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COVID-19: Applying the HIV Mathematical Model

The COVID-19 pandemic has made me think that we should think back to a prior mathematical model purposed regarding HIV. In that mathematical model, the finding was that if we tested and treated everyone with HIV infection that we could stop the epidemic. The theory is that by rapidly dropping HIV viral load in the infected we could prevent transmission and new infections. At the present time could we not consider the same for COVID-19? We are poised to be able to test the population for acute infection with a point of care rapid assay. We have a candidate approved drug Hydroxychloroquine with which we could treat the infected and drive down viral load in attempt to decrease transmission. In addition we could test citizens for immunity/ past infection with COVID-19 by serology and send them back to work. I will leave this for you to consider ------------------------------ Steven LaRosa MD Infectious Disease Physician South Hamilton MA ------------------------------
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“Weaponization of the EMR and HIPAA Against Physicians” by Steven P. LaRosa, M.D.

As a consequence of the Affordable Care Act hospitals were required to implement an electronic medical record (EMR) in the care of patients. These EMRs that we use are largely designed to code and bill but we are completely dependent on them to get the necessary data on patients to care for them. Employed physicians willingly sign on to use these EMRs and undergo the necessary training to use them effectively. What we don’t realize when we sign on is that every key stroke, medical record and tab is being prospectively audited behind the scenes. The reason this is being done is to protect the privacy of patients as outlined by the HIPAA (Health Insurance Portability and Accountability Act of 1996). This is a noble pursuit as whom amongst us wants sensitive information about us accessed by someone who is not caring for us and who could destroy our personal lives or careers with the information obtained. The trouble with the EMR auditing for HIPAA is that it flies in the face of how ...
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"Testing Strategies Against Lyme Persisters" by Steven LaRosa, MD

Recently I was contacted and interviewed by a party to get my feelings about the state of treatment of Lyme disease. On the phone we lamented about the sizable number of poor souls who continue to suffer symptoms after what is considered standard of care treatment. I made it clear to the interviewer that I practice only evidence-based medicine and that I treat patients based upon the IDSA guidelines. I also railed against physicians who treat patients with months of parenteral antibiotic therapy for “Chronic Limes’ Disease” (ha ha). I stated fairly aggressive and believe that such practices opens the patient to life threatening infections including catheter-related bacteremia and Clostridium difficile colitis. After I got off the phone I started to do some soul searching. I have gotten so used to saying the same lines over and over again, but when was the last time that I actually had looked at the literature? The answer obviously was way too long ago. I was able to identify 5 cli...
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