Paul Herscu on the Vaccine

Get the First Series of Shots!

2019 Novel Coronavirus (CoVID-19): Part XVII
2019 Novel Coronavirus (2019-nCoV (first named); COVID-2019 (later named disease); SARS-CoV-2 (final name of the virus causing COVID-2019), COVID-2019 Pandemic:

December 29, 2020 update Part 17
Paul Herscu ND, MPH
Herscu Laboratory

Get the First Series of Shots! 

I receive numerous emails and telephone calls daily, from colleagues, family members, other physicians, policymakers and schools, from across the globe, asking me what my personal position is around the topic of COVID-19 and SARSCoV-2 vaccinations. With this update, I intend to answer these questions in broad and specific ways. I would like to describe the variables to consider, so we all have a fuller, nuanced understanding to contextualize this point of view. At the end, I hope you will see why and how I believe that vaccine in this very instance, at this specific time is important for everyone to have. In the future, I hope we develop better solutions, since this one is imperfect at best, but for the first cycle for the first year, a vaccine is the best way forward. I will keep this short, and mostly touch on a few of the most important variables. Please consider reading this post in its entirety.

Amy says I lost a decade of my life this year. As this virus began early this year, most of you know the tireless work we embarked upon, and then when the virus came into full swing, we wound up working with, well, countless patients with this virus. The work is nonstop. Initially, most of the work was trying to change the course of where we were going. But that was not to be. Here, I want to describe how that intersects with the current question of vaccinating for SARS-CoV-2, why we worked so broadly and tirelessly then to create a different path forward.

Often, people want a quick answer. And when I give them the quick answer, they seem disappointed, or confused, or are left feeling surprised and unsure. One very important group is integrative medicine providers (NDs, DCs, acupuncturists, DOs, and integrative MDs etc.) Many are looking for their role at this time in regard to the topic of vaccination. Please consider this discussion in the most general way. What I mean is that the issues mentioned here are universal to every epidemic/pandemic. Please don’t simply apply this understanding to the current pandemic, but consider these basic tenets that ring true regardless of epidemic or pandemic illness. In other words, learn these issues once, and you will be able to apply this at any other time in the future. This framework is universal with regard to understanding epidemics and pandemics. 

That said, the topic of vaccinations in general has been polarized in our society, and in the midst of this pandemic, that polarization is evident and growing. Within this polarized landscape we are finding up to 50% of adults considering not seeking the vaccine, a public health disaster by any definition.

WHO/WHERE/WHEN or PERSON/PLACE/TIME

An essential concept in public health which I have written about before relates to WHO/WHERE/WHEN or PERSON/PLACE/TIME. Simply put, regarding outbreaks/epidemics/pandemics, it matters when, where, and who is falling ill. Or to be more clear, one needs to consider interventions based upon these variables. And what you might decide at one point as a good intervention may not be a good intervention at a later time or with a different person. An epidemic is a constantly changing community event, to which we must adapt. I return to this point below. 

VIRUS NATURE

Another important topic is the nature of the virus. The point I made in January, 2020, which many also made, is that this is not a virus that would being going away in the next week or month or year. It is going to be with us for a long time. Actually, I still do not think people understand the full import of this comment. This one is not just going away. Which means that we actually do need workable, long-term, broadly accessible, effective solutions. There are several pathways that do exist here, though we have, as a society, chosen only one. More on this below. 

VIRUS MUTATION

An additional variable I wrote about early in the pandemic was the mutation of this virus. I know it is in the news just now, but only half the story is reported, which is causing unnecessary, or rather, premature, additional anxiety. As we highlighted, viruses mutate. This is part of the natural order of all organisms. The main questions around mutation should be:

1. What is the rate of mutations? 

2. Where is the location of mutation in the genetic structure of the virus? 

3. What is the effect of said mutation(s). 

1. Rate of mutations. Different species have different rates of mutation. There is an understanding in evolutionary biology, which goes: If there are too many mutations, the species dies. It’s too unpredictable. If there are not enough mutations, the species dies, as the species is not adapting fast enough to the changing environment. This concept is well paraphrased in Roger Lewin’s book title, Complexity: Life at the Edge of Chaos. What we have seen from the start is that this virus mutates, though in fact, more slowly than other coronaviruses. But a change is not necessarily good or bad. It’s just a change.

2. Location of mutation. This happens to be a very important question. Mutations can impact the behavior of the virus. In means it can make the virus more or less transmittable and/or more or less severe. Will the mutation make it more or less likely for the virus to attach to the cells or more or less likely to enter the cell? Ideally, the mutation makes it less likely to hurt us. For example, a mutation in the spike protein (the part of the virus that attaches to your cells,) would be pretty useful for us as it might make the virus less likely to attach. Unfortunately, from the very start, what we have seen is that the mutations do not seem to occur in the most important part of the virus and so scientists are observing modifications, yes, but none have been important enough ones for us, at least not yet. There is a lot here to discuss but you see the point.  

3. Effect of mutation. Which brings us to the most important question when discussing mutations. Has the mutation made the virus more or less transmittable and/or more or less dangerous?  

What is in the news just now is that the mutations have made the virus more transmittable. But the real question remains: has its potential for serious illness stayed the same or has it become more or less potentially dangerous?

You may recall that I am a strong proponent of convergent evolution. Simply put, this is a concept that all species constantly adapt, via mutations, towards being less virulent, less severe towards other species. In other words, what stopped the 1918 influenza pandemic was not any sort of treatment or anything that we as a species did. What stopped it was that mutations to the influenza virus which occurred, made it less virulent and less effective at hurting humans. 

When you are listening to news related to COVID mutations, recall these questions and stay grounded in the science. 

PEOPLE PURPOSELY CAUSING VIRAL MUTATIONS

Here is a related topic I spoke of in more detail in an earlier post, and highlight here once more. We have the technology to modify the virus itself. While we can wait for the virus to hopefully mutate in less dangerous directions, we can also actively produce a mutation that benefits us. I know this may sound awful, but actually it would have been the best way forward. Please hold off passing judgement on this just now. More details below.

ECONOMICS AT POINT

I remember as part of a lecture in February, and again in a Webinar hosted by my professional organization, I made the point that the consequence of what was about to befall us was so enormous, that on the economic side, it will hurt us all. The economic and social impacts, some predictable, others unforeseen, would likely send people who recently moved out of poverty back into poverty, leading to further multigenerational poverty, not just in the United States, but across the developed and developing world economies, too. The main point I made was that the economic burden will not be shared equally. I remember colleagues disagreeing with me on this front. I think the grave reality on the ground, related to how the economic fallout is impacting individuals, families, businesses and communities, is pretty obvious to all of us at this point. 

The reason I bring this up is the following. The longer the virus situation continues as it is, the more people will suffer. We will find:

1. More individuals in poverty. 

2. More families in poverty. 

3. More communities and whole countries in crises. 

4. Less services available to those in need.

5. Higher morbidity and mortality from variables not directly related to the virus, but to the fact that the economy is not supporting people in ways that are needed. 

6. Women will suffer more than before. 

7. Children will suffer more than before. 

8. People of color will suffer more than before. 

9. Less funding for a slew of programs that benefit many portions of the population.

This is not an exhaustive list, rather illustrates the real health and welfare concerns that have to be considered and accounted for as the pandemic ensues.

THE VACCINE

In general, vaccines are an intervention to produce an immune response to change the outcome of a future illness—both prevention getting sick or mitigating severity of illness, should it occur. There should be at least four issues that come into play here. 

1. How bad is the disease?

2. How bad is the side effect of the vaccine?

3. What is the main purpose of the vaccine?

4. How stable is the modification of the disease?

1. How bad is the disease? Here we know the numbers are bad. Simply put. Described more so elsewhere. 

2. How bad is the side effect of the vaccine? We do not know the full answer to this yet, but it seems as though the side effects are less than the disease if you read the studies completed before the vaccine received approval.

3. What is the main purpose of the vaccine? The 2 main reasons for a vaccine are to either make the disease less likely to be transmitted, or to make the disease less severe when/if it occurs. Ideally, both of these occur, but not necessarily. In the current vaccine studies, the main outcomes were to limit the severity of the illness in those vaccinated, which was tested for and proved effective, but what was not tested was transmission. Did those vaccinated not pass the virus as easily? This feature was not tracked as it might have been. As one example, we do not know how many people got the vaccine and caught the virus but were asymptomatic. It is possible that more people got the virus by vaccine but were asymptomatic. We simply do not know yet. but over time we will, by actually tracking this. I await this study. What we seem to know is that less people develop less severe forms of the disease when vaccinated, than those who were not vaccinated. We have to wait until they do the studies on the second question. This should have been part of the study in the first place. I cannot for the life of me understand why this was not done. 

4. How stable is the modification of the disease caused by the vaccination? This remains an important question. We do not know the answer to this, since it is a new vaccine. My personal opinion is that natural post infection antibody immunity lasts for 6-12 months. I would very much hope that this is at least as long for the vaccine. It would be a bad sign if it is a shorter period of time and a good thing if it lasts 2-3 years. More on this below. 

PATH DEPENDENCY

This is a term I like. Simply put it is a way to say that the past decisions and events matter and percolate down, bringing us to today. The past and present are both present, but not equally distributed. The choices we made or did not make have an impact on today, and on the path we are currently on. One corollary is that because we made certain choices, we are averse to, and resistant to, alternate ways to look at a problem. No one wants to be responsible for a change. Policymakers, scientists, and funders, retreat to a position of caution. I will come back to this concept soon. 

PUTTING IT ALL TOGETHER – HOW I CAME TO THE CONCLUSION THAT WE SHOULD TAKE THE VACCINE AT THIS TIME:

1. From what we know, this virus is not going away in the near future. 

2. From what we know, this virus morbidity and mortality is staying high; at this time around 1.5%-1.75% mortality, getting closer to the 1% I predicted at the start of it all. I believe it will stay in this range for some time to come. My current projections from last January are staying the same, I believe that if nothing changes, the first full, complete cycle will end with 500,000-2,500,000 dead in the USA. There is no math that shows this to not be the case at this point, unless something changes

3. The effect of this upon the health care system is leading to failures across the board. Numerous services are failing leading to excess mortality and excess morbidity even unrelated to this virus. Emergency departments, intensive care units, and hospitals in general, are taken up by COVID patients, so that many people are not seeking or are being refused other essential diagnostic or treatment care. There is ample loss and general misery. 

4.In terms of the economy, unemployment, etc., we know the facts on the ground are not good and not getting better any time soon. 

5. In terms of health access and outcomes, BIPOC, women, and others living at the fringes are having worse outcomes. Problems such as alcohol and drug abuse, domestic violence, anxiety, depression and suicide are all increased as a result of the many ways the pandemic is playing out and researchers believe these realities will likely persist even once the pandemic is passed.

This has to come to a halt as fast as possible. In January, 2020, I described several paths that were open to move forward to limit the harm that was surely on its way. These included:

1. Prevention, emphasizing public health measures, like everyone else. Unfortunately, as a country, we did not adopt the public health measures that were needed in a timely, urgent and unified fashion.

2. Mitigating the effects of the virus, by assisting in producing a normal healthy immune response, via natural medicine therapies. We discussed several options, but FDA/FTC asked many in the integrative doctor sector to stop discussing these, to halt making claims and to discontinue making any such recommendations. Ironically, when more traditional medical institutions and providers began to discuss the same concepts, many months later, there was less pushback, but by then, these recommendations were late. That delay was costly. 

3. Developing drugs aimed at normalizing and optimizing immune response. 

4.The development and distribution of vaccinations.  

There were several others, but the main point I wanted to make was, when we, as a species, are in crisis, we work towards solutions. We excel at this. But, as a society, what was decided in the spring of 2020, is that the path forward was going to be through vaccinations. You can read about this in my writing from that time. Specifically, I said that unless we deviate from this course now, at that time, the path dependency will lead us to vaccinations. As you recall from our intense and urgent communications, I, and many colleagues, were working tirelessly on other potential pathways, but let’s leave that aside.

We as a society, our officials in charge of such decisions, chose the vaccine pathway as our essential and most important way forward. And most of all our eggs went into that basket. I know some, just for the sake of argument might disagree with this, but think about it this way, just as one example. The current vaccines were built upon the final trials of 30,000-40,000 people, after smaller trials, and a couple of billion dollars per vaccine. How much money went to study Vitamin C, Zinc, CoQ10, Resveratrol, homeopathic treatment? Any one of such studies could represent a proof-of-concept to be built upon in larger trials. Most of these treatments are readily available, inexpensive and have extremely low side effect profiles. What was/is missing is robust testing, which needs funding. As a society, we decided to shut these other options down and put the majority of focus and funding into vaccine development. Right or wrong, that decision was made.

The next point flows from this. If you are not going to fund the preventive and treatment side aggressively and properly, especially the inexpensive, natural treatments that have for generations worked on supporting healthy immune function, then you are solely reliant on herd immunity. The number I mentioned this spring is still the same for me; 300 million Americans must be immune to the virus for our society to get back to some semblance of normal. One way or another you need 300 million people, more or less safe. You can have this from vaccinating this number of people, or from having 300 million people catch the virus, or a combination of the two. But one way or another, de facto, this is the direction we decided to pursue as a society. Three hundred million people need to be immune. 

Which is where one of my math problems arises. If we have around 30 million folks that had the virus and 250,000 died from it, and we just keep going as we have, the 300 million getting it naturally leads to 2,500,000 dead. We can’t have that. This would be a complete and total societal breakdown. It leaves us with only the vaccine path.  

Remember PPT point I made above. We are where we are, at this moment in time. We have, for the most part, underfunded drug treatments, and nearly, completely suppressed the study of potential natural treatments. This is what I mean by path dependency. The society has chosen and we are now, predictably moving down one pathway, which is to get vaccinated. 

DO YOU REALLY HAVE A CHOICE?

I would like to make one point incredibly clear. In my humble opinion, in fact, you don’t really have a choice here. I know the nature of the questions I receive is, should I or should I not get vaccinated? And it seems to many as though they have a choice right now. But again, please be aware that as a society this choice was made 9 months ago. It only feels like you have a choice because of vaccine numbers. If we were forced to get a vaccine now, all of us, right now, then we would run into the problem that there are not enough vaccines to go around. But as soon as there are, the lack of choice will become apparent. We will see mass vaccinations. And if we did not reach the high level of immunity, then one by one, the various professions will begin to mandate vaccines. Courts have already determined that business owners have the right to demand workers get vaccinated. And if not, they have the right to keep employees from their jobs.

One profession after the next will roll through the demands, and if not enough health care professionals chose to take the vaccine, then it becomes a prerequisite for work, and then people who live in nursing homes and those working with them, and if still not enough, then factory workers, and if still not enough, those working in education, and then students, and if still not enough, to get on an airplane, and if still not enough, to travel by train and bus. You get the idea. One way or another our leadership and society, in general, chose last spring that we are going to get to herd immunity, and as our main path to it, we will require vaccines. I state this as a fact, not as whether we should or should not, but what reality will look like in early 2021.                                         

In other words, I believe having a discourse on if you should or should not have a vaccine is unproductive, since you don’t really have a choice, in the end. We will see how this turns out, but I am pretty sure this is the reality we live in, and is easier to grasp when you appreciate the path our public health, research and leadership chose. 

So, if you ask me if I am getting vaccinated, I say yes, because I want to continue to work with my patients and I believe all health care workers will need to have the vaccine, to achieve herd immunity this way, rather than by waiting until we all fall ill as our way towards herd immunity. 

Further, I believe that those professions and those medical societies that at this point in time come out against vaccinations, are reckless, both to their patients but also to themselves. I do not see how a practitioner would be able to survive a lawsuit from someone who becomes ill from SARS-CoV-2 who chose not to vaccinate based on such a recommendation. I am trying to be forthright here. I am fairly certain that your own professional association will not support you in discouraging vaccination.  

I am not sure how to say it here, but that ship has already sailed. 

WHAT ARE THE ROLES OF INTEGRATIVE DOCTORS WITH REGARD TO VACCINATIONS?

1. As a point of clarity, and unrelated from the other points below, many integrative doctors provide vaccinations in their offices. For example, licensed naturopathic doctors in several states provide vaccinations for their patients, as is true for other licensed providers. And just as NDs have been conducting COVID-19 testing onsite, they might also provide the vaccine. This is just another practitioner offering recommended treatment. And in fact, up until now mostly NDs have been simply describing the potential benefits as per guidelines. Fine, but nothing unique here. What follows goes beyond that, and describes what we might add to the story.

2. Integrative practitioners, for the most part, have worked for decades, and in some instances, for centuries, in helping support healthy immune response and to optimize normal immune function. According to the vaccine makers, there are a variety of immune reactions and side effects, to be expected in 3%-50% of those who receive the vaccine. It may be that integrative practitioners can help the immune system function in healthy and appropriate ways, leading to the desired response to the vaccine, perhaps even extending the benefit of the vaccine. This needs to be tested in earnest.

I am not referring to helping those with anaphylactic reactions caused by the poly-ethylene glycol ingredient in the vaccine, but rather other potential reactions. People with that known allergy are not recommended to take this vaccine. (As a personal not unrelated side note, I nearly died two times from vaccines when immigrating twice in several years, finally to this country, as a child. So, for me to say that I am getting vaccinated, you can see, this is not a simple decision, but one decided upon last summer when I understood the direction things had gone was not changing and appreciating the reality that will emerge on the ground.)

3. There are a few different vaccines on the market just now, all are injectables. I assume that by late spring, early summer 2021, an intranasal, inhaled form will become available. It may be that integrative practitioners can help those who are unable to take the injectable vaccine at this time due to issues with what is used in those vaccines, using additional natural medicine approaches with regard to prevention. This needs to be tested.

4. Assisting those with vaccine hesitancy questions. Many times, those not wanting to vaccinate seek out integrative physicians. These practitioners can help assuage anxiety about the vaccine itself. 

5. Side effect profile. I believe integrative physicians can mitigate side effects of the vaccines. We only need funding to test this out. More on this below. 

6. Special circumstances. Aside from those that cannot take the current vaccine due to known potential anaphylactic reaction, there may be other groups of individuals who will not tolerate the current vaccines, or are recommended to skip the vaccine because of age or other reasons. It could be that integrative approaches can help with preventive care and with mitigating severity of illness by normalizing proper immune response, for those unable to take the vaccine. This needs proper funding to be tested.

7. Specifically, it may well be that the side-effect profile is as intimately related to the underlying health status of the individual, just as the disease expression of COVID-19 is modified by the underlying health status of those who contract the virus. Many of these health concerns plaguing our modern society are modifiable by integrative practitioners, whether it is diabetes, hypertension, heart disease, obesity, and other common chronic diseases.

8. It may be that people who do develop bothersome or long lasting side-effects find relief from an integrative practitioner who helps the person develop a healthy, appropriate immune response and helps with underlying health conditions that may have put the person at more risk for worse outcomes in the first place. This also needs testing.

WHAT WE DO NOT KNOW?

Leadership in the country has a great deal of hope with the vaccines, though, in fact most people have not fully thought out what the future might look like if this remains the only intervention. Picture the reality of where we might be headed.

1. By the summer or at latest the fall of 2021, more or less most people will be vaccinated. Which means that there is gradual easing of restrictions, but not a complete easing until next Fall. In other words, even though we are being vaccinated in December or in January, we are still wearing masks, and some businesses are still closed or operating below pre-COVID capacity. Sadly, people are still dying from COVID-19. 

2. We don’t really know how long the vaccine will last. Hopefully it lasts longer than the disease immunity, which as mentioned above, I still personally believe to be 6-12 months. But all our eggs are in this basket of vaccinations. What happens if it only lasts for 6 months? I do not foresee people lining up for shots every 6 months. We need another egg in another basket. This cannot be the only pathway forward.

Related to this time question, we do not know if people can tolerate a second or third series of vaccination. What if you can tolerate one, but the second or third series does not work, or causes problems. There is too much at risk to only remain with this one pathway. Perhaps a more affordable, less risky approach that many people are already doing on their own or with the guidance of an integrative doctor needs to be tested and funded properly.

3. We do not know if the vaccines will continue to be effective, as the virus mutates. I mention this for completeness sake. Vaccines are made in relation to specific parts of the virus. If the current wild virus mutates out of that realm, it may be that the vaccine will stop being effective. I do not think this is a major concern here, since, as I mentioned above, the virus is mutating slowly and it is not mutating easily in the areas that the vaccine is aimed at. Having a close vaccine, like having a close virus, I believe, is protective in itself. However, it is a possibility that the vaccine will stop being effective. Having a second pathway open is vital to the security of this nation, and the quickest, easiest, most affordable pathway involves the natural medicine course, which has a known side-effect profile, and know dosage and usage. Only efficacy need be tested.  

MY WISH LIST VIS A VIS VACCINATIONS AND INTEGRATIVE MEDICINE COMMUNITY

Here’s what can be done now, with regard to COVID-19 and vaccinations. I am writing here for those working at the colleges and in professional organizations that are looking for the answer to, “What does our profession bring to the table?” They are also asking, “What should we say about the vaccination that is not already being said by the CDC/FDA/FTC?”

The main need would be an open, consistent, proactive relationship with the FTC/FDA which focuses on the following points:

a. We assist with the vaccine rollout by answering questions and diminishing vaccine hesitancy.

b. Research underscores that comorbidities predictably lead to worse disease manifestation and outcomes. Invite the work of integrative providers to impact the treatment of common chronic diseases, many of which are lifestyle and natural medicine modifiable, including diabetes, hypertension, heart disease and obesity. We have a record of proven efficacy working with these populations. When I was giving a talk on this, at one point I wept, and when someone asked me why, I said it is because what we have is a great deal of needless, pointless death. We have all the pieces spelled out to us, but it is a reluctance to broach a different pathway that allows some to die needlessly.

c. We have worked for decades on healthy immune functioning and need ongoing funding to test these approaches in regards to both prevention of and progression of COVID-19 illness. 

e. We can partner with FTC to disseminate reliable information related to effective preventive and treatment approaches where research already exists. (Zinc, Co-Q10, Vitamin D status, etc.). 

f. We assist in developing a protocol for people to use before and after vaccination to mitigate side effects, which in turn may well diminish unwanted vaccine reactions and vaccine hesitancy, and may potentially extend the effect of the vaccine. 

In other words, we need to be working on Plan B. We need and want FTC and FDA support for this work. There is an unusual problem that exists in the USA. FDA/FTC rules state that for a substance to be used to treat a disease or prevent a disease, it has to go through stringent drug trials to prove safety and efficacy. OTC products do not have to go through this process, but on the other hand, health claims cannot be made for OTC products. There has to be a middle way here. Specifically, there are natural approaches that can be easily tested, and if the results show promise, larger studies can be done, and if these interventions are shown to work to treat and/or prevent illness, then uniquely, in this instance, FDA and FTC should allow and encourage such claims to be made.

Let me put it in very plain English. It might be that the virus will become more benign, and or it might be that the vaccine works perfectly, but what if it does not? There are very simple studies, very inexpensive studies, that can be conducted with natural products that are inexpensive, and have little to no side effects. These studies could be for disease prevention or treatment. If these work they should be allowed to become part of the national plan to treat or prevent illness, something that cannot be easily done at this time with OTC products.

A few examples, what if you develop a protocol of inexpensive natural products to be taken as a preventive and seeing how many of those taking those supplements become severely ill from the virus and need to be in the ICU. It may be that for example, taking Vitamin C, Vitamin D, Resveratrol, CoQ10, and Zinc on a daily basis makes it possible to lessen the likelihood of ending up in the ICU. What if most people taking these items, if they fall ill, end up having a milder form of the disease? After all, this is what the vaccine is aiming to do, to lessen the severity of the illness. What if other items to do the same thing? But unlike the vaccine are not so specific that they wear out, as the vaccine might. What if helping the underlying health and addressing comorbidities does the same? These are not inconsequential questions, and also not difficult questions to answer. We have the expertise. We have a willing and interested public. We just need the willingness to venture into this realm and to fund studies properly, and should they be successful, be allowed to disseminate those results as treatment plans.

MY WISH LIST OUTSIDE OF CAM

To finish off on a related topic. The main way forward, in a way that puts this period of life in the past, is if the virus changes. Specifically, if it becomes less dangerous. After all, we do not say we have a pandemic of a cold. The fact that billions get sick is sort of almost irrelevant since it’s mostly not dangerous. At this moment, we are waiting for the virus to mutate in such a way that it becomes less dangerous. This is nature in its process. Hopefully it is this next year and not much later!

As I mentioned last winter, another possibility is that we modify the virus ourselves. Making it less severe, even if more transmittable, if less people or few people become symptomatic, we are all happier for it, and the vaccine question goes away. All in all, I think this remains one of the easiest paths forward. I believe the virus will get there by itself, but it will take a year, a decade or a century. Of course, I am very, very much aware of the risk here. I am, after all, an evolutionary biologist at heart. But risks versus benefits, I would rather change the virus than change ourselves with a constant barrage of vaccines. The technology exists already. It is not difficult nor expensive. It is just a path that I am not sure that the Department of Defense, who has the capacity, would pursue such a venture. Though at some point if the vaccines are not doing the trick, this may well be in our future.

My other wish is that therapies working on other parts of the immune response be properly funded. Last winter, after speaking to people who were ill with this virus, I wrote about pathways that included C1INH. Eventually a company that manufactures this molecule conducted a small trial that led to positive results. They are now in the midst of a larger trial. This drug will be expensive. But what is important to me is understanding and working on that side of the inflammatory pathway that has been left behind. I think there is a great deal to learn there, which will lead to inexpensive therapeutics.

In sum, the question of should I get vaccinated reflects a false dichotomy, it is a logic fallacy. This is the point I have been trying to get across for a year now. It can be that there are other approaches that might work in concert or instead of vaccines, should vaccines not work out for the future. These should be looked at, in earnest, as soon as we can. In regard to where we are at this time, the end of this long year, vaccination is the pathway open to us. However, once vaccinated it buys us roughly 6-12 months to articulate and act on next steps. If we do not do so, then we have squandered our precious time once more. This is the time to be brave. A change in focus, or rather broadening our focus, by funding research has been and continues to be warranted.

Good luck with everything. Sending wishes for a healthy, peaceful year to you and yours. 

Paul Herscu, ND, MPH

Living in the vaccine world……..

There seems little doubt that the world is looking to relief from the Covid situation by promoting a vaccine as the ONLY way to stop and prevent the spread of the infection in all of its variants.

My personal experience with vaccine therapy had led to a self-made decision to look for other modes of treatment where there is a choice and proven and reliable medical answer, ie homoeopathy, however, I feel that the world situation and opinion regarding covid 19 vaccines is not going to leave a choice.

This is not the article to discuss the merits or problems with a vaccine. this is about the reality of having a vaccine with or without approval or consent. Travel domestic or international may depend on it. Entry to venues or even supermarkets may depend on it. Employers have the legal right to fire employees who do not have a vaccine. How this works with the British government’s statement of not giving a vaccine passport or acknowledgement of having a vaccine publically is at odds with the truth of the matter.

So.

Im looking into the known effects of having the vaccine, sparse information available, even less regarding the ingredients, and we cannot ignore the fact that a lot of testing data has not been forthcoming. Primary effects of the vaccine do not have to be reported if it affected less that 2% of the total number of participants in the test phase. In 43000 people, that is 860 people. I disagree with this protocol emphatically.

So we need to commission homoeopathic manufacturing pharmacies to prepare the different vaccines in LM1, 6c and 30c, and test them in a proving to see what symptoms arise and find remedies that will work to rectify the problems that come up.

Your thoughts and suggestions please……..

What is the true understanding of aphorism 153?

“In seeking for the specific homoeopathic remedy, i. e., in this juxtaposition of the phenomena of the natural disease and the list of symptoms of the medicines, in order to discover a morbid potency corresponding in similitude to the evil to be cured, the more striking, particular, unusual and peculiar (characteristic) signs and symptoms of the case should especially and almost solely be kept in view; for there must especially be some symptoms in the list of the medicine sought for corresponding to this if the remedy should be the one most suitable to effect the cure.’

Strange rare and peculiar is a phrase often used in homoeopathic circles, and one in which it appears to give licence for any symptom to be used in the case taking.  However, from the aphorism 153 taken from the 5th edition above, we can see the explanation and understanding of the meaning clearly, or we should if we dismiss the veil of Swedenborgianism from Kent that obscures the true case-taking skills as outlined by Hahnemann.

All disease is a collection of symptoms that define the ‘type’ of disease, and from this collection of symptoms, a disease can be classified and if well known, the pathology and progression and even prognosis can be elicited from knowledge.. and within that disease, we can pick out the defining expression that is peculiar to the reaction of the sick person to its influence. (this is not dismissing those diseases that have never been seen before and affect the host in a very unique way).

Reading carefully, we can see that the symptoms that are to be used, are the ones that define the host’s reaction to whatever the infection is, in a characteristic way AND also are defined in a remedy in a similar manner.

To complicate matters, the defining symptoms, may or may not be known to be within the sphere of the presenting disorder, yet are present.

Let me give an example from a remedy, and from a presenting symptom. It is my experience, that a marked and strange and characteristic symptom can be present and have nothing to do with the complaint, yet will also contain the symptoms taken in the intake.

Take a patient with a respiratory disorder. Lack of oxygen has caused the lips to discolour. Normally will be blue, yet in this patient, the skin is mottled, blue and orange and red, and diffuse over the lips.

Another patient with severe psoriasis, on close examination, has the same mottled skin all over her legs between the eruptions.

Yet another patient with skin allergies has presented patches of the same discolouration across his back.

In taking the case of each, the characteristic symptom is the skin discolouration. using that, regardless of the problem, there are few remedies, if actually only one, that produces that patterning. In the main, you will also find that other symptoms of each individual disorder are present in the remedy.

That remedy is Psorinum.

If a symptom is present to such a marked degree, it can become characteristic of both the disease AND a remedy..

We will talk more at another time regarding characteristic symptoms.

 

 

 

Thoughts on case taking

If you ever want a high paying job other than homoeopathy, Id recommend marine electrician… everyone i contacted is booked out………..

That aside, case taking and why many cases fail.

simply put, it usually is because the wrong remedy is given.

Its not hard to fail. We all do it. In order to overcome a large percentage of failures, we have to examine ‘Why ‘ we fail, and usually, it comes down to a singular reason in the case taking. The bottom line is that we are picking the wrong symptoms, plain and simple.

So what is the key to picking the right symptoms?

During this period of lockdowns and distancing, its a wonderful time to study the Organon in a guided manner……..to REALLY understand what is required to treat a person.

Let me dispel a myth. This singular misunderstanding ruins so many cases that it needs to taught time and time again.

§ 211
This holds good to such an extent, that the state of the disposition of the patient often chiefly determines the selection of the homoeopathic remedy, as being a decidedly characteristic symptom which can least of all remain concealed from the accurately observing physician.

The huge mistake here is not reading the Organon in context. Kent et al use this as the primary state of the patient to prescribe………….and it is incorrect. If you use this as prescribing criteria, you may be prescribing on the personality and not the disease.

Aphorism 210 to 230, is discussing…….

§ 210
Of psoric origin are almost all those diseases that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their other morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease the condition of the disposition and mind is always altered;1 and in all cases of disease we are called on to cure the state of the patient’s disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homoeopathically with success.

So contextually, looking here….

§ 6 Fifth Edition
The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.1

No where does Hahnemann state that anything other than altered symptoms be taken into account….dont base the prescription on personality or desires unless altered and opposite to the norm, and of a marked observable nature….

This one shift in taking a case will raise your prescription success rate higher immediately………..

IHM clinic progress

Im sat here on the IHM clinic boat in the middle of a beautiful place in Watford…….. waiting on a part and someone to fit it. Its a voltage controller. Seems the one that is fitted is the wrong one, and once the solar reduced charging in autumn, it became obvious the engine was not charging the batteries…………..

£334 for the part and whatever it will cost for the services to fit it. It has to be done and hopefully fixes the problem.

Fuel boat will be next Wednesday……. Fuel and wood for the fire…….at least 150 litres of diesel. Should last few months.

Then a slow trek to London and hopefully get there before any lockdown on the canals………..

We will then fit the boat out internally with seats and sofas and desks……. Along with putting cables in for computers for students and practitioners.

We will fit out the office with a bed for when an overseas student comes for IHM training……. IKEA here we come for wardrobes and cupboards, unless some our London based practitioners point us in a cheaper but good direction.

We made the decision to take a 3 month winter mooring in Southall. This will give us chance to work on the boat and fit it out within range of shops for accessories we will need… and also to be in a fixed position for London clients if restrictions permit. We are near a water point and also a garbage disposal point……… I ordered a composting toilet yesterday which will obviate the need for cassette waste disposal. The mooring doesnt have an Elsan point for emptying. The compost waste can go in a dumpster.

Nothing is as easy as you think it is when you go off grid. We are solving the issues one by one.

I talked with my friend and colleague Antonio in Seville Spain yesterday. Seems the members of the Boenninghausen group are now the steering committee for the Andalucia Homoeopathic Association and will concentrate on good training instead of the politics. I’m proud of them.

Covid restrictions will make it difficult to have many patients or student on board initially, however we are setting up a poweful internet system to take the IHM online if we have to.

so we are doing our bit.

 

Little steps and reminders.

A few days ago, a colleague of mine outlined a health issue with a young male family member. It was a difficult situation involving a stroke, various underlying problems that all would appear on the surface to be well suited to homoeopathic treatment. My colleague was lamenting the fact that he had to suffer in silence in not being in a position to treat the patient.

For those of us who have been in practice a while, we have become accustomed to this scenario. As young thrusting homoeopaths, we wanted to treat everyone and everything, and then we learned that many do not want what is offered. Even Family, especially family. We learn about free will and choice and stand back as people get sick and take strong suppressive medication and slowly get worse in the long term.

When we take on a patient, sometimes we see that life style changes are required. This involves telling the patient that they have to adopt new ways of doing things, and even a job change to get better. Not always going to go down well with the patient.

If we are not medically qualified, we always have to make sure that we treat diseases with the knowledge that our actions are going to be scrutinised heavily by the medical profession in the event of a fatality.

Many homoeopaths ‘choose’ to work with the patient seeing an allopath at the same time, and ‘manage’ the allopathic prescriptions given, letting the patient decide what they want to take and don’t want to take. A person consulting a homoeopath usually makes their own decision after reading the effects of prescribed medicine.

My professional life and successes has the phrase ‘spontaneous remission’ litter throughout. Annoying isn’t it..

Oh, my colleagues relative died. In the end we can only do what we can do.

Is there room for us?

I’m sat on the IHM boat in Hemel Hemsted, currently with either battery or inverter issues…. either way is a fistful of money to fix. Things happen.

Watching the events of the last few months, and how the countries are pushing towards vaccines as the answer, and how the populace are either worried to distraction or are against the lockdowns ………. I’m seeing how homoeopathy is being denigrated and indeed being removed by the fact-checkers on google and Facebook and other sites. We seem to be sidelined in favour of ‘proper treatment’.

Well, I worked out a prophylactic remedy a few months ago, and of the 600 plus people  that I and other members of the IMH have given in 4 countries…. not a single case…

Guillermo Zamora and I have treated individuals with COVID sx to a good resolution………but who is listening…………?

The world is changing. Nothing will ever be the same. WE need to accept and be prepared to change how we do things and still be homoeopaths in mind and action. We need to make the room for us.

We at the IHM do not make claims to ‘cure’ COVID or offer alternative vaccines. We treat each case individually as per our Hahnemann protocols and will give the prophylactic to be taken once a week or every two weeks. Some give daily, my experience with taking more than once a week was a massive proving and difficulties until it wore off…So I advocate once a week simply because, in truth, I don’t know how long the protection lasts……. I know that weekly or even 2 weekly seems to hold.

We have to stand firm on the principles and be sure we know what we are prescribing for, the essential symptoms that need treating…… not just the remedy with the most symptoms covered.

The IHM uses the TPB of Boenninghausen simply because it follows the Hahnemannian protocols, and will work in 98% of cases both acute and chronic. We do not discount the use of other well-proved remedies and advocate a thorough knowledge of them before prescribing. The essence of using the TPB is a well-taken case and extracting the symptoms according to aphorism 153.

Every disease has a centre. The disease symptoms are known, and the patient exhibits symptoms ‘peculiar’ to the patient its either intensity or prominence. These all may have other symptoms not noted as pertaining to the disease state.

WE have to find these symptoms out of the collection of altered sensations that the patient feels. We have to remember that many symptoms are the result of the causative condition and therefore NOT prescribing symptoms per se.

Since 2016We have conducted a 4-day intensive seminar for application to become a member of the IHM. The students are all long time homoeopaths who increased their knowledge base by learning the Boenninghausen method and tidying up the loose ends that were muddied by Kent and others.  The original venue was at our clinic in Seville Spain and has now relocated to The London area on our IHM Widebeam vessel.

We will offer a free bedroom aboard the vessel for individual applicants, and will just ask for a contribution toward food. The fee for the 4 days intensive will remain at the same cost as from 2016. It will be Sterling £900.

We will be fitting out boat for teaching in the next weeks, and be ready for the new year……..to get going government permitting. We already (with the help of members Abdul Malik and Imran Khan) are putting together a clinic for when we are ready to start…

The IHM has a 4 day training opportunity, starting in 2021. We dont claim to have all the answers, but we do feel we can teach the Hahnemanninan methodology in case taking.

What we teach:

  • The rationale of homoeopathic medicine and the use of the Therapeutic Pocket Book in everyday casework.
  • The examination of the patient according to defined parameters of eliciting prescribing symptoms without the filter of all the variants of non-Hahnemann practices as taught by teachers today.
  • An in depth look at the Miasm theory in the light of infection and infectious disease models that are the accepted protocols in modern medicine.
  • Patient management utilising Hahnemannian directives for medicine administration and potency choice, frequency of dose, withdrawal of repetition of medicine on well-indicated grounds, observation of medicinal action and when to change the medicine.
  • Use of LM or Q potencies.
  • Chronic and acute prescribing and when to finish prescribing.
  • In depth explanation and use of the Therapeutic Pocket Book. The T.P.B. was devised by Boenninghausen as a synthetic approach approximating Hahnemanns thoughts on case analysis so as to find a close similimum by extracting the correct proving symptoms that match the disease state.
  • How to understand the meaning of rubrics via the patient’s symptoms.
  • Lots of case examples and analysis by Gary Weaver.
  • Help in re-examining some of the students’ intractable cases.

The future in the U.K. for I.H.M. homoeopathy

We purchased a wide beam canal boat for clinic and teaching. We can at present only accommodate 4 for teaching, government rules, (2 staff) but when we can have more, room for  10 students onboard.

Currently working on refurbishing the lounge/teaching room. We hope to be ready by the end of the year.

We will be based initially between Reading and London to the Limehouse Basin area. Then as the laws pertaining to COVID alter, we will travel up to just short of Birmingham, Oxford and over to the Bristol area.

We will operate below the purple line

The IHM will have a clinic onboard…… (we are working to convert the room). For overseas students taking the four-day membership course,  we offer free accommodation on board with a small contribution asked toward the food. This will definitely help with lessening the costs of staying in the UK. We have a full domestic kitchen with water chiller and constant hot water for beverages.

This is the staff bedroom.

Bathroom with shower and washing machine… twin sinks.

‘currently setting out a timetable and short seminar syllabus.

 

When things change, we change…

These are the latest developments in our plans.

https://ihmnarrowboat.wordpress.com/2020/09/13/so-here-we-are/

 

Latest on the IHM developments

https://ihmnarrowboat.wordpress.com/