HIV and ID Observations

November 1st, 2020

A Series of Disappointing Results of Immune-Based Therapies for COVID-19

It’s been a tough couple of weeks for immune-based therapies for COVID-19. We know that immune modulation in this disease, especially in its most severe manifestations, can improve outcomes. Favorable results from the RECOVERY study of dexamethasone have made it the standard of care for most hospitalized patients who require oxygen. And we also know that our […]

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October 25th, 2020

(Not) Attending Professional Meetings in the COVID-19 Era

The Infectious Diseases Society of America (IDSA), our professional society, held its annual meeting this week, IDWeek. As usual, I registered for and attended the meeting. Of course I should have written “attended” the meeting, as instead of having an in-person meeting in Philadelphia (the original planned venue), it was entirely done online. Another “virtual” meeting […]

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October 18th, 2020

Does Remdesivir Actually Work?

Quick answer — it’s complicated. Let’s start with a clinical anecdote — rightfully considered the weakest form of evidence, yet paradoxically holding great power over us because we’re imperfect humans. It’s the way we’re wired. In April, a patient of mine with stable HIV came into the hospital with COVID-19 pneumonia. (Certain details changed for privacy.) She works […]

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October 12th, 2020

“Dying in a Leadership Vacuum” — Defended

This past week, the Editors of the New England Journal of Medicine published a piece entitled “Dying in a Leadership Vacuum.” It’s a scathing indictment of the United States government’s response to COVID-19, in particular our inability to have a science- and evidenced-driven approach to control a disease that has now killed more than 215,000 Americans. One […]

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October 4th, 2020

Does the White House Outbreak Invalidate the Strategy of Frequent Testing for COVID-19 Control?

As I’ve written here many times, I’m hopeful that frequent, inexpensive, rapid home testing for COVID-19 will help us climb out of this pandemic mess. Let’s name it the Mina Frequent Testing Plan, after my indefatigable colleague Dr. Michael Mina who has championed it for months — most recently in a perspective published in the New […]

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September 27th, 2020

Humbled — But Still Hopeful

When Dr. Anthony Fauci joined us earlier this month for a virtual medical grand rounds, several of my colleagues participated. At the end, each was asked to comment about what they had learned so far from the COVID-19 pandemic. Dr. Michael Klompas, our brilliant hospital epidemiologist, wisely answered: Humility. His answer resonated strongly again, because this week […]

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September 20th, 2020

Sports During COVID-19 — When What Doesn’t Matter Actually Matters a Lot

A few weeks ago, I got a text from a long-time ID colleague here in Boston: Hey Paul want ur opinion … this is for an interview with MLB radio, and no one knows less about baseball than I do, but as an avid fan and wise ID doc, do you think the season should continue? […]

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September 13th, 2020

Restaurants Are Hurting — But Dining Indoors Poses Real COVID-19 Risk

As we learn more about transmission of SARS-CoV-2, the news for restaurants goes from bad to worse. And while there’s a long list of sad things about this pandemic, the decimation of the restaurant business for owners and the people who work there is right up there. The loss of the restaurant experience for us diners […]

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September 7th, 2020

Relieving the COVID-19 Testing Logjam by Separating the Symptomatic from Asymptomatic

As the days grow shorter and we celebrate Labor Day here in the United States, the end of summer looms awfully near. With that will soon come colder temperatures, more time spent indoors, kids back in school, and the inevitable respiratory virus season. How we address these “viral URIs” in the midst of the COVID-19 pandemic […]

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August 30th, 2020

Cases of SARS-CoV-2 Reinfection Highlight the Limitations — and the Mysteries — of Our Immune System

In case you didn’t notice, or perhaps were “off the grid” taking some well-earned time away from COVID-19 news, this past week we heard about several cases of SARS-CoV-2 reinfection. We’ll come back to them in a moment, but first, some questions: Why does one parent never get sick when their kids start coughing and sneezing and […]

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