Corona Chronicle 3 – An Urgent Modest Proposal

As we perhaps gain a new government, it is time to take stock of our handling of the Corona crisis, and regroup medically, emotionally, economically and multiculturally. I don’t tend to use this, but my credentials are open for all to see. I am a triple-boarded physician – pediatrics, psychiatry and child psychiatry. I am an independent-thinking physician for what that is worth.

Medical:

I propose that the Health Ministry appoint an infectious disease expert independent of Big-Pharma to make medical decisions. This physician could meet with a representative of the Treasury and the Sick Funds, but his medical decisions will be final. I can think of two such best-trained and thoroughly honest physicians in Jerusalem off the top of my head. The Corona crisis will be managed only by those up until now not involved in decision making. No point in prolonging a failure.

I propose that we adopt immediately the protocol developed by Dr. Zelenko. This involves early treatment with hydroxychloroquine, azithromycin and zinc.

The protocol has at least a moderate chance of reducing morbidity and mortality. It is the morbidity and its potential to overwhelm a plundered health system that endangers us the most. The protocol is practical, inexpensive and virtually risk free. From the point of view of risk/benefit at a time of an unprecedented health crisis, it is close to a no-brainer. It is based upon high-standard basic research which I have collected for anyone who wants to try reading it. It competes with dire threats about dying without a respirator and coffins. Aside from annoying academics because it is not yet “evidence based” I do not see a downside that justifies withholding potentialy life saving treatment. Maybe azithromycin resistance? Maybe…

Adopting the protocol involves several steps:

  1. Directing our highly developed pharmaceutical producers to mass produce these drugs and sell them to the Sick Funds at cost +10% (I would like 5%). Pharma can always be compensated with tax breaks.
  2. Reorganize family physicians to supply early treatment.
  3. Hydroxycholroquine is one of the only drugs useful in treating a not-so-rare and highly debilitating chronic autoimmune disease called Lupus. I know of one woman who reports that she is being denied this drug as it is being sequestered for possible corona treatment. This is unconscionable. We should be capable of producing rather than taking it away from those who need it.
  4. It is generally understood that 30% of the elderly population are zinc deficient. If we are really caring for this population, why not subsidize zinc supplements (25-50 mg per day) for anyone over 60 or with risk factors? That is what I have chosen to do. Again, mass production and Sick Fund provision. I personally recommend this to our now quarantined PM.
  5. Decisions about lockdown will be made weekly, not daily, and then reassessed honestly. Real case increases as opposed to fake numbers based on changing numbers of testing. Easily available report of what exactly current rules are.

Emotional:

The two most useful and least harmful agents that could help children and adults through this stressful time are overly restricted in Israel with no medical justification.

St John’s Wort has been restricted in Israel since 2000 when the Health Ministry arbitrarily removed it from OTC use based on a US study that did not impress the FDA. Currently only one form is available which is hard to use, restricted from children and contains hypericin but not hyperforin and therefore has only partial effect. I use it all the time but have to have folks order from abroad. This is unconscionable in times like this – as it has been all along for example for the populations bordering Gaza. Time to stop this nonsense and allow all forms of hypericum freely for use in children and adults. Women relying on oral contraceptives and patients on coumadin and a few other drugs need be cautious. Is that a reason to deny an entire population an OTC option for anxiety?

Cannabis – both THC and CBC- have been used for ages at times of stress. It may even have antiviral activity. Now is the time for legalization, just like that. It is unconscionable that at a time of crisis any government restrict free access including home growing for such a useful and nearly harmless agent. One person can deschedule it and we are done. That is the only responsible act at this time. Medical Cannabis needs to be revamped on the German model – provided free by the Sick Funds for medical use.

The Corona physician I proposed above should appoint a spokesperson with media abilities to communicate with our population. Absolutely NO politicians allowed. AT least some responsible thought has to be given to the effect of the current abysmal form of communicating that creates more fear than information. Enough. Cancel the nightly Netanyahu show. The spokesperson can lead the media and the Sick Funds in a campaign that assists people rather than infantilizing and threatening.

Economic

I am not the first to criticize the government’s outlier – cheap- economic program. Here I have a few thoughts.

Lots of people hold real estate as an investment. They need the rent to pay mortgages and property taxes. It should be feasible to suspend rent – personal and commercial – for 2 months and at the same time freeze mortgage payments and suspend property taxes.

Independent workers in Israel are an endangered species. I was one for three and a half decades. I survived by very low investments and costs and absolutely no loans. But few businesses are like a private practice in child and family psychiatry. Small businesses need definitive tax breaks (taxing is 50% so that is very substantial) especially those with low income who live at the border of bankruptcy. Loan payments especially need to be frozen.

Multicultural:

Social distancing is prescribed by upper middle class people with adequate space and small families. How about people with a lot less living space and a lot more kids? And cultures that are not “distanced” from the get-go? Current policy and media need to provide a multicultural forum that allows dialogue between different populations so that “social distancing” is understood within each culture. Otherwise we are heading for cheap “Haredi-bashing” generalizations, and of course the ever present demonizing of our Palestinian population. Such discussions would be a whole lot more interesting that the way the media is presenting over and over again the dire threats of the government.

I offer these thoughts as a basis for discussion. A new government is an opportunity to rethink from top to bottom. And the old government could afford to do some rethinking now no less.

About the Author
Alan Flashman was born in Foxborough, MA, and gained his BA from Columbia, MD from NYU, Pediatrics, Adult and Child Psychiatry specialties at Albert Einstein College of Medicine, The Bronx, NY. He has practiced in Beer Sheba since 1983, and taught mental health at Hebrew University, Tel Aviv University and Ben Gurion University. He is currently CEO of Family Instiute of Neve Yerushalyim, sponsoring a first fully accredited post-masters training in family therapy for the Haredi community. Alan has edited readers on Therapeutic Communication with Children (2002) and Adolescents (2005) in Hebrew, translated Buber's I and Thou anew into Hebrew, and authored Losing It, an autobiography, and From Protection to Passover.
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