Readers and Tweeters Connect the Dots on Topics From Vaccine Development to Long Covid

Letters to the Editor is a periodic feature. We welcome all comments and will publish a selection. We edit for length and clarity and require full names.

A Concerned Taxpayer Takes Stock of Vaccine Efforts

Your recent article “Novavax’s Effort to Vaccinate the World, From Zero to Not Quite Warp Speed” (July 19) seems to reveal Maryland-based Novavax as a corporation that is misusing a vast amount of taxpayers’ money so its CEO (and other officers) can make a killing selling stocks.

Novavax has contracted with many foreign countries (Spain, India and Japan, etc.) to produce vaccines (or components) meant to treat world populations in need of a means to arrest the widespread scourge of covid-19. Your article mentions how little yield of product has followed, given the financial investments made.

I find it particularly disturbing that some of Novavax’s corporate officers are benefiting by selling large blocks of stocks. In fact, I find it to be unconscionable, given the many who have died for lack of a remedy that has gone unfulfilled and, in this case, an initiative that’s overfunded.

I wish you would transmit your article to each and every member of Congress, in the hope that those who can will investigate how the funds doled out in the name of “Operation Warp Speed” are being misused, and unaccounted for.

— Carl Anderson, Baltimore

Novavax is a great vaccine, but this article shows how hard it is for a company to become a mass-vaccine producer starting from a base of zero.

— Dr Helen MacLean (@DrHMacLean) July 19, 2021

Waiting in Vain for a Novavax Vaccine?

Thank you for the article on Novavax (“Novavax’s Effort to Vaccinate the World, From Zero to Not Quite Warp Speed,” July 19). I have been searching the web regularly to find new information on this vaccine and when it might become available; most days I come up with nothing new. Your article was thorough and informative and, although I do take exception to your statement that “America is awash with vaccine options,” the information provided was very enlightening.

Many people are wary of the mRNA vaccine technology, and Johnson & Johnson hasn’t turned out to be an optimal choice, due to side effects (albeit rare) and lower efficacy. My own humble opinion is that Novavax could be of significant interest to unvaccinated Americans, depending on how the accompanying narrative is presented (e.g., tried-and-true traditional technology). Now that we have a rising surge once again in covid-19, it seems like an optimal time to introduce another vaccine option for Americans, but based on your excellent reporting, it sounds like it may not be Novavax.

— Holly King, Indianapolis

I would say this is to deter people from going to the ER for any kind of pain. I will never go to one again. I will not pay someone to be cruel to me. I can suffer better at home than in a cold, cruel ER.

— Kat Melcher? (@KatMelcher) June 29, 2021

— Kat Melcher, San Antonio

A World of Difference

Your most recent Bill of the Month story (“A Hospital Charged $722.50 to Push Medicine Through an IV. Twice,” June 28) got me thinking about when I had to go to the hospital for almost the exact same thing. Similar to Claire Lang-Ree, I was a college student and found myself doubled over due to sudden and exceptionally severe pain in the lower right side of my abdomen. I passed out from the pain, and every time I regained consciousness, I couldn’t speak and would just throw up from hurting so bad. My mom called an ambulance, and I was rushed to the hospital. While at the ER, I received an abdominal ultrasound, but the tech couldn’t find my appendix (which is apparently normal and just happens sometimes), so they ordered an abdominal CT. The CT came back normal and ruled out appendicitis, so they decided to keep me overnight for observation. At that point, my doctors began to think the issue was gynecological. I did OK overnight, and my doctors had deduced it was likely an ovarian cyst rupture that caused the pain. My blood work was normal the next morning, so my doctors allowed me to be discharged. The total cost? Less than $500 before insurance.

The major difference between my and Claire’s experiences was that I was on vacation in Budapest, Hungary, when this happened. Hungary has a public health care system. My private health insurance even ended up reimbursing us for the cost since it covered emergency visits overseas. While Hungary’s public health care system also has its problems, excessive cost to patients isn’t one of them. I can’t imagine having gone through that and then being slapped with a five-figure medical bill.

Sudden and severe medical emergencies are scary enough. The threat of going bankrupt for seeking treatment for them just puts salt in the wound. It doesn’t have to be like this. I’m glad you’re teaching Americans how to advocate for themselves against illogical and/or erroneous billing. Keep up the good work.

— Erin Bartels, Little Rock, Arkansas

A 20k bill for burst ovarian cyst ? come ON. $722 drug in question normally costs as much as a Coke.

— Jane Aldridge (@sea_of_shoes) June 30, 2021

Where’s the ‘Fun’ in That?

I’m a retired federal employee with GEHA (Aetna) insurance. I think the tone of your recent article about overcharging in the emergency room system at Penrose Hospital in Colorado Springs (“A Hospital Charged $722.50 to Push Medicine Through an IV. Twice.” June 28) was downright offensive: “Finally, make it fun. Claire and Jen made bill-fighting their mother-daughter hobby for the winter. They recommend pretzel chips and cocktails to boost the mood.”

Fun? Really?! Trying to get justice from our broken health care system, with Big Pharma and big hospital systems raking in money while ordinary people have no recourse on outrageous bills is fun?! Shame on you.

— Dr. Evelyn Hutt, Denver

“Finally, make it fun. Claire and Jen made bill-fighting their mother-daughter hobby for the winter.”The problem is, when you or a family member is sick, it’s often difficult to impossible to find the time or energy for bill-fighting, let alone a hobby.

— Dania Palanker (@DaniaPal) June 28, 2021

I’m surprised there’s no mention of rules based triage. At UW I know that, regardless of overt symptoms, people who are involved in a car accident > a certain speed are automatically trauma’d. Even if they walk in to the hospital after the wreck.

— Joe Lalli (@JollyJoeLalli) July 16, 2021

When I was working at a hospital, we pushed strongly for a statewide “Trauma Board” to help manage the proliferation and management of trauma-related services. Why?More trauma centers = more expense, worse outcomes.And now:

— Loren Anthes (@lorenanthes) July 19, 2021

Another insurance company/hospital billing nightmare to be aware of. Think the worthwhile care trauma centers deliver is only possible in a US-style model where bad billing behavior is incentivized? Not so. The UK NHS has 27 and patients don’t pay extra.

— David Meuse (@JdmMeuse) July 16, 2021

Follow the Montana Money Trail

I just read the article by Andrea Halland regarding the new private medical colleges proposed in Montana (“Influx of Medical School Students Could Overwhelm Montana Resources, Program Leaders Warn,” July 15). The article was very informative except for one glaring omission: How much? When one of our local hospitals stepped out in an uncharacteristic way against the private new facility, my first reaction was “OMG, there must be a lot of money at stake here.” Follow the money trail, and yet Ms. Halland didn’t.

There is no problem confronting the training of more physicians that the private market wouldn’t correct, if it is allowed to work. We face the shortages and problems we do now because there has not been a free market in medicine in a very long time. In fact, one could make the same claim about our public education system, which functions with the same kind of authoritative mindset.

Step back and get out of the way and watch great things happen if improvements are truly what are sought … but if everyone is just stuffing their pockets and asserting political power, it would be great if those reporting on it would at least be honest about it.

— Evelyn Pyburn, Billings, Montana

A valuable opportunity to care for the people of Montana close to home.

— Amir Bastawrous, MD, MBA (@amirbastawrous) July 15, 2021

A Long Shot on Long-Haulers

I read the article “Little-Known Illnesses Turning Up in Covid Long-Haulers” (June 1) by Cindy Loose and noticed the mention of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Based on my reading, I think it’s plausible that the long-haulers’ problems are caused by the immune system in this way: Impurities in previous vaccines allow retroviruses to enter immune cells and stay in the DNA. When the immune system is triggered, these retroviruses may be released and do damage. Dr. Judy Mikovits in her books “Plague” and “Plague of Corruption” discusses this. For example, retrovirus XMRV causes ME/CFS. Younger people are more susceptible because they have had more vaccines. I am not a medical doctor, but I read a lot.

— Art Gittleman, Huntington Beach, California

Patients have different worldviews and very simply put believe they find help either from medical system ie doctors, science, alternative therapies or in belief of illness as means for growth. When docs and patients have different worldviews problems begin.

— Tuula Saarela (@ba_tuulasaarela) June 2, 2021

Connecting the Dots on POTS

I read the article on the side effects that show up months after a covid-19 diagnosis (“Little-Known Illnesses Turning Up in Covid Long-Haulers,” June 1). This struck a chord with me because my husband has been dealing with some strange issues for the past several months that we have just now started to determine may be postural orthostatic tachycardia syndrome (POTS), which was discussed in the article. He was seriously ill two months before covid made its appearance in the U.S. and went to the doctor several times. The doctor repeatedly tested him for the flu; the results were always negative and they would send him back home with instructions to rest and drink fluids and let it run its course.

We believe he had a case of covid and it wasn’t known yet. He has had several new health issues come up in the year since — the most serious being a paralyzed diaphragm on one side. Now we are dealing with a possible POTS diagnosis.

I hope more doctors see what is happening and start making more of a connection between the two. We live in Kentucky and know how few specialists there are who treat POTS but are hopeful that a diagnosis and treatment will not be far off.

— Melanie Marville, Louisville

#pwME know all about this. Hopefully ME/CFS will now be recognized as a real issue and treatment will be available soon.

— Sabine Dreher (@sabine_dreher) June 1, 2021

— Sabine Dreher, Toronto

On Opioid Addiction: A Success Story

Even as many roadblocks and red tape are being removed so that more physicians can qualify to prescribe buprenorphine, I read this sad story of this young man needlessly dying of an overdose (“How ERs Fail Patients With Addiction: One Patient’s Tragic Death,” July 15). He clearly was not given urgent access to recovery that included the immediate administration of buprenorphine or he would still be here today and his parents would not have this permanent hole in their lives. Buprenorphine is that magical a drug, but it’s frustrating it remains somewhat difficult to acquire through a physician and/or pharmacy.

During the 1990s until 2004, my once-disciplined self changed to acting unstable and erratic at work, my marriage failed, and I periodically acted out irresponsibly — all due to the misuse of prescription pain pills. Having had rheumatoid arthritis (RA) since age 7 (in my 50s now), I had managed my pain well with over-the-counter pain medicines. (Briefly, I’m a white middle-class college-grad male, now on disability due to the unpredictability and ravages of the disease of RA.) However, for almost a decade and a half beginning in the early 1990s, my rheumatologists and pain management doctors routinely bombarded me with OxyContin, oxycodone, Vicoprofen, Norco and other narcotic opioid pain medicines. The number of narcotic pain pills I was prescribed to take daily was staggering. I quickly became addicted.

Upon recognizing my problem and after several unsuccessful attempts through Narcotics Anonymous and going cold turkey, I sought out an inpatient detox facility in the winter of 2003-04 at the urging of friends and family. I checked into the same facility twice within a few months for opioid recovery. At this time, it was early in opioid addiction recovery in medical settings; likewise, the physicians assigned to my group actually gave me Ultram (generic tramadol) for my RA pain, now a known opioid! No surprise that my attempts of recovery at the detox facility failed to keep me from abusing pain meds upon returning home … until, in 2004, an RN with my employer’s health insurance passionately recommended I see a doctor in my city who was one of only a few addiction treatment physicians nationwide allowed to prescribe a then-new drug for opioid addiction treatment: Subutex (generic buprenorphine).

Buprenorphine eliminates opioid cravings with no withdrawal side effects associated with the cessation of narcotic pain pills … all with none of the addictive euphoric effects synonymous with narcotic opioids. Within a matter of minutes of taking my first dose, I woke up from my 15-year slumber of addiction. Quite simply, buprenorphine is an immediate on-ramp to sobriety for opioid addicts with the desire to quit. I’ve been on a daily dose to this day and, although my RA is trying to take me out (I’ve since had both shoulders and both hips replaced and both wrists reconstructed), I live a normal, clear-headed healthy life with my wife while being in the best shape of my life; following surgeries with prescribed pain meds for the brief recovery process, I easily remained clean and sober with most of the pain pills left unused and properly disposed. (A side benefit of buprenorphine is that it was originally meant to fight pain, so the benefits for me are twofold.)

Every ER should give buprenorphine to all opioid abusers while occupying their beds. It works within minutes once the patient is in partial withdrawal; then the ER sends the patient directly to a doctor to treat their addiction. Buprenorphine saves lives. It saved mine.

— William Ward, Enid, Oklahoma

Agree. “How ERs fail” = “How medicine fails” = “How society fails”This poor young man died 3 months after an ER visit.

— ?????? ??????, ?? (@grahamwalker) July 18, 2021