HIV and ID Observations

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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April 12th, 2020

IDSA’s COVID-19 Treatment Guidelines Highlight Difficulty of “Don’t Just Do Something, Stand There”

The Infectious Diseases Society of America (IDSA) gathered a series of experts for what were undoubtedly many late-night calls, reviews of published and pre-print literature, and revisions (of revisions), and admirably generated a set of treatment guidelines for COVID-19. The problem — there is no proven effective treatment for COVID-19. That is, there’s no proven treatment based […]

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April 6th, 2020

Dear Nation — A Series of Apologies on COVID-19

(What I’m sincerely hoping we’ll be hearing in an upcoming press conference, and soon.) Dear Fellow Americans, I’d like to take a brief moment in today’s press briefing to say something that is long overdue. I’m sorry. In a moment, I’ll cite the specifics of what I’ll be apologizing about. But first, I want to acknowledge the sadness of this […]

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March 26th, 2020

No Opening Day … Yet

My memories of spring have always included baseball. I worshiped my older brother Ben — he’s still pretty great — and he loved baseball. So as the days in March shifted from cold and dark to slightly less cold and much less dark, the game he played so brilliantly with his friends pulled me in. I […]

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March 22nd, 2020

Quiet Hospital Zone

Academic medical centers right now would provide visitors — if they were permitted — a strange experience. Usually buzzing with clinical and research activity, with incessant human interactions in hallways, on rounds, at the bedside, in conference rooms, our hospitals are now eerily quiet — and very, very, tense. Minus the intensive care units, the “special pathogen […]

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March 16th, 2020

Difficult Times — Meaning No CROI Really Rapid Review 2020

In a usual year, right about now, I’d be obsessed with two things: What were the most practice-changing studies presented at the Conference on Retroviruses and Opportunistic Infections, or CROI? I’d want to summarize those for a patented, copyright-protected, check-with-my-lawyer-before-copying, Really Rapid Review©®. How will the upcoming baseball season play out? Most readers here don’t care, […]

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March 8th, 2020

As Testing Ramps Up, Diagnoses of Coronavirus Disease in the U.S. Will Soon Increase Substantially — How Will We Respond?

Brace yourself. As coronavirus disease (COVID-19) occurs at multiple locations around the United States, the number of confirmed cases here is about to increase big time. There are two reasons: New infections More testing Believe it or not, despite statements by certain politicians, COVID-19 tests still cannot be ordered by any clinician who believes it should be […]

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