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CDC Changes Course;  Vaccine Progress and Challenges; Racism as a Public Health Crisis; and Other Items of Interest

The Centers for Disease Control and Prevention (CDC) has changed course on its controversial revised guidelines for COVID-19 testing. The newer guidelines, issued Friday afternoon, recommend COVID-19 testing for people showing no symptoms who have been in contact with an infected person, CNBC reported.
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The previously revised guidelines issued by the CDC were not, in fact, written by medical or science experts, according to the New York Times. The Times report additionally said the guidelines were published and promoted on the CDC website against the objections of agency scientists, ultimately circumventing the CDC’s usual process for scientific review. The AAMC issued a statement in August expressing alarm over the revised guidelines when they were released.
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Politically appointed communication aides to the Department of Health and Human Services (HHS) asked for and received the CDC’s weekly Morbidity and Mortality Reports (MMWRs) that are written by career scientists — and in some cases, they introduced wording changes into the reports over concerns that they would undermine President Donald Trump’s optimistic messages about the pandemic, Politico reported. In particular, Michael Caputo, the top HHS spokesman and a former Trump campaign official with no medical or science background, has been active in trying to align the agency’s reports with the administration’s statements, including claims that fears about the virus are overstated.
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Secretary Azar waged a pressure campaign against the Food and Drug Administration (FDA) to give up its responsibility for “ensuring the safety and accuracy of range of coronavirus tests as the pandemic raged,” Politico reported. The campaign reached a climax in late August when Secretary Azar overrode FDA Commissioner Stephen Hahn, MD, and revoked the FDA’s ability to check the quality of lab-developed tests.
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USA Today published an interactive investigation exploring how the CDC failed public health officials nationwide in their battle against an emerging and persistent COVID-19 crisis. At the core of the problem was a lack of responsiveness when needed and a situation where local officials had to fend for themselves with a lack of data and equipment.
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About 100 faculty members of Stanford University School of Medicine, including former dean and former AAMC Council of Deans Administrative Board member Philip Pizzo, MD, signed a letter last week criticizing Hoover Institution Senior Fellow and Stanford faculty member Scott Atlas, MD, for his controversial positions on COVID-19 as expressed in his new role on the Trump administration’s Coronavirus Task Force. The Stanford Daily covered the story and published the open letter.
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The Washington Post detailed the government’s sweeping plan to provide free COVID-19 vaccines to all Americans under the umbrella of Operation Warp Speed. The report highlighted that most vaccines will require two doses 21 to 28 days apart and that the vaccination campaign will initially be limited to protecting health workers, other essential employees, and people in vulnerable groups.
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The Trump administration is launching the Vaccine Administration Management System to immunize millions of Americans to the coronavirus using an unproven data system that may bypass state trackers, Politico said.
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Kaiser Health News discussed concerns over a British patient’s adverse reaction to AstraZeneca’s COVID-19 vaccine candidate and how the company’s withholding of more information about the situation could slow the resumption of the trial in the United States.
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Pfizer announced that its vaccine candidate appears safe and that it is expanding its trial from 30,000 to 44,000 people, USA Today reported.
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On the treatment front, Eli Lilly said a single infusion of its monoclonal antibody drastically reduced levels of the coronavirus in newly infected patients and decreased the chances they would be hospitalized, the New York Times reported. The company’s announcement has not yet been backed up from independent scientists reviewing the results.
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Moncef Slaoui, PhD; Shannon Greene, PhD; and Janet Woodcock, MD, are co-authors of a New England Journal of Medicine perspective summarizing the progress of the administration’s Operation Warp Speed effort to bring vaccines and treatments to COVID-19 to the market quickly. “An infectious disease arsenal requires tools for targeting the virus itself and for treating disease symptoms and complications. [Operation Warp Speed] is considering the gamut of clinical needs, from preexposure prophylaxis through the convalescent period,” they wrote. Dr. Slaoui is the scientific head of Operation Warp Speed.
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Could it be that the act of merely wearing a face mask while out in public is conferring people with immunity from the SARS-CoV-2 virus? Monica Gandhi, MD, MPH, and George Rutherford, MD, both of the University of California, San Francisco, School of Medicine, contributed a perspective piece in the New England Journal of Medicine exploring the possibility of variolation, which refers to a method that immunized an individual against smallpox through exposure of a small amount of material taken from a smallpox patient, resulting in a mild, but protective, infection.
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“With a combination of a good vaccine together with good public health measures, we may be able to put this coronavirus outbreak behind us, the way we put the original SARS behind us,” and we could even return to some normality by the end of 2021, said Anthony Fauci, MD, in a discussion with the Wall Street Journal’s CEO Council.
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Aaron Carroll, MD, a professor of pediatrics at Indiana University School of Medicine, wrote an op-ed in the New York Times throwing cold water on any optimism that life will return to normal next year, saying that people will still need to take some pandemic precautions well into 2021 and even after a vaccine is widely available.
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“The ongoing trials are moving at a pace that is unprecedented for medical research. … Yet recruiting minority participants requires sensitivity to a mistrust borne of past and current medical mistreatment. Trust-building cannot be rushed. So far, participation by minority volunteers in coronavirus trials has increased only slightly compared with typically low levels for other clinical trials — and targeted outreach efforts to recruit more minorities have been slow to launch,” reported Kaiser Health News.
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“The conversation around health inequities has been reignited by the emergence of COVID-19 and has taken on a new dynamic that has emboldened medical professionals and students to speak out about subpar care for some of the nation’s most vulnerable communities, in addition to calling for the restructuring of medical curricula,” MarketWatch said in an article that also described efforts to recruit larger numbers of Black clinical trial participants for COVID-19 vaccines.
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Scientific American, for the first time in its 175-year history, endorsed a presidential candidate. The Washington Post also covered Scientific American’s endorsement of Joe Biden and reactions to its dramatic break from a nonpartisan tradition.
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Wired featured an interview with Science editor-in-chief Holden Thorp, PhD, on how he has “focused a laser-like stream of neural energy at calling out the crummy pandemic policies of the Trump administration.”
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JAMA Network ran a piece on the inevitability of more telehealth and license portability post-COVID-19. AAMC work in this area, along with a quote by AAMC Chief Health Care Officer Janis Orlowski, MD, is mentioned.
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The Health Resources and Services Administration gave $25 million to 80 organizations across 36 states to help with the opioid epidemic in 2020, Becker’s Hospital Review reported.
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Joseph Ladapo, MD, PhD, an associate professor at the University of California, Los Angeles, David Geffen School of Medicine, wrote an op-ed in the Wall Street Journal, “How to Live With Covid, Not for It.”
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Inside Higher Ed explored how different universities are navigating quarantines, stay-in-place orders, and limits to movement on and off campus.
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“Of 598 hospitalized pregnant women with COVID-19, about 55% were asymptomatic, while 16% of symptomatic pregnant women were admitted to the intensive care unit (ICU), about 9% required mechanical ventilation, and two women died,” MedPage Today reported in coverage of one of the CDC’s MMWRs.
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Coronavirus prevention measures such as wearing masks, washing hands, and keeping safe distances from people may help blunt flu season, CNN reported.
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More than 50 American municipalities have passed legislation or made formal declarations in the past year that racism is a public health crisis, the Washington Post reported.
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The Centers for Medicare & Medicaid Services’ withdrew the Medicaid fiscal accountability regulation (MFAR), Modern Healthcare reported.
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The AAMC issued a statement on the CMS decision to rescind the proposed Medicaid Fiscal Accountability Regulation. “The AAMC appreciates yesterday’s announcement from CMS to withdraw the proposed Medicaid Fiscal Accountability Regulation (MFAR). The MFAR rule would have unnecessarily and unreasonably added significant burden on states and localities to fund their Medicaid programs and ensure access to patients, particularly during the current public health crisis,” AAMC Chief Public Policy Officer Karen Fisher, JD, said.
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“Founded 168 years ago as [Chicago’s] first hospital, Mercy survived the Great Chicago Fire of 1871 but is succumbing to modern economics, which have underfinanced the hospitals serving the poor. In July, the 412-bed hospital informed state regulators it planned to shutter all inpatient services as soon as February. … [E]xperts fear that the economic damage inflicted by the COVID-19 pandemic on safety-net hospitals and the ailing finances of the cities and states that subsidize them are helping push some urban hospitals over the edge,” Kaiser Health News reported.
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The Washington Post described the wide-ranging health and environmental impacts of the West Coast’s wildfires. And Modern Healthcare described how West Coast hospitals are straining to manage this year’s wildfire onslaught.
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President Trump signed an executive order calling for Medicare to test out a tactic for lowering drug prices known as “most-favored-nation price,” which links prices for certain expensive prescription drugs to the prices that other developed nations pay for them, CNN reported.
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Primary care is increasingly relying on connecting patients with teams of health professionals to protect doctors’ time as the physician workforce is stretched, the Wall Street Journal reported.
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Some hospitals such as Northwestern Memorial Hospital are experimenting with offering live music to help patients with anxiety and isolation, the Wall Street Journal reported.
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AAMCNews explored the complicated issue of medical aid in dying in an interview with Diane Rehm, the longtime host of The Diane Rehm Show on NPR. Diane Rehm is one of the speakers featured during the AAMC’s annual conference, Learn Serve Lead: the AAMC Virtual Experience, in November.
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Modern Healthcare opened its ballot for voting on the 100 most influential people in health care. The ballot contains 300 names and allows voters to cast ballots for up to five individuals.
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Few hospitals have a zero-tolerance policy of harassment toward health care workers, according to a research letter published in JAMA Network Open and covered by Becker’s Hospital Review.
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Virtual reality is improving health care and medical education by making surgery safer, giving residents crucial practice without putting real patients at risk, and preserving critical supply chains, Harvard Business Review reported.
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The American Hospital Association is asking the full District of Columbia Circuit Court of Appeals to revisit a July decision by a panel of judges from the court that upheld the HHS’ cuts to the 340B drug pricing program, Modern Healthcare said.
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Academic medicine is taking a hard look at its role in the long-standing systemic and institutional racism that Black Americans have faced when engaging with teaching hospitals, medical schools, and research programs — an experience that historically has fostered distrust of medicine and health care within the Black community. In the second season premiere episode of “Beyond the White Coat,” David J. Skorton, AAMC president and CEO, talks with Lonnie G. Bunch III, secretary of the Smithsonian Institution, about how the history of racism in medical schools, clinical care, and research has impacted academic medicine’s relationship with the Black community.
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The AAMC, in collaboration with the Congressional Academic Medicine Caucus (CAMC), will host a virtual briefing, “On the Front Lines: COVID-19 and the Way Forward.” The event will feature Rep. Kathy Castor (D-Fla.) and Rep. Phil Roe (R-Tenn.), as well as several AAMC leaders, and it will focus on how the nation’s medical schools and teaching hospitals are actively responding on the front lines of the pandemic, including adopting innovative methods to overcome challenges brought on by COVID-19. Panelists will discuss the path forward to mitigating COVID-19 and the immediate, evidence-based, commonsense steps that the nation can take to contain the virus and end the pandemic. The event takes place Sept. 24 at noon ET.
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The AAMC is partnering with the National Endowment for the Arts and the Good Listening Project to offer virtual “Listening Poet” sessions. The sessions take the form of a brief personal Zoom call that is subsequently transformed into a work of original poetry. Each participant can choose to share their poem, with or without attribution, or they can simply keep it to themselves. This program is part of a broader AAMC medical education strategic initiative and another way for our constituents to express themselves and find solace during these critical times.
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AAMC Chief Academic Officer John Prescott, MD, will be retiring at the end of 2020 after 40 years as a practicing physician and medical school dean and 12 years of service at the AAMC. Additionally, AAMC President and CEO David Skorton, MD, announced a decision to combine two AAMC clusters, Academic Affairs and Medical Education, now led by Alison Whelan, MD, into a new cluster under her leadership.

John Krouse, MD, executive vice president of health affairs and dean of the University of Texas Rio Grande Valley School of Medicine, has announced he will step down from his administrative posts at the end of August 2021 to join the faculty in the School of Medicine.

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Milagros Rosal, PhD, has been appointed vice provost for health equity at the University of Massachusetts (UMass) Medical School. Dr. Rosal is a professor of population and quantitative health sciences in the Division of Preventive and Behavioral Medicine at UMass Medical School.
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Kimberly Yonkers, MD, has been appointed chair and professor of psychiatry at the UMass Medical School and UMass Memorial Health Care, effective Nov. 1. Dr. Yonkers is currently a professor of psychiatry at the Yale School of Medicine.
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Gregory Howell, MD, and Brook Nelson, MD, have been appointed assistant deans for graduate medical education at the University of Missouri - Kansas City (UMKC) School of Medicine. Dr. Howell is an associate professor of medicine and program director for the critical care fellowship and Dr. Nelson is an assistant professor of surgery and general surgery residency program director at the UMKC School of Medicine.
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Gregg Kokame, MD, has been appointed chief of the Division of Ophthalmology in the Department of Surgery at the University of Hawaii at Manoa John A. Burns School of Medicine. Dr. Kokame previously served as a clinical professor of the Department of Surgery.
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The National Institute of General Medical Sciences has released an array of backgrounds that can be used for those ubiquitous video calls that have become a daily (hourly?) part of our work lives in 2020. The resource helpfully provides files with compatibility for Microsoft Teams, Skype, and Zoom.
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While those backgrounds are nice for what’s visible through the camera, they won’t do anything to change what can’t be seen just out of view. Slate published a story detailing a viral photo of Gretchen Goldman, PhD, research director for the Center for Science and Democracy at the Union of Concerned Scientists (and a mom). Dr. Goldman was interviewed live on CNN looking entirely professional in her home studio, but what was out of view of the camera told a story that may be relatable to many of us. Kudos to Dr. Goldman for her scrappy special effects work.
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And finally, perhaps a little less relatable, is the latest excursion into high-fashion (and high-price) COVID-19 wear. Town and Country (who else?) reported on the new Louis Vuitton “Monogram LV Face Shields” for those who want nothing but the finest in their personal protective equipment wardrobe. The shield features the iconic Louis Vuitton logos emblazoned everywhere (if you have to ask what it looks like, please move on) and a shield made out of material that darkens when exposed to sunlight. At merely a grand per face shield, you can buy one for everyone in the family.
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Visit the CFAS Resources page for an archive of the previous edition of CFAS News as well as our People of Academic Medicine page, which features a running list of academic promotions, appointments, and departures.

Your comments and news tips are always welcome. Please email them to Eric Weissman at eweissman@aamc.org.

Read the previous edition of CFAS News.

Eric Weissman
Senior Director, Faculty and Academic Society Engagement
AAMC
eweissman@aamc.org
www.aamc.org/members/cfas

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