HIV and ID Observations

Don’t be fooled by the cute face. Right behind those whiskers are razor sharp teeth teeming with Pasteurella multocida.

There are some things in ID for which there is universal agreement among our infection-obsessed clan. You might not believe it based on the squabbles over pandemic-related issues in the press or social media, but it’s true!

Here’s a quick 10 off the top of my head, and of course there are more:

1. Childhood immunizations are good.
2. Treating the common cold with antibiotics is bad.
3. HIV treatment saves lives.
4. Staph aureus bacteremia can have life-threatening complications.
5. Cat bites are nasty, can transmit Pasteurella multocida.
6. People start losing their protective immunity against malaria when they move to a non-endemic region.
7. Eating oysters may be hazardous to your health (but we might eat them anyway).
8. Most people who say they’re allergic to penicillin really aren’t.
9. Drug interactions with rifampin are a big pain in the ___.
10. Azithromycin is a good drug, but not for the things it’s used for most commonly.

Gather 100 knowledgeable ID docs in a room, and votes should be unanimous in agreement on these views.

I suppose there could be a contrarian finding their way into the group, who somehow thinks that Staph bacteremia is no big deal, that rifampin plays well with other drugs, and that oysters are sterile, but that person would be thought of (appropriately) as very strange (and very wrong). You won’t see debates at IDWeek, our big national meeting, in which people take the opposing viewpoints on these 10 things, unless Bizarro World or Opposite George has an IDWeek.

Why do I bring these ID universalities up? Because the end of the year yielded three COVID-19–related papers that stirred up quite the debates from people in our field.

What’s so striking is that many of the people taking the opposite views are smart, knowledgeable, and well-respected in ID. All of them are well-meaning, hoping for the best path forward for managing this still-new viral infection to humankind. Yet, their opinions on these studies could not be more diametrically opposed.

In the next three posts, to kick off the new year, I’ll quickly summarize the papers, along with some of the divergent views. And I’ll briefly give you my take which, true to my personality (so I’ve been told, even teased about), seeks some middle ground — because in all three there are valid arguments on both sides. Hey, it’s worth a try, right?

Take it away, George!

Happy New Year, everyone!