HJNO Nov/Dec 2024

POLITICIZATION OF COVID 18 NOV / DEC 2024 I  HEALTHCARE JOURNAL OF NEW ORLEANS of staff; Emma; the people that we employ on our side of the fence can move that pol- icy debate and that implementation, I think, in a very good direction. Coleman I think in the previous scenario, you had the state health officer. Policy originated at the level of the secretary. The train had already left the station by the time you had a physician commenting on that policy, and the trajectory couldn’t be changed much. So, part of the role of the surgeon general is to have a physician at the top of policy cre- ation, guiding that in a direction that makes sense, not just from someone who works at LDH. And I’m not demeaning the doctors who just work there in an administrative capacity, but I think that there’s a role for someone who practices real medicine and sees the effect of these policies on a day-to- day basis to be at the origination of them. I think that we’ll have a better practical effect of policy by having him there. Rep. Tarver So, is this a little bit of a transi- tion or a shift from the way it was prior? Coleman Yes. Abraham A pretty big transition. Rep. Tarver We’ve had some commentary or suggestions in these hearings about the potential for an oncoming repeat pandemic type thing, bird flu or whatever has been mentioned. So, we have a better approach towards dealing with [this] under this sce- nario with the surgeon general and the policy. Abraham We do now. Rep. Tarver What would be some of the things that you would specifically do dif- ferently in policy under a new type of epidemic? Abraham Wind the watch. Pause. Think before you just react. That’s what happened you in favor of that, correct? Abraham Absolutely. Rep. Tarver If we had a bill or a legislative instrument to protect or enhance that, you would help us in that regard. Abraham I would. You know, I’ve been mar- ried for a long time to my wife, she’s here. I love her dearly, and that marriage bond is very, very, very important. But I will debate you that the patient-doctor bond should be a tighter bond. My patients will tell me things they will not tell their spouse, because they know I’m going to keep it con- fidential. They know I’m going to help them with whatever problem they had. So for me on a personal level, as strong as my mar- riage bond is, my patient-doctor bond – I will put it above that. Rep. Tarver You’re the surgeon general and you were the secretary of the department. What’s the hierarchy or different roles like for each of those? Abraham We’ve got Secretary Harrington and Undersecretary Drew Maranto that are doing, in my opinion, phenomenal work, that are going to oversee the Med- icaid, the other issues. As you know, LDH — you’ve seen the budget, you vote on the budget — it’s a big beast. Six to eight thou- sand employees, depending on whether you count them in town or out on sight, a huge agency that needs the leadership that Michael and Drew bring on their level. For Dr. Coleman and I, on the surgeon general side, we envision and are already moving in a very rapid pace to present public health policy that can be implemented by you guys that will change the course that this state is in right now, being at the bottom of the bar- rel in everything that I consider important — maternal and infant mortality and morbid- ity, chronic disease, you name it. We need to do a lot better. And that’s where I think Dr. Wyche; myself; Bethany Blackson, my chief talking necessarily about the illegal drugs. I’m talking about families who got hooked on drugs, who got hooked on fentanyl. You know what I’m talking about. Where is the priority? Because we talk about cost and benefit. How do you, how do you decide which battle to fight? Abraham I can only speak from personal experience, representative. Let’s go back to history. Ivermectin is an older drug now, it’s been out now a long time. Worldwide, it has been used extensively. It has basically cured river blindness in children in other countries that we fortunately don’t have here in the United States. It’s life changing. The point I’m trying tomake is the ivermectin is a drug that has a good history, and there has been so much use of it worldwide that the studies have shown it to be very safe for a long time. Now of course, on the other hand, fentanyl is like a gunshot wound to the heart – it’s gonna kill you. Rep. Tarver It has some good uses too, though, I mean… Abraham It does, in the proper setting, it is a pain control medicine. Everybody here, I’m sure, knows a patient that’s been touched by certain cancers. And some of the most hor- rific pain that I’ve ever seen a patient in is bone cancer. Certainly a fentanyl patch on that patient is both humane, and needed, and it does work. To your point of why the federal government prioritized demean- ing or degrading ivermectin as opposed to kind of putting fentanyl on the back burner? I can give you an opinion. I can’t back it up with any fact because nobody will give me a fact because we know the answer. I think I know the answer – it was political. And it’s so unfortunate because lives and good people died of that fentanyl epidemic, and it’s still happening. Rep. Tarver Moving on I guess a little bit, the doctor-patient relationship, and I compared it yesterday to attorney-client relationship,