A16| Thursday, December 3, 2020 THE WALL STREET JOURNAL.
Treating Covid Patients Effectively, Safely
Regarding Dr. Joseph Ladapo’s
“Too Much Caution Is Killing Covid
Patients” (op-ed, Nov. 25): In my
opinion, he is correct. What he
doesn’t mention is that the reason
we physicians are reluctant to use
these drugs is the lack of tort reform
that would give us some protection
from liability if later in the process
there were a problem with the cho-
sen treatment. These organizations
are rightfully fastidious about requir-
ing irrefutable data. Like most gov-
ernment agencies they move at a gla-
cial pace. They produce algorithms
that lawyers will use in court and
most juries will follow in reaching a
verdict. Algorithms are guidelines,
not rules. After completing the 26th
grade in the process of becoming a
cardiologist, maybe at times I can ac-
tually think critically and prescribe
what I believe is best for my patient.
RICHARDT.LESHNER,D.O.,FACC
Newtown, Pa.Physicians do want to see at least
reasonable evidence that drugs help
patients with the diseases for which
they are prescribed, but it is incor-
rect to state that “certainty” is al-
ways required. It is true that the
FDA requires “the totality of scien-
tific evidence available” to grant full
marketing approval for new drugs,
but it also has the ability during the
pandemic to grant emergency-use
authorization to drugs for which it is
“reasonable to believe” may be effec-
tive. That status has been granted
(and in the case of hydroxychloro-
quine, withdrawn) for several drugs
during the Covid-19 pandemic.
The article cites several examples
of preliminary studies that show
what appears to be the benefit of
drugs in treating Covid-19. Perhaps
they will be proven to provide bene-
fits on some level, but those of us in
the clinical investigation community
have learned not to jump on every
early clinical trial with a sea change
in medical practice. The folly of that
approach has been well documented
in the medical literature. As of Nov.
29, the website http://www.clinicaltrials.gov
listed 2,295 clinical trials of treat-
ments of Covid-19 currently under
way. With this amount of investiga-
tion, there will be many false posi-tives that are reported. Accepting ev-
ery new claim of benefit that comes
along as fact would betray the public
trust.
TODDJ.LORENZ,M.D.
Stanford SPARK Program
Orinda, Calif.Dr. Ladapo suggests that physi-
cians should be prescribing a raft of
unproven and discredited remedies
for Covid-19 patients sick at home, to
avoid burdening the health-care sys-
tem. Instead of saving lives, this
strategy likely would place further
stress on hospitals by delaying effec-
tive treatment and putting patients
at risk of advanced disease and seri-
ous side effects from a poorly moni-
tored cocktail of drugs.
Dr. Ladapo notes that too many
doctors mischaracterize evidence-
based medicine (EBM) by insisting
on “certain and definitive” evidence
that a treatment works. The reality
is that EBM requires solid evidence
that a remedy is safe and effective,
confirmed by high-quality clinical tri-
als. Small pilot studies and a handful
of anecdotes aren’t enough to make
people guinea pigs for unproven
therapies.
ERICLANG,M.D.
Winchester, Ky.I concur completely with Dr.
Ladapo and have personally evalu-
ated and treated over 1,000 patients
with Covid-19 in my outpatient of-
fice. I’ve had excellent results using
hydroxychloroquine early in a pa-
tient’s illness.
In addition, an essential part of
outpatient treatment is to have the
patients use their own pulse-oxime-
ter machine and check their oxygen
four times a day: at meal times and
at bedtime. They should keep the
machine on their finger for about 15
seconds before they evaluate the ox-
ygen reading. If the oxygen number
is under 93 then they must go to the
emergency room for hospital treat-
ment. They will have a short course
in the hospital, not need a ventilator
and get better soon.
With this program my last hun-
dred patients are all alive and well.
IRVINGKAUFMAN,M.D.
New Brunswick, N.J.LETTERS TO THE EDITOR
Letters intended for publication should
be addressed to: The Editor, 1211 Avenue
of the Americas, New York, NY 10036,
or emailed to [email protected]. Please
include your city and state. All letters
are subject to editing, and unpublished
letters can be neither acknowledged nor
returned.
“When did children get the right to
sue over non-payment of allowance?”THE WALL STREET JOURNALPepper ...
And SaltThe Court, Coronavirus and the Constitution
Regarding your editorial “Fire-
works Over Religious Liberty” (Nov.
27): The governor of New York and
mayor of New York City continue to
engage in a pattern of promulgating
unconstitutional orders, then with-
drawing them when the Supreme
Court agrees to hear the case. It
worked for Mayor Bill de Blasio on
gun control inNew York State Rifle &
Pistol Association Inc. v. City of New
Yorkbut not for Gov. Andrew Cuomo
inRoman Catholic Diocese of Brook-
lyn v. Cuomo. So much for that legal
gamesmanship with vital constitu-
tional issues.
Unfortunately for Gov. Cuomo in
the diocese case, the makeup of the
Supreme Court changed and he now
has to dine on the proverbial crow
despite his dismissive attitude about
the court’s decision. Attempting to
render the central issue in the case
moot by withdrawing the offensive
action will no longer be tolerated
when a strong constitutional insult is
involved. From the main unsigned
opinion to the concurring opinions,
the majority has made clear it will no
longer tolerate the offensive attempt
to dodge the crucial constitutional is-
sue. The temporary injunction handed
down by the Supreme Court was very
important and clips Gov. Cuomo’s
ability to promulgate offensive orders
unreasonably restrictive of religiousrights. All states take notice. Also,
Justice Brett Kavanaugh has recently
given notice that the Second Amend-
ment issues may soon be revisited.
CHRISTOPHERR.WOOD
Chester, N.J.I am surprised that some of the
justices don’t see the difference be-
tween individuals going quickly in
and out of liquor stores, bike shops
and professionals’ offices and large
groups of people gathering in close
proximity for extended periods in
houses of worship where they inhale
and exhale forcefully when praying
aloud and singing hymns. Don’t they
understand how the Covid virus is
spread?
ROBERTSOMMERS
Jacksonville, Fla.On Decriminalizing Small Amounts of Drugs
It’s disingenuous of Seamus R.
Fallon (“Oregon Drug Law Change
Can Help Families,” Letters, Nov. 24)
to insist that two grams of cocaine is
one-third the amount a drug dealer
would typically carry. What is the
source for such a statement? Based
on my experience as a high-school
teacher, few of the drug users in their
teen years are “drug dealers.” They
are constant consumers, many on a
daily basis, of stimulants of any kind.
Two grams of cocaine is easily quar-
tered for four classmates to afford a
half-gram each, plenty to get amped
up, behind some brewskis, especially
for diminutive teen girls. None of the
group is “a dealer” in the sense Mr.
Fallon proffers his straw man; they
are end-users for the dealers.
Oregon’s abandonment of its youth
to the drug subculture, in looming
years of turmoil and despair, will
show in time that: “As the twig isbent, so is the tree is inclined.” Can
Oregon not see the forest for the
trees?
J.CHARLESSYKES
San Jose, Calif.Mr. Fallon’s letter highlights one of
the unappreciated strengths of our
federal republic when compared with
most other countries: Individual
states can run innovative political ex-
periments without central govern-
ment interference. When the success
or failure of the experiment is evalu-
ated, other states can follow (or
avoid) the example as they wish. The
trial by Oregon should be monitored
and compared with similar results
with a placebo (e.g., Washington
state). Hard facts, not soft opinions,
should guide the country as we deal
with drug and overdose problems.
CLYDESTAUFFER
CincinnatiShelton and Fed ‘Independence’
J
udy Shelton’s nomination to the Federal
Reserve Board of Governors remains in
limbo, with three Senate Republicans hav-
ing declared their opposition.
Their stated grounds is that
Ms. Shelton is a threat to Fed
independence. That argument
is worth addressing, espe-
cially as the Biden Administra-
tion prepares to take power.
“I oppose the nomination of Judy Shelton be-
cause I am not convinced that she supports the
independence of the Federal Reserve Board as
much as I believe the Board of Governors should,”
Sen. Lamar Alexander said in a recent statement.
“I don’t want to turn over management of the
money supply to a Congress and a President who
can’t balance the federal budget.”
Mr. Alexander is retiring at the end of this
Congress and on Wednesday he gave a wise and
entertaining farewell address (see nearby). But
on Ms. Shelton and Fed independence, we’re
sorry to say he has it backward. The Fed needs
Ms. Shelton’s voice because the Fed is already
sacrificing its independence.
Take Mr. Alexander’s point about Congress
and the President failing to balance the budget.
True enough. But the Fed has willingly become
the chief enabler of that failure. By keeping in-
terest rates near zero for most of the last 11
years, and buying Treasury bonds and mortgage
securities in the trillions of dollars seemingly
without end, the Fed is reducing the cost of fi-
nancing federal debt.
This policy has sometimes been warranted—
notably in the financial panic and recession of
2008-2009 and again amid the pandemic. But
is it always warranted—and for as far into the
future as the Fed can see? That’s close to the
view of current Chairman Jerome Powell and
other Fed governors who have said they won’t
change monetary policy until 2023.
This is encouraging Congress to care not a
whit about spending restraint. That’s also true of
President Trump, who has long declared his pref-
erence for low interest rates. But Joe Biden and
his economic advisers are making clear that they
believe this brave new era of Fed policy makes it
possible for vast new spending at zero cost. This
is Modern Monetary Theory in practice, whether
or not the Fed and Congress admit it.
The consequences so far haven’t been the con-
sumer-price inflation that some predicted in 2010.
But neither did it spur the rapid growth typical
of previous recoveries. Growth was much slower
than the Fed predicted, which
meant slow wage gains for av-
erage workers, while asset
prices climbed to the benefit in
particular of the affluent.
Ms. Shelton’s supposed sin
against Fed independence is
that she warned against raising interest rates as
the Trump-era economy began to benefit ordi-
nary workers, having opposed low rates when Ba-
rack Obama was President. That’s an oversimpli-
fication of her views, as her main focus has long
been sound money and stable exchange rates. In
any case the Fed came to agree with her soon
enough after a market revolt in late 2018.
Janet Yellen, Mr. Biden’s Treasury nominee,
was in the Fed system in one job or another for
much of this era. So was Mr. Powell, who never
dissented when Ms. Yellen was the Fed Chair.
Now both are pushing more spending, with Mr.
Powell all but saying that he will buy as much
debt as Treasury can issue. And all this despite
liquid financial markets, a much faster eco-
nomic recovery than anticipated, and Covid-
vaccines on the horizon.
This isn’t Fed “independence.” It is accom-
modating the political class with barely a whim-
per of debate, much less dissent. Mr. Trump will
soon leave town so he’s no threat to the Fed. But
if Ms. Shelton isn’t confirmed, Mr. Biden will fill
the Fed opening with someone who will fit right
in with the views of the Biden Treasury. How
will that further the cause of an independent
central bank?
These columns defended Fed independence
when it was challenged by Democratic popu-
lists, when Paul Volcker needed support to raise
rates against jittery Republicans, and when
Donald Trump was pounding Mr. Powell. We
know a threat when we see one.
Judy Shelton is no threat to Fed indepen-
dence. If anything, she might be willing to point
out that a falling dollar is worth watching care-
fully, and that Modern Monetary Theory might
not be the free lunch our current economic pol-
icy lords imagine. We hope Mr. Alexander re-
considers his opposition to Ms. Shelton pre-
cisely to caution the Fed against giving up its
independence so easily.Lamar Alexander misses
the political nature of
the current Fed.
Special Counsel John Durham
D
emocrats have tried to draw a curtain
over the FBI’s Russia-collusion investi-
gation since their party’s role in that po-
liticized probe came to light. A
Biden Administration will have
a harder time burying the
truth now that Attorney Gen-
eral Bill Barr has made U.S. At-
torney John Durham a special
counsel.
Mr. Barr on Tuesday alerted Congress to his
Oct. 19 decision, two weeks before the election,
to grant Mr. Durham the status of a special coun-
sel. Mr. Durham has been investigating the deci-
sion by the FBI and intelligence agencies to tar-
get Donald Trump’s 2016 presidential campaign.
Mr. Durham had planned to wrap up this sum-
mer, but the pandemic and new discoveries in-
tervened. So Mr. Barr wanted to “provide him
and his team with the assurance that they could
complete their work, without regard to the out-
come of the election,” according to Mr. Barr’s let-
ter to Congress.
In other words, he wants to make it harder for
the next AG to sack Mr. Durham. Under DOJ regu-
lations, special counsels aren’t subject to “day-to-
day supervision” and can only be removed for
“misconduct, dereliction of duty, incapacity, con-
flict of interest, or for other good cause, including
violation of department policies.”
Democrats were prime movers of the FBI’s
Trump-Russia probe, handing the bureau a ficti-
tious dossier that became the basis for secret
surveillance warrants, years of media specula-
tion, and special counsel Robert Mueller. Obama
officials and Congressional Democrats were part
of the spectacle—including some who may want
to serve in a Biden Administration. Mr. Biden’s
AG will be under pressure to protect reputations
by shutting down Mr. Durham before he can is-
sue indictments or an embarrassing report.
As President, Mr. Biden could still direct his
Attorney General to fire Mr. Durham—but at a
high political price. Democrats defended Mr.
Mueller’s special-counsel sta-
tus as crucial to finding the
truth. and Mr. Barr said this
week that Mr. Durham should
be provided the protections of
“the same regulation.”
Mr. Durham’s decision to
accept special-counsel status suggests he wants
to see his probe through to the end. He has re-
ceived much criticism, not least from Mr.
Trump, for not issuing indictments before the
election. But that decision followed Justice
guidelines. And he deserves the chance to tell
the public what he’s learned and whether laws
were broken in the worst FBI scandal since J.
Edgar Hoover.
We dislike special counsels because they are
typically insulated from political accountability,
though we advised Mr. Trump not to fire Mr.
Mueller. In this case we’d advise Mr. Biden not
to dismiss Mr. Durham for similar reasons since
he is the only chance Americans will get of hold-
ing people accountable. Ending his probe will
smack of a coverup.
Mr. Durham plays it by the book, as he and Mr.
Barr showed by not issuing indictments close to
the election. There’s no reason to think Mr. Dur-
ham will abuse his special-counsel authority or
even that he has any political motivation—in
contrast to Mr. Mueller’s team of partisan prose-
cutors led by Andrew Weissmann.
Democrats are criticizing Mr. Barr’s decision,
with House Judiciary Chairman Jerry Nadler
saying Mr. Barr wants to “settle old scores.” No,
he wants the American people to know the truth
so there is less chance that this will happen
again. Mr. Durham is investigating to restore in-
tegrity to the FBI and Justice Department.Barr makes it harder for
a Biden AG to bury thetruth about FBI abuses.
Nasdaq vs. Warren Buffett
T
he more we think about the new racial,
gender and LGBTQ mandates for corpo-
rate directors that Nasdaq announced
on Tuesday, the more absurd
they seem.
How is a company sup-
posed to find out if a board
candidate is gay if that isn’t
already known? Is it supposed
to hire private detectives to
look into it? Once that person joins the board,
does the company then have to broadcast his
or her sexual orientation in the annual report
so progressives can be satisfied that the quota
is met? We could go on.
For a dose of sanity, we thought readers
might enjoy Warren Buffett’s views on what he
looks for in a director. The following is from the
legendary investor’s 2006 letter to sharehold-
ers in Berkshire Hathaway’s annual report:
“In selecting a new director, we were guided
by our long-standing criteria, which are that
board members be owner-oriented, business-
savvy, interested and truly independent....
“Charlie [Munger, Berkshire vice chair-
man] and I believe our four criteria are essen-
tial if directors are to do their job—which, by
law, is to faithfully representowners.Yet
these criteria are usually ig-
nored. Instead, consultants
and CEOs seeking board can-
didates will often say, ‘We’re
looking for a woman,’ or ‘a
Hispanic,’ or ‘someone from
abroad,’ or what have you. It
sometimes sounds as if the mission is to stock
Noah’s ark. Over the years I’ve been queried
many times about potential directors and
have yet to hearanyoneask, ‘Does he think
like an intelligent owner?’
“The questions I instead get would sound ri-
diculous to someone seeking candidates for,
say, a football team, or an arbitration panel or
a military command. In those cases, the selec-
tors would look for people who had the specific
talents and attitudes that were required for a
specialized job. At Berkshire, we are in the spe-
cialized activity of running a business well, and
therefore we seekbusinessjudgment.”
Nasdaq is nuts.The famous investor on
what he looks for in a
corporate director.
REVIEW & OUTLOOK
OPINION