY public health at basically every stage of the virus. When people were getting put on ventilators and killed, Hatzalah, Chemed, Yachad, and other organizations were facilitating home treatments that kept people out of the hospital and alive. My bosses procured and donated hundreds of oxygen concentrators which saved lives. Our communities have been using monoclonal antibodies to great effect, B"H, something the broader medical world has been slower to adapt.

The debates have become very political, the media coverage has been skewed, and Jewish communities were targeted with covid restrictions and enforcement more than other communities.

With the internet and social media, there has never been a better time for the promulgation of conspiracy theories. When you sprinkle in the above truths which people know from their lived experiences, those conspiracy theories become very believable.

Unfortunately, some of the more vocal medical professionals have mocked and ridiculed people who didn't go along with their beliefs. People who expressed questions about vaccines have not been treated with the respect that you have shown when answering questions. When doctors have been shown to have gotten things wrong, which is perfectly understandable in such a fast-changing situation, they have not shown contrition in the slightest.

There has also been an unwillingness of the people creating the guidelines and restrictions to acknowledge their difficulties. NYers crammed into tiny apartments for weeks on end had outdoor toddler playgrounds locked! (Outside of Jewish areas, basketball courts were open and full, but that's part of the other point)

We were told 14 days to stop the curve with fancy graphics and everything, and the 14 days kept stretching and stretching. No parameters are set for when restrictions are put in place or stopped. People are expected to live under any restrictions without any kind of indication when or how those restrictions can or will be lifted. All this in the name of "science" when they are often not scientific at all. The same officials screaming at people to get vaxxed were screaming at them for not wearing a mask alone outdoors in the summer.

Many doctors use the CDC when informing patients, they link to their site and quote their statements about vaccines and the like. If someone has lost trust in the CDC - for whatever reason, legitimate or not - they now lost trust in this doctor who "is just a puppet". Now, you can say it's not the doctor's fault that the patient is a crazy conspiracy theorist, but read the room. When large swaths of your patients have lost trust and conflate all public health agencies with Cuomo's anti-Semitic policies, don't quote the CDC.

There is much more to be written about this, but if you are really bored, you can go through my post history from about Shavuos last year and I mentioned a few times that public health officials were losing trust and it would cause long term damage. Hate to say it, but covid anti vaxism is spreading to other vaccinations as well in our community. Hypocrisy and double standards from the agencies advocating the vaccines will do that.
Quote from: ExGingi
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Re: Trust in medical expertise
« Reply #33 on: August 25, 2021, 12:31:45 PM »
Saying the truth actually makes me trust him more :P

@Yehuda57 will be able to rebut this better than I can, but it is both not true and also not helpful to single out any group by religion and even more so when it is not relevant to what you are discussing.
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Offline hvaces42

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Re: Trust in medical expertise
« Reply #34 on: August 25, 2021, 12:35:22 PM »
Could you expand on that, give examples?  Who is "they"? What is being discounted? Natural immunity and T cells have been talked about since April 2020, both in the world and on DDF.
They is the CDC or local health officials. Open a TV in NYC and watch a half hour of news and you will see 5 commercials from the NYC DOH promoting the vaccine and not saying a word about testing for antibodies beforehand. Thats just dishonest. How can you have an honest discussion without discussing natural immunity. Granted they are pandering to a low information population.   

Does having natural immunity require you to get the vaccine? If yes, why?

If I had chicken pox and shingles do I still need the varicella vaccine? If no, why?

In my opinion and from my experience natural immunity, with or without antibodies, is better than anything that the vaccine offers. I have not heard a reason otherwise because it is not discussed openly. It is probably because they dont trust people to be smart enough to discern whether they have natural immunity or not. Lowest common denominator style information. Target the dumbest part of society and make everyone conform to that demographic. 
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Re: Trust in medical expertise
« Reply #35 on: August 25, 2021, 12:35:54 PM »
it is...not true
So we start on the same page, a measles outbreak didn't happen in the hassidic community or it did happen in the hassidic community?
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Re: Trust in medical expertise
« Reply #36 on: August 25, 2021, 12:38:24 PM »
Trust in medical expertise. Absolutely.
Do not trust them to make moral and political decisions. At all.

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Re: Trust in medical expertise
« Reply #37 on: August 25, 2021, 12:38:33 PM »
As stated in my quoted post, some of the distrust is deserved, some not. For example, there are snide comments in the Crown Heights thread about doctors who gave of their lives in the most superlative ways for nothing in return. Those revolt me personally. Then you had doctors who kicked and screamed about every violation of social distancing or large events only to encourage and participate in BLM protests.

Here are some facts:

The average frum NYer knows many people who died from covid. They also know an equal or larger amount of people who were mistreated in NY hospitals, were malnourished, and suffered the worst of conditions.

Our own nonprofit organizations were ahead of NY public health at basically every stage of the virus. When people were getting put on ventilators and killed, Hatzalah, Chemed, Yachad, and other organizations were facilitating home treatments that kept people out of the hospital and alive. My bosses procured and donated hundreds of oxygen concentrators which saved lives. Our communities have been using monoclonal antibodies to great effect, B"H, something the broader medical world has been slower to adapt.

The debates have become very political, the media coverage has been skewed, and Jewish communities were targeted with covid restrictions and enforcement more than other communities.

With the internet and social media, there has never been a better time for the promulgation of conspiracy theories. When you sprinkle in the above truths which people know from their lived experiences, those conspiracy theories become very believable.

Unfortunately, some of the more vocal medical professionals have mocked and ridiculed people who didn't go along with their beliefs. People who expressed questions about vaccines have not been treated with the respect that you have shown when answering questions. When doctors have been shown to have gotten things wrong, which is perfectly understandable in such a fast-changing situation, they have not shown contrition in the slightest.

There has also been an unwillingness of the people creating the guidelines and restrictions to acknowledge their difficulties. NYers crammed into tiny apartments for weeks on end had outdoor toddler playgrounds locked! (Outside of Jewish areas, basketball courts were open and full, but that's part of the other point)

We were told 14 days to stop the curve with fancy graphics and everything, and the 14 days kept stretching and stretching. No parameters are set for when restrictions are put in place or stopped. People are expected to live under any restrictions without any kind of indication when or how those restrictions can or will be lifted. All this in the name of "science" when they are often not scientific at all. The same officials screaming at people to get vaxxed were screaming at them for not wearing a mask alone outdoors in the summer.

Many doctors use the CDC when informing patients, they link to their site and quote their statements about vaccines and the like. If someone has lost trust in the CDC - for whatever reason, legitimate or not - they now lost trust in this doctor who "is just a puppet". Now, you can say it's not the doctor's fault that the patient is a crazy conspiracy theorist, but read the room. When large swaths of your patients have lost trust and conflate all public health agencies with Cuomo's anti-Semitic policies, don't quote the CDC.

There is much more to be written about this, but if you are really bored, you can go through my post history from about Shavuos last year and I mentioned a few times that public health officials were losing trust and it would cause long term damage. Hate to say it, but covid anti vaxism is spreading to other vaccinations as well in our community. Hypocrisy and double standards from the agencies advocating the vaccines will do that.
+100000000000

So well said!!! Thank you!
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Re: Trust in medical expertise
« Reply #38 on: August 25, 2021, 12:40:26 PM »
So we start on the same page, a measles outbreak didn't happen in the hassidic community or it did happen in the hassidic community?
Happen or caused by? (note that my filter blocks YouTube and I am relying on how the article quotes him)
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Re: Trust in medical expertise
« Reply #39 on: August 25, 2021, 12:42:42 PM »
As stated in my quoted post, some of the distrust is deserved, some not. For example, there are snide comments in the Crown Heights thread about doctors who gave of their lives in the most superlative ways for nothing in return. Those revolt me personally. Then you had doctors who kicked and screamed about every violation of social distancing or large events only to encourage and participate in BLM protests.

Here are some facts:

The average frum NYer knows many people who died from covid. They also know an equal or larger amount of people who were mistreated in NY hospitals, were malnourished, and suffered the worst of conditions.

Our own nonprofit organizations were ahead of NY public health at basically every stage of the virus. When people were getting put on ventilators and killed, Hatzalah, Chemed, Yachad, and other organizations were facilitating home treatments that kept people out of the hospital and alive. My bosses procured and donated hundreds of oxygen concentrators which saved lives. Our communities have been using monoclonal antibodies to great effect, B"H, something the broader medical world has been slower to adapt.

The debates have become very political, the media coverage has been skewed, and Jewish communities were targeted with covid restrictions and enforcement more than other communities.

With the internet and social media, there has never been a better time for the promulgation of conspiracy theories. When you sprinkle in the above truths which people know from their lived experiences, those conspiracy theories become very believable.

Unfortunately, some of the more vocal medical professionals have mocked and ridiculed people who didn't go along with their beliefs. People who expressed questions about vaccines have not been treated with the respect that you have shown when answering questions. When doctors have been shown to have gotten things wrong, which is perfectly understandable in such a fast-changing situation, they have not shown contrition in the slightest.

There has also been an unwillingness of the people creating the guidelines and restrictions to acknowledge their difficulties. NYers crammed into tiny apartments for weeks on end had outdoor toddler playgrounds locked! (Outside of Jewish areas, basketball courts were open and full, but that's part of the other point)

We were told 14 days to stop the curve with fancy graphics and everything, and the 14 days kept stretching and stretching. No parameters are set for when restrictions are put in place or stopped. People are expected to live under any restrictions without any kind of indication when or how those restrictions can or will be lifted. All this in the name of "science" when they are often not scientific at all. The same officials screaming at people to get vaxxed were screaming at them for not wearing a mask alone outdoors in the summer.

Many doctors use the CDC when informing patients, they link to their site and quote their statements about vaccines and the like. If someone has lost trust in the CDC - for whatever reason, legitimate or not - they now lost trust in this doctor who "is just a puppet". Now, you can say it's not the doctor's fault that the patient is a crazy conspiracy theorist, but read the room. When large swaths of your patients have lost trust and conflate all public health agencies with Cuomo's anti-Semitic policies, don't quote the CDC.

There is much more to be written about this, but if you are really bored, you can go through my post history from about Shavuos last year and I mentioned a few times that public health officials were losing trust and it would cause long term damage. Hate to say it, but covid anti vaxism is spreading to other vaccinations as well in our community. Hypocrisy and double standards from the agencies advocating the vaccines will do that.
Add to this the constant flow of people (including Dr Brix) not following the guidelines they promoted for others. Could there be other factor involved for each? Maybe, but that still makes for bad optics and distrust.
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