Coronavirus

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Steve Williams
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Mormad said:

https://www.medpagetoday.com/blogs/vinay-prasad/90445

You guys are gonna LOVE this, i think. Really well written opinion piece about Fauci and other scientists trying to shape behavior or policy with their words and the consequences of such.
Fauci went from relative obscurity to rock star virtually over night. Many others just like him. He doesn't seem to shy away from all of the attention either.
Mormad
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Steve Williams said:

Mormad said:

https://www.medpagetoday.com/blogs/vinay-prasad/90445

You guys are gonna LOVE this, i think. Really well written opinion piece about Fauci and other scientists trying to shape behavior or policy with their words and the consequences of such.
Fauci went from relative obscurity to rock star virtually over night. Many others just like him. He doesn't seem to shy away from all of the attention either.


To be fair, relative obscurity is in the eye of the beholder. To be well known in your field and then move into the public or political realm is the way it works usually. His rise is less meteoric than that of community organizer to POTUS. J Just saying.
Steve Williams
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C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
PackPA2015
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To be honest, no I don't go out in public hardly at all, because I interact with COVID positives on a daily basis and I have a newborn at home that I don't want to expose to COVID, flu, or RSV any more than he might already be due to my profession. Furthermore, every community is different. In my rural county, mask wearing and social distancing are much less than in more urban areas such as Raleigh, Durham, or Charlotte. We have seen flu cases and we typically do not see spikes this early in the season anyways so it has been a more normal year - maybe slightly less in flu numbers - than in other communities.

As far as your other question, there are studies that show that masks do reduce transmission of influenza in some capacity. The amount of benefit is not large, but there is benefit. There are greater reductions in transmission with good hand washing and social distancing. Again, when you combine all that we have done to combat COVID, you can see why influenza has declined.

My personal theory is that school closings and lower numbers in school is likely having a huge impact. Schools are always a hotspot for influenza transmission.

To hammer this point again, when you see the COVID cases , there is no mistaking them with typical flu cases. No comparison.

I don't think we may ever agree on this which is fine. Just know there is no conspiracy mixing flu and COVID cases. There's just not. One can argue, and likely successfully, that some political figures have taken things too far or not far enough depending on your viewpoint. But that does not mean that there is mass fraud behind the scenes with our flu season. You can have poor politicians, which we do, without mass medical fraud, which we don't.
Mormad
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I wouldn't want his job. The stress of responsibility for the health and function of my own subset of the community keeps me up at night. I constantly worry about and re-evaluate my decisions and opinions. I can't imagine the weight of responsibility of my opinions affecting policy and the potential physical and mental health of the country. Especially when the answers aren't known with any clarity. Really really tough gig.
caryking
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On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
Mormad
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I agree with you. That's why i said "largely." There has always been bad players in medicine who committed fraud for money, and there always will be. But i don't think it's rampant enough to drive the numbers we're witnessing. It is more rare than would be required to meet the narrative of many. Could be wrong, but that's simply not what I'm seeing here anyway.
PackPA2015
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I can't explain your specific examples obviously without all of the details. Could there be rogue individuals out there? It could be possible, but it would need to be a mass operation to make a dent in the actual numbers. That's just not occurring. There's no evidence for that and there never will be. I personally know individuals who have lied about not being tested and ending up with a positive and later admitted to it. I don't for a second think most of the human race would do that. Just rogue individuals.

However, I don't think you are quite understanding how the coding and billing system works. The people who would benefit from extra funds have absolutely no access to patient charts or codes. This theory is just not possible based on that fact alone. Read Mormads post previously if you want more info on that.

I also think that the general public does not quite fully understand death certificate documentation and also the effects COVID can have on the body. We know from multiple medical studies that COVID can cause heart arrhythmias (leading to sudden death), blood clots (leading to sudden death), multiple organ failure (leading to gradual death). On a death certificate, you list the direct cause of death, such as cardiac arrest, first, and then all of the possible causes next.

If you have someone whom dies from cardiac arrest, who is positive for COVID, and has a history of heart disease, there is absolutely no way for a doctor or other provider to know 100% what caused the arrest. He or she has to list all of the possibilities on the certificate or face fraud charges and lose his or her medical license. I can promise you, providers are not willing to lose their careers on faking a death certificate. There's no benefit for us to do that. We don't receive any kickbacks for COVID patients. We definitely don't receive salary increases for patient deaths.
Mormad
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Yep, the docs are by and large doing the documenting, and yet the overwhelming majority have no social, political, or financial reason to doctor the chart and make covid look worse. We HATE covid and it's implications. It is costing us money hand over fist. Again, there is and always will be fraud, but it's not overly rampant and there is no conspiracy among the providers in some concerted effort to trick society. We're not like politicians who make a killing doing so.
Pacfanweb
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Steve Williams said:

C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
He's the dude that Trump put front and center when Covid hit. It's a natural thing, I'd think.

Although I don't watch CNN so I can't speak to your example as to how that channel in particular views him.
Mormad
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Pacfanweb said:

Steve Williams said:

C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
He's the dude that Trump put front and center when Covid hit. It's a natural thing, I'd think.

Although I don't watch CNN so I can't speak to your example as to how that channel in particular views him.



Agreed. I don't watch CNN and have watched less than 2 minutes of Fauci in my life, but i assume a news agency will make some ID rock star their agency's face of a worldwide infectious pandemic. If it wasn't Fauci, it would be somebody. A rise from the world of infectious disease to the public eye in the face of covid just doesn't too weird to me. Doesn't really matter. We need to beat Kentucky!
BBW12OG
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Steve Williams said:

C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
Best analysis of Fauci I have read. Couple him being played by Brad Pitt on the uber liberal SNL you summed up him in a nutshell. He was GIVEN the power to determine many outcomes by the DNC run media and once they realized they had a pawn in place he ran with it and is continuing to placate to the sheep that follow the MSM and the talking heads. He should have said what HE knew when HE knew it rather than speculating to fit a DNC run media narrative to destroy the President and his response. Don't get me wrong, Trump could have made better decisions and not said as much until he knew more. But you have to be a blithering idiot to not see through Fauci, CNN, MSNBC, DNC-MSM to know they had an agenda from January 2017 until Trump was gone.
waynecountywolf
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Mormad said:

I wouldn't want his job. The stress of responsibility for the health and function of my own subset of the community keeps me up at night. I constantly worry about and re-evaluate my decisions and opinions. I can't imagine the weight of responsibility of my opinions affecting policy and the potential physical and mental health of the country. Especially when the answers aren't known with any clarity. Really really tough gig.
As well as threats upon himself and his family
waynecountywolf
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From the comments:
"In fairness, we should consider Dr. Fauci's March remarks in context. At the time, far less was known about the novel coronavirus then now, and recommendations were made based on experience with other infectious respiratory viruses such as SARS. In particular, the level of presymptomatic and asymptomatic spread was not yet known, nor was aerosol transmission given sufficient consideration. In that context, it was very reasonable to advise that masks be worn by the ill, under the assumption that people who were contagious knew they were sick. Now we know this is not the case, and that universal masking is important."


The long New Yorker article I linked above, goes into some detail regarding acquiring masks and the national supply at the time.
https://www.newyorker.com/magazine/2021/01/04/the-plague-year
Daviewolf83
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Mormad or PackPA - Do you agree this would be a valid way to reduce hospitalizations? It appears there is ample supply of the monoclonal antibodies and there has been good success in reducing hospitalizations.

Reportedly, the state of Georgia is acitively working to setup out-patient transfusion clinics to administer the antibodies in an attempt to reduce hospitalizations. Is this definitely something that could be administered on an out-patient basis and reduce the need for hospitalizations?

Daviewolf83
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Here is an idea NC should definitely be considering with regards to vaccinations. I have read Florida and Texas are doing something similar.

PackPA2015
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Daviewolf83 said:

Mormad or PackPA - Do you agree this would be a valid way to reduce hospitalizations? It appears there is ample supply of the monoclonal antibodies and there has been good success in reducing hospitalizations.

Reportedly, the state of Georgia is acitively working to setup out-patient transfusion clinics to administer the antibodies in an attempt to reduce hospitalizations. Is this definitely something that could be administered on an out-patient basis and reduce the need for hospitalizations?




In my opinion and many other providers' opinion, there is not enough data to answer that question. The only published info so far comes from a small number of patients and not a true randomized control trial. The Infectious Disease Society of America (IDSA) recommends against it's use until we have more information. It is also incredibly expensive drug which could pose problems.

Our hospital system sent us an email the other day saying we could use it with informed consent from the patient, but they do not recommend universal use by any means in that patient group.
Daviewolf83
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PackPA2015 said:

Daviewolf83 said:

Mormad or PackPA - Do you agree this would be a valid way to reduce hospitalizations? It appears there is ample supply of the monoclonal antibodies and there has been good success in reducing hospitalizations.

Reportedly, the state of Georgia is acitively working to setup out-patient transfusion clinics to administer the antibodies in an attempt to reduce hospitalizations. Is this definitely something that could be administered on an out-patient basis and reduce the need for hospitalizations?




In my opinion and many other providers' opinion, there is not enough data to answer that question. The only published info so far comes from a small number of patients and not a true randomized control trial. The Infectious Disease Society of America (IDSA) recommends against it's use until we have more information. It is also incredibly expensive drug which could pose problems.

Our hospital system sent us an email the other day saying we could use it with informed consent from the patient, but they do not recommend universal use by any means in that patient group.
Thanks PackPA. I know Dr. Scott Gottlieb has been a big proponent of the drug's use, but I have not seen a lot of other information on its use.
Mormad
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Our system has a new hospital to home program designed to offer care in the home to avoid hospitalization. We also have an outpatient infusion center to complete remdesivir infusions for those discharged or to offer monoclonal antibody infusions based on the criteria you provided.
caryking
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On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
BBW12OG
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I have coworkers all over the country. We have all been working from home since March after the ConEx show in Vegas. March 10th - 14th.. it was cancelled early. After that, we've all been working from home. Our company is requiring us to follow the guidelines established by every state we cover. It's all over the place. The biggest issue is that there are two definitive set of guidelines being established and not one singular answer. Where did the flu go? Has anyone ever asked that question to Fauci??? Why hasn't there been any attempt to not politicize this? I am hoping that when this is over everyone evaluates what the media has done to this country in order to make a buck....
PackPA2015
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Absolutely not going to beat you up over that. There are bad people out there, including bad medical providers. Most are not that way.

We are now taught coding as a part of our training. We do all of our own coding. My generation of providers grew up with technology and it is not an issue as it was when we first went to EMR for the older providers. Scribes and such are a thing of the past for the most part. So, I can tell you with great certainty that that is not a country-wide issue.
caryking
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On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
PackPA2015
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pineknollshoresking said:

PackPA2015 said:

Absolutely not going to beat you up over that. There are bad people out there, including bad medical providers. Most are not that way.

We are now taught coding as a part of our training. We do all of our own coding. My generation of providers grew up with technology and it is not an issue as it was when we first went to EMR for the older providers. Scribes and such are a thing of the past for the most part. So, I can tell you with great certainty that that is not a country-wide issue.
I'm not trying to create a narrative as I don't have enough information to create a pattern. Unless somebody works in a facility, they would know more than I.

I will say this, the facility I'm referencing is a major one and would probably blow you away if exposed. Take it for what it's worth...


Understood. I just don't know of many hospitals that work that way. Every hospital I've been in as a student or employee, the provider does all coding. No one else is allowed to put the diagnosis code in. Your name goes on the chart if you even open it up and all of that is subject to investigation if an issue is discovered. I just cannot recall of any instances of a provider telling someone else to code for them. That's just not how it works in any facility that I have ever been in. Interesting story for sure. I still do not think it is a widespread issue though.
Mormad
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That's really interesting stuff, king. Just a few quick comments.

1. I didn't know nurses coded anything, especially COD. They document everything. But do they actually submit codes (other than nurse practitioners, of course)? Had no idea that was a responsibility of theirs'. I will ask nurses tomorrow when I'm on call so i can learn something.

2. Coding has changed dramatically in 30 yrs. New laws, new codes, new regulations, new EMR, and coding courses for providers. We now code all E&M codes prior to patient checkout in the outpt setting using the EMR. And i do all of my surgical coding, though that's not universal. We have certified coders that internally audit every surgical code we enter and then submit the codes electronically.

3. i have no doubt that there are many examples, especially early on, of people getting labeled as covid that weren't covid, or examples where the COD wasn't clear. When people suddenly died of a covid like illness, but no test had been performed, maybe they were inappropriately labeled as covid? But i suspect that's a very small percentage of the cases, and offset by true covid deaths not labeled as such.

4. Hypothetical: if a trauma patient is critically ill and intubated, tests positive for covid, and gets pneumonia on the vent and dies, what is the cause of death? There is no way to know. Covid becomes much more deadly in this scenario. Lucky for the nurse in such situations, it's not her responsibility to decide what is more likely to determine the COD. But i see no political or financial incentive for the doc to determine covid as COD, as it's already a documented diagnosis so the hospital will get their extra money.

At any rate, i hope examples like yours are few and far between. Better yet, i hope they're examples of misunderstandings. Who knows?
Mormad
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Spoke to an icu nurse. At least at our facility, a nurse has no authority to determine or code cause of death.
caryking
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On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
Ncstatefan01
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BBW12OG said:

Steve Williams said:





C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
Best analysis of Fauci I have read. Couple him being played by Brad Pitt on the uber liberal SNL you summed up him in a nutshell. He was GIVEN the power to determine many outcomes by the DNC run media and once they realized they had a pawn in place he ran with it and is continuing to placate to the sheep that follow the MSM and the talking heads. He should have said what HE knew when HE knew it rather than speculating to fit a DNC run media narrative to destroy the President and his response. Don't get me wrong, Trump could have made better decisions and not said as much until he knew more. But you have to be a blithering idiot to not see through Fauci, CNN, MSNBC, DNC-MSM to know they had an agenda from January 2017 until Trump was gone.
say what?
BBW12OG
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Ncstatefan01 said:

BBW12OG said:

Steve Williams said:





C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
Best analysis of Fauci I have read. Couple him being played by Brad Pitt on the uber liberal SNL you summed up him in a nutshell. He was GIVEN the power to determine many outcomes by the DNC run media and once they realized they had a pawn in place he ran with it and is continuing to placate to the sheep that follow the MSM and the talking heads. He should have said what HE knew when HE knew it rather than speculating to fit a DNC run media narrative to destroy the President and his response. Don't get me wrong, Trump could have made better decisions and not said as much until he knew more. But you have to be a blithering idiot to not see through Fauci, CNN, MSNBC, DNC-MSM to know they had an agenda from January 2017 until Trump was gone.
say what?
What part are you struggling with? Let me know.
Ncstatefan01
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BBW12OG said:

Ncstatefan01 said:

BBW12OG said:

Steve Williams said:





C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
Best analysis of Fauci I have read. Couple him being played by Brad Pitt on the uber liberal SNL you summed up him in a nutshell. He was GIVEN the power to determine many outcomes by the DNC run media and once they realized they had a pawn in place he ran with it and is continuing to placate to the sheep that follow the MSM and the talking heads. He should have said what HE knew when HE knew it rather than speculating to fit a DNC run media narrative to destroy the President and his response. Don't get me wrong, Trump could have made better decisions and not said as much until he knew more. But you have to be a blithering idiot to not see through Fauci, CNN, MSNBC, DNC-MSM to know they had an agenda from January 2017 until Trump was gone.
say what?
What part are you struggling with? Let me know.
I would say, in this case, I'm not the one who is struggling.
ciscopack
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Steve Williams said:

C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
WRONG! You watching him on CNN, Steve?

From Dr. John I. Gallin in 2007...




The Fauci family pharmacy; Tony started delivering prescriptions when he was old enough to ride a bike. The family lived above the pharmacy.

In 1966, during the Vietnam War, he was called to serve. He left New York City for the National Institutes of Health (NIH) to join what was affectionately called the "Yellow Berets". He served his military obligation in the Public Health Service at NIH. He was a Clinical Associate in the program of Sheldon M. Wolff, MD, the Chief of the Laboratory of Clinical Investigation and Clinical Director of the National Institute of Allergy and Infectious Diseases (NIAID). It was during his fellowship at NIH that he completed his training in infectious diseases and in allergy/immunology and began his long, close clinical research partnership and friendship with Wolff.

He has earned the respect and trust of politicians on both sides of the aisle. He has advised every President from Ronald Reagan to the current Donald Trump. His knowledge, clarity, and frankness have made him so effective.

I would describe Tony Fauci as a realistic optimist. He demands perfection and that is good. He delegates authority and responsibility effectively. He is very sensitive and loyal to his staff. He can keep his mouth shut. He never tells a secret, ever. He is a fabulous doctor and his patients adore him. When he talks he knows what he is talking about. He is wise. He cares about all people. He knows the names of the janitors, elevator operators, and animal caretakers. They all love and respect Tony Fauci because he talks with them, never at them. Tony Fauci is the kind of person you know you can call upon whenever you have a need, no matter what that need is.

And where do all these wonderful traits come from? I believe they come from his strong upbringing that instilled the importance of family.

The AAP has made an incredible choice this year in selecting Anthony S. Fauci as their George M. Kober medalist. He is an exceptionally dedicated and talented physician, scientist, educator, administrator, spokesperson, politician, and advisor to our Congress and Presidents. His life's work will profoundly affect generations to come. He is, quite simply, an extraordinary man. It is for all these reasons that I am so honored that Tony Fauci asked me to introduce him as the 2007 Kober Medalist, the highest award of the Association. Please join me in saluting Anthony S. Fauci, MD, on the occasion of his receiving this very prestigious award.

George M. Kober Medal

The Kober Medal is awarded annually to a member of the Association of American Physicians upon the recommendation of Council. This award is given to an AAP member whose lifetime efforts have had an enormous impact on the field of Internal Medicine (or the specific member's discipline) through the scientific discipline they have brought to the field and the many outstanding scientists that they have trained. This award is given every year.

Introduction of Anthony S. Fauci, MD 2007 Association of American Physicians George M. Kober Medal

Awards and honors


Did I know Tony Fauci last year? Nope! It took less that 1 week on Trump's Medical Covid team for me to know, that is a guy I can trust! The dude bit his lip while trying to help Americans and turn DJT towards helping them too! If DJT had listened, over 100,000 Americans would not be dead who are and he'd be far more likely to be re-inaugurated on Jan. 20th?








ciscopack
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Tony Fauci =

Vincent Thomas Lombardi

John Robert Wooden

Paul William "Bear" Bryant

William Stephen Belichick

Philip Douglas Jackson...


redsteel33
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Steve Williams said:

C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.


100%.
Oldsouljer
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ciscopack said:

Steve Williams said:

C'mon man, CNN has turned Fauci into their rock star. That's just reality. A year ago no one outside of the medical circle had a clue who this guy was and he gives every indication that he thrives in this new found attention. That's not to take away from any of his contributions as a whole. Just how I see it.
WRONG! You watching him on CNN, Steve?

From Dr. John I. Gallin in 2007...




The Fauci family pharmacy; Tony started delivering prescriptions when he was old enough to ride a bike. The family lived above the pharmacy.

In 1966, during the Vietnam War, he was called to serve. He left New York City for the National Institutes of Health (NIH) to join what was affectionately called the "Yellow Berets". He served his military obligation in the Public Health Service at NIH. He was a Clinical Associate in the program of Sheldon M. Wolff, MD, the Chief of the Laboratory of Clinical Investigation and Clinical Director of the National Institute of Allergy and Infectious Diseases (NIAID). It was during his fellowship at NIH that he completed his training in infectious diseases and in allergy/immunology and began his long, close clinical research partnership and friendship with Wolff.

He has earned the respect and trust of politicians on both sides of the aisle. He has advised every President from Ronald Reagan to the current Donald Trump. His knowledge, clarity, and frankness have made him so effective.

I would describe Tony Fauci as a realistic optimist. He demands perfection and that is good. He delegates authority and responsibility effectively. He is very sensitive and loyal to his staff. He can keep his mouth shut. He never tells a secret, ever. He is a fabulous doctor and his patients adore him. When he talks he knows what he is talking about. He is wise. He cares about all people. He knows the names of the janitors, elevator operators, and animal caretakers. They all love and respect Tony Fauci because he talks with them, never at them. Tony Fauci is the kind of person you know you can call upon whenever you have a need, no matter what that need is.

And where do all these wonderful traits come from? I believe they come from his strong upbringing that instilled the importance of family.

The AAP has made an incredible choice this year in selecting Anthony S. Fauci as their George M. Kober medalist. He is an exceptionally dedicated and talented physician, scientist, educator, administrator, spokesperson, politician, and advisor to our Congress and Presidents. His life's work will profoundly affect generations to come. He is, quite simply, an extraordinary man. It is for all these reasons that I am so honored that Tony Fauci asked me to introduce him as the 2007 Kober Medalist, the highest award of the Association. Please join me in saluting Anthony S. Fauci, MD, on the occasion of his receiving this very prestigious award.

George M. Kober Medal

The Kober Medal is awarded annually to a member of the Association of American Physicians upon the recommendation of Council. This award is given to an AAP member whose lifetime efforts have had an enormous impact on the field of Internal Medicine (or the specific member's discipline) through the scientific discipline they have brought to the field and the many outstanding scientists that they have trained. This award is given every year.

Introduction of Anthony S. Fauci, MD 2007 Association of American Physicians George M. Kober Medal

Awards and honors


Did I know Tony Fauci last year? Nope! It took less that 1 week on Trump's Medical Covid team for me to know, that is a guy I can trust! The dude bit his lip while trying to help Americans and turn DJT towards helping them too! If DJT had listened, over 100,000 Americans would not be dead who are and he'd be far more likely to be re-inaugurated on Jan. 20th?









I've known him by reputation for years from my time at NIH, and have formed an opinion that isn't particularly flattering. But sticking to hard facts, I'd really like to know more about the taxpayer dollars his organization funneled into the Wuhan virus lab.
WarrenPeace
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Mormad said:

I wouldn't want his job. The stress of responsibility for the health and function of my own subset of the community keeps me up at night. I constantly worry about and re-evaluate my decisions and opinions. I can't imagine the weight of responsibility of my opinions affecting policy and the potential physical and mental health of the country. Especially when the answers aren't known with any clarity. Really really tough gig.


Haha. Wow. You poor soul.
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