I can imagine it must be incredibly frustrating and distressing for medical doctors to invest so much time and effort to reach their positions, driven by a passion for preventing illness and unnecessary death, only to witness rising sickness and fatalities fueled by pseudoscience and conspiracy theories.
I left clinical medicine almost a year ago. After 30 years of being a medical doctor I had enough. I was fighting too many wars on too many fronts. It was exhausting and was taking a serious toll on my health.
I also had RSV in my late 70s (before the vaccine was available). Six weeks of the worst cough I ever had. The rib pain was excruciating. Other than the cough being worse during the daytime, it reminded me of pertussis.
Curious what your thoughts are on seniors getting this RSV vaccine. I remember about three years ago...I think the suggested age was 65 and older, then it was 70 and older and now it is 75 and older....unless you have other conditions. I had a heart attack about three years ago and my cardiologist wouldn't give me a yes or no answer as to if I should take it. Who else would have been better than his opinion. He has yet told me to get a vaccine. So I have continued to wait and worry that I might catch it. I just turned 70.
I have a tendency to get pneumonia following a cold, plus allergy- related asthma. I really thought I should get the vaccine. I think for how awful this was for me at 67, and my healthy 17-year-old had a rough time as well, more people should consider getting it.
I'm so sorry. We are so vulnerable it seems now. My daughter who is 32 even with getting the flu vaccine caught the type A flu and it was awful for her. Had to take her to the urgent care. Her fever was 103 and that was with Advil! And she has no health issues. Was so frightened. She was put on Tamiflu. After another bad day and night her symptoms got more bearable. I wore a n95 mask and wore gloves while taking care of her and thank goodness didn't catch it. Won't take the "flu" as being just the flu anymore. That is for sure.
Early one morning in the doctors' lounge a colleague, a pulmonologist, was bemoaning his unusually full ICU, and how sick all his elderly patients were, most on respirators. I told him that we in pediatrics were in the middle of an RSV outbreak and seeing a lot of children with bronchiolitis. I saw him again two days later. Based on what I had told him, he had tested all his ICU patients for RSV. Every single one was positive. This was a long time ago, by the way.
RSV was for the longest time talked about exclusively as a pediatric disease and thought to be only a bad cold in adults. Testing in adults was rarely done. No longer. The frequent and often serious consequences of RSV infection in the elderly is now well known and monitored.
Here are two links that should help with your decision:
Hello Dr. Galbraith. I thank you so very much for your taking the time and telling me this, as well as giving me the two articles. I really get the feeling that more physicians are very hesitant to give medical advice...in regards to vaccines, medications etc. I guess my cardiologist and my primary care doctor are hesitant to advise me to get the vaccine in case I get the side affect of guillain barre syndrome. But, it sounds like the chances of catching RSV are a lot higher than GBS. Frightening though to think that it could happen. I will probably get the vaccine, but worry about the possibility of GBS. Again, I am so grateful and thankful. Sincerely, Pat
The information about using AI for triage was interesting, but it would be more informative if compared to the same questions for the triage nurses that are available by telephone (or perhaps with some systems, online?). In my experience, they seemed to pretty much always say go to the doctor - so I wouldn't be shocked if they recommended doctor visits for even more than 65% of the unnecessary scenarios (though of course my experience is anecdotal).
I read the Liz Marnick article and then I read some of the reader comments, which were frustrating. Many of the commenters seemed to miss the entire point of the article and were filled with vitriol towards parents who don't vaccinate. But the whole point of NOT doing this is to increase vaccination and improve public health, no matter what you think of the parents and their ideas. Sigh. Keep fighting the good fight, YLE.
Following up on KathyO's point, a key question about the AI-chatbot medical triage: how good is it compared to realistic alternatives? Decide on my own without the chatbot? Ask a random friend? Like KathyO's experience, my doctor's nurse seems to *always* say to come in, often with a 1-2 day wait.
Interesting thought. I think the biggest concern here is that for true medical emergencies, AI-chatbots are going to be *wrong* more often then right. And that's life-threatening. So in those cases, going to the doctor is the correct call. I'm sure there are also liabilities for nursing staff to consider when encouraging you to go to the doc!
**But also thanks for posting these findings about chatbot medical advice. It's certainly helpful to hear this reality-check about how reliable the bots are(n't).
Long ago there was a TV ad where a man in a doctor's uniform said, "I'm not a doctor, but I play one on TV". That has come true with RFK Jr, and now Casey Means. If Senator Bill Cassidy won't speak up, public health professionals should.
Not all physicians are MD's. There are plenty of us DO's out there. If you don't want to use DO/MD, the consider physician. Or, you could just call us all DO :)
Neonatal Nurse Practitioner here. We have been seeing the trend of parents refusing vaccinations for a while now, but there has been a steep decline since RFK’s decision about the birth Hep B dose. It almost seems like more the exception for parents to want that first dose for their baby than refuse it (anecdotally, of course). Unfortunately, we are now also seeing many more parents decline Nirsevimab and 2 month vaccines for their babies, which is so disheartening, especially for NICU babies who have a significantly higher risk of serious respiratory disease. Much like the epidemiologist who wrote the NYT piece, I was also unvaccinated as a child, and now find myself in the unique position of trying to convince other parents to vaccinate their children. Education and conversation with people I trusted were the things that changed my mind. I always try to keep that in mind when talking to parents, and remind my colleagues that it is possible for people to change their minds.
My mother had whopping cough as a child; her aunts and uncles told me stories of playmates that got sick and never came back to school. Of funerals. All my children are vaccinated. It wasn't even a question because of the stories I was told.
Now my siblings do not get covid or flu shots, because politics. Guess who is home sick with their 2nd/3rd round of covid.
QUESTION: Would you do a deep dive into the stability of the overall US healthcare system? How vulnerable is the system to collapse due to funding cuts and more uninsured people coming to the ER? Thanks.
QUESTION- MD told me recent diagnosis of Hashimoto's disease correlates with having covid. Is this accurate? Have thyroid diseases risen post-covid? He didn't say whether it was the vaccine or the disease itself? Thoughts? Thanks.
I am not a medical professional, just a patient with really complex health issues including autoimmune issues. Hashimoto’s is an autoimmune disease. It is thought to be hereditary, but “hereditary” can mean several different things. COVID could trigger the onset of symptoms of Hashimoto’s, but it is highly unlikely to have caused it if you did not already have a possibility of developing it. That chain of events is not specific to COVID. In people with a genetic predisposition for autoimmune disease (which is otherwise invisible) any severe illness or major health event could “turn on” the autoimmune problem (or not.) This is known to happen with Lyme disease, other tick-borne illnesses, mononucleosis, and even influenza. Why this happens to some people and not others is unknown and there is no way to predict it, so far.
Because thyroid disease has so many different causes and it is not primarily caused by infection it is difficult to answer your question about whether there is a known link between thyroid disease and COVID. There are two ways that scientific research could establish a link. First, by demonstrating a biological mechanism that causes it and then showing that it happens in real life in humans. Second, by showing statistical probability (which is not a cause just a likelihood.)
The first path would take decades of research beginning with computer modeling and then studies with specially bred lab rats or mice. There is research heading in that direction, but it will take more breakthroughs in genetics research to make such a study realistically possible. The second path requires lots of medical records (over 50,000) of people who had COVID and who also had diagnostic tests for thyroid disease whether or not they had any symptoms of thyroid disease. The records would have to include people who had the diagnostic tests but who had no symptoms that would call for the tests to be done, a practical problem.
To overcome the practical problem that not everyone gets tested for thyroid disease, you could design a human research study of people with a previous documented COVID infection and then test all of them for thyroid disease. You would compare this to people who did not have a documented COVID infection and were tested for thyroid disease. It would take thousands of participants to get useful results. It would show statistical likelihood rather than cause. Setting up such a study is very expensive and takes years to run the study. (It is unlikely to happen. Thyroid disease does not get a lot of research funding because it is very treatable and it doesn’t kill people.)
So unfortunately there are no answers to your questions. It’s not because they are bad questions, but because the resources and data needed to get answers your questions do not exist right now. Decades in the future population studies of millions of people (which is what epidemiologists use) might show that thyroid disease did rise after the pandemic. Unfortunately, without more details that still would not tell us why.
I think it is incredibly important to translate vaccine hesitancy/refusal into dollars - so thanks for doing so. If people don’t care about public health (as tragic as that may seem), they can often be induced to care about increased costs for themselves, whether in the form of taxes or higher health care costs.
As for Casey Means…I simply have no words that can adequately express the horrors of continually putting the least intelligent, competent and qualified people into some of the most important positions in the country. It feels like committing societal suicide. I sincerely hope she will be sent packing.
Re: Liz Marnick's NYT 2/27/26 op-ed in the NYT ("I Grew Up Unvaccinated. Now I’m an Immunologist." I think the core issue isn't whether to vaccinate, it's how one makes decisions. Dr. Marnick's mom made her decision based on hearsay; i.e., a few stories by non-experts. In contrast, Dr. Marnick made her final decision based on data, collected by experts. So many people don't understand that individual stories may not be representative. That's why evidence-based decision making is preferred.
We are cautiously celebrating the emancipation of our Iranian friends and family. I have been an honorary member (by marriage) of the greater Iranian diaspora community for thirty years. Azadi! And Javid Shah—the best hope for the future of Iran.
Liz Marnick's op-ed is a great read. Our feelings and our upbringing absolutely influence how we feel about medical treatment. As a retired Neonatologist , I am frustrated by the vaccine distrust as I have, first hand, seen the difference it has made in childhood morbidity and mortality. But...you can lead the horse to water but you cannot make them drink. Even if it endangers others. It's a fine line between compassion and frustration. Thanks for YLE's work to continue to educate and find common ground and ways to communicate. And finally, I hope your family can get through the horrible situation in Iran.
I have shared my concerns about Casey Means with Susan Collins, who you might think, would give this nomination veto serious consideration since she is running again in Maine but I'm not holding my breath. She seems to be a Trump rubber stamp except in those instances when her vote is not critical. Very frustrating.
I can imagine it must be incredibly frustrating and distressing for medical doctors to invest so much time and effort to reach their positions, driven by a passion for preventing illness and unnecessary death, only to witness rising sickness and fatalities fueled by pseudoscience and conspiracy theories.
I left clinical medicine almost a year ago. After 30 years of being a medical doctor I had enough. I was fighting too many wars on too many fronts. It was exhausting and was taking a serious toll on my health.
I got vaccinated for Covid and Flu last fall. Didn't get around to RSV vac. I'm only 67! Got RSV from school-age kids. Weeks of coughing, miserable.
Next year all three vaccines for sure!
Oof, sounds so rough. Thanks for sharing, hope next year is different!
I also had RSV in my late 70s (before the vaccine was available). Six weeks of the worst cough I ever had. The rib pain was excruciating. Other than the cough being worse during the daytime, it reminded me of pertussis.
Curious what your thoughts are on seniors getting this RSV vaccine. I remember about three years ago...I think the suggested age was 65 and older, then it was 70 and older and now it is 75 and older....unless you have other conditions. I had a heart attack about three years ago and my cardiologist wouldn't give me a yes or no answer as to if I should take it. Who else would have been better than his opinion. He has yet told me to get a vaccine. So I have continued to wait and worry that I might catch it. I just turned 70.
I have a tendency to get pneumonia following a cold, plus allergy- related asthma. I really thought I should get the vaccine. I think for how awful this was for me at 67, and my healthy 17-year-old had a rough time as well, more people should consider getting it.
I'm so sorry. We are so vulnerable it seems now. My daughter who is 32 even with getting the flu vaccine caught the type A flu and it was awful for her. Had to take her to the urgent care. Her fever was 103 and that was with Advil! And she has no health issues. Was so frightened. She was put on Tamiflu. After another bad day and night her symptoms got more bearable. I wore a n95 mask and wore gloves while taking care of her and thank goodness didn't catch it. Won't take the "flu" as being just the flu anymore. That is for sure.
Early one morning in the doctors' lounge a colleague, a pulmonologist, was bemoaning his unusually full ICU, and how sick all his elderly patients were, most on respirators. I told him that we in pediatrics were in the middle of an RSV outbreak and seeing a lot of children with bronchiolitis. I saw him again two days later. Based on what I had told him, he had tested all his ICU patients for RSV. Every single one was positive. This was a long time ago, by the way.
RSV was for the longest time talked about exclusively as a pediatric disease and thought to be only a bad cold in adults. Testing in adults was rarely done. No longer. The frequent and often serious consequences of RSV infection in the elderly is now well known and monitored.
Here are two links that should help with your decision:
https://www.nfid.org/5-reasons-why-vaccines-are-good-for-your-heart-2/
https://www.facebook.com/Sublettecountypublichealth/posts/february-is-american-heart-month-certain-vaccines-are-especially-important-for-p/1227021502876164/
Hello Dr. Galbraith. I thank you so very much for your taking the time and telling me this, as well as giving me the two articles. I really get the feeling that more physicians are very hesitant to give medical advice...in regards to vaccines, medications etc. I guess my cardiologist and my primary care doctor are hesitant to advise me to get the vaccine in case I get the side affect of guillain barre syndrome. But, it sounds like the chances of catching RSV are a lot higher than GBS. Frightening though to think that it could happen. I will probably get the vaccine, but worry about the possibility of GBS. Again, I am so grateful and thankful. Sincerely, Pat
The information about using AI for triage was interesting, but it would be more informative if compared to the same questions for the triage nurses that are available by telephone (or perhaps with some systems, online?). In my experience, they seemed to pretty much always say go to the doctor - so I wouldn't be shocked if they recommended doctor visits for even more than 65% of the unnecessary scenarios (though of course my experience is anecdotal).
Absolutely, I think we need to learn more here! As Kelvin wrote below, how much better is this, though, without the chatbot.
I read the Liz Marnick article and then I read some of the reader comments, which were frustrating. Many of the commenters seemed to miss the entire point of the article and were filled with vitriol towards parents who don't vaccinate. But the whole point of NOT doing this is to increase vaccination and improve public health, no matter what you think of the parents and their ideas. Sigh. Keep fighting the good fight, YLE.
Following up on KathyO's point, a key question about the AI-chatbot medical triage: how good is it compared to realistic alternatives? Decide on my own without the chatbot? Ask a random friend? Like KathyO's experience, my doctor's nurse seems to *always* say to come in, often with a 1-2 day wait.
Interesting thought. I think the biggest concern here is that for true medical emergencies, AI-chatbots are going to be *wrong* more often then right. And that's life-threatening. So in those cases, going to the doctor is the correct call. I'm sure there are also liabilities for nursing staff to consider when encouraging you to go to the doc!
**But also thanks for posting these findings about chatbot medical advice. It's certainly helpful to hear this reality-check about how reliable the bots are(n't).
Long ago there was a TV ad where a man in a doctor's uniform said, "I'm not a doctor, but I play one on TV". That has come true with RFK Jr, and now Casey Means. If Senator Bill Cassidy won't speak up, public health professionals should.
I've been pleasantly surprised to see the line hold. She may in fact not get nominated
Not all physicians are MD's. There are plenty of us DO's out there. If you don't want to use DO/MD, the consider physician. Or, you could just call us all DO :)
But just don't call us "providers"
Neonatal Nurse Practitioner here. We have been seeing the trend of parents refusing vaccinations for a while now, but there has been a steep decline since RFK’s decision about the birth Hep B dose. It almost seems like more the exception for parents to want that first dose for their baby than refuse it (anecdotally, of course). Unfortunately, we are now also seeing many more parents decline Nirsevimab and 2 month vaccines for their babies, which is so disheartening, especially for NICU babies who have a significantly higher risk of serious respiratory disease. Much like the epidemiologist who wrote the NYT piece, I was also unvaccinated as a child, and now find myself in the unique position of trying to convince other parents to vaccinate their children. Education and conversation with people I trusted were the things that changed my mind. I always try to keep that in mind when talking to parents, and remind my colleagues that it is possible for people to change their minds.
This is so disheartening and infuriating!
It really is! It breaks my heart to think about what these kids will have to go through.
My mother had whopping cough as a child; her aunts and uncles told me stories of playmates that got sick and never came back to school. Of funerals. All my children are vaccinated. It wasn't even a question because of the stories I was told.
Now my siblings do not get covid or flu shots, because politics. Guess who is home sick with their 2nd/3rd round of covid.
QUESTION: Would you do a deep dive into the stability of the overall US healthcare system? How vulnerable is the system to collapse due to funding cuts and more uninsured people coming to the ER? Thanks.
QUESTION- MD told me recent diagnosis of Hashimoto's disease correlates with having covid. Is this accurate? Have thyroid diseases risen post-covid? He didn't say whether it was the vaccine or the disease itself? Thoughts? Thanks.
I am not a medical professional, just a patient with really complex health issues including autoimmune issues. Hashimoto’s is an autoimmune disease. It is thought to be hereditary, but “hereditary” can mean several different things. COVID could trigger the onset of symptoms of Hashimoto’s, but it is highly unlikely to have caused it if you did not already have a possibility of developing it. That chain of events is not specific to COVID. In people with a genetic predisposition for autoimmune disease (which is otherwise invisible) any severe illness or major health event could “turn on” the autoimmune problem (or not.) This is known to happen with Lyme disease, other tick-borne illnesses, mononucleosis, and even influenza. Why this happens to some people and not others is unknown and there is no way to predict it, so far.
Because thyroid disease has so many different causes and it is not primarily caused by infection it is difficult to answer your question about whether there is a known link between thyroid disease and COVID. There are two ways that scientific research could establish a link. First, by demonstrating a biological mechanism that causes it and then showing that it happens in real life in humans. Second, by showing statistical probability (which is not a cause just a likelihood.)
The first path would take decades of research beginning with computer modeling and then studies with specially bred lab rats or mice. There is research heading in that direction, but it will take more breakthroughs in genetics research to make such a study realistically possible. The second path requires lots of medical records (over 50,000) of people who had COVID and who also had diagnostic tests for thyroid disease whether or not they had any symptoms of thyroid disease. The records would have to include people who had the diagnostic tests but who had no symptoms that would call for the tests to be done, a practical problem.
To overcome the practical problem that not everyone gets tested for thyroid disease, you could design a human research study of people with a previous documented COVID infection and then test all of them for thyroid disease. You would compare this to people who did not have a documented COVID infection and were tested for thyroid disease. It would take thousands of participants to get useful results. It would show statistical likelihood rather than cause. Setting up such a study is very expensive and takes years to run the study. (It is unlikely to happen. Thyroid disease does not get a lot of research funding because it is very treatable and it doesn’t kill people.)
So unfortunately there are no answers to your questions. It’s not because they are bad questions, but because the resources and data needed to get answers your questions do not exist right now. Decades in the future population studies of millions of people (which is what epidemiologists use) might show that thyroid disease did rise after the pandemic. Unfortunately, without more details that still would not tell us why.
I think it is incredibly important to translate vaccine hesitancy/refusal into dollars - so thanks for doing so. If people don’t care about public health (as tragic as that may seem), they can often be induced to care about increased costs for themselves, whether in the form of taxes or higher health care costs.
As for Casey Means…I simply have no words that can adequately express the horrors of continually putting the least intelligent, competent and qualified people into some of the most important positions in the country. It feels like committing societal suicide. I sincerely hope she will be sent packing.
Re: Liz Marnick's NYT 2/27/26 op-ed in the NYT ("I Grew Up Unvaccinated. Now I’m an Immunologist." I think the core issue isn't whether to vaccinate, it's how one makes decisions. Dr. Marnick's mom made her decision based on hearsay; i.e., a few stories by non-experts. In contrast, Dr. Marnick made her final decision based on data, collected by experts. So many people don't understand that individual stories may not be representative. That's why evidence-based decision making is preferred.
https://sandyrock.com/
We are cautiously celebrating the emancipation of our Iranian friends and family. I have been an honorary member (by marriage) of the greater Iranian diaspora community for thirty years. Azadi! And Javid Shah—the best hope for the future of Iran.
Liz Marnick's op-ed is a great read. Our feelings and our upbringing absolutely influence how we feel about medical treatment. As a retired Neonatologist , I am frustrated by the vaccine distrust as I have, first hand, seen the difference it has made in childhood morbidity and mortality. But...you can lead the horse to water but you cannot make them drink. Even if it endangers others. It's a fine line between compassion and frustration. Thanks for YLE's work to continue to educate and find common ground and ways to communicate. And finally, I hope your family can get through the horrible situation in Iran.
I have shared my concerns about Casey Means with Susan Collins, who you might think, would give this nomination veto serious consideration since she is running again in Maine but I'm not holding my breath. She seems to be a Trump rubber stamp except in those instances when her vote is not critical. Very frustrating.