STOP POLITICIZING MEDICINE: Facts vs. Myths of the Frontline Doctors Video

America’s Frontline Doctors. This viral video has been circulating over the last day or so and I’ve been replying to some on their posts, but I figured since so many are both sharing this post and have been engaging in civil conversation (thank you!), I’d piece together my thoughts here. It’s very long, but as a Registered Nurse and future Physician Assistant, here are my thoughts. I’ve watched the video (and the newest one too!), read the articles, and have been following the research (not the news!) on COVID since it first started. If you want a better understanding on HCQ use as treatment and post-exposure prophylaxis, read on!

Disclaimer: I refuse to politicize this situation. Cancel culture is dangerous. I have spent the last 5 years studying medicine, I have spent the last 7-8 years working in/being exposed to medicine. I am not discrediting these doctors in any way, I know just how hard they have worked to become knowledgeable in their fields and I respect their opinions and experiences. 100%. However, when recommending a treatment and declaring it a cure for COVID, it MUST be backed by credible research, not just personal experience. So, I would encourage you to at least do the research, read this post and the studies I am attaching, before suggesting and advocating for medical treatments without a medical license or education.

My biggest concern with this video is that the studies using HCQ (hydroxychloroquine) + Zinc + Azithromycin in the outpatient setting are still being studied, meaning they are not complete. Therefore, we cannot say, scientifically that this drug combination works or does not work. The other point to consider, is that Dr. Stella Immanuel is a medical director of an urgent care and board-certified pediatrician. Her license is not tied to any hospital privileges, indicating that she is an outpatient provider. This means the patients she is seeing and treating with the HCQ combo are the pts going to their general practitioner or local urgent care. Based off what we do know, most of the COVID deaths are occurring inpatient (in the hospital and ICUs), not outpatient. So naturally, the recovery rate is 100% in those who are not severely ill (outpatient) and without risk factors/complications. There is not sufficient evidence to say that we can safely treat COVID patients in the hospitals and ICUs with HCQ. 

Earlier on in this pandemic, HCQ was used experimentally inpatient and was no longer recommended due to older patients developing cardiac arrhythmias and complications and other patients developing something called Stevens Johnson Syndrome (a drug reaction causing the skin to blister up and slough off, causing severe burns) even with short term use. The risk was too high without proven evidence that the drug actually works. 

Many have been talking about the safety of HCQ and its use in pts with rheumatoid arthritis or lupus. Even as an antimalarial. Dr. Harvey Risch posted a research article advocating for the use of HCQ in the outpatient setting as a prophylactic measure. The studies he referenced followed the patients for 7-10 days after a course of HCQ + Azithromycin and reported zero cardiac side effects. Based on what I know of the drug, the half-life of HCQ is 40 days, meaning that it takes 40 days for half of the drug to be metabolized. So, imagine being hit with the highest drug dose (800mg) on day 1 and then days 2-10, you are taking 400mg a day. This medication is building up in the body and will take 40 days at minimum to be reduced by half. 4.8 grams of medication will be reduced to 2.4 grams in 40 days. Even that amount is sufficient to cause side effects long after the 7-10 days that these patients were being followed. I don’t know if these patients did or did not develop cardiac symptoms, but until we know and have data to support it, it is not safe or ethical to prescribe this drug for COVID. 

Now the other point that is being discussed is the use of HCQ early on in the viral replication cycle to be most effective. The doctors in the video and Dr. Risch agree that by the time the patient is admitted to the hospital, it is too late for HCQ to be effective. The key point here to remember is that the general trend of progression is that a COVID patient does not become symptomatic until 7-14 days after exposure. Meaning, that the virus has had time to replicate enough to create symptoms. The premise of using HCQ to treat is based on a study published in 2005 stating that HCQ inhibits the replication of the SARS virus in vitro. It has also been found more recently that HCQ inhibits the replication of SARS-CoV-2 (COVID) in vitro as well. However, many medications have been shown to inhibit COVID in vitro, but have been ineffective in the human body. Once a pt is symptomatic and presenting to the clinic for care, the virus has replicated significantly, rendering the premise of this study inconclusive

Fortunately, other randomized controlled trials (the gold standard for research) have been done, which I linked below, and are testing the efficacy of HCQ in an infected human body, not just cells. These, however, have shown that the use of HCQ in mild-moderate cases inpatient have actually extended a patient’s hospital stay and increased their rates of ventilation and intubation. Not saying that the HCQ caused the worsening symptoms, but simply demonstrating that the standard of care that the hospital is using (remdesivir – an antiviral medication) is actually better than using HCQ. They’ve done another study where 719 patients had a strong positive exposure to COVID and half were given HCQ, the other half were given a placebo. The results of those on HCQ were the same as those on placebo. Both either contracted or did not contract COVID at the same rate regardless of whether they were taking HCQ.

Now, I’ve been seeing a lot of misinformation regarding the research being done into HCQ as a viable treatment option. This post is not intended to declare HCQ ineffective, but rather help people understand that the Remdesivir, the current standard of care, has improved mortality rates compared to HCQ in studies that have been completed SO FAR. 

However, there are currently 243 registered clinical trials evaluating the use of HCQ and COVID, many are in the outpatient setting. Researchers are hard at work studying the efficacy of HCQ. Many of these studies are actually being pushed out much more quickly due to an expedited process of peer reviewing the articles and data. However, science isn’t something that can be rushed. The recommended period of time to follow a COVID pt is about 28 days. So, following a large enough group of COVID patients for 28 days, in of itself takes a significant portion of time. The work is being done. I just ask you to be patient.

As far as trialing HCQ in an outpatient setting, the issue we run into, is that there is not enough conclusive data pointing to the benefits of HCQ YET compared to the current standard of care for physicians to deem this an appropriate treatment. Taking an oath to “do no harm” means that if the standard of care has been shown to be more effective than a treatment option, or a treatment that is being studied has not been proven yet to be beneficial or harmful, then it should NOT be administered until it is known to be both safe and beneficial. So, all this to say, it could definitely be a viable treatment option in the future; however, we don’t know YET if it’s safe or effective to give to COVID patients. The work is being done, the process is being expedited; however, I would argue that it is dangerous to state, as these doctors did, that a medication or med combo is a cure to COVID and we should no longer wear masks, when there is insufficient data to back that up. 

Here’s why: In the 1960s, thalidomide was being prescribed by physicians as a novel treatment for morning sickness. It was deemed a miracle drug. However, they later found out when these children were born, that thalidomide was actually causing amelia (a birth defect where the baby is born missing one or more limbs). My point being, we just need more evidence before we start handing out HCQ.

I find it encouraging that all 350 of Dr. Immanuel’s patients have been prevented from going to the hospital. I hope that she has been compiling data and will submit this data for analysis and further research (larger sample sizes, double blinded randomized controlled trials, etc), since she is so hopeful. Historically, patients have shown significant improvement within 2-3 weeks and can relapse a few weeks after that, leading to ventilation and potentially death. Until we have data regarding her experiences, and when in the viral replication cycle these patients presented, were treated, and how long they were followed after discharge, I cannot comment on the validity of 100% recovery rates.

Please also consider the state of our economy. The insurance model in the United States closely ties access to healthcare/health insurance to employment. With sky high unemployment rates, those who are at the highest risk of developing COVID and dying from it are the least likely to have insurance, meaning that they are not going to the doctor until they are SEVERELY ill, which these doctors agreed, is too late for HCQ. So, under a national insurance model (which I am not necessarily advocating for!), this could be an option if HCQ is found to be effective in preventing the virus or preventing hospitalization from the virus. But here under our current insurance model, those who are dying from this virus, are not the ones who will benefit from this treatment.

Here’s the takeaway. These doctors clearly have experience in their respective fields and have put in the work to become licensed professionals. Some of them have experienced COVID firsthand and based on their experiences, have reason to believe that HCQ + Zinc + Azithromycin may be an effective prophylactic treatment. 

HOWEVER, if nothing else, please hear this: Medication treatment decisions CANNOT be based on personal experience. It’s wonderful if HCQ helped your family member with COVID. However, there are studies that have demonstrated that other medications are MORE effective at preventing mortality rates compared to HCQ. We cannot change the standard of care when the evidence does not support a change. To do so would be both unethical and irresponsible.

So be patient, the fact that there are 243 studies ongoing to find a treatment for COVID gives me hope. The fact that there are vaccines in the works, being tested and studied, gives me hope. There is hope, America, now we just ask you to be patient!

Also, please just wear a mask. Even if it all turns out to be a hoax (spoiler alert: it’s not!), then at least you can rest assured knowing that you did not morally sacrifice someone’s life for your convenience or your political affiliation. Love your neighbor as yourself. Period.

Thanks for reading if you made it all the way to the end. You’re a rockstar!

@kbcarlson96

Here are the studies referenced:

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

https://www.medrxiv.org/content/10.1101/2020.07.15.20151852v1

Harvey Risch study

Additional source: Laurel Bristow, infectious disease clinical researcher

Facebook is a disease.

The Devil Critiques Expressions That Mention Him | The New Yorker

I am not a religious person. I would consider myself “Agnostic” if I had to put myself in a category. However, for the sake of my narrative, let’s assume that the biblical version of God and the Devil exists. People tend to personify things, so God and the Devil are often portrayed as these physical beings with two arms, two legs and maybe two horns if you’re feelin’ artsy. However, if you are a person of faith, I would like to propose that the Devil is manifesting himself/herself/itself in a form that is much less conventional than you might think.

It is wild to me that people can no longer be rational humans. The ability to think for oneself has ironically decreased since the access to information has increased. Only 20 years ago, if you wanted to know something, you physically had to go out of your way to learn the information; But now everything is at your fingertips. As technology advances, we as humans now use our brains less than ever. While that sounds great, I personally and wholeheartedly believe that the adverse effects greatly outweigh the benefits. Instead of opening up a book and exploring subjects in great detail, people are content with simply reading headlines.

According to multiple research studies, it is estimated that approximately 60-70% of people click ‘share’ on Facebook without ever clicking on the link to the article or video. Most people are probably skimming over this sentence as we speak. Therefore, if a headline simply matches their belief, they will share it without even thinking about the consequences or repercussions of the false narrative they may be spreading. Now, I can see how this might not be the end of the world and I’m sure you probably think I should be wearing a tinfoil hat, but there is a deeper threat than people even realize.

Oh yeah, the Devil analogy. Basically, I am saying that Facebook is comparable to the Devil. That may seem slightly hyperbolic, but Facebook totally sucks. It is a catalyst for the spread of negativity and I will explain why I am comparing a social media platform to a theological dude that lives in a fiery Hell (I didn’t read the book, but I heard it’s popular). 

People see a headline and share it without even bothering to explore the validity. And we all know Facebook loves to gather information on you. I was literally talking to my friend about kayaks the other day, and he showed me a picture of one on his phone, and the next day, I was getting ads for ‘yaks for the first time in my life. It’s a known fact that Facebook listens to your conversations, yet no one seems to really care about that, but that’s a topic for another day. Espionage is not the only way it gathers information, too. It also tracks what you share, like, and who you interact with. It processes that information and your feed is then personalized to show the things you have interests in. You ever wonder why you have hundreds of friends on Facebook but you only see the same 10-15 people on your feed?

Now that seems cool at first glance, but what this actually does is create a bubble of like-minded people. You no longer see a bunch of different viewpoints and you only see the ones that you personally believe in (for the most part). So everyday, when you open up Facebook, your beliefs are constantly being reinforced, making it appear that everyone around you thinks the same way that you do. It is completely sheltering you from opposing thoughts and ideas. If you see opposing thoughts on your feed, it’s more likely than not due to the fact that someone with similar thoughts as yourself has commented on that post. This has caused severe problems in how we interact with the world, because when you only see your viewpoint everyday, you start to think that everything else is incorrect, when that very well may not be the case. It builds this unnecessary desire to defend your point of view; which are just thoughts that have been spoon fed to you by the Facebook bubble that you live in.

It fosters this hostile environment, one in which would not exist if you weren’t hiding behind a keyboard, interacting with “friends” that you have never even talked to in real life. You get more ballsy and start to say things to people that you wouldn’t say if you were face to face. It creates an online world that does not represent what is actually going on in the physical world. Everything is amplified. People start attacking grouped viewpoints instead of addressing individual issues. You no longer are forming your own opinions and you are simply using information gathered by your group without realizing that you’re lumping together multifactorial arguments. People start using “blanket statements.” I am literally doing it right now as I say “you,” assuming that every person reading this right now doesn’t agree with me.

Wanna know who fucking loves this? Politically biased news stations. Or as I like to call them… news stations. They will write headlines that don’t match the narrative of what actually happened in real life, feeding off of an already flawed Two Party System. They know that if they write, “Donald Trump says [insert literally anything here, good or bad],” then these groups of like-minded people will start to share it all over facebook and it will generate revenue. As long as the headline matches a specific point of view, it doesn’t matter what actually happened in real life. The mindset is just to get more ammunition, in the form of shares, to defeat the other “team.”

Wanna know who that helps? Absolutely no one except yourself. Your shares are not changing people’s mind and your shares are not solving real world problems. People are being pushed farther and farther apart every single day, when if you simply look at individual issues, I am confident that more people will agree on things rather than oppose them. People would much rather bash someone’s character, instead of research a contrasting point of view to see where they are coming from. And even worse, many people will bash other people’s character before they even research THEIR OWN point of view. This negative behavior is reinforced by the people in their bubble, so it seems acceptable.

Arguing in groups pushes people away rather than bringing people together to find commonalities and solutions. If we continue down this same path, a collapse in our country will inevitably happen. I genuinely believe that the world is a much better place than Facebook portrays it to be. If you just close your laptop and have coffee (and/or a beer) with someone who has different views than you, the hostility would not match what is being displayed on Facebook. 

Now I am not saying that problems DON’T exist in the physical world, because they do, and it would be ignorant to neglect that. What I am saying is that the media and Facebook are designed to silence positive news and amplify negativity, making it appear that the world we are living in is burning to the ground. Instead of sharing news based on the headlines, people need to take the time to research opposing arguments instead of “canceling” them so quickly. Deleting someone off of Facebook because you disagree with them only shrinks the bubble that your internet persona lives in. Instead of calling someone racist, educate them on your personal experiences. And instead of saying All Lives Matter, just like… literally say anything else. Too many people are fixated on riling up other groups instead of looking in the mirror and addressing their own flaws. 

There are people out there who are in the 1%, smoke marijuana, voted for Trump, believe that women should have the right to choose what they do with their body, want border security, and support the Black Lives Matter movement. You can’t just take one of those things and assume the rest of their beliefs based on the actions of group behavior. Good groups can be brought down by the actions of very few of its members… that’s why there are so many memes about how group projects suck. Sometimes people in a group differ in skills, ideas, faith, race, gender, and values. Lumping multifactorial things together only splits this country further apart and we never realize most of us are standing on common ground. 

Facebook grouped us together, reinforced our beliefs with misleading headlines, and made us believe the world is worse than it actually is. The media, perpetuated by Facebook, has valued monetary gain over bringing people together to solve legitimate problems, causing us to lose sight of all the good that is going on behind our computer screens. 95% of Facebook consists of fighting, when it should be about sharing dumb memes, pictures of puppies, and supporting the actions of people who do good in this world. I don’t know about you, but to me, that kind of sounds like the actions of… idk… the Devil.

@RyanLangdon_

Click Here for website dedicated to sharing only positive news

A WHITE PERSON’S PERSPECTIVE ON COPS

Cops exist to protect and serve the American people. They are thrown into underserved communities and have to deal with potentially fatal situations without knowing what could happen. Now, I understand how that can cause you to be frightful and force you to take certain measures to protect yourself, however the actions of Derek Chauvin were inexcusable, disgusting, and criminal.

While many people are trying to fight for equality, these actions not only further the racial disparity, but it builds more obstacles. When people like myself, and others who I associate myself with are searching for a common ground between all races, events like these destroy all progress that has been made over the years. And that’s not even the point. This is deeper than race, gender, or creed. This is about the absence of concern for a fellow human.

Who are Derek Chauvin and Tou Thao? Two Minneapolis police ...

The sad part about this situation is that it happens all the time. The system is just simply broken. I have friends that are police officers and they are great people. They were raised by great families and would NEVER do anything like this. However, this needs to be a profession where not even ONE evil person wears a badge. As the legendary Chris Rock once said, “American Airlines can’t be like, ‘yeah most of our pilots like to land, we just got a few bad apples that like to crash into mountains.'”

If killing 8 cells in a uterus is considered murder these days, then why is brutally taking a man’s life not classified as such? Just watch the video. He was begging for his life and DEREK CHAUVIN showed no concern. He is either a murderer or a moron, and either way he should have never been responsible with a gun and a badge in the first place. To even lack the basic knowledge that kneeling on someone’s neck will cut off the blood supply to their brain should be a crime in itself.

Maneuver police used on George Floyd largely banned in Minnesota ...

If a lawyer needs to spend nearly a decade in post high school education to understand just a SUBSPECIALTY of the law, then how is it possible for the people responsible for MAINTAINING those laws to understand them in less than a year of training? Clearly the whole process to become a cop is flawed. And I don’t have the answers to fix it. But it is something that needs to be brought to the attention of people much more powerful than me.

No matter what color your skin is, if you don’t feel sick to your stomach after watching the video of DEREK CHAUVIN brutally MURDERING George Floyd, then you are the problem. You are the wedge between improving the relations between whites and POC.

Saying, “Yeah but it happens to white people too,” is completely missing the entire point. By saying that, you are lacking any remorse for the lives lost in this civil war we are living in. Even if white people are being killed by cops too, clearly it isn’t a big enough issue, otherwise it would have been addressed a long time ago. Instead of trying to compare struggles, why don’t you try lifting up a group of humans who lost someone who was part of their community. We shouldn’t be suppressing the momentum of social growth, we should be taking our knees off of the necks of people who just want their voices to be heard.

Derek Chauvin, the police officer who knelt on George Floyd's neck ...

@RyanLangdon_

Some people have the inability to see faces, and it’s actually quite common.

Have you ever gone out into public, pre-quarantine, with the fear that you might recognize someone you know? No one on this planet wants to do small talk with that dude that sat behind you in geometry class in 2009, right!? Well, what if you had the inability to recognize them? There are people in this world who have a medical phenomenon called, “Prosopagnosia,” or more commonly referred to as, “Face Blindness.” These individuals lack the ability to recognize faces of even the most iconic people. And in some of the worst cases, they can’t even recognize their own face. Although this may be new information to you, this condition is actually quite common. Some studies report that 1 in 50 people have Face Blindness to some degree. 

If you have ever seen a tv show, and they blur out the faces of bystanders in the background, then you have experienced something similar to Face Blindness. The area in the brain responsible for analyzing faces as a whole does not work the way it’s supposed to, so every single time they interact with someone, they may not recognize who they are until they hear their voice. This area in the brain is called the fusiform gyrus, and it could be damaged from trauma, stroke, or infection. It can also just simply deteriorate over time. 

If you look at the picture to the left, it is kind of difficult to recognize who you are looking at. The brain has difficulty identifying the image because that is not how faces are normally processed in the brain. However, when it’s flipped, it becomes fairly obvious who we’re dealing with here. It’s not that they can’t recognize faces because they are blurry, as seen in vision disorders like Macular Degeneration. They just physically can’t process the image in their brain. While this condition is extremely fascinating, it can be quite detrimental to these individuals. 

People with this condition have reported feelings of anxiety, embarrassment, and social exclusion due to their diagnosis. People with a severe form of Prosopagnosia could be given a picture of themselves and not know who they are looking at. So, going out into public could create some awkward moments. If someone waves to you while you are at the grocery store, no matter how close, you may not know who they are. While at times I wish this was an excuse I could use to avoid social interactions, this can have great effect on forming meaningful relationships with new people. 

There isn’t a treatment for this condition either. The best way to deal with Face Blindness is to find coping mechanisms. For example, individuals with Face Blindness usually recognize people based on their hair style. While the face is unfamiliar to them, they still have the ability to process hair, or lack thereof. In an interview I watched, a person with Prosopagnosia was shown a picture of just a person’s face. Naturally, the subject did not recognize who it was. Little did they know, the face they were looking at was the person who was showing them the picture, sitting right in front of them. Im sure the majority of you could recognize at least 4 of these people, however, people with severe Prosopagnosia wouldn’t know any of them.

As I stated before, this is quite common. It appears to be a spectrum and some people can go their whole life without even knowing they have a mild form of this. But on the flip side, it can be extremely severe. Imagine going your whole life without ever knowing what your own face looks like to other people. The brain is an extremely complex organ and the more we study it, the more insight we will get on the behavior of our own species. 

@RyanLangdon_

Hydroxychloroquine has become less about the PATIENTS and more about the POLLS

I hold no political affiliation. I feel like it is important that I make that message clear before I begin. I think the far left and the far right are equally absurd and to choose one political agenda over the other, without even CONSIDERING that both sides can each have good ideas and bad ideas, is wildly closed minded to me. But that’s not the point of my message here. This is less about my affiliation with politics and more about my affiliation with the science community. It is something that I have chosen to dedicate my life to because I am attracted to its quest for the unbiased truth.

That being said, the way that politics has used Hydroxychloroquine as a campaign tool is sickening. Science will do their job with the drug. If it works, they will figure that out. If it doesn’t work, they will still figure that out. But the political community has skewed the minds of people who know literally nothing about science by publishing biased articles to support their own agenda. It went from being a drug that could potentially help save millions of people and it has turned into a tool to achieve political gain.

People are so brainwashed by politics, that people think it’s acceptable to talk like this to people who are greiving.

Honestly, the drug may work. The drug very well could be curing 100% of people, but we don’t have unbiased proof of that yet; things take time. All the stories about the drug are just reports from doctors tinkering around with their treatments on the fly. Coronavirus doesn’t have a definitive treatment plan because it’s a brand new mutation, so doctors on the front lines are being forced to experiment in the field. Hypothetically, a doctor gives Hydroxychloroquine to a patient and they get better. That doesn’t necessarily mean that it was solely the drug that made them recover. The majority of the people are getting better anyways, so who’s to say that the prayers that they have been sending aren’t curing them. I’m not saying either one is right, we just genuinely don’t have the controlled studies to support it. 

In no way do I think that doctors should stop using Hydroxychloroquine in clinical practice either, but science has and always will do their best to answer important questions. Arguing about it at the political level is only halting the momentum of the research because large media outlets on both sides of the political spectrum are pushing biased stories to help their case in this upcoming election. This medication is used for other health conditions like chronic Lupus and Rheumatoid Arthritis. It is used because it’s risks vs. benefits have been tested in clinical trials by people who have really big brains. So asking, “what do we have to lose?” completely neglects the fact that we could run out of the medicine and then the people who really need it, the ones it has actually been tested for, may not have access to it. So if this drug ends up being tested and it’s determined that it doesn’t work as well as other options, many people’s lives could be negatively affected by this political push to put all of our eggs in one basket. 

Like I said, I hold no political affiliation, and I am not rooting for whether the drug works or not, I just think we should all shut up about it, and let science do their job behind closed doors like it’s been doing for the last billion years. I am fearful that we are going to neglect potentially better options if we determine efficacy based strictly on empirical findings. 

I’m not trying to come across as a conspiracy theorist when I say this, but politics has brainwashed people into “choosing a side” on the drug rather than being open minded about exploring its true efficacy. That should never, EVER happen in science. You must remain unbiased and actually determine which side is correct so we can do what’s best for our PATIENTS and not for the POLLS. This doesn’t just go for Hydroxychloroquine either. At the end of the day, the patient should receive the therapy that is the most effective for their condition, rather than the drug that has the best marketing team. As my Pharmacology professor always says, “be Y.O.D.A.” You must always be Your Own Data Analyzer, and don’t just believe everything people say on the internet. Literally… question what I am saying to you. I am challenging you to research what I am saying. You may end up teaching me something.

@RyanLangdon_

Cliff Notes Of The Coronavirus (brief summary of the COVID-19 pandemic)

Everyday, thousands of articles regarding the coronavirus are being written. People are either downplaying the current situation or they are having a full blown panic attack inside their bomb shelter, sitting on a throne of toilet paper they have stockpiled. Regardless, I think it is important to understand exactly what is going on here. So, I have decided to trace this virus and give people an overall big picture of how COVID-19 is affecting the world and my toilet paperless bathroom. 

Before we discuss COVID-19, I think it is important to understand how novel viruses begin. Many of these new viruses are what we call, “Zoonotic Diseases,” meaning that they jump from animals to humans. One of the most infamous zoonotic diseases is the Human Immunodeficiency Virus (HIV). The first reported case was in 1959, when a man in Congo reportedly contracted HIV from a chimpanzee. Clearly the destruction of HIV is devastating, therefore taking zoonotic diseases lightly is simply the wrong way to go about this. Now, on the flip side, most novel viruses infect a few people at most and then fizzle out. Unfortunately, if it is highly contagious and picks up steam, it is extraordinarily difficult to stop it. 

The first case of COVID-19 can be traced back to November 17th, when a man in Wuhan, China likely contracted the disease from a bat. This is when the first major mistake came in. China originally thought that the virus could only be contracted from bat to human. They failed to recognize that human to human transmission was even an option at the time. Knowing what we know now, I think that China would have handled the situation a little differently. Unfortunately they did not, and the virus began to spread in similar ways as the Influenza virus. The city of Wuhan, China has a population of over 11 million people. Let me repeat that…. ELEVEN MILLION PEOPLE. They are all crammed in one city, therefore human interactions happen quite frequently. 

China still was in denial about the severity of the coronavirus, so the spread of it lost control. Some news sources even noted that China tried to hide the spread of the disease for quite some time before it became too big of an issue. The ability to fly from one continent to the next is an incredible tool for our society, however in situations like this, it can perpetuate the spread of infectious diseases. On January 19, 2020, the first case of coronavirus hit the United States. It was a 35 year old man who presented to the hospital with respiratory symptoms and fever. When asked if he had any recent travel, he reported “Wuhan, China.” From there, the outbreak in Washington began. 

The scariest part about the transmission of infectious diseases is that you can pass along the virus to people without even knowing you have it. According to Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH, it can take up to 5.4 days to develop symptoms from the onset of your exposure. So, if you come in contact with the virus on Monday, it is likely that you will not develop the cough or fever until Saturday. Therefore, every single person you come in contact with could likely contract COVID-19. If you are one of the people that are not taking the social distancing seriously because you are asymptomatic, you could potentially be the reason behind countless transmissions. And for some people, they could be carrying the disease and never even develop any of the symptoms. 

Originally, I admittedly was not very concerned. But the more research I did, the more concerned I became. It wasn’t until I saw what was going on in Italy until my concern level rose. There are so many cases right now that they literally do not have enough space in hospitals to treat some of them. Therefore, they are being forced to choose who gets treated or not based on moral principle. If you are younger or have children, your life would most likely be spared over someone else’s. Even healthcare workers are getting sick and are being forced to continue to work. If that happens in the United States, we are literally fucked. 

The precautions being taken may seem dramatic to many, however it is necessary. If we continue to let this virus spread and fail to follow the protocol set in place by people much smarter than you and me, then we could end up in the same situation as the Italians. This article is not meant to scare anyone, it is simply just stating facts. 

This is the trajectory of the cases in the United States. It is a scary thing to look at because it does not appear to be slowing down at all. I’m less worried about the severity of the disease itself, and more worried about overwhelming ICU’s, which can lead to many more deaths. We all need to do our part in slowing down the virus, because it can (and most likely will) become a much bigger problem than it is today. Lay down, catch up on Netflix, and help reduce the transmission while the experts work on the vaccine to help our nation reduce the spread even further. 

@RyanLangdon_

How My Internal Monologue Affects My Attention Deficit Disorder

My name is Ryan Langdon and I accidently blew the minds of over 10 million people this week. It has been a wild experience. I have received thousands of messages from all types of people. I have received interview invites, messages from celebrities, and even had a little filipino man photoshop himself into pictures with me. I have heard input from a lot of you, however I feel like you guys do not know where I stand on this situation. It appears to me that having an internal monologue is a spectrum. There are some people that do not have it, which I have decided to call “hyponeurovocalism.” In contrast, there are people who have a strong internal monologue, aka “hyperneurovocalism.”

I was diagnosed and treated for Attention Deficit Disorder (ADD) in 2009. After this whole post blew up I realized that my inability to focus in school was caused by the inability to control my inner monologue. I could be sitting in class, trying my best to focus on what the teacher is saying, but my monologue just drifts off and I lose focus on what is being lectured. After speaking with a few people who are hyponeurovocal, I realized that they report that they do not daydream often (I know it is a small sample size). Therefore, I believe that the cause of ADD is directly related to the internal monologue. 

When it comes to ADD, no one ever talks about what goes on in their head. It is a common stereotype that individuals with Attention Deficit Disorder are distracted by shiny things, but that’s not the case at all. It’s a much more subtle thing in my experience. People only talk about what medications they are on, rather than how the disorder actually manifests inside their head. Most conversations go a little something like this:

“I have ADD”

“Me too.”

“Adderall or Vyvanse?”

“Concerta.”

“I heard Concerta sucks”

“It works for me.”

No one ever explains that no matter how hard you try to focus on something, that internal monologue will take you into a different world. There are many physicians who still do not believe that ADD is a real medical diagnosis. However, as someone that has spoken with many people on this subject and has studied medicine, I would have to respectfully disagree. 

ADD is not correlated with IQ level, rather, it is a problem with controlling that inner voice. I can drift off into another world in the blink of an eye, until I snap back to reality by the sound of my entire class typing notes. “Oh shit, I must have missed something important,” is something I have said inside of my mind many times before. If I do not take my medication, I can not read more than two sentences without my internal monologue shifting gears and talking about something unrelated. If I am reading a book, my internal monologue could be vocalizing the words, but then it can slowly transition into an entirely different topic. Although my eyes are scanning the page still, I will absorb absolutely nothing and have to restart from the point I lost focus. It is exhausting and frustrating, because as much as I want to remain attentive to the words on the page, I can not keep my thoughts anchored to a particular subject. 

My entire life, most of my learning came from outside the classroom. It takes a lot more work than people realize to teach yourself everything. I hardly absorb any information in class, therefore studying requires much more time for me. People are jealous that I have adderall, but all it does is even the playing field. I’m sure it gives hyponeurovocal people a strong advantage, however all it does is allow me to focus for more than 7 seconds without daydreaming about different scenarios in which I am saving my entire class from a masked gunman. 

I am not sure if this is how everyone else with ADD operates, however I have a strong suspicion that their experience is very similar to mine. If that is the case, then this whole inner monologue news may be a helpful screening tool in diagnosing Attention Deficit Disorder. It is a wildly misdiagnosed/undiagnosed condition. So understanding exactly what is going on inside of people’s heads could lead to a more accurate way to treat the individuals with this problem while simultaneously avoiding overdiagnosing and over treating patients who do not fit the criteria. I would like to hear how other people with ADD relate to my experience.

@RyanLangdon_