COVID-19: Will the Vaccine Save Prisoners?

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Prison health, for humanitarian reasons and because prisons are breeding grounds for contagious diseases, should be high on the list of distribution for the vaccine even as the incarcerated are seen as the most expendable members of society.

The Pfizer vaccine for COVID-19 is expected to arrive in hundreds of sites next week under an Emergency use Authorization (EUA) from the Food and Drug Administration. In Arizona, it will be administered, by appointment only, in centralized drive-thru locations ("pods") to persons on the 1A allocation list. That includes healthcare workers and nursing home residents—not prisoners.


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More than half the inmates at the Arizona State Prison Complex in Yuma test positive for COVID. Staff are getting certified to administer vaccine, when it becomes available, but the vaccine is already too late for more than half. The not-yet-positive inmates are housed separately and required to wear cloth masks when outside their cells. But inside or outside their cells, they are breathing the same air.

Orofecal spread of coronavirus is possible. Virus lives in the GI tract and wastewater for days or weeks. Virus has been isolated from restroom exhaust fans. In one study of environmental contamination, the air sampler had to be quarantined twice despite wearing full protective gear. If virus is aerosolized from flushing toilets, the prison mask policy will be of limited value.


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So, what can we do to protect both prisoners and staff? A disproportionate number are minorities, the population most severely affected by the disease.

On Dec 8, the Senate held a second hearing about early treatment for COVID. While none of the witnesses said anything related to politics, or anything critical about vaccination or public health mitigation measures, Sen. Chuck Schumer (D-N.Y.) attacked the hearing, Chairman Ron Johnson (R-Wis.), and witnesses as being political, "anti-science," and "anti-vaxx"—before a word was said.


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There is apparently an Anti-Early-Treatment movement, which confuses being pro-treatment with being "anti-vaxx." It has specifically discouraged use of hydroxychloroquine (HCQ), but official guidance from the National Institutes of Health (NIH) recommends no treatment for outpatients—except for the recent addition of mostly unavailable new monoclonal antibodies.

In contrast to official therapeutic nihilism, testimony at the hearing provided great hope about ivermectin, which has been called "a miracle drug," having saved millions from terrible parasitic diseases in Africa and other developing areas. In more than 30 studies completed to date, all studies show effectiveness for COVID-19 in early and late disease and for pre-exposure and post-exposure prophylaxis (PrEP and PEP in HIV/AIDS parlance), as the graphic below shows.


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There have been no large-scale randomized controlled trials (RCTs) for use in COVID-19 because of difficulty in obtaining funding. The research money goes to novel drugs and vaccines with huge profit potential. But safety has been shown with nearly 4 billion doses taken by humans since 1981.

Prisoners could be offered the choice to take one dose of ivermectin today and a follow-up dose in perhaps a week. Or they can wait to get infected soon and vaccinated whenever.

 

Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974.

She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989.

She is currently president of Doctors for Disaster Preparedness. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fifth editions of Sapira's Art and Science of Bedside Diagnosis published by Wolters Kluwer. She authored books for schoolchildren, Professor Klugimkopf's Old-Fashioned English Grammar and Professor Klugimkopf's Spelling Method, published by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine. 

More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons

She can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it..


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