Dr. Meryl Nass, MD wrote Covid-19: Doctors in Norway told to assess severely frail patients for vaccination/ Fitness for Vaccination in the BMJ Rapid Response system. Doctors here in the USA have been actively discouraged and punished for assessing and then writing a medical exemption when indicated. And yet, everyone who undergoes a surgical procedure has to have a "fitness to operate" exam here in the USA. From this exam, the surgeon will know if the patient can survive the surgery. Because the surgeon can be sued. Vaccines, without any liability, instill no fear in medical professionals. They default assumption is the same for adults as it has been for infants and children since we started writing 14 years ago. Safe for everyone all the time. But we know that is not true. A description of what a Pre-Op appointment entails is below Dr. Nass' Rapid Response. Following the deaths of dozens of elderly Norwegians, Dr. Nass poses what should be a question on everyone's lips to ensure SAFETY and HEALTH for all.
Re: Covid-19: Doctors in Norway told to assess severely frail patients for vaccination/ Fitness for Vaccination
The deaths of frail elderly after vaccination , and subsequent guidance to Norwegian doctors to perform an assessment instead of issuing universal guidance on vaccinations for their patients, has reanimated an old medical concept: fitness for vaccination.
Vaccination used to be an individual decision, made jointly by patient and doctor, that the benefits of a vaccine for that patient exceeded the expected harms. Patients paid small sums to be vaccinated.
Payment systems changed, and the government or insurance companies took over paying for vaccinations. Then the Affordable Care Act in the US waived all copayments, allowing pharmacies and grocery stores to advertise "free" vaccinations while you shop. Pediatricians were given bonuses if they reached assigned target levels of "fully vaccinated" children, which could amount to tens of thousands of dollars.
Vaccine mandates were brought in, and became tighter over the ensuing years. Children who are not fully vaccinated cannot attend school in certain states, regardless of their religious or philosophical orientation.
To make the mandates work, the concept of "fitness for vaccination" was undermined, then deeply buried. All vaccines became "safe and effective."
It is a tragedy that deaths and anaphylac events have occurred following Covid vaccinations. But maybe some good will come of it, by focusing awareness on the fact that vaccines are drugs, whose use is never absolutely risk free. Let us hope that the idea of establishing fitness for vaccination has been permanently disinterred.
Competing interests: No competing interests
19 January 2021
MD Internal Medicine
Ellsworth, Maine 04605 USA
BMJ Rapid Response
Medline Plus Test and Visits Before Surgery
Pre-op is the time before your surgery. This checkup usually needs to be done within the month before surgery.
During this visit, you will be asked about your health over the years. This is called "taking your medical history." Your doctor will also do a physical exam. Your surgeon will want to make sure that other health conditions you may have will not cause problems during your surgery. So you may need to visit:
A heart doctor (cardiologist), if you have a history of heart problems or if you smoke heavily, have high blood pressure or diabetes, or are out of shape and cannot walk up a flight of stairs.
A diabetes doctor (endocrinologist), if you have diabetes or if your blood sugar test in your pre-op visit was high.
A sleep doctor, if you have obstructive sleep apnea, which causes choking or a stop in breathing when you are asleep.
A doctor who treats blood disorders (hematologist), if you've had blood clots in the past or you have close relatives who have had blood clots.
Your primary care provider for a review of your health problems, exam, and any tests needed before surgery.
Tests Before Surgery
Your surgeon may tell you that you need some tests before surgery. Some tests are for all surgical patients. Others are done only if you are at risk for certain health conditions.
Common tests that your surgeon may ask you to have if you have not had them recently are:
Blood tests such as a complete blood count (CBC) and kidney, liver, and blood sugar tests
Chest x-ray to check your lungs
ECG (electrocardiogram) to check your heart
Some doctors or surgeons may also ask you to have other tests. This depends on:
Your age and general health
Health risks or problems you may have
The type of surgery you are having
These other tests may include:
Tests that look at the lining of your bowels or stomach, such as a colonoscopy or upper endoscopy
Heart stress test or other heart tests
Lung function tests
Imaging tests, such as an MRI scan, CT scan, or ultrasound test