Thread by @ben_ouyang

Great @A_P_S_A Seminar: "The role of the physician scientist during a pandemic"

Live tweeting thread!

"What are the most important frontline clinical questions?"

@SalliePermar: "It seems that children aren't as affected, even among immunocompromised children. What causes the difference in response b/w adults and children?"

@SalliePermar: "What are the routes of transmission?"

@DMAronoff: "What will be the outcome of this societal experiment of wearing masks?"

@DMAronoff: "Why do we have 30 year olds dying of infection, and sometimes 100 year olds don't? We're chiselling away big chunks like hypertension, diabetes, but there is lots from genetic information."

@DMAronoff: "How durable is our immunity to this virus? Will those infected keep immunity, or will it wane over time?"

@DMAronoff: "There are so many questions that we could spend a whole day whiteboarding the questions!"

Albrecht: "how would you test people that have already been infected by covid19 and how would that go about?"

@SalliePermar : "Animal models. Study re-infection and see if infection/immunity is around in the long term. It'll be important to show in human populations. We prepare now for the 2nd/3rd waves by setting up the clinical trials now. Follow pts infected in this wave 4 long term."

@JoseARodrigues8: "How has seeing covid patients changed how you interact with clinical teams and pt management?"

@DMaronoff: "At Vanderbilt, we have two multidisciplinary clinical huddles/day. 1 for pts in ICU, 1 for pts not in ICU. Reps from physicians in infectious disease, PMCC, immunologists, rheumatologists, virologists, clinical trialists. Primary care providers participate too."

@SalliePermar: "Pharmacists + microbiologists. Going over what changed this week. Multidisciplinary has become the new norm and something I hope will continue."

@YentliSA : "What do we tell family members about where we stand for developing therapies for covid19?"

@SalliePermar: "Listen to the scientific community. Look at the landscape, which changes every day. It's not simple and it's not static. Pointing to one source may not be feasible in the short term."

@DMOronoff : "Some really good compilers of info: National Library of Medicine. Good in communication to stick to what we know and stick to fundamentals. It's not wrong to say there are no proven therapies and no vaccines for covid19."

@DMOronoff : "The best offence right now is defence. The concept that we're communicating over the power of electrons instead of in person is really important in preventing the spread of a respiratory infectious disease."

@DMOronoff: "Why are we distancing? Why are we washing hands and using disinfecting sanitizer? These are really basic and go back to the flu pandemic of 1918, but they're important questions to answer."

@DMOronoff: "Important not to get into the angstrom level of our research, and spend time explaining the basics of preventing spread."

@JoseARodrigues8 : "Do you feel like you were prepared to communicate so well about this disease? Or was this something you picked up while training elsewhere?"

@DMAronoff: "All the training standing in front of posters. Having to practice my research pitch, whether it's for a grant, or literally in an elevator has been invaluable for communication."

@DMAronoff : "I have to learn in real time about how my city and hospital are dealing with this, ingest it, and give it out in aliquots to say in a way that's understandable to a broad audience."

@DMAronoff : "Scientists are among the best prepared to be public health and science communicators. Growing trend + emphasis now for students to be science communicators!"

@SalliePermar : "Physician scientists have an advantage of taking a huge story and summarizing it down into a one-liner. They're well-poised to speak to the broader community."

@SalliePermar: "Now, more than ever, it's important for scientists and physician scientists to take that podium and earpiece and turn it into an important message."

@YentliSA : "How do you recommend research to trainees during this time when a lot of labs are shut down?"

@SalliePermar : "As mentors, one of our tasks now is to come up with research opportunities that are virtual. This is a new challenge! For mentees: if you are in an established research community, you can bring up an idea to your mentors. If you've wanted to learn R, go for it!"

@JoseARodrigues8 : "How do folks that are ambitious, how to balance opportunism vs trying to address the problem?"

@DMAronoff: "The long view is important one here. This will pass and labs will reopen."

@DMAronoff: "This shows we can rapidly do team science. I think we may see a bit of a renaissance in the importance of physician scientists and the importance of biomedical science. It may open people to interest."

@DMAronoff: "When things gradually reopen, labs will be very hungry to bring new scientists in. Hold onto hope. I think this is a time where great change is afoot."

@YentliSA : "Coronaviruses seem to come every decade now. Will this further a push for more research in vaccines and virus research?

@SalliePermar : "Antibodies may be the quickest way to make vaccines, but it might not be the best way to protect us from the next coronavirus pandemic. We need a vaccine that can be cross protective and protect us from the next decade of different coronaviruses."

@DMAronoff: "I do not have a better answer than that!"

@JoseARodrigues8 : "What can we do for nursing homes?"

@DMAronoff: "People in nursing homes are often highly vulnerable. Infection prevention is not quite as geared up as in a tertiary hospital. We've been trying to help nursing homes to develop testing as they can. We want to do the things we know works: limit visits, screen HCWs."

@DMAronoff: "The flip side of preventing this, is that often these nursing homes have many mental health challenges, like dementia, and so this is a really bad problem. This pandemic is teaching us about how to deal with group homes and preparing us for the future."

@yentli: "There's a crisis for medical personnel. What can we do as physician scientists?"

@SalliePermar: "Fatigue and burnout in HCWs is amplied. While you'll get the push to address the problem at hand, in the long term, what will this look like to young people who are looking to healthcare as a potential career. It takes creativity to help this in next workforce."

@DMAronoff:"we're prepping everywhere for a surge of pts. All hands on deck. People are suffering It is incumbent on us as physician scientists to drop the research we're doing and ask "what can we do?" We have lots of physician scientist that are volunteering."

@DMAonoff: "Also giving physician scientists new opportunities to bring their perspective to solve problems in the clinical space. Supply chains, make weekly literature reviews that everybody needs to know, etc. I don't see us getting through this without physician scientists."

@JoseARodrigues8 : "What kind of skills as physician scientists allowed you to lead in this response and enables you to do great things?"

@DMAronoff: "It's imp to understand that the work you're doing as a physician scientist in training: how to interpret data, how to think, how to eval pts, how to synth+formulate. You're learning basic translateable fundamentals that can be applied when you suddenly need them.

@DMAronoff: "Skills in putting teams together, understanding the problems needed to solve, understand how to solve the problems, and develop metrics to understand how well we're solving them."

@DMAronoff: "I've been been a virologist, nor been involved in a pandemic, but the things I'm being asked to do, I've trained to do after years of learning and mentoring."

@SalliePermar : "Using the power to collaborate. Knowing how to link things and important minds together to solve a problem. Putting someone in their best position to help in that collaboration. Boiling down the important questions."

@YentliSA : "Trainees, it's okay to feel lost and confused during this time. It's also okay to fight covid with your training. It's okay to support your family and friends and vulnerable during this time. Protect your mental and physical health during this time."

@JoseARodrigues8 : "I wanna thank our #doubledocs community. The virtual meeting has had hundreds of attendees!"

And that's a wrap! Thanks @YentliSA @JoseARodrigues8 for moderating (esp thru the bombers), and @SalliePermar @DMAronoff for sharing such inspiring advice and experience! 👏

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