Panel of health experts discusses burnout, disparities and the future of the pandemic in COVID-19 special session
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By Lisa Braverman and Doriann Geller

Lisa Kachnic, MD, FASTRO, moderated a set of timely presentations and an interactive dialogue with three executive leaders in health care: Patrice Harris, MD; Amalia Del Riego Abreu, MD; and Rachel Levine, MD. Annual Meeting attendees were also fortunate to receive a personalized thanks and pandemic update from Anthony Fauci, MD.

Dr. Harris, an Atlanta-based psychiatrist and immediate past president of the American Medical Association (AMA), focused her comments on physician burnout. She argued we have not been having the conversations we need to have about mental health in general, and that mental health and wellness should be at the center of our work. Amid COVID-19, we are concerned about our health, families, medical practices and more.

Physician burnout emerged as an important topic long before the COVID-19 pandemic. We are not helpless in this situation and there are things we can do to fight burnout, Dr. Harris asserted. First, it is crucial not to conflate burnout with medical mental health diagnoses. Checking in on one another is essential, as is engaging in personally helpful and healthy activities such as meditation and physical activity. Dr. Harris demonstrated that it is not just acceptable, but essential, to honestly share that you are struggling with current events. We must “make sure we are checking in on our teams and our staff,” she said.

Speaking to disparities and innovations in the pandemic-affected Americas, Amalia Del Riego Abreu, MD, noted that the pandemic has hit in many areas that were already experiencing huge challenges. Dr. Del Riego Abreu, Unit Chief, Health Services and Access at the Pan American Health Organization’s (PAHO) Health Systems and Services Department, noted the Americas are now the epicenter of the pandemic. Resource challenges, including a lack of running water, affect some hospitals in this region.

Despite the challenges, however, Dr. Del Riego Abreu capitalized on the heartening innovations many countries have undertaken. Accelerated medical school graduations, hospital shift management and employee risk mitigation have all enjoyed successes in the fight against COVID-19. She ended with a quote from Carissa F. Etienne, the director of the PAHO, who celebrated health care workers on World Health Day: “We must also care for our health workers through support networks that allow them to preserve their mental and physical health. We must celebrate them for the heroes they are and protect them from stigma. We should encourage and admire our health workers, not fear and disrespect them.”

Rachel Levine, MD, Secretary of Health for the Commonwealth of Pennsylvania and president of the Association of State and Territorial Health Officials (ASTHO), gave an overview of the current fall COVID-19 resurgence. She outlined containment strategies and challenges of contact tracing. She said she “[disagrees] with anyone who says we cannot work to contain this virus. We cannot go to a strategy of herd immunity; there is no virus where you develop herd immunity. The way you develop herd immunity is through vaccines."

We have a collective responsibility to work together, Dr. Levine argued, for the common good. She spoke about vaccine hesitancy and the importance of effective, basic public health messaging campaigns. An approved vaccine is likely to be rolled out in at least three phases, she noted, with the most vulnerable populations being eligible for vaccination first. In the live Q&A session, Dr. Levine said she believes we will be masked in public until at least 2022.

All panelists took questions from Annual Meeting attendees. They discussed what has sustained and surprised them through this pandemic and how their current selves are different than they were in December and January. Dr. Levine asserted that we will make it through this pandemic better and stronger, but it will be a journey and a relay race.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, addressed Annual Meeting attendees. He thanked attendees for their good work before giving an overview of COVID-19’s infectiousness and the latest facts and figures associated with the virus.

Reiterating that COVID-19 is much more than the common cold, Dr. Fauci noted that as of October 19, 2020, the United States is the hardest-hit country in the world with 8.1 million cases. As the weather in the Northern Hemisphere gets colder, there has been an uptick in cases in the United States, Europe and elsewhere.

Dr. Fauci explained that the role of aerosols in spreading the virus is not entirely clear, and bars, gyms, coffee shops, indoor restaurants and religious gatherings remain risky locations for spreader events. While social distancing is extremely important, fewer patients have been visiting hospitals for non-COVID medical emergencies. The reluctance to visit medical establishments may have devastating future consequences, as peer-reviewed publications have estimated approximately 10,000 excess deaths from breast and colorectal cancers in the near term.

Racial disparities in COVID-19 outcomes are particularly troubling. Dr. Fauci assured attendees that panels of experts are meeting regularly in the United States to develop treatment guidelines. To date, there are several promising treatments including Remdesivir, Dexamethasone and three promising families of vaccines in trials. The talk concluded with information about preventcovid.org, a site where individuals can express interest in joining a clinical trial with no obligation.

Published on October 29, 2020


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