HJNO Nov/Dec 2024

HEALTHCARE JOURNAL OF NEW ORLEANS I  NOV / DEC 2024 11 THE PROMPT lessons fromhistory. This is our opportunity to break from that trend. I hope we seize it now. Thank you, Mr. Chairman. Rep. Jack “Jay” William Gallé, Jr. Thank you, Dr. Abraham, for that. I appreciate your can- didness. I want to say thank you for your honest testimony and your honest view- point from being a treating physician your- self. I think those things need to be said. So, we all thank you. Were you a treating physi- cian during COVID? Abraham Yes. Rep. Gallé How many patients with COVID would you say you treated? Abraham Since the pandemic started early 2019, in the neighborhood of 20,000 COVID patients. Rep. Gallé Have you lost any patient to COVID? Abraham I have lost them. Rep. Gallé Can you give us a percentage on the number that you’ve lost versus those who you treated successfully? Abraham It depends on how you define lost or where you define lost. Certainly, patients that I had that went into a hospital situation, some unfortunately did not come out, that were placed on the ventilators. Those that I treated inpatient, in my clinic, I don’t know that I lost any. Rep. Gallé Can you repeat that? Abraham I want to give a very truthful and honest and reflective answer. But those — and we had some very, very sick patients — that had faith in us, faith in our clinic, where at one point it was only my daughter, myself, and my wife that were operating the clinic because everybody else we had basi- cally sent home, I don’t remember losing a patient that we treated in the clinic. Rep. Gallé What do you attribute that suc- cess in clinic to? Abraham Just common sense. We saw early on what worked. We certainly saw, nation- ally, what didn’t work. The basis of medi- cine is science. You fall back on your train- ing, you fall back on your education; and in this COVID pandemic, you had to reach way back to the first year of medical school and remember your physiology, your biology, your biochemistry, and how those cells in those lungs reacted to this particular virus. COVID certainly was a virus of infection, but more predominantly, it was a virus of inflammation. You all here have read about what is called cytokine storm. The cytokines are chemicals that are released in the bod- ies that take an insult, that produce severe inflammation in the body. COVID’s not 100% targeting the lung, but certainly the lung was the main organ that it impaired, and that’s what caused death in most cases. The heart was also impacted. When I would do CAT scans on my outpatients, patients that we treated in the clinic, there were patients where we would get results back from the radiologist where 60-80% of their lung vol- ume were inflamed and infected, with what was called by the radiologist, a ground glass appearance. That’s the inflammatory com- ponent of COVID. Oxygen exchange was greatly impaired and that’s where COVID did its worst damage. Rep. Gallé Can you share with us some of the early treatment that you used on your clinic patients? Abraham Yes, we were one of the clinics that would certainly prescribe a presupposed, or off-labeling — the ivermectin, the Plaque- nils [hydroxychloroquine]. We knew that the inflammatory component of COVID had to be checked very quickly to prevent that cytokine storm that had already occurred, or at least suppress it. So you go back to your biochemistry, why were these drugs being used in lupus? Why [was] Plaquenil used in other instances? If you look at those two drugs specifically, the ivermectin and the Plaquenil, they are strong anti-inflam- matory drugs. Early on, the CDC recom- mended not to use steroids in our patients. I’ve never stopped using steroids because they have also a very strong anti-inflam- matory component. What we noticed — and we would bring these patients back some- times two, three, four days in a row to treat with some steroid injections, certainly we cover the secondary infection with an anti- biotic, such as Zithromax, because it also has an anti-inflammatory component, along with being an antibiotic — but we would see improvement day-to-day. And again, I can- not stress how sick some of these patients were. They literally put their lives in our hands and, you know, great faith. We just could not let them down. Rep. Gallé If you were able to create early treatment, how come there weren’t more doctors who were engaging in early treat- ment and perhaps preventing some of the hospitalizations and the eventual placement on ventilators for some of these patients? Abraham I think a lot of it was fear from retaliation. I know that I got to the point in my practice where I would write a pre- scription of, let’s say ivermectin, and I was getting to the point where certainly the big box pharmacies and some of the local phar- macies were not wanting to fill it. And that’s where I give huge credit to our current gov- ernor. He came in and said, “No, you’re the doctor. You know the patient, do what you need to do to save patients.” In response to his letter that he wrote to the pharmaceuti- cals or the pharmacist, they backed off and we were able to move forward, to a point. We, in my opinion, were getting misinfor- mation from the CDC. I’m not sure, I don’t think it was malicious. I hope it wasn’t, but I think that really no one knew how to treat this particular viral particle. I go back in