HIV and ID Observations

June 28th, 2020

Is COVID-19 Different in People with HIV?

From the start of the COVID-19 pandemic, one of most common questions I’ve received has been whether COVID-19 has different clinical manifestations in people with HIV. Would it be more lethal since people with HIV have impaired immune systems? Or milder since some of the damage in severe cases is immunologically mediated? Or would it be similar, […]

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June 21st, 2020

Dexamethasone Improves Survival in COVID-19 — Why This Should Be Practice Changing Even Before the Paper is Published

When the news broke last week that the dexamethasone component of the RECOVERY randomized clinical trial was halted because those receiving the drug were significantly more likely to survive, I posted the following: – Very welcome news, dex is cheap, widely available!– Demonstrates the power of RCTs vs obs studies, which were conflicting– How will the […]

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June 7th, 2020

Hydroxychloroquine Not Effective in Preventing COVID-19 — In Praise of a Negative Clinical Trial

The headlines might read, Malaria Drug Ineffective in Preventing COVID-19 — but that doesn’t do justice to a remarkable clinical trial, just published this week in the New England Journal of Medicine. Led by Dr. David Boulware at the University of Minnesota, the study asked this question:  Does hydroxychloroquine (HCQ) prevent the development of COVID-19 in people […]

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May 31st, 2020

America the Not So Beautiful Right Now, with a Must-Read Book Suggestion

Have you read W. Kamau Bell’s The Awkward Thoughts of W. Kamau Bell:  Tales of a 6′ 4″, African American, Heterosexual, Cisgender, Left-Leaning, Asthmatic, Black and Proud Blerd, Mama’s Boy, Dad, and Stand-Up Comedian? If you haven’t, may I suggest you put it at the top of your list, and pronto? In addition to being funny, […]

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May 25th, 2020

A Major Advance in Non-COVID-19 ID Research You Might Have Missed

One thing about the COVID-19 pandemic — other important non-COVID ID news gets crowded out. As a prime example, take HPTN 083, a major clinical trial in HIV prevention. The results are a big deal, and should have garnered more attention when they were released last week. This randomized, double-blind pre-exposure prophylaxis (PrEP) study compared long-acting injectable […]

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May 17th, 2020

Does Strictly Limiting Outdoor Activities Help Prevent the Spread of COVID-19? A Call for Reason

I really miss playing tennis. Tossing that out there to confess up front why the following might not be the world’s most objective perspective. But take a look at this: Here's the sign up in our local parks. Given what we know about COVID-19 transmission, does this make sense? Or is it too restrictive? Asking for a friend […]

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May 10th, 2020

Thank You to Inpatient Nurses — The People Doing the Most Direct COVID-19 Patient Care

Anyone who does inpatient medicine or surgery knows well the major imbalance in time spent on direct patient care between doctors and nurses. Nurses spend way more time actually with patients than we do — I’m referring to time in the rooms caring for patients. While we round and review charts, document lab test results, bring up […]

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May 6th, 2020

Early Memories of Burton “Bud” Rose, Founder of UpToDate — and Medical Education Visionary

Let’s rewind the clock a bit — OK, a lot. Ancient history. It’s winter, 1986. An interview day for medical residency at Brigham and Women’s Hospital. A bunch of us nervous medical students sit in a conference room, wearing our interview suits, while Dr. Marshall Wolf tells us what to expect that day. Amazingly, Marshall knows all […]

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April 27th, 2020

Leaked Remdesivir Study Information, Tocilizumab and Sarilumab Trials, and the Hazards of Early COVID-19 Research Findings

In the podcast I did with Helen Branswell — Infectious Diseases and global health reporter for STAT — she mentioned that the flow of scientific information for the COVID-19 pandemic made the commonly cited “drinking from a fire hose” analogy somehow inadequate. Since she’s from Canada, I offered Niagara Falls as an alternative, to which she […]

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April 19th, 2020

Gratitude Before, During, and After Rounding on COVID-19 Service

It snowed in Boston yesterday morning — heavy, wet flakes covered the daffodils and tulips that just started coming up — but this brief return to winter didn’t make my red, itchy eyes from spring pollen feel any better. The flowers didn’t look too happy either. Oh well. But just as the annual misery of a typical […]

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