June 24, 2020
Dear Texas Physicians, especially primary care, urgent care and nursing home doctors,
When the COVID 19 pandemic hit the U.S.A., we stopped in our tracks, shut down our O.R.s, closed our clinics, and even gated our hospitals to all but urgent or emergency patients in response to Governor Abbott’s Executive Order GA-09. At that point in time, we had very few COVID cases, hospitalizations, or deaths in Texas. We took these drastic steps to “flatten the curve.” The situation was assessed, and supplies such a PPE, ventilators, and money were shifted to areas of our county hit hardest, particularly New York City- a city like no other, that was unprepared and about to be overwhelmed.
According to my local San Antonio news (KENS 5 Staff (KENS 5) Published: 10:23 PMCDT March 17, 2020 Updated: 10:20 PM CDT March 30, 2020), there had been at least 212 known cases of coronavirus in Texas and five reported deaths from COVID-19 as of March 20. In stark contrast, New York Governor Andrew Cuomo issued an emergency order directing hospitals to increase their capacity by 50% as coronavirus cases across New York surged to 20,875, as of March 23, 2020. As New York’s COVID wave hit like a tsunami, ours was still barely a sprinkle, but we shut down for them and to prepare for our impending surge.
So here we are now, 3 months later, riding the Texas surge of the COVID wave, which has been purportedly “flattened” by varying orders from each of the fifty states’ Governors. We are all familiar with the intervening crises and consequences of our actions of the past 3 months. What have we learned? Will we repeat mistakes of the past, or will we use experience to save Texas lives? How will others respond and help us in return? A lot will depend on us, and we need to step up and lead. Politicians and media have proven they are not epidemiologists, statisticians, or physicians, and even their best intentions have impeded best possible outcomes.
As physicians, we must constantly do our homework. Most of us started studying COVID 19 in January or earlier. In the interim, we have seen our ability to treat our patients and the patient relationship itself interfered with and restricted in unconstitutional ways that have harmed our patients. We have seen major scientific journals, studies, and organizations engage in intellectual dishonesty resulting in retraction of articles from Lancet and NEJM and studies being stopped and restarted worldwide based on such scientific fraud. We witnessed flawed study designs result in severely ill patients receiving toxic and potentially lethal doses of drugs. We sat by as New York kept medications from the national stockpile from being available to outpatients, hoarding and hiding behind manipulative FDA-generated restrictions, possibly driven by conflicts of interest and political motives. We watched governors send COVID-positive nursing home patients back to their nursing homes only to infect others and then die with no choice to be treated. On the other hand, we saw ingenious, boots on the ground, true physicians use what is immediately accessible to actually save lives. Dr. Robin Armstrong’s treatment of his nursing home patients and staff in Galveston, Texas stands in stark contrast to Governor Cuomo’s treatment of nursing home patients in New York. And Dr. Vladimir Zelenko’s use of hydroxychloroquine to care for his outpatients in New York stands in stark contrast to the way it was misused for inpatients on Governor Cuomo’s watch.
I fear that as more physicians have become employees, many fear retaliation, including firing, from their employer hospitals and healthcare systems, academic institutions, private equity groups, or insurance corporations. Many physicians acquiesce to unquestioningly following bureaucratic algorithms, accepting guidelines as mandates, and not innovating solutions for fear of retaliation by medical boards, threat of loss of licensure, and even threat of jail time and fines. This top down fear and intimidation leaves patients without their best advocates, their physicians- ironically, amidst a pandemic, when one would think it is our nation’s physicians we need the most.
Yet, there is hope. Half of physicians remain in private practice, subservient only to our patients and Hippocratic oath. These are the physicians patients must seek. These, like Drs. Zelenko and Armstrong, are such model physicians.
Please, fellow Texas physicians, consider treating your high risk COVID-19 patients using Dr. Zelenko’s protocol or a thoughtful individualized variation thereof. Do your homework on this. Consider treating symptomatic COVID patients early, within five days of the onset of their first symptoms, with safe, low dose hydroxychloroquine, zinc, and either azithromycin or doxycycline- before the viral load is huge, before the lungs are suffering the ravages of cytokine storm including microemboli, and before the patient deteriorates to a condition requiring hospitalization. At least offer your patients this option. Patients deserve the right to try. This will change the course of the pandemic in Texas. This is our charge, our right, and we must stand and lead.
Dear Texas Patients, as we ride out the surge of our delayed, flattened wave, be smart. If you develop symptoms, ask your urgent care or primary care doctor to prescribe you Dr. Zelenko’s protocol or their individualized variation thereof based on your individual medical status. This is not experimental. This is how doctors have practiced medicine since the beginning of time- using our years of knowledge, training, experience, and wisdom, to the best of our abilities, innovating using what we’ve got, to help you, ingeniously- while first, doing no harm. Realize, in spite of what politicians, bureaucrats, and media types tell you, we routinely write prescriptions for medications for “off-label” uses as standard of care, and as encouraged by and regarded as standard practice by the FDA. This Zelenko treatment protocol is low risk and inexpensive. You can begin it immediately. If the doctor you are seeing will not do this, find a doctor who will. You have a choice, and you must be your own best advocate at this time when many physicians are constrained by employers or other non-physician overseers, who are more interested in protecting their profits and taking no risk than in helping you. To us, your physicians, treating you is not a risk; it’s our calling. We are blessed to serve you, and honored to at least try for you.
Kristin S. Held, M.D.
- Identify patients with a high risk of dying
- Treat them within 5 days of first symptoms
- Use a triple drug therapy
Hydroxychloroquine 200 mg twice daily for 5 days
Zinc sulfate 200 mg once daily for 5 days
Azithromycin 500 mg once a day for 5 days
“We can END the COVID 19 pandemic if we put human lives before profit and politics. Identify patients who are at high risk to die and treat them WITHIN FIVE DAYS of onset symptoms. I had a 99.7% survival rate in my patients and an 84% reduction in hospitalizations.”- Vladimir Zelenko, M.D.