Good Clinical Evidence for Good Clinical Outcomes

Medical recommendations invalidated by non-medical personnel:

We were asked to liaise with government and private organisations in various countries regarding whether a medical letter exempting a patient from wearing a face mask will be accepted in their domain. We subsequently reviewed government documents and liaised with government departments, CEOs, company presidents, directors and board members.

Many medical doctors who provide ‘face mask exempt’ recommendations have patients (often children) presenting with genetic problems causing serious medical problems, or presenting with mental health problems such as depression, or with learning disabilities, hearing, developmental or neurodevelopmental difficulties such as ADHD (Attention Deficit Hyperactivity Disorder) or ASD (Autism Spectrum Disorder). Some patients present with a history of anaphylaxis or serious allergies or asthma, or serious medical and mental health concerns relating to head injuries or dementia (many relating to head injuries have a military history). Comorbidities are not uncommon. Most of these clinical presentations are associated with significant risk.

Mask wearing for most children and adults, but especially individuals in these contexts, often cause severe distress and perpetuate or increase functional impairment, often markedly increasing bio-psycho-social risk and harm.

Many other contexts in terms of development, medical or mental health are relevant here and can cause significantly increased risk and harm, as most medical colleagues agree.

Ongoing indiscriminate mandatory initiatives, such as testing, self-isolation or quarantine, without clear patient specific clinical indications, weighing possible risks and benefits, can cause similar increased risk and harm. We have previously shared examples.

Most of our referrals in the last year are of children of medical doctors, academics and legal colleagues; referrals have increased markedly of children where parents are professionals engaged in the pandemic. At least 90% report “it was fine before the first lockdown, but since then all spiralled, and face masks continue to drive the distress and trauma, a constant cause of chaos and fear”, GP.

Many patients (some colleagues report 50-80% of their patients), adults and children, have been started on regular or long term medication such as antihistamines or Prednisolone by GPs or medical doctors to “assist children or patients to cope with mask wearing or avoid serious allergic reactions relating to or exacerbated by mask wearing”, GP, which can have a “detrimental affect” on the immune system, immune response and can lead to serious medical complications.

“This needs to go to the International Human Rights Court or Criminal Court, because no good clinical evidence has ever supported face mask wearing in any public context, and it causes harm to many, but people are forced to do it – this goes against anything we’ve learnt in Medicine as doctors, and it is going on for more than 2 years for many.” Medical director, 20 years clinical experience. It is our understanding that many medical colleagues have referred this matter relating to deprivation of liberty not based on good clinical evidence to legal colleagues and courts.

Many doctors report that they have started patients on regular benzodiazepines to “cope with mask wearing”, which not many responsible psychiatrists will support in the community as part of a regular treatment protocol weighing potential risks and benefits, considering concerns relating to addiction (often within days); there is usually no long term benefit, only risk, with these treatment options. We have informed medical doctors of our concerns. Replies include “what must I do … no one cares enough to stop these face mask rules and follow good evidence instead, they care about power and fear …”, GP and Emergency Department doctor. These concerns are relevant in the NHS, prison populations, private and pro bono sector, and will likely lead to markedly increased harm.

Face mask wearing in the general public is not associated with or supported by good clinical evidence, as most medical doctors and relevant professionals, as well as the WHO, will agree, and now, with this indiscriminate mandatory initiative continuing for more than 2 years after the onset of the outbreak, despite lack of good evidence, and with good evidence of increased risk and harm associated with face mask mandates, medical doctors are starting or maintaining children and adults on medication associated with serious risks, side-effects and additional harm; no argument can be made relating to clinical appropriateness, medico-legal soundness or ethical consideration in this domain.

“This is relevant in the world of liability if you force people to wear masks when there is no good evidence behind this, and when it harms many people, and then they have to be started on medication to cope with this harm, but this medication too can cause and causes even more harm in other ways, such as addiction or low immune responses” GP, legal background.

We were asked to liaise with various organisations in various countries regarding whether a medical letter that exempts a patient from wearing a face mask, which is accepted in the UK, and many other countries, will be accepted in the host country or various businesses, airports, airplanes, cruises or ferries. We were also asked to visit businesses or areas to observe and gather information, which we have done.

Most businesses accept letters from doctors exempting patients from face mask wearing. Most CEOs agree that “face masks cause more problems, especially anger, fear and aggression”.

We thank the CEOs and directors who have responded to us; only 5-10% did not respond, however, clear information was provided on websites within a short period of time in many instances. It is our opinion that most share concerns and the agenda to protect the general public as the first priority.

Further to liaison with academic, clinical and legal colleagues, non-medical personnel invalidating medical recommendations by an appropriately qualified, registered and licensed medical doctor for their patient(s) is found to be clinically inappropriate or negligent and unacceptable from a medico-legal, legal and ethical point of view, and individuals who invalidate medical recommendations will be liable in court for any adverse outcomes. It is our understanding that a ‘state of emergency’ will not alter this fact. Most medical doctors now agree “a state of emergency is now not clinically appropriate in most nations, and has not been in 6-9 months”, medical specialist.

“Medical doctors are taught to provide recommendations based on their current impression of the current clinical presentation, formulation and complications or risks for the patient. If someone decides not to follow the recommendations, be it the patient, GP, social worker, teacher, CEO, government official, and there are any adverse outcomes due to this decision not to follow your recommendations, they are responsible or liable, irrespective of (context). … Everyone does however have the responsibility to think for themselves and to gather more information or opinions if they are not comfortable and do not agree with the doctor or if they have concerns. … They have to use their brains, resources, gather information. People also need to remember that things change often and fast, so review often. Risk assessment is not a one time thing or easy, it is constant, and it includes extensive assessments, liaison and observation, so it is best, in my opinion, to follow the advice doctors give for their patients if you have any degree of uncertainty. …” Medical doctor, legal training, 20 years experience in court work

It is our understanding, further to liaison with legal colleagues in various countries and domains, that no emergency legislation or ‘state of emergency’ can invalidate the above including medical opinions, recommendations, reports or letters for their patients in any context.

We recommend speaking to your GP or medical doctor or team and getting legal advice for every question and context.

“We are so happy that good clinical evidence is followed by many countries such as Sweden, France, the UK, Belgium, Portugal, Spain, Greece and Italy, so many others in Europe and the USA and now South Africa have dropped restrictions – some have dropped all restrictions, which now makes sense, despite all the threats that will continue to pop up, but with any pop up threat, face masks will never make sense, because no good evidence supports face masks, it is a dark age type thinking in my opinion and most medical doctors agree I think”, medical specialist.

We are offering pro bono input in the EU this year, along with the UK. Colleagues agree that “it is best to avoid areas where you need to wear masks to get there or to work there, because we also need to protect our own health and trying to manage risk and harm in a context that supports risk and harm makes no sense”, medical specialist.

“I am so glad we can travel again, this sustains health for so many – freedom. I have so far gone to 5 EU countries, all where I never have to wear a mask, we haven’t worn masks in 6 months and we can live again and we are starting to believe there is hope. No one goes to the islands by ferries of my friends and colleagues, because oddly you have to wear a mask on a ferry, but often not on the plane, like in Greece. We love Greece, but we will wait for things to change. So many countries have suffered because many avoid travel if they have to wear masks, and masks hurt so many people. How simple is it to follow good medical evidence in a medical scenario?”, medical specialist.

“The countries who stopped all mandates and mask wearing have better numbers or equal numbers to others, and look at Florida where no one wears masks nearly, and most are over 75 or 65, well many are, they have good numbers – why? Because they follow good clinical evidence, and fear does not rule.” Medical director and specialist

Many individuals in every domain such as government, business, law or social care have consistently made significant efforts to follow good clinical evidence, medical recommendations and to liaise with various medical agencies or professionals to gather relevant information to educate their teams regarding possible protective factors as well as risk and harm to inform the weighing and decision making process, which resulted in subsequent informed and responsible decisions for clients, staff and the general public. We thank you. You lead by example.

We would also like to take this opportunity to thank CEOs and presidents of companies or organisations who have gone to great lengths to contact us ahead of policy changes to discuss concerns and to prioritise the health and safety, based on good evidence, for their customers or guests. These decisions will have a global impact to protect the general public.

Lastly we would like to thank colleagues in local health ministries, Public Health England, the WHO, the ECDC and the CDC for their commitment to following good clinical evidence.

“Following good clinical evidence is one of the simplest things in this situation, and it certainly does not include face masks or mandating face masks in any setting outside of hospital settings for immune compromised and surgical settings; if we don’t follow good clinical evidence we should not hope for good clinical outcomes.” CEO, medical doctor

If you would like to know more about our work in the EU and UK this year, please contact us at admin@mentalhealthbus.co.uk – we currently have more or less 25 medical and non-medical volunteers (mostly GPs, psychiatrists and paediatricians), but we always need more hands or feet to play Football.

We are also waiting for confirmation from South Africa to proceed in a local township. We will aim to be available for this project as a priority this year and also, if possible, next year. We usually aim to remain available for all projects and visit on a regular basis offering consultation or clinical input if required to ensure sustainability. If you are interested in joining us, please contact us via the email address as mentioned.

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