Lois Levine

Writing about all that has gone terribly wrong in 2020 is the easy thing, so instead, I thought I would finish off the year with a list of all the things the health care community can be grateful for from 2020. 

Yes, we are living through a deadly pandemic, and no one is certain when life will return to the way we remember it from 2019. But, in spite of all the dark news, there has been spectacular scientific progress, wise counsel from experts we trust, and a tremendous grass roots movement of love and support that came streaming in from all over the world in random communities. (Remember those images of 7 p.m. standing ovations from open windows across the globe, as hospital workers changed shifts?) Here are some other things that I am grateful for as well:

 An unflappable doctor with a gravely voice and slight Brooklyn accent, Anthony Fauci, the director of the National Institute of Allergy and Infectious Disease first made a name for himself in the 1980s, working with AIDS activists as early as 1981 to desperately find a cure for the HIV virus at a time when the government was largely ignoring "the gay plague." This year, he continued to inform us about COVID-19 with the same calm countenance he has always been known for, delivering the unvarnished facts, neither minimizing or exaggerating the impact of COVID-19, and has more than earned our trust as 

 go-to medical advisor who will deliver what we need to know—the scientific truth.

Pfizer-BioNTech and Moderna moved, with unprecedented speed, from the laboratory to the Federal Express trucks to the hospitals, vaccines with minimal side effects and staggering efficacy rates of more than 94%. As a point of comparison, scientists began working on the polio vaccine in the 1930s: It wasn't until 1953 that Jonas Salk was able to create one for the public that was truly safe and effective. And in 2019, a vaccine for Ebola was approved, 5 years from the start of its phase 1 trials, which was lauded for 

 Recent images in documentaries showing nurses and doctors treating patients of the 1918 Spanish flu are shudder-worthy: The masks are made of porous gauze, and most health care workers wrapped them around their mouth, leaving their noses exposed. We know so, so, so much better now.

Sure, at times those Sunday afternoon Zoom calls with the whole family made you groan after a while, but the technology still provided the second-best way to reach out and touch someone we love, or miss, or both.

 This one is huge. It no doubt transformed the medical office landscape permanently, allowing sick and contagious patients to be diagnosed and treated from the safety of their homes (providing a great deal of comfort for both the health care worker and the patient, who both could be in danger of being infected). 

  In 1946, Goldie and Jerry Lippman, working with a chemist at Kent State University, developed a waterless hand cleaner for rubber plant workers; called Gojo, which was a mixture of petroleum jelly, mineral oil, and less than 5% alcohol. Then, in 1988, the company that the Lippmans created invented Purell—and the rest is clean-hand history.

 Roughly 160 million Americans turned out to vote in 2020, almost 25 million more than did so in 2016. The 2020 presidential election turnout will now go down in history as the highest voter turnout of all time. That's the toughest argument of all when cynics tout that people just don't care. And keep on caring, we will.

Articles

Believe it or not, there was a sunny side to 2020.

What we have to be thankful for from 2020

It was a year like no other, but that didn't mean we had to hide under our beds and wait for COVID-19 to pass. Throughout the United States (and the world), best practices to protect the public and its first responders were put into place and updated throughout 2020, so that life, in certain instances at least, could continue as "normally" as possible

Thanks to the American Academy of Pediatrics (AAP), we continued to alert you to new and revised guidelines to keep your patients as safe as possible, such as in the case of playing sports, where updated recommendations included labeling a child's personal effects (water bottle, tissue box, etc.); remaining in a car or designated area until the game begins; and avoid sports huddles, sharing food or drinks with teammates, and cheering in close proximity. You can read the full article 

We also shared with you stories on the best 

and use telemedicine for office visits, and, during this past summer, we talked to Dr Andrew Schuman about how 

Now that we are moving into 2021, with 2 vaccines on the market, as well as plans to start including children in FDA trials for vaccines, we will continue to update you on all you need to know regarding this pandemic.

A look at how we learned to protect ourselves and our patients from COVID-19 over the past year.

How we armed ourselves for COVID-19 this year

As if new surges of COVID-19 along with a new variant of the virus aren't bad news enough, troubling reports from the United Kingdom are now suggesting that this new strain could be more infectious to children than the original virusnei.

The British government's New and Emerging Respiratory Virus Threats Advisory Group (Nervtag) notes that this new variant "has a transmission advantage over other virus variants currently in the UK," said Peter Horby, professor of emerging infectious diseases at Oxford University and chair of Nervtag. Neil Ferguson, another Nervtag member noted, "there is a hint that it has a higher propensity to  infect children."

The new variant, labeled VUI-202012/01, might be 50%-70% more infectious than the previous virus. Ferguson noted, "what we've seen over the course of a 5 or 6-week period is that the variant in under 15 [year olds] was significantly higher than the non-variant virus." The original strain of COVID-19 may have not spread so easily to children because, one theory suggests, children have fewer of the doorways called angiotensin-converting enzyme 2 (ACE2) receptor that the virus uses to enter a human's cells. Professor Wendy Barclay, another Nervtag member said the mutuation of the virus seem to be making it easier to breach those doorways.

The scientists all agreed, though, that more data needed to be drawn before any conclusions could be reached.

Several reports coming out of the United Kingdom are suggesting that the newest variant of COVID-19 might be more infectious for children.

Is the new strain of COVID-19 more infectious for children?

The National Institutes of Health (NIH) has awarded 8 new research grants to help identify children who are at high risk of contracting multisystem inflammatory syndrome in children (MIS-C), a severe result of COVID-19 in some children. 

The studies will include how genetic, immune, viral, environmental, and other conditions influence the level of severity of COVID-19, and the chance of it progressing to MIS-C in certain cases. The awards are a part of the Rapid Acceleration of Diagnostics (RADx) Radical (RADx-rad) program that supporrs non-traditional approaches and new uses of existing technologies to address gaps in COVID-19 testing and surveillance.

The studies, which will be using artificial intelligence and machine learning, will be studying genes, immune system proteins, and other biomarkers, examine how the virus interacts with the body and how the immune system responds to it. The awardees and their project names are:

Jane C Burns, University of California, San Diego
Diagnosing and predicting risk in children with SARS-CoV-2-related illness

Cedric Manlhiot, Johns Hopkins University, Baltimore
A data science approach to identify and manage MIS-C associated with SARS-CoV-2 infection and Kawasaki disease in pediatric patients

Ananth V Annapragada, Baylor College of Medicine, Houston
Artificial intelligence COVID-19 risk assessment for kids

Audrey R Odom John, Children's Hospital of Philadelphia
Diagnosis of MIS-C in febrile children

Usha Sethuraman, Central Michigan University, Mount Pleasant
Severity predictors integrating salivary transcriptomics and proteomics with multi neural network intelligence in SARS-CoV2 infection in children

Juan C Salazar, Connecticut Children's Medical Center, Hartford
Identifying biomarker signatures of prognostic value for MIS-C

Charles Yen Chiu, University of California, San Francisco
Discovery and clinical validation of host biomarkers of disease severity and MIS-C with COVID-19

Lawrence Kleinman, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey
COVID-19 Network of networks expanding clincial and translational approaches to predict severe illness in children

The National Institutes of Health award 8 research grants to develop ways to identify children at high risk for multi system inflammatory syndrome I children (MIS-C).

Lois Levine

Articles

What we have to be thankful for from 2020

How we armed ourselves for COVID-19 this year

Is the new strain of COVID-19 more infectious for children?

NIH funds 8 new studies on COVID-19 related MIS-C in children