The anonymous hero of the pandemic: the story of the unknown doctor
He had to fight two enemies simultaneously: COVID-19 and the media.
Versão em português aqui.
Many countries around the world have monuments in honor of their unknown soldiers. In France, since 1920, the remains of an unidentified soldier from World War I have rested in the Arc de Triomphe. In Moscow, it is a tradition for visiting leaders from other countries to lay flowers at the tomb of the unknown soldier, an anonymous hero who fought against Nazism during World War II.
The story I am about to tell is about a doctor, not a soldier. And it's not about a doctor who died while fighting the COVID-19 pandemic, but about a doctor who is still alive. However, I will preserve his identity because he broke several rules to fight the pandemic. Furthermore, he encouraged other people to do the same. Revealing his name today could negatively affect his professional career.
Dr. Unknown is from a charming city with less than 50,000 inhabitants on the coast of Brazil. His routine was simple, attending patients at the public hospital, going to restaurants, and enjoying his free time with his family on weekends. Everything changed when the world began to be haunted by alarming news about COVID-19. "I was already realizing that something was wrong. Because the idea was to scare people," he said.
At the beginning of the pandemic in 2020, Brazil, inspired by China's experiences, adopted strict lockdown measures. It included the prohibition of people attending public places, such as beaches and parks, as well as the closure of commercial establishments. "At first, I confess that I accepted the lockdown for a while until the dust settled. Until we understood," said the doctor. At that time, the police pursued and arrested people who went to the beaches, which was celebrated on social media.
While dedicating himself to studying the disease and possibilities of treatments, Dr. Unknown noticed, after a few weeks of lockdown, that slogans like "stay at home" were creating a new and strange class struggle. "I saw that the supermarket worker wasn't staying at home, nor the bus driver," he said. "It was weird."
The fear of the pandemic was affecting society as a whole. The doctor's phone and WhatsApp didn't stop ringing. "People were extremely tormented with everything, wanting to know something," he said. That's when he decided to respond to all his patients at once. He did a live broadcast on social media sharing everything he knew about the disease and the possibilities of treatments. The doctor was following the preliminary results of treatments with hydroxychloroquine proposed by Didier Raoult from France and Vladimir Zelenko from New York.
"What is expected of a doctor in the case of a pandemic?" he asked. "That he studies what this pandemic requires and goes to the front line. It was a time when one couldn't be a coward."
Dr. Unknown had already treated some patients with the hydroxychloroquine, azithromycin, and zinc protocol. "It was our only weapon at that time," he said. And with his patients, he repeated Raoult and Zelenko's early positive impressions of the results. None of those treated worsened, were intubated, or died.
His live broadcast ended up being watched in several places in Brazil. With the video, other doctors who were seeking to treat COVID-19 with cheap, generic, and patent-free drugs ended up contacting him. They reported encouraging results with the same protocol: no one worsened. Simultaneously, Raoult and Zelenko began to be mercilessly attacked by the media around the world. "The courage of Didier Raoult and the courage of Vladimir Zelenko were emblematic for me," he said. "Didier was persecuted in France like a criminal."
The live broadcast was censored on social media as "disinformation." He was only trying to reassure people and explain why unpatented medications were being attacked. Dr Unknown spoke about health authorities promoting Remdesivir. Later, the approval and recommendation of Remdesivir were deemed to have a "very, very bad look" in an investigative report in the Science journal. "We could already see that it was orchestrated," he said.
Criticized on social media and personally offended in his city, being called a "science denier," the doctor became irritated. But, according to him, these were just barriers to overcome. "The certainty of doing what was right, and expected of a doctor, gave me a lot of tranquility. I was worried about treating, about reassuring. I wasn't worried about criticism," he said.
Hydroxychloroquine and ivermectin, until shortly before the pandemic, were sold without a prescription. At some point, ANVISA, the Brazilian drug regulatory agency, changed these conditions. In addition, it even removed hydroxychloroquine from pharmacies. "These movements against only strengthen those who know they are telling the truth," he says.
Dr. Unknown had already treated about 200 COVID-19 patients and none had died, but the media daily highlighted the increase in the number of deaths. By mid-2020, Brazil was already registering more than 1000 deaths per day. Meanwhile, journalists constantly emphasized in their long reports that the medications had no scientific evidence. This was the daily message transmitted.
Soon the doctor noticed something intriguing. His patients, faced with the message conveyed by the media that the medications had no scientific evidence, and the message from the doctor who attended to them, stating the opposite, tended to trust more in the medical authority present. No patient questioned or refused to take the prescribed medications.
Since the possibility of waiting for a change in the media approach to explain the effectiveness of the medications was not viable, Dr. Unknown decided to explore another option to inform people about the available treatments and save as many lives as possible. This option arose after a friend of the doctor, a pharmacist in a neighborhood pharmacy, called for help in treating infected patients who were coming to the pharmacy. Dr. Unknown instructed the pharmacist about the treatment and prepared medical prescriptions containing hydroxychloroquine, azithromycin, and ivermectin. "That's where the idea came from that I could go to other pharmacies," he said.
First, he went to all the pharmacies in his town. Every time he arrived, some employee asked if the medicines works: "It works a lot," he used to say. "I used to explain to them how it was, they wrote it down. I'm sure or almost sure they would make it. As they always did."
Being at home, distressed by the news broadcasts driving people away from valid treatments, having his posts on the internet censored, his social media accounts restricted, or trying to refute news in the comments section were definitely not options. And after visiting all the pharmacies in his city, the doctor began to travel to neighboring cities, where no one knew him and he could speak without being censored.
Upon entering each pharmacy, he adopted the strategy of requesting hydroxychloroquine and ivermectin, observing the reaction and asking about sales of these drugs. Usually, he heard comments about people's fear, due to the information disseminated by the media about side effects. At that point, he introduced himself as a doctor and discussed the benefits of the treatment and the very low risks. "I explained and the seed was planted," he reports. "And in doing so, we certainly managed to prevent many people from being hospitalized."
"The history of medicine in Brazil is the history of pharmacy counter care," said Dr. Unknown.
The reactions of the pharmacy clerks were good: "I don't know if it was luck or if I was observing for a long time. They all took notes. They were all very curious. The intention of the people was to help. They saw the despair of poor people who didn't have access to doctors. I didn't have any problems."
As some of the visited cities were very small, the doctor had to adapt the protocol. At the height of one of the waves of infections, he visited a village that had only one pharmacy. And that pharmacy didn't have ivermectin. "There was nothing. And the ivermectin they had was from a feed store. I told the guy that this ivermectin is the same one given to dogs," he said. After the clerk was surprised, the doctor explained that it wouldn't do any harm. "And I showed him in my car that I had a lot of canine ivermectin that I gave to my patients and I took myself."
The protocol he taught included vitamin D, vitamin C, and zinc, which did not require a prescription. However, some of the medications, such as azithromycin, always required a prescription. In the more distant pharmacies, Dr. Unknown couldn't leave his medical prescriptions. "They always manage to get around it, especially the smaller pharmacies," he says. "The goal was to help. They did it."
In total, Dr. Unknown went to six neighboring cities. Sometimes he would leave in the morning and only come home at night. "I took advantage, being a doctor, that I could surpass all the sanitary barriers," he recalls. "I went for this, just for this. It was a mission, really."
In addition to going out to inform everyone that there was an effective treatment for COVID-19, both in person and through telemedicine, he treated 957 patients. In Brazil, the fatality rate is 1.89%. That means, for every 53 infected people, one person dies. But he had only 16 hospitalizations and only two deaths. One of them was a patient with multiple comorbidities and morbid obesity, and another who started treatment only when the disease was already very advanced. And as he was already a public servant, he treated everyone for free.
Today, Brazil has registered just over 37 million cases of COVID-19. Among those infected, there have been 700,556 deaths. If the entire country had the same proportion of deaths as Dr. Unknown, there would only be 77,624 deaths. In other words, 622,932 people would still be alive. This number coincides with dozens of other doctors who followed the same protocols.
Recently, in a casual meeting, the doctor talked to a clerk from one of the pharmacies in town, specifically the one from the poorest neighborhood. "If it wasn't for what we did, a lot of people would have died," said the clerk.
This article is part of a series of stories about doctors who treated COVID-19 throughout the pandemic and had very few deaths among their patients.