Thread by @jocalynclark

6 months to the day that I wrote our lead @TheLancet editorial on a mysterious new pneumonia-like outbreak drafting it in 3 hours instead of the usual 3 days. Colleagues gave input in 1 h instead of 24 h. 6 months for the world to change forever. #writing
thelancet.com/journals/lance…

Writing a leader under those conditions is risky: what was the outbreak & would it spread? Are we making something of nothing? Should we go soft or hard on China’s response & transparency? What about this ‘lockdown’ of Wuhan, an intervention we thought of as draconian (ha ha).

Our EIC edited the leader; we waited overnight for WHO to decide about the PHEIC. New cases from around the world were reported (we couldn't keep up). We had the first 2 research reports from China describing the novel coronavirus.....We were under pressure to go live ASAP.

On Friday morning, making changes til the last moment we hit 'send' to share our editorial with the world, along with the 2 research papers. High fives all around. But we had no idea what the next few weeks & months would bring... #COVID19

Editorial:
thelancet.com/journals/lance…

Research paper #1
thelancet.com/journals/lance…

Research paper #2
thelancet.com/journals/lance…

The decision to choose the mysterious pneumonia-like outbreak in China as the topic for our long leader was not unanimous. (it's typical for a variety of opinion in editorial meetings). Remember, back in Jan info was scarce. Nearly impossible to imagine then what we have now.

So, adding to possible 'panic' was real.

But so were the severe clinical effects reported in the 2 research reports for the first cases of 2019-nCOV (as we called it then)... almost 1/3 had ARDS and 15% died, in the report of perhaps the first 41 cases. This was v worrying.

thelancet.com/journals/lance…

Separately, the report of the familial cluster (n=6) established person-to-person transmission of "this novel coronavirus" in hospital and family settings - we called it 2019-nCoV then.

thelancet.com/journals/lance…

I have found it worth reflecting on these past 6 months. That day (in the office, which I miss) madly writing, entirely out of my comfort zone with the mystery outbreak, not wanting to let my colleagues (& readers) down but just needing to get it done - feels like a lifetime ago.

#COVID19 has since completely re-shaped all of our professional and personal lives. For medical journals (& editors) it has been a boon (amazing content). A knife-edge (can't get it wrong). A tsunami (500x greater volume of submissions). A blessing and a curse. #writing

It takes a village to keep up, vet & produce content in the middle of a pandemic, and thank god esp for ID expertise across the team 🙌 --> thelancet.com/coronavirus

Since people seem interested in the editorial writing process I will share a bit more, including my notes which I rarely do. 6 months ago, Jan 23, I wrote 4 pages of notes in our leader meeting - unheard of! You can tell I was green on the topic of coronaviruses. 🤷🏼‍♀️

That day in our leader meeting (we call editorials written by the editors, leaders) I pitched the topics of 1)impacts of mining on health in Brazil 2) cervical ca for World Cancer Day Feb 4 and 3) to highlight World NTD Day on Jan 30. Remember y’all these were pre-COVID days 🤦‍♀️

It was my turn on ‘the rota’ to write the leader. The 15 or so of us @TheLancet editors pitched, discussed, debated ...we chose to editorialise on the new coronavirus. Our EIC felt strongly & gave detailed guidance —> my notes show how important it was to get the ideas on page.

We agreed as editors that there was a role for us and that we can & should make some preliminary judgements on several dimensions. #COVID19 #TBT #writing

1) the troubling clinical & epi data reported in the 2 first research reports, which we were about to publish, were clear ..

2) any reflection/reaction on the world’s response to date was much less clear.... & 3) our assessment of the China response as of Jan 24 needed to be true & fair... but how soft or hard we went was not certain. We had to be careful & considered despite the massive time pressure.

I’ll finish this #writing #covid19 thread by emphasising the importance of our team work (never easy to write as a group but always productive) and the fact that we have a China based editor, with invaluable local expertise.