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John Livingston

Truth and Consequences

Audrey Dutton is one of Idaho’s most talented and exceptional reporters. In an article in the Idaho Capital Sun dated May 5th 0430 she gives Dr. Ryan Cole and his company a journalistic autopsy (or was it a colonoscopy) that I am sure will win awards and accolades. I have seldom agreed with Ms. Sutton’s positions on medical and public health issues and her most current dissection using her talents and commanding control of creating a narrative are impressive though steeped in supposition. I wish she would use her skills and talents in a similar fashion to expose the corruption and waste that has occurred throughout our State as the symbiotic, crony, corruption between government agencies and private contractors has caused far more damage to patients and taxpayers than any of Dr. Cole’s alleged activities.

I have met Dr. Cole three times. I have agreed with him almost 80% of the time. Our biggest difference has been regarding my feelings about vaccinations. Me and my family are all vaxxed and boosted mostly because my daughter in law came down with diffuse histiocytic lymphoma and required chemotherapy and a splenectomy in the middle of the pandemic. She is the very definition of an immune compromised host, so the risk-reward calculation changed for me and my family. I wondered why public health specialists, members of advisory and health boards, hospital administrators and members of hospital boards were given a higher priority early on regarding vaccinations than people who were immune compromised like my daughter in law, or high-risk groups like the elderly. Maybe that is something Ms. Dutton could dissect. I have been a big supporter of Dr. Hahn and how she has functioned. Her experience as a clinician and as a public health specialist are to be respected, just like Dr. Cole’s expertise should be respected. Both had credible voices in the debate. I never agreed with both all of the time. My arguments early on were that in the history of modern medicine we have never been able to contain an airborne upper respiratory tract virus.

That the only virus modern medicine has been able to completely eradicate with vaccinations was smallpox (Dr. Fauci finally made that assertion two weeks ago in an interview with CNN). I argued during the initial surge that only N-95 masks properly worn were effective in protecting those wearing the mask and those around them from transmission or infection with the virus(The CDC just admitted to that 4 weeks ago) I argued that natural immunity was better than vaccination. I argued for type 3 mitigation strategies—isolating the at risk, those with comorbid conditions and the elderly and letting anyone else define and mitigate how they and their families should negotiate their own individual risks was the most efficacious method of controlling the virus.

I argued that social distancing would have little impact on transmission or infection rates (a study from John’s Hopkins last month proved zero correlation between social distancing and infection and transmission). I argued several months ago that one of the biggest lessons to be learned from the pandemic is how unhealthy our population is in the United States. Obesity rates were at an all-time high prior to the pandemic and today they are higher—the average adult it is estimated gained 15lbs during the pandemic. Start exercising and stop eating America if you want to mitigate risk in future pandemics. Stop smoking, drink in moderation and don’t use drugs. All will be more important in my humble professional opinion to a person’s individual health than a mask or isolating

Pathologist typically don’t practice clinical medicine, but their Idaho license allows them to do so. I know many pathologists who are still practicing that used their clinical skills at the St. John’s Free Clinic in Boise and the Pocatello free clinic. Nobody questioned their ability to practice clinical medicine and one pathologist asked for an opinion from the State Board of Medicine prior to donating his services and received a “go ahead” I know of two pathologists who have used their Idaho license to practice serving medical missions. How many pathologists in Idaho have written prescriptions over the past 2 years?

I have felt that self-referral from clinician to pharmacy or laboratory walks a very fine conflict of interest line. I feel the same way about an advisor sitting on a public health board or on the Governor’s Advisory Board who represents the special interest of a lobbyist or industry that benefits from decisions that they make on the committee. What about when a representative from an agency of government who is responsible for regulating and transferring funds to providers sits on the same board with representatives of those same providers? Corruption does not have to be illegal to cause great damage.

Issues regarding the purchase and use of laboratory equipment are beyond my level of expertise. I do believe the “cycle threshold” for the PCR test is worthy of my comment. Very early on credible scientists including Dr. Jay Bhattacharya and Scott Atlas from Stanford and Dr. Marty Makary from John’s Hopkin’s and members of The Barrington Declaration have expressed concerns about the threshold level of testing. The greater the number of cycles—especially beyond 30-35, the greater the number of false positives. The question never answered about this issue is —how many people are symptomatic, hospitalized or died, that required testing beyond 35 cycles? Were we so concerned about positive tests that we forgot about the clinical disease? A situation I warned about in one of my earliest articles.

One of my biggest concerns even prior to the pandemic has centered on the integrity of the medical and scientific communities when publishing in scientific journals. The quality and validity of scientific investigation has deteriorated over the past twenty years. Scientists using the imprimatur of a respected scientific journal—think about retracted articles in The New England Journal of Medicine and Lancet during the pandemic, or a publication of a government agency—Centers for Disease Control (CDC) or National Institute of Health (NIH) have been less than transparent in reporting their findings both at the State and National levels. I personally know of two high ranking government officials who share my concerns. I asked one if I could use his name in public and he said absolutely not. “If we admitted to what happened in the heat of battle many people would go to jail”. For those two individuals, transparency, and the use and abuse of emergency orders at the Federal and State levels were their biggest concerns. The inability to allocate scarce resources and the abuse of accounting for government funds to providers and agencies was a close second. 

Ms. Dutton did a very good job of documenting her case and concerns. Dr. Cole as a physician and CEO of a company is more than capable of defending himself. When applying a ‘Standard of Care” or” Standard of Medical Practice” defense I believe a good Idaho Attorney will find it not hard to defend him. Straddling a fine line between conflict of interest, off label use of drugs, the use of telemedicine, were everyday occurrences during and before the pandemic. The medical community needs to take a second look at these issues. They need to apply not the “Dutton standard” across the board to all providers, but a medical ethical standard to all providers.

If Ms. Dutton wanted to make a real contribution and win bigger awards she would take a deep dive into the crony, collusive, corruptive processes that have become more visible because of the pandemic. She should report using the same accounting and auditing methods that she used for Dr. Cole’s practice. Holding large hospital providers, private labs set up just for Covid Testing and even government agencies accountable are all worthy of investigation.

The truth may not support a political narrative. It will be interesting to see if Ms. Dutton is more interested in the truth or the narrative. How she chooses to proceed will tell us a lot about her motives and prejudices.

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