Author Archives: John Rensimer

A VOTE FOR BIDEN/HARRIS IS A VOTE FOR WHAT?

1. Economy: A downturn. The Obama-Biden 8-years were among the worst for economic recovery in history. Democrats, by nature, always answer economic problems with raised taxes and regulations- reversing what produced the unparalleled Trump recovery pre-COVID-19. Our crippled economy will be devastated. Think of where our economy and country would now be had we not had the super-hot Trump economy of January, 2020 to cushion the blow of the Pandemic lockdown?

2. Tax Increases:

• Income tax,
• Capital gains tax (on investment income),
• Inheritance tax (taking your assets from a lifetime of work, acquired with money already taxed once, to redistribute to others),
• Corporate tax, which the corporations pass on to their consumers with higher prices (for example, at the gas pump).

Look out for taxes on your Social Security (your money that was deposited over your working years and to be returned to you near retirement) and retirement accounts; like 401K and IRAs. You need to pay for the “Green New Deal,” somehow (estimated $75,000 per person). You need to pay your “fair share.” The Democrats will decide what’s fair. Of course, Democrat political leaders will exempt themselves and wealthy donors. They exempt themselves from Obamacare. Sound extreme? Note that California Democrats this past month proposed imposing annual state income tax on anyone permanently leaving California for the following 10 years. Economic slaves. This is what they do with power, even against Democrat voters (not leadership).

You need to clearly explain to your voting age kids that when Democrats levy a heavy inheritance tax (to even out the classes and fill their coffers for voter handouts), the assets and property you accumulated over a life of hard work will not come to your heirs—your kids and your grandkids. The government gets to redistribute it to illegal immigrants, permanently unemployed people on entitlement programs, and any other group whose vote they want. With taxes, everything is on the table.

3. Supreme Court Packing: You’ve had 9 justices for 150 years. Overall, a fairly balanced court that decides issues with broad impact on our society and culture. The Supreme Court was intended by our Founders to be THE politically impartial branch of government. Democrats will expand the court to 15, 20, or more. Who knows? This has been a liberal/progressive movement priority for years. It is at the core of undoing an America they hate, calculated to permanently lock in their agenda. Packing the court with liberal judges will assure the court will be making law rather than interpreting law, as opposed to our elected representatives in Congress who are accountable to you. Because their agenda is so radical, they understand it will not pass through the constitutional legislative process. What they cannot get passed through Congress, they will pass through the courts with their hand-picked judges. The most extreme, unthinkable laws governing all our behavior and lives will rule the land. A permanent imposition of liberal, monopolistic authority accountable to no one. The Supreme Court would permanently be a political court, maintained as such by one political party…just like in dictatorships in Third World countries.

And, they have mentioned changing Supreme Court Justice terms from lifelong to some limited number of years, so they are influenced in their decisions by the possibility of losing their positions—like elected officials. The lifetime appointment afforded Supreme Court justices was intended to insulate the highest court from the pressure of political influence. The Democrats will end that, and that it will be their agenda and self-interests that run the Supreme Court.
This week Joe Biden and Kamala Harris adamantly and arrogantly refused to answer questions on whether they would “pack” the court until after the election (their words)…because they will “pack” the court. Biden said voters do not have a right to know which way he will go with packing the Supreme Court until after the election!

4. New States: Washington, DC; Puerto Rico; and California divided into two or three states. Each with two new Democrat senators will assure control of Congress forever, by the Democrats, no matter how extreme they are and how out of synch with traditional values of the American people. After that, more new states, as needed, to assure power. Sounding like Russia or China or Venezuela, yet?

5. Electoral College Abolition: After packing the country with illegal immigrants who are the Democrats’ solution for Black Americans leaving the imposed Democrats’ “plantation” of the past 50 years(as they become more educated and independently thinking), the Democratic Party, once in complete control of the White House, the Senate, and House of Representatives, will “pack” the Supreme Court and then see to it that the Electoral College (which has worked to evenly spread voting influence equitably across all areas of the U.S. populace) is done away with, hinging election outcomes on population centers like New York and California, areas with the highest concentrations of Democrats. Although, the elections will be nominal only. The Democrats will control the outcome no matter what. If somehow the Democrat candidate did not win, their complete control of government gives them the means to un-do the election. The fabricated impeachment of President Trump failed only because the Democrats did not control the Senate. With 1-party rule, elections would be a sham, the winner would be pre-determined, just like Vladimir Putin gets 95% of the vote in Russia; He never loses and there is no chance of him losing. We will then no longer have a representative democracy. It will be mob rule. Extreme Leftist mob rule. By the way, if Democrats hold the majority in the House of Representatives this election and gain that in the U.S. Senate, look for them to complete impeachment of President Trump and to throw him out of the White House, irrespective of whether the American People elect him to a second term.

6. Green New Deal: This is a strategy to take over the economy (and so our lives), under the guise of a remedy for climate change despite there being no proof any climate change is man-caused or will respond to man-made interventions. This scheme will turn over all our economic lives and futures, and those of our children and grandchildren, to the Democrat leadership. This sudden economic paradigm shift will make us and our heirs economic slaves.

7. The Wall/ Illegal Immigration: The Wall, which has shut down illegal immigration by over 95%, and it is not even completed, will come down. The Democrats need a huge, uneducated population dependent on government to assure their votes. You are looking at a Third World America for no reason other than hardwired Democrat power. Tied to this will be free healthcare, free college, and free housing for illegals. Ask yourself, if a law were passed that no immigrant could vote for 10 years after coming to the U.S., would the Democrats be just as eager to support illegal immigration? It’s about votes, not compassion for downtrodden people. The Democrats are manipulating the issue of illegal immigration to exploit our sense of compassion as a way to grow their political power with more votes.

8. Reparations: Kamala Harris, who will likely become president in short order, given Joe Biden’s obvious mental infirmity and age, has openly advocated for reparation payments to Black America for slavery over 150 years ago. She has been the most extreme Left of all in the U.S. Senate. No one in America today benefitted from slavery. Kamala Harris will impose a tax to generate the money to pay reparations to the Black Community; another redistribution of wealth, mainly to Black and White political leaders and activists as a wealth windfall, not to the community. Robert Woodson, a Black civil rights leader from the 1960s, of the Woodson Institute, calculates that Black Americans have received $70 trillion over the past 50 years, yet most of it is unaccounted for and did not make it to the people, such that many still live abjectly and the remedies that money was intended to support have never been realized. Woodson concludes the race issue is kept alive by corrupt Black and White leaders and operators to distract attention of Black Americans from looking closely at how they have diverted the money. So, deserved or not, the reparations have been paid and squandered. There is no reason to believe the current push for reparations would end up any differently, that is, being diverted by and enriching the politicians, as they perpetuate the “systemic racism” lie.

9. Gun Control: The Second Amendment will be dead with the permanent Democrat control of federal government and the packing of the U.S. Supreme Court. So what? Well, the general public will be disarmed just as police are defunded and weakened in enforcing the law (another Democrat priority). Guns won’t go away. They’ll just be in the hands of predator criminals. Illinois, a Democrat-controlled state, has the strongest gun control laws in the country, yet South Chicago is a virtual gun war zone, with highest numbers of gunshot wounded and dead victims in the country for years; New York is getting there. We will disarm the innocent and the vulnerable. Victims are “out.”

10. Defund/ Re-Imagine Police: This has already happened in Democrat controlled locales, with resultant increase in assaults, rapes, murders and violent intimidation of citizens as they eat dinner out or walk the streets- with no police responding to their calls of distress. No arrests or prosecution for theft, looting, or violent assault (can’t do that to Democrat voters). Burned and damaged cities across the country during Summer 2020 are a glimpse of what the future would look like, permanently.

11. Riots/Black Lives Matter: It is clear from its own website and both verbal and written statements of BLM leadership (and its Mission Statement) that Black Lives Matter is a domestic terrorist organization that is joined to and participating in the riots in major Democrat-governed U.S. cities and towns- with looting, arson, and anarchy becoming the norm these past 4 months. Kamala Harris recently assured us it is justifiable and necessary, and to count on it continuing, no matter who wins the Presidential Election. They support anarchy. That means she and the Democratic Party support this lawlessness and societal disruption. This is the answer for their premise of “social injustice.” It is payback time with reverse social injustice, mainly against whites. But the riots have ruined many minority lives and neighborhoods. Their hate is boundless and only directed at creating fear and taking power. The “social injustice” and “systemic racism” themes are political theater. Lies to justify tearing down the social order and upending America. Recently, a BLM leader angrily proclaimed, “We’re not requesting, we’re taking.” Think about that the next time you’re seated at an outdoor café and these miscreants decide to intimidate you and your friends/loved ones. Who are you calling?
The themes of systemic racism and social injustice are the foundation for creating disorder, fear, panic, intimidation, and desperation. End game…power. Hitler’s rise, circa 1932-35, used the exact same strategy of division and fear.

12. No School Choice: The Democrats are committed to public schools as the only ones for your kids and grandkids. Why? Schools are critical to the big picture, the long-range societal game plan. Feed the schoolkids a steady diet of Leftist propaganda when they are young. Tailor the textbooks and curriculum to the extreme ideology the Democrats have embraced. That America is fatally flawed as a “systemically racist” nation, its founding and early decades marred by the “Original Sin” of slavery that cannot be forgiven, even though a predominantly White society ended slavery and eventually elected a Black man to the White House. The fall-out from Democrat infiltration of the educational system and the brainwashing of our kids with the false premise of a racist country today has already materialized. We have witnessed it. They have programmed our younger generations that the answer is to hit “delete” on America’s history and all traditions, the tearing-down of statues and the whitewashing of historical figures from our consciousness, rather than learn history so as to try not to repeat past missteps and abuses, and acknowledge the great progress we have made since those early days. How do the Democrats do it? Through the massive teachers’ union with dues going to Democrat candidates and campaigns. The Democrats assure the teachers’ benefits and pay and workplace, and the teachers deliver the votes and the brainwashing.
Hostile take-over of the education system is not a new strategy. Adolph Hitler took over the schools and created the Nazi Youth Corps because he realized the power and ease of indoctrinating young minds with his “truth.” It is why the Democrats are pushing to lower the voting age to 16, to get their votes while the propaganda is still a fresh influence on their opinions, the value being the Democrats recruit lifelong supporters who faithfully and mindlessly vote Democrat every time. Note, high-level Democrat leaders’ children usually go to private schools. The rules are not for them, they’re for us.

13. The Children: As just explained, they are the key to the future. So, convince them of the obscenity of the American Model, and you then make way for “Cancel Culture” and “Critical Race Theory,” undermining the First Amendment (Freedom of Speech) because, with a purpose to reform, we revise any history that offends or challenges Leftist/Progressive ideology and beliefs… change names of buildings, streets, and monuments; destroy statues; burn books; re-write history texts; ban speech judged as sexist, racist, or “triggering”. Tell people what they can say, you tell them what they can think. Liberals are superior, open-minded, tolerant, and “on the right side of History,” as opposed to “fascistic” conservatives…as long as you agree with them. If you don’t, you’re demonized. That’s what they’re teaching our kids. You are 100% with us, or you are our enemy; there’s no room for Moderates. Orwell’s “1984” and “Animal Farm” anyone? We’re there with this election. This is what “wokeness” is all about. I think you’re starting to get it.

14. Election Reforms: The deck needs to be finally and permanently stacked. 16 year-olds to vote. By that age, their minds are indoctrinated by public school liberal teachers. And, they’ve never owned property, paid taxes, built a business, tried to raise a family, or worked. Lots of opinions, with no life experience, no wisdom. But, their votes will be in the can and equal to all of us who have supported them and who do all the work. Tax the social security money you earned and which was taken from you over your work life to pay for free college? OK with a 20-year old.
Likewise, giving the vote to criminals and felons assures them running the streets and doing whatever they want without worry of prosecution by liberal district attorneys. The same for cancellation of bail-bonding. The majority of prisoners are minorities, the lifeblood of Democrat power. Democrats use them, need them. Put them on the streets, regardless of what risk that presents for the general, working public. It’s about votes, not victims (just as with illegal immigrants).

15. Death of Religion: Progressives worship the religion of “the state.” A higher authority threatens whole-hearted devotion to the central government. Liberal judges and politicians have inexorably pressed to diminish religion in our country. Anything to do with religion must be eliminated from the public square. Crucifixes and Stars of David, as well as religious holidays, will slowly but surely be marginalized and eventually disappear from public places, like military cemeteries.
16. Socialized Medicine: ObamaCare was deceptively dubbed the Affordable Care Act. Affordable, no, terrible, yes. The Democrats have intentionally made ObamaCare outrageously unaffordable, so that the American people will plead for an alternative, any alternative. And that will be single-payor (socialized) medicine. The entire healthcare economy will be run by politicians, who for some reason have exempted themselves from ObamaCare. To see how they will grade managing the nation’s healthcare, you need look no further than the Veterans Administration Healthcare System and the United States Postal System. The anathema of efficiency and value, both shining examples of government mismanagement and waste. They will fare no better with healthcare. The quality of care will deteriorate. The costs will skyrocket. The government will raise taxes to bail themselves out of their bankrupt, awful medical system. But they will control it and, with a 1-party system, they will control it forever.

In several years, when you’re suffering or anxious about yourself or a loved one and waiting for your 80-day scheduled doctor’s appointment, remember your vote against President Trump. Remember your vote against President Trump when you assess the bedside manner of the dispirited, inexperienced, unengaged nurse practitioner (you don’t get a physician).

17. Fossil Fuel Industry: The Green New Deal will put the Oil & Gas industry out of business. Sure, we anticipate and look forward to electric vehicles and innovative energy sources. However, under the Trump Administration, for the first time, we have become energy independent of other countries; actually the leading exporter of oil. This is the single most important achievement to benefit our national security other than developing and implementing advanced weaponry. We are no longer at risk from other countries withholding oil and manipulating prices to price-gouge the United States. Oil runs our economy and our military. Think of previously being vulnerable to Russia, Saudi Arabia, other Arab countries, Venezuela, Mexico. Not anymore with President Trump.
We will evolve, incrementally, in due time, away from fossil fuels and toward other sources of power. But that time is not now. An abrupt and premature shift to the Green New Deal will cause cataclysmic economic disruption from collapse of fossil fuel industries. A depression for one of the country’s most important industries will threaten national security, and of course be the reason for more taxing by Democrats and the name of their new slush fund.

18. Welcome Back, China: The Chinese Government is advocating Joe Biden. Why? He and his family have deep business (possibly criminal) ties to that country. They see President Trump as an adversary who has called them out on COVID-19 and is committed to bring the world community together to insist on reparations for China’s unleashing the virus as an act of virtual bio-terrorism against the world and mostly the U.S. President Trump has inflicted tariffs on China to re-balance unfair trade practices at work for decades (which Biden is on the record as supporting, as he and his family have enriched themselves with China’s money, while Biden was on-the-clock as a Senator and Vice President of the United States).President Trump is the first president to confront China as the most notorious cyber-thief of U.S. military secrets and corporate business know-how over the last 2 decades. China would resume its raiding of American advantage with Biden in the White House, and Biden would look away and “glad-hand” Chinese leaders, as his track record shows, while he and his family get richer from Chinese money. Biden as president would also pose the highest potential security risk because of his and his other family members’ financial entanglements with China.

19. Media Complicit/Propaganda Machine: It is well-documented that over 90% of media journalists and reporters are self-avowed liberals. Anyone paying attention knows that the “mainstream media” are the voice of the Progressive Movement. Not unbiased, not objective, not balanced. This is perhaps the greatest danger to our democracy and constitutional society, other than killing the Electoral College, creating new states, and packing the Supreme Court. This goes for those who run social media, like Facebook and Twitter, in spades. And, media have stayed away from questioning Biden and Harris on any of this, so far, just weeks away from the election. We have already completely entered the Age of American Censorship as of the 2020 Presidential Election. The American people are fed misinformation and veritable lies: systemic police racism, white privilege, social injustice, mostly “non-violent” protests (not riots), police violence on minorities…the end justifies the means. And, you will never see more blatant and dangerous censorship when, on the day the NY Post, one of the most widely circulated newspapers in the world, published emails showing Joe Biden had lied about his involvement in his son’s, Hunter, questionable business dealings with and profiteering from Ukraine while Joe was a sitting Vice President, Twitter and Facebook shut down any display of that breaking news with enormous relevance to the election. This is the world we are voting for when we vote for Democrat statism.

20. Defund Police: To buy votes of societal outcasts, miscreants, and felons, the police must be moved out of the way. Create a lie of police brutality and racism, then pull their funds. Democrats want to then “re-imagine” policing. Once they have political power and so funding power over police, they can direct them as their official enforcers against their adversaries in the community. And, tell them to pull back and lay-off their anarchist allies, Black Lives Matter and Antifa, as those actors create mayhem and fear and take what they want. See video of some of the people dining out with these misfits screaming inches from their faces, taking their food and drink, and imposing themselves at their tables. Where are the police? Think Gestapo and Hitler’s Brown Shirts. All has been televised these past 4 months. Victims are out, predators in.

21. Detroitification of Upscale Suburbs: Biden wants to revive Obama’s “Affirmatively Furthering Fair Housing Program.” That would support Section 8, low-rent, housing projects in middle and upper class neighborhoods to translocate minorities from the inner city. What will the suburban soccer moms who voted Biden in because they found President Trump “too icky” think when they see criminal threat and crime dramatically increasing at their doorsteps and nearby shopping areas? What about the threat to their children out and about. What about their property values plummeting as they need to walk away from their homes to be safe?

22. Joe Biden: Who is he?
a. He withdrew from his two prior presidential runs because he was found out to have plagiarized (stole) from other writers and represented the content as his own. A cheat and a liar without leadership intellect.
b. He finished several spots from the bottom of his law school class.
c. A number of citizens from Delaware, the state from which he is a U.S. Senator, were recently interviewed and could not name one noteworthy thing he has said or done over a 47-year political career.
d. Racism: A number of quotes that you can easily retrieve on the Internet clearly establish he has deep racist beliefs about Blacks dating back to his entry in politics in the early 70s. That would be devastating for a Republican. He was close friends with and even gave a eulogy for Senator Robert Byrd (Democrat, W, VA), who had a well-known long history as a Southern racist, early in life a member of the Ku Klux Klan. Even Kamala Harris, his current running mate, labeled him a racist during the Democratic Party nomination campaign.
e. He openly admitted he had a prosecutor in Ukraine who was investigating his son, Hunter, for possible criminal behavior, fired by threatening to withhold U.S. foreign aid to Ukraine if it was not done the same day he demanded it—as a sitting Vice President and a director of U.S. policy toward Ukraine under President Obama.

This is the definition of quid pro quo, and is illegal. His son further substantially enriched himself with the help of his father’s VP position, having no other explanation for the millions he received from Russia and China. This is highly worrisome that these enemies of the U.S. could have leverage over a sitting president because of possibly illegal dealings and financial incentives. This is all on record, televised multiple times.

23. Democratic Party
a. Weaponized the FBI (supposed to be an apolitical protector of the interests of the American people) to participate in treasonous spying and then lying to the FISA court on allegations against then President Donald Trump based on misinformation and lies (developed, paid for, and provided by Hillary Clinton’s campaign officials to FBI staff who knew the information was lies) in order to undermine and take down a duly elected president’s Administration. The very definition of treason. Recent written documents show that Hillary Clinton approved and ordered this; and, that President Obama and Vice President Joe Biden knew of all this in their last days in office. They were complicit. They did not stop it.
Democrat congressional leadership continued the lie to the tune of $35 million dollars in taxpayer expense and over 3-years with fraudulent investigations to try to impeach the president and to obstruct his governance, accusing him of what they had done…colluded with Russia. Projection, a well-worn strategy of the Left.
b. Hillary Clinton and multiple investigators in the Mueller Investigation destroyed evidence likely related to criminal or unethical behavior on their part. So far, no fallout.
c. The Democratic Party twice manipulated their nomination process for presidential candidate so that Senator Bernie Sanders could not win, making Hillary Clinton and Joe Biden the winners, counter to the majority of their own party’s voters.
d. Donna Brazille, news commentator, debate moderator, and Democratic Party loyalist fed questions to Hillary Clinton prior to her debate with Donald Trump in 2016.
e. Democratic mayors and governors refused to allow police to do their jobs in stopping looting, arson, property destruction, and violent attacks on police and community people and failed to call in the National Guard to immediately stop anarchy and violence.
Police and citizens were injured or died. Property was destroyed. Businesses were wrecked. Damage will take decades to reverse, if ever. And, this was largely in minority neighborhoods. Minneapolis, Seattle, Portland, Kenosha, Louisville…They failed to do their main duty to maintain public order and safety. And, there have been barely any prosecutions of perpetrators (their voters). In fact, Kamala Harris and other wealthy Democrat Party supporters provided bail money for anarchists in Minneapolis. Be clear, to create a TV picture of violence in the streets and burning cities, they were willing to ruin lives, even allow violent and fatal assault of innocent citizens, many their own constituents, just to create a picture of “Trump’s America.” Lives were expendable to regain power. Power lust at any cost.
f. Democratic leadership, across the country, in cities and towns, imposed severe, protracted societal and economic COVID-19 lockdowns long after we had a good idea of how to minimize hospitalizations, serious illness, and deaths…while the middle-class saw its life destroyed. Lost businesses, homes, savings. All done in an election year—devastating human lives of working people to create despair and desperation for the purpose of regaining power. They could not beat Trump on his Feb, 2020 economy or his long list of achievements, despite unrelenting persecution and investigations. He was unbeatable. So, kill the economy. Raze the cities. Assault the citizenry. Burn the forests. And, beat the drum on the COVID-19 Pandemic—put a name on it. Trump’s Pandemic. Trump’s America—on fire, blood in the streets, homeless, depressed, out of work, hopeless. The politicization of this pandemic will be seen by historians (unless Democrats are elected, whereupon they will re-write it) as one of the great disgraces and low-points in American history.
g. Democratic Party Essence/Identity: This past week Jane Fonda was quoted saying that the coronavirus was “God’s gift to the Left.” Yes, over 210,000 dead Americans and many more suffering with the illness and with persistent physical and emotional damage from the virus. And then there are the lost jobs, homes, savings, futures. Meanwhile, she sits in her Beverly Hills home with her glib musings. Disconnected from the tragic reality of the “little people” who progressives say they represent. Lies. You may be too young to remember “Hanoi Jane,” in her 20’s in the late 1960’s, garbed in army fatigues with a smirk on her face, sitting astride a North Vietnamese anti-aircraft gun unit that took aim at American airmen. Even though our Constitution permits protest and free speech, such behavior in the country of the enemy during wartime is treason. She has never been held accountable and many liberals see themselves as societal disruptors above the law. They hate America, what it has been and what it is. And, they hate themselves. And she also embodies one of the sore contradictions of the Left’s position that they seem to dislike, even hate, America, yet they stay here. And, many of them have had extraordinarily privileged lives because of the way it is. The answer is, they do not hate America, they just want to rule it.
h. Democrat Leadership/Principles: Looking over all of the above, you must wonder what drives Democratic Party leaders? A single story answers that. Kamala Harris was unrelentingly arrogant and offensive in the Senate hearings on the Supreme Court nomination of Justice Brett Kavanaugh a couple years ago, when, as a standard bearer for the Me Too movement, she essentially labeled Justice Kavanaugh as a serial rapist in front of the nation and his family. This was with no due process and only the hearsay testimony of Christine Blasey Ford and a couple other witnesses, all the testimony of whom was ultimately discredited. Harris stated to Ford, “I believe you.” She was willing to ruin the life and sterling reputation of a man with impeccable credentials and to bring shame to his family. The mantra of the moment was that only an alleged woman’s say was necessary to establish guilt of a man accused of sexual assault.
Then, during the Democratic presidential candidate nomination process, when Joe Biden was her adversary (and her personal political ambition was on the line), she likewise agreed that she believed a woman who was accusing Joe Biden of sexual assault in the 1990s when she had worked for him.
Then, when a black man, James Blake, was shot by police in Kenosha, Wisconsin about a month ago, a man with a sexual assault (on a woman) history, and who had just sexually assaulted his former girlfriend (she called the police) just before the shooting, Kamala visited him in the hospital to express her regard for him and to commiserate with him (for political purpose) as a black victim of another act of “racially motivated police violence.” Subsequently, she accepted Joe Biden’s (sexual predator, according to her earlier in the year) offer to be his running mate in the presidential campaign. What happened? What does this show?
Democrat leaders have only to principle beliefs,

1. Power at all costs
2. Their right to decide what is right and what can be said. If you agree with them, you are ok and not at risk
They do not believe in any of their issues. Their issues and agenda are made to create victim groups and division, and then to angle for their votes and other support by claiming to represent their interests. They are experts at propaganda and political manipulation.
But, there is no authenticity to their party. Issues are manufactured, division fomented, and hate promoted. What happened to the Me Too Movement Democrats were so vocally ardent about against Justice Kavanaugh? Answer: Harvey Weinstein, Jeffrey Epstein, Senator Al Franken, Bill Clinton, Anthony Weiner, Matt Lauer—all high-level Democrat liberals. Whatever it takes to get into and remain in office where they enrich themselves by working laws and tax benefits for their richest benefactors: media moguls, tech CEOs, Wall Street financiers, celebrities, and each other in the political class. And then there is the lobbyist money. So, racism, abortion, taxes, illegal immigrants, gun control, climate change, law enforcement, white supremacy, reparations, social injustice, you name it…the issue means nothing to them other than to mobilize votes and money to keep them in their elite positions. A cynical aristocracy.

Democrat leaders avoid discussions on policy: trade, economy, jobs, education and national security. No, they campaign on personal attacks on their opponents. Have you noticed how many times President Trump has been asked by liberal media if he disavows White Supremacists? How many times Democrat leaders have mentioned white supremacy in the same sentence with his name? It’s guilt by association. Incessantly join his name to the label to create a belief that White Supremacy and Trump are indelibly synonymous. How many times has Joe Biden been asked where he stands on White Supremacy, despite documented history of closeness to ex-Ku Klux Klan members and obviously racist remarks over his entire public career? When has he been asked about his backing of law enforcement in light of Kamala Harris’ bailing out Minneapolis anarchists who wrecked the city? How much pursuit has there been by media of Biden’s son’s potentially illegal activities with Russia and China (and Ukraine) while his father was a sitting Vice President that have national security implications? All these “personal” issue questions would be driven hard by Democrats against a Republican.
Finally, why is it always a Democrat when vote cheating/fraud is found? Can you recall a Republican involved in that?

Same question for sexual indiscretions. It happens in both parties, but by far it is a Democratic Party behavior—those who are publicly sanctimonious about their advocacy and regard for women. It is all about pandering for power.
Democrat voters take their leadership at face value—but they are mostly feckless tools of these cynical operators.

Conclusion:
So, you want to vote against Trump. What is Joe’s specific plan for the economy, for healthcare, for education, for jobs, for law and order, for taxes, for the Supreme Court, for the Electoral College, for the energy industry? His entitlement to be president is no agenda, other than to be the “Anti-Trump.”
COVID-19 will go away. And, then we will need a builder. We need someone who believes in our free enterprise model and our Declaration of Independence that guarantees equal opportunity, not equal outcome. Someone who believes in the central tenet of what defines America…upholding The Constitution to protect the individual from the government. Their goal? Overpowering centralized government. Socialist Democrats are for equally bad outcomes for all except their leadership and their cronies. Equality of misery, for everyone else.
When you pull that lever, know what you are voting “for,” not just “against.” Is your personal dislike of Trump and his style so intense as to look past all that Democrats have done and said they will do to a country that your children and grandchildren will inherit? An irreversibly socialist, single-party state, like China or Venezuela?
There is a sobering moment when one must look deep inside, then be prepared to look in the mirror 4 years from now and take responsibility for what you helped create. You will be accountable for a dystopian future, a nightmare from a science fiction novel. It’s simple, ask yourself what the country needs, what we must have happen, with?,
The Economy
Healthcare
Law and Order
The Supreme Court
The Constitution/Checks and Balances of Governmental Branches
China
I know, this can all sound like a ranting conservative. Maybe. But, answer these questions by specific examination of the facts, not your personal dislikes, and vote for your family’s, your community’s, and your country’s best interests; it is dangerous and irresponsible to do otherwise. Before turning over the government to the Democrats with their extreme Left faction, ask yourself what problems have they solved in the past 4 years? Or, the prior 8 yrs under Obama-Biden? What have they done other than attempt to depose a duly elected president and to stop him from succeeding at anything and to tear apart a country during a time of national crisis? Know what you are voting for.

Edward R. Rensimer, MD

Re: F/U Vaccine

Friends/Clients,

We are fully stocked with this season’s influenza vaccine and you can receive it with a quick “walk-in” visit without a physician appointment. Just call our office. We are focused on the least time for patients in our facility to minimize COVID-19 exposure.

Ed Rensimer, MD

 

CORONAVIRUS UPDATES CONTINUED

 

 

COVID-19 Update No. 14: “Trump’s Pandemic”/Politics

10/23/2020

Just weeks away from Election Day and, if the polls are to be believed (not a given), President Donald Trump is behind. Since he fares better than his opponent on the economy, now and into the future, it must be that personal dislike of him and the public’s inclination to blame him for the state of the COVID-19 Pandemic account for the poll deficit. Of course, all this occurred on his watch, but a review of the facts will clarify what is and is not reasonable about all this. In order to arrive at proper conclusions, we must revisit the beginning of COVID-19 in the U.S. Starting there, the questions to answer are,

1. How might all this have gone, at best?
2. What was done?
3. How has it gone?

Recall that the first U.S. COVID-19 case was Jan. 21, 2020. It had clearly come from China. Despite a widespread outbreak with many deaths in China at least the prior 2-3 months (very possibly longer), with the arrival of a novel virus on our shores, the first priority was to get information from the Chinese experience with haste. China would not cooperate. They would not allow our CDC experts access to their high security biological lab (much of which was funded by U.S. taxpayers) in Wuhan where SARS-CoV-2 (COVID-19 virus) had been under study, virtually the epicenter of the Chinese epidemic. So, from the outset we had no helpful information. We were starting at zero (and we now know the virus was spreading here exponentially, but silently). We were already behind. In addition, the Chinese misinformed us, suggesting human-to-human transmission was not a serious issue. By that time, SARS-CoV-2 was already showing up outside China, in other parts of Asia, India, and Western Europe.

Further, the nature of novel, pandemic viruses is to spread quickly and in rolling waves over 1-2 years after their first appearance. So, the cat was out of the bag with the first U.S. case and no one could have stopped it. No one. We now know that up to 20% of infections have no symptoms, and 60% are mildly ill. And, we had no test yet to detect the virus. So, we would spend a couple months just to collect actionable information allowing policies and protocols to contain spread. And we had no idea who was at most risk for serious disease and death. We were entirely in the dark for the first couple months on what we faced.

The President did what leaders do. While trying to develop information, he announced the problem to the country with a calm, optimistic tone. Should he have then been grim and worried, leading the country to panic- a rush on supermarkets, home supplies, banks? No. That is not leading. But, on Jan. 31, 2020 (10 days after our first identified case), he made a bold decision to stop travel from China, anticipating the worst. He was immediately criticized by Joe Biden as being “xenophobic” (racist) against the Chinese. Nancy Pelosi, Democratic Speaker of the House, smilingly told the country to go to Chinatown to eat Chinese food, as she did so on camera. This was the “anti-Trump” strategy. Whatever he does, do or say the opposite and find a way to label him. So, from the start, some Democrats worked this pandemic for political advantage. As Jane Fonda, a lifelong Democratic Party darling, recently said, “COVID-19 was God’s gift to the Left.” … but not to the over 215,000 COVID-19 U.S. dead.

He then shut down travel to and from Europe on March 12, 2020. Leadership.

1. How might this have gone? What was done?

With what we know about pandemic viruses’ behavior and the SARS-CoV-2 virus specifically, no one could have contained this. Infectious Diseases specialists and public health experts know this. President Trump’s COVID-19 Task Force, which he formed immediately, came out with the most reasonable approach. The goal was not to stop the virus. It was to “mitigate” it. The idea was to break an expected tsunami of cases into many smaller “surge” waves, so that the healthcare system had sufficient workers, facilities, and equipment to optimally treat the afflicted. Italy failed at this and so choices were made by its physicians of who would get the ventilator and who would be made comfortable to die… rationing care. This never happened once here, despite a horrific hotspot outbreak in New York City. Why? Because the President and his Task Force mobilized the military and private sector business to go into wartime mode to outfit two U.S. Navy hospital ships for expanded bed and intensive care unit capacity in a matter of weeks… record time. The ships were deployed to New York City and Los Angeles. Both the Democrat Governor of California, Gavin Newsome, and New York’s Democrat Governor, Andrew Cuomo, were effusively grateful and complimentary of the president’s time-critical effectiveness and speed in getting the job done for these governors and their constituents.

In parallel, the president had the biotechnology companies develop an accurate diagnostic test for SARS-CoV-2 within the first month, and then ramp up production and distribution of test kits as soon as possible over the next couple months. This was essential to success, to have a tool to detect the enemy and to track its behavior and extent. Only with this could we develop a containment strategy while working on the currently ill. Likewise, personal protection equipment (PPE) of facial visors, masks, gloves, gowns, and cleansers were urgently needed, especially for frontline medical workers, and the president pushed manufacturers to retool their factories for massive production of all this and ventilators that were sorely needed for survival. All of this activity was initiated and coordinated by the president’s Task Force. But, its work also included mobilization of the U.S. basic and medical science communities to study the virus in detail and to start clinical studies on patients and patient groups to start to define methods and standards of care for the clinicians charged with care for these patients—an ongoing process to continually re-evaluate new data and to optimize care, the goal being to minimize the death rate. So, the death rate and intensive care occupancy by COVID-19 patients has dropped radically.

Finally, the CDC also daily and weekly produced guidelines and protocols as new information was collected real-time for the medical profession, first-responders, and hospitals and the general public (schools, restaurants, bars, sports venues, etc). There was a necessity to address virus exposure across the society with the goal of mitigation to limit further spread. And so, to bend the building huge wave of new case numbers downward, all of this had to happen at virtually the same time. President Trump’s Task Force, under his leadership, got this done.

Sure, there were some shortfalls in production and distribution of supplies in the early months, but this was unavoidable with an unprecedented biological catastrophe (at least since the 1918 Spanish Flu Pandemic). And, President Obama and Vice-President Biden had exhausted the supplies of PPE with the 2009 H1N1 Influenza Pandemic from the national stockpiles and never replaced them. Nevertheless, everyone received the best care available in the moment.

To diminish the first, huge wave of cases, a “lockdown” of the country was done under the advice of public health experts, such as Dr. Fauci and Dr. Birx—to be managed by each state’s governor according to their state’s density of population, total population, rate of new cases, and many other factors. And, now that more was known about those most at-risk for serious COVID-19 disease and death, strict quarantine of the most vulnerable was effected. It was clear that any lockdown was a double-edged sword. The more severe and longstanding any lockdown, the more societal paralysis and collateral COVID-19 damage: ruined businesses, defaulted mortgages, exhausted savings, mental illness exacerbation, alcohol/substance abuse incidence rising, broken marriages, physical violence, diminishing tax bases threatening government and public services breakdowns, closed medical practices, and financially tenuous hospitals, and on and on. Knowing the peril to his white-hot economy and the potential political fall-out in an election year, President Trump called for sweeping lockdowns in outbreak hot-spot areas in the best medical interests of the American People, per the discretion of governors and local leaders.

One important point about lockdown that has not been discussed. The longer and more severe they are, the more people are not exposed to the virus and so not developing immunity. So, when strict, long lockdowns are terminated, it is a set-up for massive resurgence of infections—creating the tsunami that mitigation was designed to avoid. That is what is happening in Europe now. Lockdowns were over-done there. Lockdowns are supposed to be managed to slow down and, so to spread out, new cases. President Trump did that.

Finally, President Trump had the Food and Drug Administration (FDA) streamline its ponderous, inefficient approval process so that promising medications and other therapeutics could be fast-tracked in what was a public health cataclysm. This innovation also is relevant to what appears to be a record-breaking development of a COVID-19 vaccine, expected to be available by the end of 2020, an unheard of 8-9 month timeline, compared to the usual 3-5 years. This could only occur with the lightning fast mobilization of U.S. basic science companies and academic institutions by an expert leader and manager to develop the science on the nature of SARS-CoV-2 as well as its interplay with human immune systems (immunology). This had to start up back in March in order to meet a vaccine target arrival date in late 2020, or early 2021. Fantastically ambitious and unprecedented.

Finally, it appears likely we will have a vaccine that will enable us to return to our usual lives understanding that a new vaccine is never a given possibility. Do we have a vaccine for HIV/AIDS, Herpes simplex, Zika virus? No.

How has it gone?
Well, cases continue to appear and deaths continue to occur. But, again, that was always expected. It could not be otherwise. We had to open, or sacrifice the country’s economy, and so America. With that, more people would be moving about, and so, with increased testing as well, there would be mounting case numbers. Many of these are positive COVID-19 tests without illness, though the media does not explain this critical detail when announcing panic “alerts” on “surges” of new cases, which fits their aim to exaggerate and to sensationalize. But, the focus should not be on the media’s alarmist “alerts” on new case totals as people re-engage in their lives. The focus should be on several facts,

1. The public is, by far, more used to the need to “social distance” and to wear masks, where appropriate. It is not the “new norm”; rather, a new norm for a while…probably another year (depending upon the effectiveness of the anticipated vaccines).

2. The medical profession now has methods and tools to deal with the worst cases. So, COVID-19 hospital admissions, ICU cases, and deaths are all way down the past 3-4 months. Most of the deaths occurred when we were COVID-19 ignorant and inexpert. This will only continue to improve as more medications and other therapeutics (monoclonal antibody and convalescent plasma infusions) become available. Many are in the pipeline and will be available in just months because of the mobilization of private enterprise, the healthcare system business and scientific communities, and military and public health sectors—all done immediately and in parallel by President Trump’s Task Force from the outset. An apt analogy would be America’s all-out, full-societal response to entering World War II after December 7th, 1941, Pearl Harbor.

3. Children are increasingly back at school. That is necessary as they have been hit hard in their development in crucial years of their lives. Long-term life success is highly correlated with the elementary school years’ experience. There are next to no deaths in people under 19 yrs-old who are otherwise healthy. Recent studies show in 1 in 1,000 school children acquire SARS-CoV-2 at school; 1 in 2,000 teachers. And, children are now known to not likely spread SARS-CoV-2 to adults. Adults get COVID-19 from other adults.

4. With easing or cessation of lockdowns, we will see more cases. But, the great majority of those new cases are in people in their 20’s, not a risk for serious disease or death more than seasonal influenza. The more of this that happens, the more “herd immunity,” until finally, between those previously infected and immune and those who have been vaccinated, we will see this all in our rear-view mirror, much as any virus that is part of the human condition, such as influenza. The president is correct when he says we have “turned the corner.” Case counts will continue to register, but death rates and hospitalizations will go down and the virus will gradually mutate to a weaker form. Anything that suggests otherwise is misrepresentation to create panic. Walk away from that.

MASKS

One other topic should be discussed…masks. Politically, the failure to religiously wear a mask or to insist on it has been used as a “virtue signal” for social irresponsibility, and wanton disregard for others, in fact, gross negligence. This has been a drum loudly beat by President Trump’s adversaries. And, they have used mask wearing, virtually every time in front of a camera, to create political theater over the issue as a negative signal on President Trump’s alleged personally unethical behavior and incompetency, as well as an ever-present reminder that we have a pandemic and it is on Trump’s watch; so, he owns all its negatives (or so they assert).

No one can argue against wearing a mask. If it allays anxiety in an individual because they are “doing something,” then, so be it. But, it is clear that the data on efficacy of masks having a reliable impact on the risk of acquiring COVID-19 are conflicting. Likewise, the opinions of experts on the matter. The CDC just turned out data on patients who were so COVID-19 sick that they were admitted to the hospital. Of those, 71% had worn a mask all the time; 14%, most of the time. Seems like the mask did not provide much value. The U.S. Surgeon General, some months ago, doubted their value. On March 8th, Dr. Anthony Fauci (NIH) said masks were not needed. He since then has seemed to advocate them, but he has vacillated on his position, like on other pandemic issues, many times during this pandemic. But, before we take a political party’s condemnation carte blanche, we should examine an issue, the facts of which are still evolving, ourselves. The Democratic Party and Joe Biden’s opinions on this are just perhaps not entirely motivated by established science. The bottom-line on masks from the CDC is that masks may decrease the risk that someone ill with SARS-CoV-2 will spread it to others, but it is less clear whether masks protect the wearer.

Note, just last week, the World Health Organization pronounced COVID-19 quarantine lockdowns no longer advisable because any value with respect to COVID-19 prevention were negated or even outdistanced by the severe collateral damage of societal isolation, economic damage, and non-COVID-19 medical morbidities and deaths from the lockdown as people delayed or avoided medical attention for serious problems out of fear (from the media) of acquiring SARS-CoV-2 while seeing a physician or going to a hospital. And, until this, lockdowns were written in stone, COVID-19 dogma, as necessary, even to the point of many Democratic Party governors over-reaching their legitimate legal authority to bring to bear almost COVID-19 martial law on their constituents as they restricted their constitutional rights. Yet, the lockdown issue is still open to debate by qualified experts.

You want to end COVID-19? Put every person on a private raft at sea for 3 weeks. Done, virus gone. The only fool-proof anti-SARS-CoV-2 intervention is strict social distancing. And now, knowing it hangs in the air in minute, aerosol particles, everyone must be at least 20-feet apart. As for masks, jury’s out.

The Election/Trump/Biden/Pandemic: Conclusions

Lexicon: Propaganda, misinformation, disinformation, political theater, exploitation, manipulation, mistruths

All of the above.
Well, if you’ve gotten here, you have the picture of all that went into, over a very short time, orchestrating a comprehensive public health, medical, and societal response to this unprecedented crisis, without the benefit of any collaboration with those who originated the outbreak. Really astonishing by anyone’s measure. I won’t say unprecedented. FDR, likewise, mobilized all needed expertise and resources with our sudden entry to WWII.

Nevertheless, Joe Biden, Kamala Harris, and the Democratic Party leadership seem to have gotten away, in this age of sound bites and partisan social media edits, to misconstruing President Trump’s leadership and effectiveness in confronting the pandemic for the American People. They claim President Trump has been asleep at the switch, fiddling away while Rome burned.

Joe says he would have done (in fact, will do) it differently. He’ll let us know (just like with Supreme Court “packing”) what groundbreaking solutions of his would have turned all this around, after the election. Funny. What happened to the telephone? To email? I am sure the Administration would have welcomed a message from him with his prescient wisdom to impart on ending the COVID-19 Pandemic from a former vice-president. Certainly, no one committed to the welfare of the American People (and the country) would withhold information that would save lives until after an election. That would be a pre-requisite for a would-be president.

Had Biden been president in January, he would not have stopped travel from China. Remember, China had a wobbly economy and would not take well to such a lockdown of travel between the U.S. and China. Besides, they needed the SARS-CoV-2 to spread broadly across the world—a receding tide to lower all ships. They needed the U.S. hurt, badly, without firing a shot so that their timeline for becoming the Number One Super Power of the 21st Century was not derailed. And, the Bidens are tightly entangled with them through under-the-table business schemes when Joe was VP, more evident every day.

According to Joe Biden, President Trump is personally accountable for all the COVID deaths. Any competent president would have prevented all of them, according to Biden. Well, the pandemic modeling in February suggested about 2 ½ million U.S. deaths with what was known. That’s 6X more than so far. Had Biden been president and not stopped China travel, there would be tens of thousands more deaths. Parenthetically, tens of thousands of these deaths were mass-murder actions by several Democrat governors defying (New York, New Jersey, Pennsylvania, Michigan) CDC guidelines and sending recently infected elderly patients back to their nursing homes to pollinate thousands of doomed residents (about 11,000 estimated deaths by Gov. Andrew Cuomo, alone, who still does not take responsibility and still holds office; says a lot about their real concern for all those deaths about which they decry President Trump).

When Biden does offer up a sampling of what he would do, it is everything President Donald Trump already has done. But that’s just like Ole Joe. Once a plagiarizer, always a plagiarizer (the reason for his two prior failed runs for the presidency).

But, we don’t need to speculate. Joe Biden was charged by President Obama with managing the 2009 H1N1 Influenza Pandemic. In the U.S., 61 million were infected (compared with 5 million with SARS CoV-2). There were about 12,500 deaths with H1N1 compared to over 215,000 so far with COVID-19. However, the SARS-CoV-2 virus is 6X more lethal than seasonal flu and 30X more lethal than the 2009 H1N1 flu strain. If SARS-CoV-2 had been the virus in 2009 with 60 million infected, Biden would have presided over 360,000 deaths. Joe Biden is in no position to criticize President Trump. Yet he does. Politics. Trump has been a master, given the unprecedented circumstances. His virus is a killer, more like the 1918 Spanish Flu with a death rate of 2%.

His chief of staff, Ron Klain, said, “It is purely fortuity that this isn’t one of the great mass casualty events in American History,” in commenting on Biden’s management of that pandemic. The fortuity was that, though the virus spread prodigiously, it was much less lethal than SARS-CoV-2. Joe lucked out. However, not so for the 12,500 who died, who were mostly between 15-40 years old. SARS-CoV-2 deaths are about 50% in nursing home patients, well past their life expectancy. 80% are over 65 yrs-old. So, Joe Biden was tested on a pandemic and did not fare so well, relatively.

So, in closing, just to get this right, first, Trump did too much, too fast, because he’s a racist. Then, he did next to nothing (and he doesn’t wear a mask in the shower!) and so mass-murdered over 215,000 people, which would not have happened with a President Biden. Guess we can all relax because all this will be over and we can return to our lives when he’s sworn in. At least that’s the Trojan Horse they’re selling to the American People. Maybe the Democrats will be charitable and at least take 25,000 off the death totals due to Democrat governors’ gross negligence, so as to not hold them against the president. Nah!

If you say President Trump failed, you need to say what he did not do that should have been done and when, with the information available at the time, it should have been done. And, if so, where were you with these ideas when all this was playing out? You don’t get to be Monday Morning Quarterback with no facts, only criticisms, to claim you would have done better.

The best benchmark of success is a decrease in death rate (deaths per total cases), decrease in hospitalizations, and opening up of the economy. All of that has been happened about 6 months after the inception of this nightmare. The media panic us with “surging” new case numbers which mostly reflect more and more availability of tests…the vast majority are minimally ill, or not at all. Beware of this messaging. It is cynically perverse politicking the pandemic in an election year.

As for President Trump, as a specialist in these matters, I cannot see how anyone could have done better. Thankfully, we have had an expert business manager/developer executive as the Chief Executive when COVID-19 arrived. Biden, who has never created a job or a service, never been an executive manager, and never started and run a business would have been a tragic failure, with unimaginable losses for our country. If elected, he’ll get the benefit of all Donald Trump has done and President Trump will get no credit from the partisan media.

Edward R. Rensimer, MD
Infectious Diseases

 

COVID-19 Update No.13: Being A Low-Risk Patient

6/29/2020

How long will this go on? Well, we had the worldwide 1918 Spanish Flu Pandemic, which cycled continuously, with about three major surges of disease and death more than two years. It is a fair guess that 1-2 years of COVID-19 will be prominently in our lives. However, we are physically interconnected across the globe in a matter of hours with air travel. And, this is a below-the-radar SARS-CoV-2 virus that is spreading most vehemently in the 48 hours prior to the onset of illness symptoms, when the unsuspecting host is shedding virus profligately and that person is going about their life with abandon, unaware of the danger they pose to family, friends, co-workers. So, the features of modern civilized society make predictive models of COVID-19 behavior and pandemic timelines tenuous at best.

The best thing has always been to avoid doctors and hospitals by maintaining your health and physical conditioning. More so now, with the extraordinary communicability of this virus as every place in the healthcare system is a trafficking funnel that concentrates the sick, medically infirm, and elderly… those at most risk for COVID-19 fatality. The healthcare system is the worst place to be, the frontlines.

What are you to do? You are not a habitual medical care seeker (there are those). But, you have blood in your urine, unexplained weight loss, fever, extreme new-onset fatigue, or cryptic chest pain. Problems that cannot wait-out COVID-19. And, the collateral damage of COVID-19 contagion is yet to be tabulated- people delaying seeing a physician or going to the Emergency Department because of COVID-19 fear- and die of a stroke, heart attack, septic shock, ruptured appendix, etc.

How do you balance the risk-benefit of being evaluated timely in the context of COVID-19 exposure risk? Below, I will give you practical ideas and actionable points that should provide a template for your medical care until all this is way in our rear-view mirror.

1. Telemedicine Appointments: Many medical offices are offering at-a-distance visits that may be effective for the problem (we do). Most certainly, the physician should lean strongly toward this type service for those over 65yrs and/or with underling medical conditions. Whether an in-person visit is in the patient’s best interests, and so necessary, is a medical decision by the physician. Ask your physician if they are set-up for this.

2. Minimize Time in Medical Facilities: This is intuitive on its surface. There are creative ways to do this aimed at infection control. It is all about pre-emptive communications, personal preparations for the appointment, and operational flexibility of your medical professionals. To limit your exposure time to other patients and the medical staff,

a. Complete all forms and provide all documents (updated insurance, prior medical records) prior to arrival.
b. Inform the office staff you will wait in your car until they call you to enter the facility so that you can be showed directly into an exam room, with no time among others in the waiting room.
c. Wear a mask (consider a double-mask, like I wear) and rubber gloves.
d. Have your story (onset, timeline, encounters with other physicians, medications and their impact on the problem or lack of it, prior diagnostic test reports- blood, urine, imaging) written out to present the physician. Optimal if this can be forwarded pre-visit (FAX, secure email).
e. Have your questions and concerns defined and written for the encounter.
f. Try to physically distance (other than the actual physical exam) during the visit (6 feet or more from others, including the physician and staff).
g. Do not be seen by medical professionals who are not wearing masks.
h. Clean your hands when exiting the medical facility, in a building restroom if needed.
i. Most of these measures are also relevant to an Emergency Dept, laboratory, imaging facility, physical therapy, pharmacy, and other medical service locations.
j. Wash your hands thoroughly as soon as you arrive home, touching nothing else (consider keeping hand cleanser in your car, as well).

3. Potential COVID-19 Illness Case: It is medically irresponsible to have a person who has an illness consistent with COVID-19 come into a medical office, potentially exposing staff and other patients to the virus.
a. Your physician’s staff should be asking each person trying to come in whether they have recently had symptoms consistent with COVID-19, exposure to a confirmed COVID-19 case, or themselves been found positive for COVID-19? These patients need to be turned away from an in-person office visit. The physician can arrange a phone or telemedicine (computer) visit. What if that person is really sick, with ominous symptoms, such as shortness of breath? They must be directed immediately to the hospital Emergency Department, with the doctor and the patient calling the ED staff to forewarn them of an arriving COVID-19 illness so they can sequester the patient into areas designated for such cases, protect themselves, and give directions. Such patients are not welcome at outpatient labs and imaging facilities- they do not want to be shut down because their staff have been compromised and/or infected. The rest of us do not want them closed down either, nor physicians’ offices. We need them up and running out of self-interest.

4. Conclusion: Stay away from medical professionals and medical facilities, but, with any problem that would normally bring you to contact your physician, do that and let them decide how to address the issue. Do not sit on something you normally wouldn’t. COVID-19 isn’t the only thing that can come to a very bad outcome.

Lastly, if your physician and staff cannot work with you in line with the aforementioned principles or they seem apathetic, dismissive, and/or ill-prepared, maybe it’s time to look for another physician.

Edward R. Rensimer, MD

COVID-19 Update No.12: “Surging” Case Numbers, Media Alerts, and Reality

So, COVID-19 “lockdowns” were eased and new COVID-19 case numbers “surged”? We should all panic. The pandemic is roaring back and we can do nothing but lockdown again. Texas’ governor, Greg Abbott, is giving that serious consideration. This, even though we know further, significant societal lockdown carries dire consequences for our economy and all Americans, while COVID-19 poses a death risk now approaching a small multiple of seasonal flu, and that for a small group of people, mostly the very elderly and medically infirm. The average age of COVID-19 death is 82 yrs, about the U.S. life expectancy for other causes. But, with the alarmist nature of the media and of breakneck, reflexive 24/7 “Media Alerts” and “Breaking News”, we don’t deliberate on the situation… we emotionally react with dread and borderline hysteria.

Lets’ try something new. Let’s calm down and think through the facts, like scientists, like physicians.

1. The Pandemic Goal: It never was to stop the virus. The cat was out of the bag in January and it was spreading with unprecedented speed and ease across the globe. Based on prior “novel” virus pandemics, we knew this would play out over 1-2 years until the virus slowly changed (mutated) to partner better with humans biologically, rather than kill them (which is against its own interests- a suicide virus). The virus would become the vaccine; eventually, once about 60% of the human herd had been infected and had immunity, the potential human hosts would be radically reduced, and so the pathway to those at most risk for death. The virus would become just another background occurrence in the human condition- like influence, West Nile virus, head colds.

So, we took measures to slow down the outbreak pace (“mitigation”) and to spread it out over many months, rather than over the initial 2-3 months, to allow us time to learn more about the virus and how to deal with it. More medications and management techniques. Maybe a vaccine (but don’t count on it). And, with the concern that the Fall season brings people to congregate more in close-ventilated spaces, as well as the certain annual rise of flu cases, the chief goal was to spread COVID-19 over months so the healthcare system could have staff, supplies, and equipment so no one received less than optimal care when both viruses hit.

Conclusion? Once we re-opened we knew there would be more COVID-19 spread, more hospitalizations, more deaths. It was acceptable, balanced against the sure devastation of lives and of the country with continued lockdown. So, what is happening was expected to happened, yet there is anxiety all about, fanned by the media.

Leadership needs to monitor COVID-19 hospital admissions and ICU occupancy, and adjust infection control measures to match the case numbers to resources. This is analogous to Harris County officials “bleeding off” water in phases threatening to burst the Addicks Dam during Hurricane Harvey to minimize flooding. Some property would be lost, but not all property.

Finally, despite increasing COVID-19 cases, the fatality rate has decreased, suggesting more of the cases may be in those under 65 yrs-old. If that continues, we could be moving toward the 45-60% “herd immunity” that will dramatically decrease the size of future outbreak “waves”.

2. Case Increases Across the South: It is unclear why this is so, but possibly the cases were at such a low number because of intelligent, effective lockdown measures initially such that we did not have the outbreak disasters seen in New York, New Orleans, etc, due to major errors in management (public transit, nursing home errors, Mardi Gras), and so less infections. As we eased lockdowns, COVID-19 is now getting to more people, but in the intended, measured way. Further, with increasing outside heat, people in Florida, Texas, and Arizona are naturally driven more indoors to air-conditioning, much like the effect of winter’s cold air arrival in the North. We know most COVID-19 infections are acquired among household members in close, prolonged contact, not people out and about.

3. COVID-19 Case Labelling: There is an incentive for hospitals and the medical profession to label a medical case as “COVID-19” diagnosis. Why? The government and insurers are processing payment for testing and care quickly and at good rates in order incentivize the system to prioritize care for COVID-19 cases as this has been termed “a national health emergency”- analogous to FEMA dollars for floods, hurricanes, tornadoes. The uninsured are even covered, where hospitals would normally eat the bill for them, other than a tax write-off.

So, I arrive at a hospital from a serious car wreck. Now, all patients arriving at the hospital are screened for COVID-19 to protect the staff. But, once that test is positive, I am labeled as a COVID-19 case. If I die from my injuries and was only carrying COVID-19, but not ill from it, I may be labeled as a COVID-19 death. There is a financial incentive to over-diagnose. There is also a political incentive. Make this a bigger, more ominous epidemic, governors, mayors, county judges are given more room to exert power. Be clear also that this is a presidential election year and many politicians have a big stake in not seeing the economy recover for fast and in making this natural disaster the result of mismanagement by current leadership to influence elections.

4. Social Distancing/ Politics: Somehow, over a thousand medical professionals disgracefully issued a letter stating that the specter of COVID-19 transmissibility during huge public protests across the nation took backseat to the cause of “systemic social justice”. I suppose the COVID-19 virus threat to individuals, which previously required draconian isolation measures by political fiat, now was not so much. I guess “Black lives DIDN’T Matter”, since many of the protestors were black and it is well-established that black death rates from COVID-19 are substantially higher than other groups. Even if mostly younger blacks were protesting, they could take virus to their families.

So, many medical professionals took a political position against their professional oaths to protect the health and medical interests of patients. This put people at risk for serious injury and death, in the name of a political protest movement which was based on a questionable, yet unproven, premise of “systemic social injustice”. Moreover, just weeks before, medical leaders advised and insisted on tight, protracted COVID-19 infection lockdowns with absolutely probable devastating effects on the lives and health across our entire population. It is unequivocal that “social distancing” is the most effective measure against COVID-19 propagation. You put yourself on a single-person raft in the middle of the Gulf of Mexico the next 2 years, you don’t get COVID-19.

Did anyone but me note that the incubation period for acquiring the COVID-19 virus to onset of illness is up to 14 days, and the uptick of cases in Houston occurred 1-2 weeks after the local mass protest gathering and funereal crowds for George Floyd in Harris Country? Yes, what was predicted and speculated is happening. But, the media has no interest in making this association, as apparently they are all-in with the “social justice” movement.

This must be stated. It will be remembered as a low-point for the medical profession and leadership who advocated against the public good, resulting in loss of “precious” lives (“Every life is precious” is, I think, what had been the mantra) out of political self-interest. A disgrace. Disgusting hypocrisy.

Edward R. Rensimer, MD

COVID-19 Update No.11-2nd Wave or Expected Blip

Recently, in some parts of the U.S., including here in Houston, TX, we have, just weeks after businesses have gradually re-opened, seen an uptrend in COVID-19 new cases. Think back to March. At that time there was a strategy of containment and mitigation of the pandemic curve’s upward tack. It was felt too late to stop COVID-19. Rather, the aim was to “flatten the curve”- to turn the new cases curve to horizontal and then gradually downward. That “mitigation” occurred by dramatic lockdown of human interactions and wearing masks, hand cleansing, and social distancing. The curve was bent and new cases as well as deaths declined.

As we saw the resulting economic devastation, a deliberate decision to re-open was made and it was presumed that with people out and about, COVID-19 activity would pick up. It had to. But, we had, for the country’s greater interests, to re-open and expect an increase in new cases.

That’s where we are. We are seeing an uptick in COVID-19 cases. Further, keep in mind that 100X more COVID-19 tests are being done than 2 months ago. This naturally will detect cases that before would have gone unseen. The result? An appearance of increased disease activity, which might actually be an increased detection of cases that were already there, all along.

In the month ahead, look to hear new information showing far more COVID-19 cases than before, many more subclinical or asymptomatic “infections”. Further, we should see the COVID-19 total case denominator grow substantially, which will decrease the mortality rate a good deal, perhaps just above seasonal influenza- say, 0.2-0.3%. If you have 10 deaths in 10 cases, the death rate= 100%. 10 deaths in 1000 cases is 1%. The denominator is everything.

Finally, if there really is some true increase in COVID-19 cases, the long-term benefit is “herd immunity”- much fewer people available to be infected for a large 2nd wave in the Fall.

So, don’t panic, even if the media have a political agenda in keeping this thing going. Wear your mask, wash your hands, and socially distance. Enjoy the gradual re-opening, but continue to be smart in playing your role in continuing to “bend the curve”, until we are told we can go back to “normal”, which I believe is 1-2 years away.

Ed Rensimer, MD

Director, International Medicine Center

Copyright, 2020, E. Rensimer, MD, All Rights Reserved

COVID-19 Tests: Nasal Virus PCR and Antibody

Remote Rapid COVID-19 Serology (Antibody) Testing Availability 5/8/20

Document Number 1

We would like to announce that we are currently set-up to provide highly accessible, convenient testing for COVID-19 serum antibody (as well as nasal viral PCR swab test; see elsewhere). The presence of this antibody suggests resolved infection and probable immunity from re-infection (how long is unknown, though likely at least a couple years, if not lifelong). How protective this antibody is against re-infection and the duration of that protection (which will likely vary from person to person) will be defined in the next few years, but currently is unknown.
This information may be useful in considering no further need for an individual to practice social-distancing or to wear masks. Frequent hand washing would still be advised for the protection of those around us as even a COVID-19 immune person could contaminate their hands with SARS-CoV-2 virus, and so other people and environmental surfaces; until the pandemic recedes.
No appointment with the doctor is needed. We will immediately set-up a medical requisition for you at a lab for the bloodraw.
When results are back, we will notify you and provide documentation of the result for presentation to any interested parties – such as nursing home staff, hospital staff, employers or any other entities who need to know that you do not have COVID-19 and are immune to it. It is best to do this test at least 2 weeks after the onset of COVID-19 illness, to minimize the chance that you might still be shredding dangerous virus as your infection resolves. The antibody test cannot determine whether you are colonized with or shedding infectious virus, but it is unlikely once you are IgG (late) antibody positive.
If you are getting tested post recent COVID-19 on suspected COVID-19 illness, you should continue to practice infection control measures (distancing, masks, washing) for at least 1 week after the blood was drawn or 3 weeks after last illness symptoms to be sure you had not just gotten over the infection as the blood was drawn, since infected individuals may continue to shed COVID-19 virus at least 3 weeks post-infection onset. Up to 80% of people infected with COVID-19 have no or minimally noticeable symptoms.

PROCEDURE

1. To start the testing information intake process, go to our website’s COVID-19 WALK-IN TESTING INTAKE FORM ORDER SHEET (click on red sentence below)

2. Payment will be required prior to or at the time of our ordering your COVID-19 blood test and the service charge will not be billed to medical insurance.
The laboratory’s test charge itself may be covered, but you will need to provide your medical insurer with the cost of the test for possible reimbursement.

3. We will provide written documentation of your result and an explanation of any possible implications of the result for you as soon as it is available.
We suggest you take a photo of that document to store in your mobile phone, just like a driver’s license.

Note: The RELIABILITY of current COVID-19 antibody tests has NOT BEEN ESTABLISHED. If you decide to proceed with testing, you accept this limitation on the significance of the result. For a more detailed explanation on the state-of-the art on COVID-19 antibody testing and what it can and cannot achieve, see “COVID-19 Antibody (Serum) Testing”.
Edward R. Rensimer, MD
Director, International Medicine Center

CORONAVIRUS-19 WALK-IN TESTING INTAKE FORM ORDER SHEET (CLICK HERE)

Remote COVID (SARS-CoV-2) ANTIBODY Testing

International Medicine Center

9230 Katy Freeway, Suite 400

Houston, TX 77055

713-973-6078

imc@traveldoc.com

5/8/2020

Document Number 2

Our facility is offering expedited, remote (no physician visit needed) testing for SARS-CoV-2 antibody. We prefer to do this without appointment so that we can manage workflow in our facility as well as to minimize exposure of all involved to each other. The aim is maximal testing of the community with minimal waste of time and exposure to others. See our detailed comments on the value and limitations of the test itself in Document Number 3.

PROCEDURE,

1.To receive a testing order by our physician, you must complete and email us our short testing request form,

CORONAVIRUS-19 WALK-IN TESTING INTAKE FORM ORDER SHEET (CLICK HERE)
Send to: imc@traveldoc.com

2. We will call you to confirm that a test order has been sent to the lab or to schedule you a brief office visit of the nasal swab test.

3. When results are back, we will call you,

Result Turnaround Time:

Antibody: 1-3 days

Nasal Swab PCR: 2-7 days

4. If physician consultation on the results is desired, notify us so we can set up a formal appointment.

5. Charges: Administration/Case Evaluation Fee:

IgG Antibody Test: $ 50  / PCR Test: $75

IgG Antibody Test Charge: $­50 LabCorp; $50 Quest Lab

PCR Test: $ 100 LabCorp; $100 Quest Lab

We cannot guarantee this test will be covered by your insurer, but you can submit it.
We will notify you of the result and provide a certification of result document which will provide interpretation and possible implications of the result.

Edward R. Rensimer, MD
Director
International Medicine Center

CORONAVIRUS-19 WALK-IN TESTING INTAKE FORM ORDER SHEET (CLICK HERE)

COVID-19 Antibody (Serum) Testing 4/27/20

Document Number 3

There is overwhelming demand for the antibody test for Coronavirus-19 (SARS-CoV-2). People want to know if they can go back to work, their kids see their friends, go to restaurants and sports events… get their lives back. There is a building sense that we have an economic emergency as, if not more, important than the pandemic. After all, the pandemic largely targets mostly limited groups of people for severe illness or death – the elderly and the medically compromised. But, the economic disaster hits everyone and potentially could do so for years. We need this test.
But, the urgent need does not create a reliable test, at least not yet. What it does is create an entrepreneurial opportunity to be exploited by companies looking to get rich on the desperation of everyone hoping to end the public health shut-down and to start companies up again. We all want this.
But, does desperation ever result in anything but serious, perhaps grave mistakes? What does a test need in order to be reliable? Think about it. What would it mean to you if a pregnancy test were unreliable, with a high rate of false positives? What about a cancer screening test with a high rate of false positives or false negatives? In other words, you could not be near sure that you did or did not have cancer, despite the result your physician gave to you.
That is the reason the federal Food and Drug Administration (FDA) evaluates new medical tests. It determines whether a test reliably yields results that are ultimately true to the purpose of the test.
In the context of a national emergency of contagious disease, the FDA has decided to allow tests for COVID-19 antibody to be offered to the public as EUA, Emergency Use Authorization. If the tests APPEAR to be legitimate, they get an EUA status. But, such tests have not been studied for sensitivity and specificity by the FDA– how well they detect COVID-19 antibodies and whether those antibodies are a result of the COVID-19 virus, rather than other coronaviruses, which cause 20-30% of head colds. This is called “cross-reactivity”, leading to false positives for SARS-CoV-2 virus antibody reports. Currently available tests have not been vetted by the FDA for tendency to cross-reactivity for coronaviruses other than that which causes COVID-19 disease.

So, where are we?

COVID-19 antibody testing is being offered here and there. Is it reliable?

Well, many of the antibody test companies have products made in China. At this point, there are over 120 companies in the game. Some have claimed 80% sensitivity (8 out of 10 chances if you have the antibody their test will be positive). But, in use, some of their tests have actually only been 20% positive. Is that a reliable test? And so, at least 20% of the people will at least know they have the antibody, right? No. . WHEN THERE IS LOW PREVALENCE OF A DISEASE ACROSS A LARGE NUMBER OF PEOPLE, ANY POSITIVE IS LIKELY A FALSE POSITIVE. What does that mean? If I test 1000 2 year-old baby boys for pregnancy, and 3 tests are positive, are 3 baby boys pregnant? Or, is the test false positive because of something else in those boys’ bloodstream? If I test 1,000 20 yr-old, sexually active women for pregnancy and 3 are positive, what are the chances those 3 girls are pregnant? Virtually 100%. The prevalence of pregnancy in baby boys is zero. The prevalence of pregnancy in 20 year-old women is substantial. The prevalence of the problem the test looks for in a given population determines how likely a positive is true or false.

So far, screening in large populations here and in other countries is suggesting 3-5% of the general population had been COVID-19 exposed by positive antibody tests. That means any positive antibody test is more than likely false positive. That problem will hopefully be solved by antibody tests that have passed muster for sensitivity and specificity, and so achieve FDA-APPROVAL (not “authorized”)

 

With the currently available antibody tests, this is IDEALLY (if the specific testing product ultimately meets medical standards) what the antibody tests CAN DO,

1. Tell who has been infected and developed an immune response to COVID-19 virus.

2. Tell the POSSIBILITY of some (uncertain how much or how long) immunity to COVID-19.

3. False Negative Result: the individual has been infected, but has negative antibody because,
a. Weak immune system due to underlying medical conditions or medications (cannot produce antibodies)
b. The specific testing product (brand) is not of good quality.
c. The individual is actually infected and it is too early in the illness to form antibodies.

4. True Negative: the only solid valuable result; the person is still at risk for infection

5. Tell who qualifies to donate plasma for possible COVID-19 investigational treatment with antibodies

Ideally, what the current antibody tests CANNOT DO,

1. Tell if a person is immune to re-infection
It is unknown whether the antibodies detected by currently available tests are “signal” (just “flags” that the virus has passed through a body) or “protective”. People with Herpes simplex have positive serum antibodies, yet they have recurrent herpes attacks. Immunity against any infectious agent can be complex; more than just due to antibodies.

2. Tell how long the antibodies will last

3. Diagnose or exclude active COVID-19 infection

What do you need to know?

1. If an antibody test is performed at home, an urgent care center, or a doctor’s office (usually “rapid” tests), it is likely unreliable. Commercial labs, like LabCorp and Quest, will offer test products more likely to eventually receive FDA-approval status, and so with results that may be more reliable, though that is still not established.

2. No one knows if COVID-19 antibodies are protective against re-infection (though, likely they are, at least partly) or how long they last.

3­. Antibody testing done by large commercial labs, such as LabCorp and Quest, are probably the best tests available at this time, though still may be far from the high standards for any medical testing (ideally sensitivity and specificity over 95%, with a very low rate of false positives).

4. Regardless of how good any antibody test product is, the science is not yet developed on whether the antibody detected by the test can imply immunity to SARS-CoV-2 virus. The result cannot be used to decide on the need (or lack of it) for continued quarantine, social distancing, masks, etc.

CONCLUSION: Beware of antibody testing and relying on the results at this time. Currently, the World Health Organization, given the COVID-19 antibody tests available, recommends against it.

At this time, we can offer this testing, provided the patient/client is fully informed on all the issues described in this document
AS SOON AS SUCH TESTING CAN BE RELIED UPON, WE WILL PROMOTE IT.

Edward R. Rensimer, MD
Director, International Medicine Center
Houston, TX

CORONAVIRUS-19 WALK-IN TESTING INTAKE FORM ORDER SHEET (CLICK HERE)

ON-SITE, REMOTE LOCATION COVID-19 GROUP TESTING SERVICE

Rensimer & Associates can, on a case-by-case basis, depending upon location, number of tests, and time of day/urgency, offer remote location testing of groups.

1. Physician Time: $450/hour*
Staff Time: $75/hour/staff member (usually two support staff needed)*
Administrative fee: $50/test
Test Fee (nasal swab):

LabCorp $100
Quest $100

*Travel time will be billed

These fees will be paid up front with reimbursement for tests not done if the final total of tests is less than the number of tests previously projected. Physician and staff time fees will not be refunded. Minimal charge for our time will be $1,000.

2.This service includes patient results callback, results reporting to Public Health Dept., and a certificate of test results.

3. A group listing of examinee names, phone numbers, and dates of birth will be required 24-48Hrs prior to an appointment to minimize time needed to provide the service, and so your lower cost.

4. To fairly estimate the cost, we project about 90 min/50 tested individuals at your location if all information has been provided upfront and the individuals are immediately available.

5. Documents provided,
a. COVID-19 POSITIVE RESULTS ACTION FORM: provides directions to the examinee on steps to take if they test positive.
b. COVID-19 POINT OF VIEW/BUSINESS: This is a document that provides fact-based information to employees relevant to their return to the workplace during the COVID-19 pandemic. The document can be modified to the needs of the organization.

Edward R. Rensimer, MD
Infectious Diseases
Director, International Medicine Center

Copyright, 2020, E. R. Rensimer, MD, All Rights Reserved

WALK-IN COVID-19 TESTING

WALK-IN COVID TESTING

We are now offering, without a physician appointment needed, COVID-19 testing by,

1. Nasal Swab SARS-CoV-2 (COVID-19) virus PCR
2. COVID-19 Serum Antibody (blood)

If you have a group for which you need testing, on a case-by-case basis, we may be able to do it on-site (your location), depending on distance and the size of the group.

Edward R. Rensimer, MD
Director, International Medicine Center