Without Four Pillars, Global Pandemic Response was a House of Cards

McCullough's Four Pillars of Pandemic Response presented a balanced approach that would have spared hospitalizations and deaths.

As the rate of new cases, hospitalizations, and deaths from the Omicron wave diminishes, many are asking what mistakes the CDC (and the NIH and FDA) should acknowledge. In a recent video message to CDC employees (summarized by TIME Magazine), Director Rochelle Walensky said: “To be frank, we are responsible for some pretty dramatic and pretty public mistakes, from testing to data to communications.”

One obvious mistake she didn’t mention was the failure of the CDC and other agencies to attend Senate Hearings on the COVID-19 crisis. The hearings were golden opportunities for agency officials to get valuable feedback from practicing doctors, research scientists, and other professionals on how the pandemic should be handled. The US Senate Committee on Homeland Security and Governmental Affairs, chaired by Senator Ron Johnson (R-WI), held four hearings with witnesses who presented their findings and then answered questions. Transcripts and video recordings of their statements were published on the Senate.gov website. 

The first hearing — held on May 6, 2020 — was led by the renowned pulmonary and critical care specialist Pierre Kory, MD, MPA, who correctly interpreted the data on corticosteroids and their role in the treatment of COVID-19. The second hearing on ambulatory multidrug regimens was held on November 19, 2020, with majority witnesses Dr. Peter McCullough, Dr. Harvey Risch, and Dr. George Fareed. The minority witness (now current White House Coronavirus Coordinator) was Ashish Jha, MD, MPH. A third hearing was held on December 8, 2020, primarily to discuss the safety and efficacy of Ivermectin in treating COVID-19. The most notable testimony was offered by Drs. Pierre Kory and Jean-Jacques Rajter.

The final, most comprehensive hearing was held on January 24, 2022 — the day after the Defeat the Mandates Rally in Washington, at which tens of thousands of Americans gathered to protest the unjust mandates. The Rally culminated at the Lincoln Memorial, where doctors, nurses, scientists, religious leaders, entertainers and journalists addressed the assembled protestors.

The January 24, 2022, Senate hearing was co-moderated by Dr. McCullough, with dozens of doctors, nurses, patients, attorneys, and independent journalists in attendance. Roundtable presentations were given, and questions were answered on the “Four Pillars of Pandemic Response.” Dr. McCullough first published these principles in the fall of 2020. The Four Pillars illustrate how public health and clinical resources should be deployed in response to a novel infectious disease outbreak. They are as follows:

1). Contagion control 2). Early Ambulatory Treatment 3). Late Treatment in the Hospital 4). Vaccination.

This approach would have provided immediate care and relief to those who were ill at the time in order to to reduce hospitalizations and deaths while developing a long run strategy. The four pillars should have been the framework for monthly updates from the White House Task Force and the CDC/NIH/FDA, with input from teams of practicing doctors and experts on each of the pillars. 

In evaluating how America’s health agencies — and those of all nations —performed during the COVID-19 crisis, the four pillars of pandemic response offer a clear interpretive framework that applies to any community, hospital, or health system. Every organization that acted in a decision-making capacity during the pandemic should do a post-mortem evaluation of its actions through this framework. The most glaring policy errors resulted from the total omission of Pillars II and III. The suppression of early and late treatment resulted in hundreds of thousands of needless deaths and millions of hospitalizations. Without the four pillars, the global pandemic response was a house of cards.   

Time Magazine Walensky, CDC Mistakes

https://www.hsgac.senate.gov/imo/media/doc/Testimony-Kory-2020-05-06-REVISED.pdf

https://www.hsgac.senate.gov/hearings/early-outpatient-treatment-an-essential-part-of-a-covid-19-solution

https://www.hsgac.senate.gov/imo/media/doc/Testimony-Kory-2020-12-08.pdf

McCullough PA, Alexander PE, Armstrong R, Arvinte C, Bain AF, Bartlett RP, Berkowitz RL, Berry AC, Borody TJ, Brewer JH, Brufsky AM, Clarke T, Derwand R, Eck A, Eck J, Eisner RA, Fareed GC, Farella A, Fonseca SNS, Geyer CE Jr, Gonnering RS, Graves KE, Gross KBV, Hazan S, Held KS, Hight HT, Immanuel S, Jacobs MM, Ladapo JA, Lee LH, Littell J, Lozano I, Mangat HS, Marble B, McKinnon JE, Merritt LD, Orient JM, Oskoui R, Pompan DC, Procter BC, Prodromos C, Rajter JC, Rajter JJ, Ram CVS, Rios SS, Risch HA, Robb MJA, Rutherford M, Scholz M, Singleton MM, Tumlin JA, Tyson BM, Urso RG, Victory K, Vliet EL, Wax CM, Wolkoff AG, Wooll V, Zelenko V. Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19). Rev Cardiovasc Med. 2020 Dec 30;21(4):517-530. doi: 10.31083/j.rcm.2020.04.264. PMID: 33387997.

McCullough PA, Vijay K. SARS-CoV-2 infection and the COVID-19 pandemic: a call to action for therapy and interventions to resolve the crisis of hospitalization, death, and handle the aftermath. Rev Cardiovasc Med. 2021 Mar 30;22(1):9-10. doi: 10.31083/j.rcm.2021.01.301. PMID: 33792243.