Christmas Thoughts

 

"Let's turn to Matthew chapter 1," I told my children.

"But I want to open presents!"  Victoria wailed.

I suppose I am one of those cruel Dads who thinks it is his duty to instill in his children the reason for the Christmas season, but it does seem important.  Victoria was the only one who expressed her frustration with my diabolical plan.  Elise was too young to realize that it even was Christmas Day and the other children were old enough to hide their impatience.

As my children read through the story of Jesus' conception and the visit of the wise men, I thought of the different miracles in the story.  The virgin birth, the star, and the mixture of faith and unbelief demonstrated by the various actors within this account.

"So, what is today?"  I asked my children, when they finished reading.

"It's Jesus' birthday,"  Elliot said.

"No, Elliot," Vince said firmly.  "It is the day we celebrate Jesus' birthday.  We actually don't know what day Jesus was born."

"So, how should we celebrate Jesus' birth?"  I asked.  "Do you think it would be good to have a birthday cake and sing Him "Happy Birthday?"

Elliot nodded.  He likes cake of all kinds, particularly birthday cakes.

"There were two groups of gifts given in this story," I continued.  "There were the gifts the wise men brought and then God gave us the best gift of all -- His Son.  So, what can we give Him in return?"

"We should give him our hearts," Anna said.

"That's right," I said.  "But I think there is something more.  How did Jesus tell us we could do things for Him?"

My children were silent.  This was too much of a "Guess what Dad is thinking" sort of question.  I am good at asking those and typically I am the only one who seems to come up with the answer that I am looking for.

"Jesus said that as we do things to the least of these, we do it to Him.  So, as we see people in need around us and do things for them, we are giving Him gifts."

I continued to ponder on this concept.  The goal I have when I give a gift to someone is not to give them something I want, but something they want.  The same should be true when I approach my Savior.  Often the hardest part is figuring out what that person actually wants, but Jesus was clear about that subject.

Jesus did not say He wanted big celebrations with lights and trees and positive postings on Facebook -- there's nothing wrong with those things, He just didn't ask for them.  He said simply that He wished for His followers to love the world the way He did.  He wanted His people to give until it hurt and then to keep giving until it stopped hurting.  He wanted them to continue the ministry He began so many years ago.

For Him, that would be the greatest gift of all.

Vaccines and Pyrrhic Victories

                             

The year was 279 BC and King Pyrrhus of Epirus decided to invade Italy and challenge the growing Roman Republic for domination.  He mustered his forces and gathered allied troops in southern Italy.

All went well until they came to Asculum.  There the Roman forces had massed and pitched battle ensued.

History tells us that the Greeks won a resounding victory over the Roman forces.  Casualties on the Roman side were at least double those of the Greek forces.

The only thing was that the Romans could (and did) quickly call up more forces to replace their losses while King Pyrrhus could do nothing to replace his casualties.  Many of his commanders died in the battle and his allies started to lose interest in the war.  He is quoted by Plutarch as saying in the aftermath, "If we are victorious in one more battle with the Romans, we shall be utterly ruined."

Thus was born the term Pyrrhic Victory. 

I think we hear of it most often these days in terms of sporting events.  A team wins a close game only to see its star player go down with serious injury.  They have won the battle, but lost the war.

I have heard many people say variations on the statement, "What does not kill me will only make me stronger."  The reality is something different.

"What does not kill me may make me a lot weaker."

The Diseases of the Past

There is a common misconception about the diseases of the past.  People believe that the danger was that they caused death.  Of course, that was some times true, but more often, they just left an individual damaged for the rest of their lives.

Polio weakened muscles, some times to the point that people required external ventilators, called iron lungs.  German Measles caused children to be born with severe birth defects.  Youth carried hearing and vision loss for the rest of their lives from the remnants of H. Flu meningitis.

These little bodies told the tale of Pyrrhic Victories.  Battles won, but damage so severe that life would never be the same.

Many of these infections were viruses and so even modern medicine with its antibiotics has few tools to deal with them.  It is a blessing that we know few younger people who have walked through these infections. 

From this were born vaccines.  The first true vaccine was the rabies vaccine, created by Louis Pasteur (the small pox vaccine was earlier, but it doesn't really count from my standpoint).  Considering that rabies was (and is) 95 percent lethal, this was a real game changer. 

The concept with vaccines is simple.  Give a person a small dose of killed or weakened virus or bacteria and let their body create antibodies to that infectious agent.  The doses are typically kept small and so most vaccines require multiple doses to be certain that there are protective antibody levels present.

Over the years since, there have been many vaccines created to deal with a variety of illnesses.  With the advent of vaccines has come a fear -- fear of the "secret ingredients" in the vaccines and a belief that it is healthier to get these illnesses the "natural way."  As though God intended children to suffer through Measles, Mumps, German Measles, and Diphtheria on their way to an unhealthy adulthood.

I am going to try to wade through some concerns that people have about vaccines and then touch a bit on the recently released COVID vaccines.

History of Vaccines

The very first vaccine was for Small Pox.  Small Pox was an illness that devastated Europe for centuries.  It was said that ten percent of the population died from Small Pox.  There was no treatment.

Then, in 1798, Edward Jenner had a light bulb moment.  Others had noticed that the milk maids in London had the best complexions of anyone around and figured out that it was because they got infected with Variolae Vaccinae (Cow Pox).  Dr. Jenner had the idea of infecting lots of people with Cow Pox and thereby preventing Small Pox infections.

It worked and death rates from Small Pox dropped considerably.  Unfortunately, it was a bit of a dead end as it was mostly happenstance to find a mild disease that provided immunity against a deadly disease.

The first true vaccine was for rabies.  Louis Pasteur was a genius who had already done work to come up with a vaccine against Anthrax for live stock.  He decided to turn his attention to rabies and managed to grow the virus in the brains of rabbits.  He then killed the virus and in 1898 injected some of the material into a boy who had been mauled by a rabid dog.

Amazingly, the boy did not succumb to rabies and the door was opened to begin work on other organisms.

Since that time, there have been hundreds of vaccines worked on.  Some of the projects have been successful and some haven't.

Everyone is Afraid.

As I read posts about vaccines, it is clear to me that there is a large group of people who is more afraid of getting a vaccine than getting the diseases they are designed to prevent.  

This says that vaccines have worked.  We don't see people in iron lungs any more from polio.  We don't have members of our community dying from Lock Jaw.  We haven't seen children with Measles related encephalitis.  This is not because we have treatments for these infections.  We don't.  We just have shots that are remarkably effective at preventing them from happening.

At the same time, we still don't have great treatments for these illnesses.  A six year old boy last year spent 57 days in the hospital after getting Tetanus with treatment costing over 800,000 dollars.  Perhaps the shots would have been better.  https://www.cdc.gov/mmwr/volumes/68/wr/mm6809a3.htm

Secret Ingredients in Vaccines

Vaccines do contain preservatives, they contain tiny amounts of formaldehyde and aluminum.  This all sounds terrible and many have claimed that they are dangerous.  The only thing is that we live in a world that is pretty toxic.  A breast fed baby will get more aluminum in a couple of days than is present in any vaccine on the market.  Fortunately, our bodies break down the tiny amounts of toxins present in our environment and diet very quickly.

Mercury is notably absent from most vaccines at this point -- only present in multi-dose vials.

Vaccines typically contain adjuvants as well.  Adjuvants are designed to deliver an antigen in such a way that it gets the maximum effect from the immune system.  When you feel achy after a vaccination or get a low grade fever, it is typically because the adjuvant is "doing its thing" and revving up your immune system.  Adjuvants: Introduction | British Society for Immunology

All of these ingredients are kept to as tiny an amount as possible and none of them are secret at all.  Vaccine Ingredients .  Vaccine Additives

Vaccines Don't Work?

Many people have the perception that vaccines don't work.  Rates of childhood illnesses fell due to better care of drinking water and better health care.  We have antibiotics and even a few anti-viral agents.  I have seen many post this sort of statement (mostly related to the possibility of COVID vaccine), "We don't have any effective vaccines against viruses." or "We have a flu shot and still have lots of deaths from influenza."

Of course, this ignores the fact that polio, measles, mumps, rubella, Hepatitis A, Hepatitis B and Chicken Pox are all viruses and we have effective vaccines against all of those.  

We are actually pretty good these days at creating vaccines against viruses.

Influenza is an exception.  The issue with influenza is that it is a virus that mutates a lot from season to season.  It lives in poultry and pigs in China and as it transitions back and forth each year, the virus changes quite a bit.  Each year, the CDC makes a judgment about what strains of flu will be most common.  Sometimes they guess right and sometimes they are off, but for a typical year, the flu shot may be anywhere from 20 to 60 percent effective against the common strains.

(I still recommend the flu shot for those who can take it -- it's the best we have and it generally is somewhat effective).

Why There Aren't More Vaccines

So if vaccines are so wonderful, why don't we have more of them?

As with everything, there are multiple reasons.  The most important thing for a vaccine to work is that humans have to be capable of long term immunity to an organism.  So, with infections like Measles and Chicken Pox, people get a single infection and then are immune for life.  This is an ideal scenario.  We only have to simulate this to get the same type of response without the infection.

Unfortunately, our bodies are not able to handle many viruses.  HIV and Hepatitis C are not infections that are typically cleared by our immune systems.  People who have these viruses have chronic infections for years and while those patients do form antibodies to these viruses, the antibodies are not protective.

Then, there are infections that we only form short term immune responses too -- things like RSV.  Vaccines against those sorts of infections are difficult and often require regular boosters to be effective.

Some things, like the common cold are caused by lots and lots of different pathogens and so it becomes difficult to design a vaccine that would cover even 70 percent of the most common causative organisms.

Finally, the disease has to cause enough health issues and be wide enough spread, to make it worthwhile for someone to invest money to come up with a vaccine.  For instance, Ebola causes a lot of death and devastation, but each time there was an outbreak, it was controlled with public health measures before a vaccine was developed and so the matter would be dropped till the next outbreak.  We do have an Ebola vaccine now, but it took many years to develop mainly because Ebola was "controllable" with public health measures.  The common cold, while very contagious and prevalent, doesn't cause serious enough health issues to warrant investment in a vaccination.

Temporality Doesn't Equal Causality

Children are very prone to magical thinking.  They blinked three times quickly and then someone broke a plate immediately afterward and they think they caused it and are careful not to blink again.

Adults are often the same.  They got an injection and immediately thereafter they got sick.  Their child got an injection and developed an illness.

With vaccines, we do large studies with thousands of people to see if there are things that are more common in the vaccinated patients compared to the normal population.  It is really hard to prove a negative, but we can say that in studies of thousands of children who have gotten the MMR vaccine, there is not any increased rate of autism compared to unvaccinated children (actually studies indicate 7 percent lower incidence in vaccinated children).  'No link between MMR and autism,' finds major study - NHS (www.nhs.uk)

The issue is that MMR vaccine is typically given around 15 months of age and that is also the age that most parents begin to notice issues with their children who have autism.  Autism is about 90 percent genetic.  There are some environmental factors that can be identified, but vaccination does not seem to be one of them.  Link Between Genetics and Autism (verywellhealth.com) 

Fetal Cell Lines

One of the biggest ethical issues with vaccines has to do with use of fetal cell lines to make vaccines.  There are a number of cell lines made with cells taken from babies that were aborted in the 1960s through the 1980s.  There are no ongoing abortions done to produce vaccines, and the infants were not aborted for the purpose of making these cell lines, but obviously this taints our view of these particular vaccines.

The vaccines that are commonly used that are grown on these cells are the Rubella (German Measles), Varicella (Chicken Pox), and Hepatitis A vaccines Vaccines Grown on Fetal Cell Lines.  I do still recommend using these vaccines.  To me, it is akin to organ donation from someone who was murdered.  Not using these vaccines will not change the abortion, but perhaps some good can come from the prevention of disease.

Others will differ from me on this and that is understandable.  I think these are two different view points on the subject of Fetal Cell Lines that look at the ethics from a Christian perspective.  This one is by Dr. Amy Givler:  Am I My Brother's Keeper  This one on the Gospel Coalition:  Are Fetal Cells Being Used for COVID Treatments

With the COVID vaccines that are coming, the Charlotte Lozier Institute put together a nice table looking at which of the vaccines were made using fetal cell lines and which not.  Fortunately, most were not made with these.  Charlotte Lozier Institute

Many medicines (including these vaccines) have some testing on these fetal cell lines during development, although they do not continue to use the cell lines to produce the vaccines.  Among the medications tested on these cell lines (at some point) seem to be ivermectin, monoclonal antibodies, and Remdesivir.  It must be understand that while these have been tested with virus made in fetal cells, they are not manufactured using these cells.

Ethically, any time there is an option, I think we would do well to steer away from vaccines made with these cell lines and go to other options.  

Not All Sources of Information are Equal

In today's climate, everybody has an opinion, the problem is that not all of them have facts behind them.  Someone like Robert F. Kennedy Jr. is trained as a lawyer.  I am sure that he is well meaning, but he doesn't have insight or understanding necessary to give an informed opinion.

While personal stories have impact and people who come across very strongly seem like they should have evidence on their side, that may not be the case.  It is useful to look at actual statistics from places like the CDC.

I will do my best to share things are true and researched, but even here, it is wise to check up on me and make sure I have data behind my opinions.

COVID Vaccines

Operation Warp Speed has been in full gear since the beginning of the year.  Three vaccines are in the process of being launched and several more are in line behind them.  I would like to finish by briefly mentioning those.

mRNA Vaccines

Messenger RNA is a hot topic lately.  mRNA is what takes messages from the DNA to the ribosomes, where proteins are manufactured.  The DNA never leaves the nucleus, but it generates mRNA that tell what proteins are to be made.  https://www.modernatx.com/mrna-technology/science-and-fundamentals-mrna-technology 

Till recently, vaccines involved growing a bacteria or virus and then either weakening or killing it and then giving small doses of it to patients to generate antibodies.  

A more recent vaccine, called Shingrix, actually took manufactured surface proteins from the Herpes Zoster virus and administered them to patients.  This turned out to give extremely good immune responses -- better than earlier vaccines for shingles.  Shingrix

mRNA vaccines take this a step farther.  They use mRNA to get the cells in a patient to make proteins that look like surface proteins on the COVID virus.  The body then sees this spike protein as something foreign and begins to generate antibodies to it.  Eventually, the mRNA wears out and the cells stop making the protein.

In the trials, these vaccines were very effective -- between 90 and 95 percent effective at preventing any COVID infection after the second dose and 100 percent effective at preventing serious infections.

Side Effects were mostly things like fevers, muscle aches, and fatigue.  There were four people who got the vaccine who developed Bell's Palsy, although it isn't clear if this was related to the vaccine.  Some people had allergic reactions to them.  Side Effects of Pfizer's COVID Vaccine  

While these vaccines have been rushed along, they have already been tested on thousands of people.  And testing isn't over.  The FDA will be doing post-hoc analysis to see if there are any other things that show up.  The most important thing is clarity -- patients need to know what the side effects of these vaccines are.

Do These Vaccines Change Your DNA?

There is a rumor going on that getting one of the mRNA vaccines will change your DNA and once that happens, "even RKF Jr. won't be able to help you."  I think this misses how mRNA works.  

In the human cells, DNA is the software code that instructs cells how to make the different proteins they need to function.  However proteins are made in a part of the cell called the ribosomes, while the DNA never leaves the nucleus.  mRNA is the go-between that takes messages to the ribosomes telling them what proteins to make and how to make them.

With a vaccine that uses mRNA, the mRNA never makes it to the cell nucleus.  It functions in the ribosomes until it is degraded at which point the cell stops making the protein.

Even if somehow your DNA was changed, the worst case scenario would be that some important protein in the DNA would be damaged and the body would do what it normally does, which is take care of that cell with a process called apoptosis.

For those who question evolution, this should be obvious.  Mutations don't randomly create new species, because they don't stick around if they aren't useful.  (See the book Darwin Devolves for more on this subject).

Traditional-style COVID Vaccines

Astra Zeneca, Janssen, and Merck are all working on vaccines that are developed with a more traditional process.  Basically, they grow COVID virus and then kill it.  The Janssen and Astra Zeneca vaccines use fetal cell lines, while the Merck use monkey cells to grow the virus.

It is a little soon to comment about these except to say that the AZ vaccine had some odd things with their trial.  They made a mistake in the trial and gave a bunch of people half a dose of the vaccine.  Those people got a full dose with their second dose and compared to those who got two full doses, they had better results.  https://www.biopharma-reporter.com/Article/2020/12/10/What-next-for-AstraZeneca-s-half-dose-COVID-19-vaccine  I don't know what this means, but the data for the half dose is less than what maybe we would like.

Other Vaccine Candidates

There are many other vaccines coming down the road.  Some others will be mRNA, some with proteins, and some with killed virus.  It is too soon to say much about them except that each one will need to be studied individually before they are given approval to be used.

Were They Launched Too Fast?

The first COVID vaccines came out with less than a year of development.  This happened because world governments threw billions of dollars at the vaccine development and guaranteed the companies making them that they would buy the vaccines, regardless of their effectiveness.  That is to say, if Moderna's vaccine was completely ineffective, the US government would still have bought a bunch of it (but not administered it to patients).

The point was to get the companies to begin manufacturing millions of doses of these vaccines, even before the testing was done.  By taking away the risk from the vaccine manufacturers, they saved a lot of time and fortunately, some of the early vaccines are much more effective than we had ever hoped.

In addition, technology has come a long way.  We know how to grow viruses and kill them.  We know how to make basic vaccines.  The whole genome of the COVID virus was sequenced in March.  These are the sorts of things we can do today that would have been very difficult to do ten or fifteen years ago.

At the same time, there is more testing to do.  As vaccines are given we will be watching for anything concerning.  This watching never stops.  If I see a significant reaction to a tetanus shot, I still report it to the CDC who will track it, even though tetanus immunizations have been on the market for decades.

Take Home Message

I am a big believer in vaccines and vaccination programs.  Some, like the flu shot, are not terribly effective and some that have been tested have caused serious issues (RSV in the 1960s, Rotavirus in the 1990s).  Every one that is released needs testing prior to release and then continued analysis after release to be certain that they are safe and doing what they are supposed to to prevent disease.

The COVID vaccines have been tested on thousands of people so far.  We know that they are very effective at preventing serious COVID infections and hospitalizations.  They have had some allergic reactions and otherwise minimal issues.  Certainly, as we give these vaccines to millions of patients, other things will show up.  There will be more allergic reactions.  Perhaps other side effects or groups of patients that shouldn't get it.

I do plan to get a COVID vaccination.  The issue to me is not my personal risk from COVID -- it is probably small (although we don't know all of the long term implications of COVID infections).  The issue to me is that I could be the conduit whereby someone else gets COVID who does worse than I would.  I have seen all too many situations where a younger person gave COVID to someone older.  The younger person sailed through unscathed, while the older individual ended up in the hospital and came out weakened.

More than anything, I believe in vaccines to prevent Pyrrhic Victories and am glad that we live in an age where we have the option to protect our children from illnesses that could have maimed them in another era.

Outpatient COVID 19 Care

 

 

I picked up the phone.  It was the third time that day that I was making this sort of call.  “Ms. Nellie?”  I asked when someone picked up on the other end.

“Dr. Waldron,” the voice on the other end said, the words pouring out.  “I don’t know if you know, but I tested positive for COVID.  I guess my daughter gave it to me after Thanksgiving.  I’m so worried.  Some folks have told me at my age that it is a death sentence!  What should I do?”

Over the next several minutes, I talked to my distraught patient about her diagnosis and some things to do and some things not to do.  Most of all, I tried to instill in her a sense of hope.  Things would be OK.

What we know at this point is that most people with COVID will have mild illnesses.  At least 90 percent will be able to take care of themselves at home without requiring hospitalization.  The younger you are, the less likely you would need anything more than supportive care.

When to Get Tested

It is often difficult to know if you should go get tested for COVID.  You have a little tickle in your throat and maybe your nose is stopped up a little.  Maybe your neighbor stopped by for a quick chat and then called you a couple of days later to let you know that he tested positive for COVID.  There are a myriad of symptoms that we can experience and it is sometimes hard to know when to go get a test.

Common COVID symptoms are cough, fever, and muscle aches.  Loss of sense of smell is an obvious one that we associate with COVID infections, but to be honest, only about 60 percent of symptomatic people will have this symptom and so I wouldn’t put too much stock in the fact that you can still smell.  If you have the other symptoms you should probably get tested.

There are a lot of people who have other symptoms – GI (diarrhea, nausea) or simply confusion when their infection starts

If you have these symptoms and you need to be around other people, it is important to get tested.

If you have no symptoms but a possible exposure, it is probably best to wait.  Testing early is very prone to false negative tests.  Remember that you must have a certain level of virus in your system for the test to detect it.  Running out to get tested the day after an exposure may make you feel better, but it won’t really tell you if you are infected.

Dealing with a Negative Test

One of the hardest things is to figure out what to do with a negative test result.  Quite simply, a lot depends on your level of suspicion.  If your symptoms all fit COVID-19 and you had a known exposure, I wouldn’t trust a negative test.  Too often it is a false negative – either the swab wasn’t good enough, or some other factor made the test negative.

Of note is that Rapid COVID tests seem more prone to false negatives and so should be trusted a bit less than the standard PCR tests.

But if the test is positive, what should you do?

Isolation

Probably the hardest thing if you test positive for COVID is staying away from other people.  Many individuals don’t feel too bad and they want to get back to normal as quickly as possible.  The current recommendation is that you stay home for at least ten days.  At that point, as long as your symptoms have resolved for 24 hours, you can get back to normal.

It is not OK to continue with normal activities, even if you wear a mask and aren't really sick.  Quite simply, you may have gotten a mild illness, but you could easily infect someone else who might give it to someone else and eventually, one of those folks could get really sick with it.  The goal is to break that chain of transmission.

While you are isolating, it is a kind thing to notify the people you have been around for the last several days of your positive test.  Some states are doing "contact tracing," but it is probably taken better if you let your friends know yourself.

Don't Feel Guilty

I think all of us know that we could "do a little better" at social distancing and wearing masks.  If you come down with COVID-19 there is a tendency to blame yourself or, others for your infection.  Those sorts of feelings aren't helpful and could lead to destructive emotions like anger and bitterness.

As Scarlett said, "Tomorrow is another day."

Rest

Much of what we do for COVID is “supportive care.”  These are things like pushing fluids, resting, and deep breathing exercises.  The whole point of this is to give your body the care it needs in order to fight the infection off and avoid a superimposed bacterial infection.  We know that this can happen with influenza and it can happen as well with COVID.

Some have suggested using a device called an incentive spirometer.  This is something that people use after surgery to make sure they are taking deep enough breaths and while there is not testing showing it prevents more serious lung infections with COVID, it would make sense that it would help.

Fever Control

I have met some people who believe that it is important to “sweat out” their fevers and they avoid medications like ibuprofen and Tylenol.  There is no particular benefit to letting your temperature go way up and certainly you will feel a lot worse if you do.  My experience is that it is easier to keep your fever down than to get it down once it shoots up.

It is probably better to keep the temperature under 100 with either Tylenol or ibuprofen.

Vitamin D Supplementation

We know that people who have low Vitamin D levels seem to get worse cases of COVID than those who have normal levels.  That said, it doesn’t seem to help very much to start taking it once you get sick. 

My recommendation would be that if you are planning to get COVID down the road you should go ahead and start on a Vitamin D 2000 unit a day now.  If you aren’t sure if you plan to get it, it wouldn’t hurt to take it anyway.  https://www.covid19treatmentguidelines.nih.gov/adjunctive-therapy/vitamin-d/

Zinc

A lot of people think that Zinc is the wonder supplement when it comes it respiratory infections.  There is some indication that low zinc levels can increase risk of bad COVID infections.  There is no indication that taking zinc if you aren’t deficient does much.

I still generally recommend folks take 25 mg of Zinc a day while they are combating COVID.

Vitamin C

Vitamin C is another vitamin that is a "wonder vitamin."  It is the sort of thing that most of us take more of when we come down with colds.  There have been studies done looking at mega doses of Vitamin C (6000 mg) with COVID and did not indicate any benefit.

On the other hand, there was a study that showed that taking between 1000 and 2000 mg at the first onset of cold symptoms seemed to shorten colds duration by a little bit.  This is the dosage that I recommend people to start on.  It is safe and may help a little bit.

Other Over the Counter Medicines

Some people complain of stomach upset with COVID-19 and it can be helpful to take some Pepcid as this is pretty effective at calming that down.  Typically the cough with COVID is a dry cough, but if you have much mucus production, Guaifenesin (Mucinex/Robitussin) can be helpful to thin that out so that it doesn’t gum things up as much and is easier to cough out.

I do not recommend the “D” versions, as the pseudoephedrine in them tends to raise blood pressure and heart rates without a whole lot of benefit.

Monitoring

Hopefully you have a thermometer and can keep track of your temperature curve.  I am surprised how many moms think they can tell someone's temperature by a hand on the forehead.  "Feels like about 101, Honey."  Even if you have this skill, it is nice to have a calibrated instrument capable of giving an accurate reading.

The handiest thing to have if you are dealing with a COVID infection is a pulse oximeter.  A pulse oximeter used to be a very expensive piece of equipment that only medical offices and clinics could afford to have, but the prices have come down a lot.  It is a little device that goes on the end of a finger (or a toe) and gives you an oxygen saturation and pulse reading.  These are two important things.

Typically, even if you feel bad and are working a little harder to breathe, your oxygen level should stay up.  Three reasons to consider heading to the hospital for further evaluations are (1) decreased oxygen level (less than 95 percent for someone without chronic lung disease), (2) fast pulse rate (over 100), or fever that stays elevated despite medications to bring it down.

Other Medicines

It is hard to know what to say about other medications.  If you have asthma, certainly COVID can worsen your control and increasing inhalers and even adding steroids would be in order.  As far as steroids and COVID in patients without asthma exacerbations, they don’t help, unless people need to be hospitalized and placed on supplemental oxygen.  I have tried nebulized budesonide and despite reports to the contrary it really didn't seem to make much difference in how my patients did (they generally did fine, but there was no sudden turn around with this).

Hydroxychloroquine really doesn’t seem to be effective and isn’t recommended, despite some doctors claiming that it is helpful.  I know this has become very political, but if Dr. Zelenko's treatment regimen has any benefit it is from the Zinc.  I can't find any studies that replicate his retrospective study findings.  Hydroxychloroquine to treat COVID-19: Evidence can’t seem to kill it | Science-Based Medicine (sciencebasedmedicine.org) 

Antibiotics are not generally helpful unless someone begins to show sign of a bacterial infection on top of their COVID.  This will typically either be in a patient who requires hospitalization or someone who thought they were getting better and then a few days later begins to have recurrent infectious symptoms.

I will mention Ivermectin only to say that I don’t know about it.  Some are recommending it now, at various stages of COVID infection.  It may help, but it probably needs some formalized testing.  This is a summary of the issues with studies dealing with ivermectin.  Ivermectin is the new hydroxychloroquine, take 4: Bret Weinstein misrepresents meta-analyses | Science-Based Medicine (sciencebasedmedicine.org)  The studies all seem to include lots of other medicines including lactoferrin, hydroxychloroquine, doxycycline, steroids and Zithromax making it difficult to sort out what benefit is really from ivermectin and what is from other things.  Further, one of the biggest studies that showed benefit from ivermectin has recently been withdrawn due to some issue with plagiarism and fraudulent data.  Flawed ivermectin preprint highlights challenges of COVID drug studies (nature.com) If your health care provider is comfortable prescribing it, it probably wouldn't hurt, but I have not found it be helpful in my practice.

Monoclonal Antibodies

The number one thing that we know helps people avoid hospitalization are infusions of monoclonal antibodies.  These are infusions of antibodies that are targeted at the COVID virus, basically to help our immune systems fight of COVID more effectively.

The studies that looked at REGEN-COV antibodies found an 81 percent reduction in "events" (deaths or hospitalizations) between the antibody group and the placebo group.  1.5 percent of those who got antibodies required hospitalization, while 7.8 percent of those who got placebo ended up in the hospital.  Phase 3 Prevention Trial Showed 81% Reduced Risk of Symptomatic SARS-CoV-2 Infections with Subcutaneous Administration of REGEN-COV™ (casirivimab with imdevimab) | Regeneron Pharmaceuticals Inc.

It is important to note that these antibodies are most helpful if given early -- they are not approved for people requiring hospitalization and oxygen therapy.  They probably show the most benefit in patients who are at high risk for developing complications from COVID -- people over 55 years of age or those with risk factors.  They are not approved for people under 18 years of age.

Many states require a referral from a medical provider to give these infusions, but some states have set up infusion sites where people can self refer upon receipt of a positive COVID test.

Antiviral Agents

There are a couple of antiviral agents that are likely to be available soon in the United States.  The first one, from Merck, is called molnupiravir.  It is moderately effective for those who have mild to moderate COVID and cut people with those symptoms need for hospitalization by 30 percent.  The benefit of this is that it will probably be cheaper than an antibody infusion and of course, it is a pill, so it doesn't require a visit to a specialty pharmacy.  At this point, if someone is high risk for developing severe COVID, I would still do an antibody infusion as it seems more effective than this antiviral medication.  9 Things You Need To Know About the New COVID-19 Pill > News > Yale Medicine

Pfizer is releasing a protease inhibitor called Paxlovid.  Early data suggests that it is about 90 percent effective at preventing progression to severe COVID.  This pill is a little farther away from release, but my guess is that the benefit of this will replace monoclonal antibodies for the majority of people.

Obviously, there are many scientists working on specific agents against COVID and there will be more things coming out that will be quite effective.

Primary Care Provider

I know a lot of folks get their routine care from places like Urgent Cares, but it is really helpful to be established with a primary care provider.  Even if you get your COVID swab at an Immediate Care, the follow up will be done by a primary care provider.

Our office has been calling patients daily to check up on them after a COVID positive test, until they seem to have turned the corner.  If there are issues that develop, we are able to treat or help them sort out what the next step is.

I think it is important, even in a quarantine period, that people realize they are not alone.

Hospitalization

Probably only about ten percent of people with COVID will end up in the hospital.  Obviously at this point, you are in the hands of someone else and will need to rely on the doctors at the hospital for good care.  Typically now, depending on how sick you are, hospitalized patients are being treated with dexamethasone (a steroid that has the best data for reduction of COVID mortality), oxygen, and low molecular weight heparin (for prevention of blood clots). 

Remdesivir is a medication that is used in some ICU settings.  It has gotten a bad reputation due to some doctors (who don't work in ICUs) claiming that it causes kidney failure in a high number of patients.  Studies do not show that when Remdesivir is used to treat COVID pneumonia that increases the risk of kidney failure.  I will say that some pretty major trials have shown minimal benefit to using Remdesivir.  The Cochrane Review analyzed data from multiple trials and indicated that it is pretty ineffective at reducing length of hospital stays or deaths.  Remdesivir for the treatment of COVID-19 | Cochrane  There is no indication that Remdesivir makes anything worse (the same Cochrane Review says that there are "fewer side effects with Remdesivir than other treatments"), but it may not be beneficial in the way that we hoped.  

Some patients will require ventilation.  ICUs are trying to position patients on their stomachs (prone positioning) to try to keep fluids from collecting at the back of the lung.  Obviously, this isn't the easiest position to care for someone in, but it does make a difference in survival rates.

We are doing much better at taking care of patients who are admitted to the hospital.  Even for people who require ICU admission, at least 70 percent will survive, although it will probably be a long road to get out of the hospital.

Hope

The most important thing to me with any diagnosis is not to lose hope.  This is true with COVID-19 as well.  Regardless of the things that you have read about how terrible things “can” get with COVID-19, chances are good that you won’t ever need to cross that bridge.  Worry does not change a thing about the future, but it certainly makes the present less enjoyable.

I have made lots of these sorts of calls to inform people of positive COVID test results.  The most important thing for me in those calls is to remove the sense of despair that many, particularly the elderly, experience with this news.

As I think about it and what to do with the time you have while isolating, I would encourage you to pray – not just for your own healing, but also for those who are experiencing it first hand, the health care workers who are stressed out, and just for general healing in this nation.

Real good can come out of any experience.  Even wading through the waters of a COVID-19 diagnosis.

“When I am afraid, I put my trust in you.”  Psalms 56:3

The Mind of Vince

 

"Vince," my wife, Elaine, said.  "I'm looking for the CD that Elliot needs to play along with for his piano practice.  Do you know where it is?"

"Of course," Vince answered, looking at the stack of CDs he had been sorting through earlier in the day.

Our household is one of the few south of the Mason Dixon line that still listens to CDs.  I think, everyone else uses Pandora or Spotify or has reverted to vinyl.  I don't know if these silvery discs are better than MP3s, but since we own them, we still listen to them.

"Well, where is it?"  Elaine asked Vince, with a touch of frustration in her voice.

"It should be easy to find," Vince said.  "I just finished organizing them."

Elaine studied the CD boxes for a several seconds.  "How did you organize them?  They don't seem to be organized either by style of music, or alphabetically."

"Oh, I didn't organize them that way," he replied.  "I organized them by copyright date.  It makes more sense than any of the ways you mentioned."

He went over to the stack and thumbed through them.  "Here it is," he said, offering the CD to his mother.

Vince's mind works differently from mine.  It may be an obvious way to organize literature, but I can't imagine trying to find something in a library where all of the books were arranged by copyright date.

"Ah, yes sir, The Lord of the Rings you say?  That would be over here in 1954.  Right beside Wheel on the School and Horton Hears a Who!  A very good year if I might say so..."

I may not understand how my son's mind works, but I fathom even less of the mind of God.  Isaiah 55:8,9 say, "For my thoughts are not your thoughts, neither are your ways my ways, declares the Lord.  For as the heavens are higher than the earth so are my ways higher than your ways and my thoughts than your thoughts."

William Cowper wrote words to a song many years ago:

    God moves in a mysterious way

      His wonders to perform.

    He plants His footsteps in the sea

      And rides upon the storm.

The problem isn't that God's ways don't have purpose.  The issue is that their purpose is far beyond my feeble ability to fathom.  It is easy to think that God doesn't know what He is doing, or worse, that He is a capricious God, vindictive, and only looking for our destruction.

Nothing could be further from the truth.

When we don't understand God's purposes in our lives, it is mainly that we don't really understand God's mind or His ways.  The best course is to trust Him and wait.

We will see that our Heavenly Father has our best purposes at heart, even when His ways are mysterious beyond our understanding.

Eleven Lessons From the Lord the Rings

 

I have always loved the Lord of the Rings (books not the movies) since I first read them. I was probably seven and when I got to the end, I was sad -- not just because of the final parting, but also because a whopping good tale was over.

Tolkien's stories probably seem a little dated these days. They move a little slowly. He didn't like to kill off his main characters. His descriptions of places are fairly long and odd poems and made up languages dot the text.

Maybe it is because of these things that I have loved the books so much, but I have also found that there is a wisdom and a Christian ethic that fills these books that a lot of modern fiction is missing. Other books may be more intense and drama filled, but they don't speak to me in the same way.

I have cobbled together ten quotes and what they say to me.

Life is not about battles.

"Victory cannot be achieved by arms..." --Gandalf

I think many people read the Lord of the Rings for the first time expecting to find pages rippling with magic spells and scintillating battles. While there are some of both of those things, they are a small portion of the books.

Our world and even Christians have lost track of what will bring victory. It is not achieved by battle, but rather by small people doing the little they can.

God is guiding each situation.

"I can put it no plainer than by saying that Bilbo was meant to find the Ring and not by its maker. In which case you (Frodo) were meant to have it." -- Gandalf

Tolkien made it clear throughout the story that there bigger hands guiding the story. Sauron and Gandalf and others are doing what they can to push events in one direction or the other, but Someone greater is making sure that at the right time a tiny hobbit finds a magic Ring.

That to me, is a very encouraging thought.

Kindness shields us from much evil.

"Pity? It was pity that stayed his hands. Pity and Mercy: not to strike without need. And he has been well rewarded, Frodo. Be sure that he took so little hurt from the evil, and escaped in the end because he began his ownership of the Ring so. With Pity." --Gandalf

Gandalf was responding to Frodo's upset statement that it was a pity that Bilbo didn't stab Gollum when he had the chance. Gollum had betrayed them and was dangerous to the quest. Gandalf's answer left no doubt of his opinion of the subject.

Kindness, even to someone who doesn't deserve it, yields blessing in the end.

Those who focus too much on the darkness brave two perils -- despair and desire.

"It is perilous to study too deeply the arts of the Enemy, for good or for ill." -- Elrond

"Didst thou think that the eyes of the White Tower were blind? Nay I have seen more than thou knowest, Grey Fool... For a little space you may triumph on the field, for a day. But against the Power that now arises there is no victory." --Denethor

The Lord of the Rings makes it clear that there are two dangers. Saruman, a very wise man and wizard, was corrupted through his study of Sauron's arts. He desired the same sort of power and prestige that he thought that path offered.

On the other hand, Denethor, Steward of Gondor, was driven to his own destruction by the sights he saw of the enemies of his land. Truly it is dangerous to meditate too long on the darkness.

It feels very appropriate to contemplate this thought for a long moment. It feels as though the righteous, in these times, have been driven in one of two directions. Either they are using the Enemy's weapons against him or, they simply despair -- the evil is just too great to be overcome.

These things ought not so to be.

Even the most evil men are not evil in the beginning.

"For nothing is evil in the beginning. Even Sauron was not so." --Elrond

The message is clear. It is not that there is good in everyone that will rise up, like Anakin Skywalker from the ruins of Darth Vader.

Rather, those who are evil have fallen because of the choices that they made. Those who are good are  on the right path because of decisions that they have taken. Integrity comes because someone chooses every day to follow the right path, not because he or she is inherently righteous.

Good things are worthwhile, even if we don’t understand them.

“He that breaks a thing to find out what it is has left the path of wisdom.” --Gandalf

Gandalf was responding to Saruman who has just told him he is no longer Saruman the White, but Saruman of Many Colors. Gandalf responded simply “I liked white better.”

Perhaps there is a need in us to understand the inner workings of everything. It is more important to identify wholesome, good, and pure things and cling to those, even when we don’t understand them completely.

It is the smallest deeds and lives that make the difference in this world.

“Yet such is oft the course of deeds that move the wheels of the world: small hands do them because they must, while the eyes of the great are elsewhere.” --Elrond

Human nature is to focus on great feats of athleticism and courage and to think that the course of human events is altered by these things. The adage of Mother Teresa rings true, we can not all do great things, but we can all do small things with great love.

The Ends Do Not Justify the Means

'But fear no more! I would not take this thing, if it lay by the highway. Not were Minas Tirith falling in ruin and I alone could save her, so, using the weapon of the Dark Lord for her good and my glory. No, I do not wish for such triumphs, Frodo son of Drogo.' -- Faramir

Faramir, brother to Boromir is a wonderfully noble character.  His relationship with his father, Denethor, is filled with tragedy, as Denethor clearly valued Boromir above his younger brother.

Frodo is attempting to find a way into Mordor when Faramir captures him and Samwise.  In this chance encounter, Faramir has the opportunity to take the ring from Frodo and bring it back to his city, assuring the men of Gondor of certain victory.

When facing the same decision, Boromir fell to temptation, but Faramir chooses against the temptation.  He cannot use the enemy's weapons against him, even if it is only the way to assure his country of victory.

Those who use evil weapons end up corrupt in the end -- even if they have only good motives.

We are only setting the table for another generation.

“Yet, it is not our part to master all the tides of the world, but to do what is in us for the succor of the years wherein we are set, uprooting the evil in the fields that we know, so that those who live after may have clean earth to till. What weather they shall have is not ours to rule.” --Gandalf

There are tasks for each day, decisions that we make that will affect the course of the lives of our children and our children’s children. This is not a new concept, nor is it terribly deep and yet, our human tendency is to focus on ourselves and our pleasures rather than on those who will come after.

Regardless of our intentions, future generations will reap the seed we sow today.

Heroes are those who keep on despite the darkness.

“That’s not the way of it with tales that really mattered or the ones that stay in the mind. Folk seem to have been just landed in them, usually – their paths were laid that way as you put it. But I expect that they had lots of chances, like us, of turning back only they didn’t.” --Sam

I suppose we read stories incorrectly. We read them knowing that the hero overcomes, that good wins, and that Sauron is destroyed (minor spoiler), but the characters in the midst of the story don’t know that. They only know that the challenges set before them seem overwhelming.

Each one of us is in a story today and we don’t know the ending. It is our challenge to persevere despite the darkness.

Heroes give for others even though they may not personally enjoy the results of their labors.

“I tried to save the Shire, and it has been saved, but not for me. It must often be so, Sam, when things are in danger: someone has to give them up, lose them, so others may keep them.” –Frodo

This is for me, the saddest point in the story. Frodo returned to the Shire but was so deeply wounded that he could never find healing. He doesn’t hold that against the hobbits who don’t understand.  He is only glad that something good has been saved.

So it is for us. We must make the effort, endure the darkness, and continue on, not because we get some benefit, reward, or medal at the end. Rather something good has been accomplished. Something valuable has been saved.

Everyone has a reason for playing a part in this story.

Even Gollum.

Thanksgiving in 2020

 

"What are you thankful for, Victoria?"  I asked my six year old daughter.  It seems to be the time of year for thinking about gratitude and I wondered what she would say.

"I am thankful for chickens," she told me.  "And I am thankful for the eggs that they lay."

Victoria has really enjoyed us having chickens and goes to check on them and check for eggs at least two times every day.    Who knew how much a few Rhode Island Red chickens would mean to a family?

Maybe this year doesn't seem like a good year to think too much about Thanksgiving.  We have gotten through this year, but it certainly doesn't seem like one filled with a lot fun and excitement.  I Thessalonians 5:18 says, "In everything give thanks..." and while that may seem appropriate for pastors, maybe it feels like something that regular, every-day sort of people can't quite put into practice.

I think there is a special blessing though if we can look for reasons to be grateful.  So I decided to try to make a little list.

I am thankful for a house that doesn't stay clean.  

It means that I have five energetic children who have the desire and the ability to read books and play with all sorts of things.  It means I have a one year old who believes that her divinely appointed purpose is to empty every drawer within reach onto the floor.  The fact that my children need some encouragement to put things away after the fact says they are normal children.  For that I am grateful.

I am thankful that we continue to have church services.  

Our church has been curtailed a lot.  We are spaced out and only meeting once or twice a week.  Things are different than they were before March of this year.  But we are still meeting.  We do still fellowship.  The Spirit of God continues to move in His people.  The fact that services are not exactly like they were will only make me value it more when we do "go back to normal."

I am thankful that there are lots of opinions on Facebook.

There have been times that I thought that it would be wonderful to live in a world where everyone believed like John Waldron, but it is the differences between us that make this world an interesting place.  

I am grateful that I get hungry -- multiple times per day.  

It would be nice if I didn't feel it necessary to eat quite so often.  I have seen enough patients who have lost their appetite to know that this is a big deal.  I enjoy my meals as much as anybody and eating Thanksgiving Dinner would not be nearly as enjoyable without a little seasoning of hunger.

I am glad that I go home tired at the end of each work day.  

My weariness tells me that my patients trust me enough to come and see me.  As hard as some days are, I would rather do what I do than anything else.  It is a blessing not only to have a job, but to have one where you can make a (positive) difference in the lives of others.

I am thankful for COVID.  

This is perhaps the hardest thing of all to be thankful for.  This tiny respiratory virus has changed everything this year -- mostly for the worse.  It has let me know what and who is important in my life.  It has made me realize how important my relationship with God is.  It has led me to pray for lots of people that I don't even know.

There are lots of other things I could mention.  There have been hard events and times of blessings, but most of all, I am thankful that my Heavenly Father has held my hand through each day.  It is with the knowledge of how good God is that I can thank Him in every situation.

The difference between a thankless heart and one full of gratitude is a belief that everything that happens to me is for my good and planned by One who is only good.

I am not Pollyanna, gushing constantly about how wonderful everything is in my life.  I get discouraged, but even when I am down I know that God is the source of every good thing in my life -- especially the chickens.

Praying for Astronauts

 "And we go to Final Countdown!"  A woman's voice crackled with tension.  "10 -- 9 -- 8--..."

My children and I were watching the launch of the Space X Falcon 9 Space Capsule that was to link up with the International Space Station.  If those doing the telecast were nervous, I also felt tense.

"And we have lift off!"  A blinding light emitted from the base of the rocket and slowly the rocket began to leave the launch pad.  Then rapidly it soared, becoming a glowing light headed for the dark recesses of Space.

As I watched the rocket rise through the atmosphere, I began to pray for the astronauts.  "Lord, keep them safe.  Protect them..."  

Perhaps in this scientific age it seems unneeded, but I remember another space flight when I was eleven years old.  It was the flight of the Challenger where the seven crew members aboard "Slipped the surly bonds of earth to touch the face of God."

The Challenger disaster was the first time that I had thought of the Space Program as anything but routine.  Up to that point, I did not understand the dangers involved in space flight.  That day in January of 1986 was the beginning of my realization that science cannot solve all problems.

As I've gotten older, I realize this more than ever.  I am sure that there are still many among us who still have an undying confidence in science, but I realize that there is something -- Someone -- more.

And so, as I watched the Falcon 9 rise, I prayed for these astronauts I didn't know at all.  They had families who wanted to see them again.  Science had done what it could, but I wanted God's hand of protection over their flight.

I think about this now in terms of COVID-19.  There are men and women who every day gear up to take care of very ill people in clinics and ERs and ICUs.  They are doing the best they can.  They are using all the tools that science has given them to care for themselves and for others.

They are stressed to the maximum.  Perhaps those of us still on the ground watching them throw caution to the winds can do a bit more.  Perhaps we can give them encouragement in some little way.  Maybe we can pray for them, that God would give them strength and courage.  That He would calm their minds and give them peace in a way that Science cannot do.

We need to draw our prayer circle just a little wider...

These days, Science sits on the throne, but  even its most ardent devotees have an uncomfortable feeling that it is but a usurper.  It give no peace or joy to its followers.  Its control is at best tenuous as we await the Return of the King.

Joy and Politics

 

The United States Presidential Election of 2020 is past.

Sort of.

Votes are still being tallied and lawsuits filed.  Emotions are running hotter than ever.

For some reason, a stanza from the poem "An Irishman foresees His Death" by William Butler Yeats keeps coming to my mind.

    "My country is Kiltartan Cross

        My countrymen Kiltartan's poor.

    No likely end could bring them loss

        or leave them happier than before."

The poem is a dark look at World War I from an Irish perspective.  This, unnamed pilot, believes that he will give his life in battle and nothing would change for his people.  

Perhaps this is a nihlistic way of looking at the world.  It doesn't matter what we do, bad things will happen and there is nothing we can do to prevent it.  

I reject that view.  Rather to me, this poem speaks of the peril of faith in the wrong things.  More importantly, it tells me that it is dangerous to get our joy from shallow sources.

At the end of the vote counting, roughly half of the people will be happy and half will be angry and disappointed.  I am cynical enough to believe that in 18 month's time, most will be more than a little frustrated.  As powerful as the President is, he is very ineffective at bringing joy to the people.

Nehemiah 8:10 says, "Do not be grieved, for the joy of the Lord is your strength."

Joy is something we need in hard times.  It is different from happiness in that it is less obvious, but it is also not founded on circumstances.

Our Heavenly Father is faithful and strong enough to provide peace and joy to us in every situation.  His people would do well to show that they have tapped into this unlimited source.

God's people need to have less faith in politicians.

His servants need to have more faith in Him.

Most of all, the Children of God must never let politicians steal their joy.

The Christian and Politics

 

"Latesha," the message on my phone read.  "You too can make difference!  We need you to get out and vote for candidates who can produce change!"

I paused for a moment with a shocked look on my face.  It has been over 20 years since I entered the witness protection program and someone had finally figure out my true identity -- Latesha Smith.  And now, with this blog post the reality is out over the whole internet... 

This is not the only text message I have gotten over the last several weeks, intended for someone else, but encouraging me to take up my civic duty.  Reading some of the posts on Facebook, I would be convinced that the main duty of Christians is to vote for the right candidates.  Certainly if we can put God back into the legislative process, this country would be a better place.

The Two Kingdoms

Anabaptists have traditionally have had a view of the kingdoms of this world which is decidedly negative.  The rulers of this world are never truly at peace with the Kingdom of God.  At best, these worldly kingdoms have an uneasy truce with the church, but often they attempt to manipulate it and coerce its followers.

There are no theocracies on earth and even those countries that pay lip service to a deity in their Constitutions cannot truly claim to serve God in their actions.

I suppose hope springs eternal.  Perhaps if enough people in a democracy voted the right way, truth and morality would prevail.  Certainly that seems to be a common refrain and yet, there are certain dangers we need to think about when Christians get too focused on politics.

Opportunity Cost

Quite simply our mission on earth is to enlarge and strengthen the City of God.  This will not happen through political means.  Enacting good laws can get our neighbors to clean up the outsides of their homes and lives, but this is not the goal of the servants of Christ.

Our goal is to introduce people to Jesus and allow Him to change their hearts.  

Everyone of us has only 24 hours each day and 7 days each week.  Ephesians tells us "Look carefully then how you walk, not as unwise but as wise, making the best use of the time, because the days are evil."  Quite simply, politics to me feels like a waste of time compared with other ways we can use our time.

Push towards Hyper-Patriotism

The Prophet Jonah is well known to us.  We know the story of how he was called to give a message of God's judgment to the nation of Assyria.  Instead he fled, only to be swallowed by a fish.  

What is hidden until the end of the book is Jonah's reason for fleeing.  It wasn't that he was afraid of the Assyrians or that he didn't believe God's message.  Quite simply, Jonah was afraid that the Assyrians would repent and find forgiveness.  As a devout Jew, he could not abide the possibility that his enemies would find redemption.

At the end of the book of Jonah there is a beautiful question from God "Should I not pity Nineveh, that great city, in which there are more than 120,000 persons who do not know their right hand from their left, and also much cattle?"  

The answer is never given, but should appear clearly to the reader.  God is bigger than politics and He desires redemption for all -- Republicans, Democrats, and Independents.  His servants would do well to remember that.

Being too focused on politics can lead us to think that those on the other side of the political aisle are unworthy of redemption.  The political process really seems to have led to a high level of anger and it is hard to imagine praying for those who we see as despicable.

Taking an Easier Way

At the beginning of Jesus' ministry, we have recorded in Matthew 4 of Satan coming and tempting Him.  One of the temptations was to worship Satan and in return, the devil would give Him all of the kingdoms of the world.  

Quite simply, Satan was offering an easier way for Jesus to achieve His goal.  This was a way that did not involve suffering and the cross.

Today, Satan beckons to Christians with the message that they do not need to invest themselves in ministry and discipleship and mentoring others.  Instead, they can use the political process to achieve the same ends, with much less effort.

Satan would tell us that our goal is legislating against sinful behavior, but nothing can take away from our true basic responsibility -- to introduce people to Jesus.

Overestimating Politics

About one hundred years ago, this country embarked on an experiment with something called Prohibition.  For thirteen years, a Constitutional amendment went into effect that prohibited the sale of alcohol in the United States.  Church groups were very pleased, because they believed that alcohol was a major source of immorality in the United States.

In some ways, Prohibition worked.  It reduced alcohol consumption by quite a bit.  Rates of fetal alcohol syndrome dropped considerably.  Rates of cirrhosis and alcoholic liver disease plummeted as well.

At the same time, organized crime flourished with the illegal alcohol trade.  In numerous woods and hollers illegal stills popped up to nourish the continued desire for that which was now illegal.

Laws had changed while hearts remained the same.

Then in 1933, Prohibition was quietly repealed and everything went back to the status quo.  Prohibition left the law books and entered the history books.

In some ways, Prohibition was unusual.  More often than not, politicians are simply not able to carry through on their campaign promises.  The House or the Senate simply doesn't cooperate or judges shoot down laws that have been enacted.

Far more than that, enacting the right laws may make for a safer society for the righteous, but it doesn't fix the fact that the "Heart of man is deceitful above all things and desperately wicked."

Jesus said to Pilate "My kingdom is not of this world."  

It is easy to fall into the trap of believing that if the right person isn't elected President, if the wrong party controls the Senate and the House, that God's will cannot be done on this earth.

It is not so easy to circumvent the will of God.

We are called to share the Gospel, to serve, to disciple, and to teach others.  We are to love as Jesus loved, even those who might differ from us in beliefs.  We are called to introduce those who do not know Jesus to our Master.

Only then will hearts be healed.

Only then can the world be changed.

The Christian and Conspiracies

  

"Dad, why do people believe conspiracy theories?"  My twelve year old son asked me.

"I don't really know, Vince," I said.  "They've been around for a long time and so I suppose they must help people deal with life in some way, but I'm not sure exactly how."

And so my mind began to turn, thinking about the subject and trying to understand it.

Conspiracy theories aren’t anything new.  Throughout history, there were lots of different ones.  In Europe, long before World War II, there were strong beliefs that Jewish people were behind many terrible things in history.  Europeans in the Middle Ages even believed that Jews caused the Black Death by poisoning their wells.  More recently, there have been lots of interesting, if unprovable theories about the assassination of John F Kennedy.  

The conspiracy theories that you buy into depend on who you are and the culture that surrounds you.  Citizens in the Middle East are much more likely to believe that the holocaust was faked or believe that many recent terrorist activities were sponsored by Western countries with colonial aspirations.  On the other hand, Americans tend to believe that government agencies are “out to get them.”  They think that the CDC is controlled by unsavory elements that are trying to harm the citizens of the United States.  They are sure that “Big Pharma” is creating illnesses to pad their bottom line.

The most important thing about conspiracy theories, is that they do not require facts, but are more dependent on strong belief by the people espousing these theories.  So, if you believe that the earth is flat, that the moon landing was a hoax, or that the CDC and all the other “experts” are faking the COVID pandemic, you need very little data to back up your opinions and convincing you that the main stream opinion is correct is likely impossible.

Conspiracy Theorists Value the Wrong Opinions.

I remember a patient of mine who came to see me after seeing her cardiologist.  "He tells me that I need a pacemaker and defibrillator," she told me.

"He's a good doctor," I told her.  "I think you should probably go ahead and do it."

"Yes," she said.  "But he doesn't really know me and I know he doesn't care about me like you do.  That's why I wanted to come and talk to you about what he wants to do."

I understand this feeling.  Experts may be smart, but do they really have our individual concerns and needs in view?  Maybe they are just trying to make their next boat payment.  

At the same time, a cardiologist is far better to listen to when it comes to a decision about a pacemaker than a family doctor.

Conspiracy theorists are unwilling to trust the mainstream “experts.”  They claim (and rightly so) that experts aren’t always correct.  Computer models and initial predictions are often wrong.  So they choose other experts and ignore the facts and data informing their chosen expert's opinions.

The most important thing when evaluating a video on You Tube should not be “does this make me feel good,” “is this person charismatic,” or “do I like what they are saying.” The question should be what facts are behind their statements and is there real data that backs up their opinions.

I would say one thing more, which is that true experts are quicker to say “I don’t know” when something is unclear.  This is not always the case with Conspiracy theorists.

Conspiracy Theorists Exaggerate Their Credentials.

I come at this from a medical standpoint.  I have read articles where doctors claim to have cared for “thousands of COVID patients” or to be members of some Harvard task force.  Investigating further, you find that these claims are exaggerated. 

I am not someone who claims that you need board certification to have a valid opinion on a medical subject, but I also don’t think you need to be deceptive about who you are and what your background knowledge is.

For what it is worth, I am a small town family doctor in Central Virginia who wants to serve Jesus and thinks a little too much about things like this.  Those are my only credentials.

Conspiracy Theorists Only Bring Up Facts that Support Their Theories.

I suppose this is not surprising, but conspiracy theorists are quick to delve into tiny sentences in articles that don’t really support their point of view and claim that they support what they believe.  Understand that this is not a court of law, this is about having a real understanding of the facts about anything from COVID, masks, or even assassinations.

If you are talking about masks, for instance, I want an explanation of why countries who use them see reductions in new cases and deaths from COVID and do not see lots of hospitalizations and ER visits from mask induced hypercapnia.  If you don’t address this, I am going to be less willing to listen to some of the other things you are sharing.

If your claim is that the earth is flat, I want more than criticism of the round earthers, I want an explanation of the physical laws we see and observe.  Skipping that makes me believe that the round earth scientists are correct.

Conspiracy Theorists are Unwilling to Trust Occam’s Razor.

William of Occam in the 1300s believed very strongly that all extra details need to be stripped away and the simplest explanation of the facts should be viewed as the most likely explanation.  This is the opposite of most conspiracy theories. 

For a conspiracy theory to be really juicy, there need to be secret powerful societies involved, as well as some foreign labs, and maybe a couple of suitcases full of money floating around for good measure.  All these sorts of things make a good spy story, but not so much what we see in our every day world.

If the CDC makes a recommendation, it is not because a political party is paying them off, nor is it because “Big Pharma” is manipulating them.  It is because the scientists that work there believe what they are saying to be accurate.  If they change that recommendation, it is not because they are being paid off, but because new data has come out that makes the older recommendations no longer valid.

Conspiracy Theorists are Looking for Reasons.

Terrible things happen in this world.  Men assassinate world leaders.  Terrorists fly planes into tall buildings.  Viruses somehow transition from bats to humans in China and lots of people get sick and some die.  All of it seems like there should be plots behind it, replete with secret labs, illuminati, and criminals in dark suits and sunglasses.

Unfortunately, there aren’t always reasons behind things.  The experts give their assessment of the situation and it doesn’t feel adequate.  In this absence of “real” answers, people rise up who will explain the "why" of each tragedy.  Each of these individuals has a following, if not the facts.

 Conspiracy Theories Harm the People Who Believe Them

There are probably a number of ways in which these beliefs are harmful, but there are a few which stand out to me.  First of all, they lead to a general paranoia.  There is enough evil in this world without believing that the people charged with our safety and protection are trying to destroy the very things they are supposed to protect.  Paranoia is a dangerous mind set and one that can lead to depression, fear, and anger.

Further, it seems as though people who believe conspiracy theories in one area tend to have these beliefs become generalized.  Quite simply, if you are certain that one part of the government is lying to you, it is easy to believe that other parts are as well.

Another thing is that folks who believe conspiracy theories are often unwilling to do things that would be beneficial to them from a health and wellness standpoint.  They are afraid of vaccines or cholesterol medications and will not try them, even though there are numerous studies that show benefits.

The last thing is that these theories really seem to lead to anger and hatred of all who hold different views.  I suppose it is human nature, but over time people seem to become really entrenched in their beliefs and believe that all others who hold different beliefs are foolish.

Christians Are Commanded to be Discerning

We know that in the Old Testament, false prophecy was judged harshly.  False prophets were to be put to death if a single one of their prophecies was incorrect.

In the New Testament, Christians were still commanded to be discerning.  John, in I John 4:1 said, "Beloved, do not believe every spirit, but test the spirits to see whether they are from God, for many false prophets have gone out into the world."  Quite simply, John did not want the early Christians to naively believe everyone who came along.

We are to be like the Bereans, searching and trying to understand to see who is really sharing truth.

Buying Into Conspiracy Theories is an Indication that Christians are too Invested in this World.

This is a mouthful. 

Jesus told His disciples that they were to be in this world, but not of it.  Paul told Timothy that “A time is coming when people will no longer listen to sound and wholesome teaching.  They will follow their own desires and will look for teachers who will tell them whatever their itching ears want to hear.”  It feels as though this Scripture has come to pass in my hearing.

Of course Christians care about the society they live in, but they should care more about seeing people meet Jesus.  Our focus should not be understanding the darkness, but on spreading the light.

It is important for Christians to evaluate carefully the source of their information, but even more, not to become overly politicized.  When Jesus returns in the clouds, he will not be riding a donkey or an elephant and those He returns for will be those who have served Him, not those who voted a certain way or posted the right memes on Facebook.

They will be those who visited Him in prison, who saw Him hungry and fed Him, and who saw Him in need and gave freely to help His needs.  The message of the Gospel is clear.  As we do these things (or don't do them) for the neediest among us, we do them to Him.

This morning I pray for clarity and for truth to prevail.  I pray for anger and dissension among the people of God to end.  I pray for false prophets and false scientists to be revealed.

Most of all I pray that Jesus’ followers could focus on Him and the world to which they are going.  

While Conspiracy Theories may, in some convoluted way explain the darkness they will never spread the light.

This world needs that light more than anything else.