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COVID-19 TW3, September 27-October 3, 2020

I'd be surprised if any of this blog's readers would catch the reference to TW3, an abbreviation for a short-lived television series, That Was The Week That Was, first appearing in England on the BBC and then in the US. It was a bit of a parody of current events, and I'm not even sure how I still remember it except for the fact that its writing crew included one of my favorite children's book authors, Roald Dahl, as well as a couple of future members of the Monty Python comedy group. That obtuse reference aside, this past Thursday I was planning to post a list of 3 new items of interest regarding our current pandemic; then, our President developed COVID-19 disease.

At this point we should all be pleased that he appears to be stable, but I wish we had more details of how contact tracing and quarantining is going related to all the possible contacts. By now (Sunday October 4) all contacts should have been notified and plans for testing, quarantine, and/or isolation should be complete. Regardless, those original 3 items are still worthy of mention.

The Children's National Hospital-National Institute of Allergy and Infectious Diseases 3rd Annual Symposium. This event was held on September 29 and initially was established to build on collaboration in research and education between CNH and NIAID. This year the symposium focused on COVID-19 with quite a lineup of speakers, including Dr. Anthony Fauci from NIAID, Dr. Peter Hotez from Baylor College of Medicine (and formerly from GWU), and Dr. Ezekiel Emmanuel from U. Pennsylvania. The presentations were a mix of more general and/or clinical presentations along with basic science updates, particularly in immunology. Anyone can access the entire day's session at a CNH link. I highly recommend the above 3 speakers and also the question and answer periods between the different sessions.

National Academy of Science, Engineering, and Medicine Framework for Equitable Allocation of COVID-19 Vaccine. On October 2 NASEM held a webinar discussing their 237-page report, long awaited by many of us who have been following the progress of this very important advisory committee. Anyone can download a digital copy of the report at no cost. The committee was co-chaired by Dr. William Foege, a former director of the CDC, and Dr. Helene Gayle, who has held many key international healthcare positions including heading the Bill and Melinda Gates Foundation and then CARE. (I might add she is a graduate of CNH's pediatric residency, though before my time there.)

I was very impressed by the thoughtfulness, breadth, and depth that went into the report. This group actually completed the entire plan in about 2 months, an amazing feat. Of course the report is a lot to get through, but if you want to browse look at page 86 of the PDF document about the allocation framework, the Table on page 90, the discussion beginning on page 92, and the graphic below from page 94. The exact plans for implementation will depend primarily on the Advisory Council for Immunization Practices, NIH, and other agencies and when/if various vaccines are approved. Clearly it will be a very complex undertaking, but I am very much in agreement with the group's foundational principles and plan. I hope to have time to describe the plan in slightly more detail at the next Montgomery County Pediatric Society meeting on October 12.

"The Carnage of Substandard Research During the COVID-19 Pandemic." This is a direct quote from the title of an article published in BMJ last week, quite an eye-catcher! Despite the sensational title, it's an excellent discussion of the difficulties of interpreting medical research and reports in the pandemic era, although all of these problems existed previously. The author is a bioethicist, and she highlights some key issues including the number of retractions or withdrawals of articles, the large number of studies published only on pre-print websites that do not undergo peer review, and the overall substandard research methods, perhaps fueled by the urgency of the pandemic but resulting in hasty conclusions. It's a short article, take time to read it and decide where you stand.

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