An ongoing dialogue on HIV/AIDS, infectious diseases,
September 22nd, 2021
What I’ve Been Busy Doing, Besides Seeing Patients — and Bonus Animal-Related Infection Podcast
Long-time readers of this site (and I thank you deeply for that) might have noticed a lengthier gap than usual between today’s post and the previously published one.
Nearly three weeks! Wow! What on Earth is he doing? He must be really busy. That or just lazy.
In order to reassure you that the former is a better explanation for the silence than the latter, here are a few non-patient care things gobbling up the time that typically would go into crafting one of these posts:
1. ID fellowship interviews. COVID-19 notwithstanding, we continue to attract some truly brilliant, mission-driven, and just wonderful young physicians to this field. And can you blame them? It’s by far the most interesting and challenging medical subspecialty, arguably now more than ever.
But the process of reviewing applications, doing the interviews, and submitting our reports takes time — as it should. By the way, check out this paper that surveyed applicants and program directors after the first year of “virtual” recruitment to ID. Seems like virtual here to stay, at least in some capacity.
Just wondering — how many of those interviewees only put on the top half of their interview suits, and stuck with jeans, sweats, scrubs, or shorts for the bottom half? Zoom can’t tell!
2. The NEJM FAQs on COVID-19 vaccines. Or should I write Covid-19 vaccines? For reasons only the editors understand and are keeping secret from me, here on NEJM Journal Watch we write it as COVID-19, while in NEJM itself, it’s Covid-19. Go figure.
But if you know of another content area with greater changes day by day — sometimes hour by hour — than these amazing vaccines, it would be news to me. These FAQs require constant attention and updating, and even then one feels hopelessly behind. Talk about a Sisyphean task, one that might not get easier for some time.
Note that I am both very proud (and surprised) that I spelled “Sisyphean” correctly without looking it up and very grateful to Amy Herman at NEJM Group for her help on this giant project.
3. An opinion piece on the strange lack of guidance for booster doses with the one-shot J&J vaccine. Is the one-shot Johnson & Johnson vaccine less effective than the mRNA vaccines? Yes. Do we have evidence that giving an mRNA vaccine to prior adenovirus vaccine recipients boosts responses? Yes. Doesn’t even J&J think that its vaccine needs more than one dose?
Probably yes — their opinion further amplified by their press release of some of the ENSEMBLE2 data, though my co-author on the New York Times piece, Dr. Michael Lin from Stanford, still has some concerns:
Finally, ENSEMBLE2 results (2-dose J&J vaccine) have arrived. The results?
Good, in a preliminary way
A disappointment, in the inexplicably tiny sample sizes and large uncertainties
Also some questionable real-world analyses
— Michael Lin, PhD-MD (@michaelzlin) September 21, 2021
We’ll see. Regardless, it’s just so strange that with all the chatter about boosting the Pfizer-BioNTech (especially) and Moderna vaccines, the 14 million Americans who got one shot of J&J still wait for guidance. “Soon,” say many experts. Will be glad when that day comes.
4. Debating the top animal-related infections, with Dr. Jeanne Marrazzo. She’s the Chief of ID at the University of Alabama, a long-time friend and ID colleague, a scintillating conversationalist, and a true animal lover. One of my junior colleagues considers her a “hero” in ID. Who could be better for this O-F-I-D podcast? Note that I didn’t specify what I meant by “Top Animal Infection” — could be very serious, or having a cool life cycle, or just an amazing name, or having a great clinical anecdote, or some combination of all of the above.
So listen, learn, and laugh! And let me know in the comments if we left out one of your favorite animal-related infections. There are just so many.
(Quick aside — I got the idea for these silly drafts from one of my favorite writers in the world, Joe Posnanski. I even wrote him a fan letter! He does even sillier drafts with comedy writer Michael Schur on his “Poscast”, and gave me permission to do these Infectious Diseases ones since they don’t have overlapping content. He’s about to release a massive book, The Baseball 100. If you have even the slightest interest in baseball, I can’t recommend it strongly enough.)
(Transcript here, and also available on iTunes, Spotify, Overcast, or anywhere you get your podcasts.)