Dara Kass, MD, is an emergency medicine physician and Associate Professor of Emergency Medicine at Columbia University Medical Center. An advocate for women in medicine, she is a founding member of Time’s Up Healthcare, as well as the founder and CEO of FeminEM.
Andrés Bendesky, MD, PhD, is Assistant Professor of Ecology, Evolution, and Environmental Biology at Columbia University and a Principal Investigator at the Zuckerman Institute.
Dr. Dara Kass began her presentation by sharing the importance of public trust during a pandemic. Over the past few months, she had been confronted with the significance of clinical decision making and leadership during uncertain times, and she reasoned that public trust required 3 things: honesty, humility, and humanity.
Honesty At the start of the pandemic, there were many unknowns about COVID-19. This led to a flurry of guesses, instead of the usual time-tested, evidence-based communications scientists typically rely on. For example, there was not much evidence 6 months ago about the effectiveness of masks, and conspiracies started to arise. As more evidence started to emerge supporting mask-wearing, these conspiracies were disproved, but they still lingered, since there wasn’t much space for evolving information. Honesty provides this space, Dr. Kass said, and people need transparency.
Humility Doctors need to be open to feedback and admit mistakes. Trust is cumulative, and if any interactions with the public go wrong, their perceptions of truth can also be affected, Dr. Kass said.
Humanity Dr. Kass emphasized the need to be sensitive with people, and to be sensitive yourself. Dr. Kass, who was infected with COVID-19 earlier in the year, made the conscious decision to be public with her symptoms and her anxiety online, normalizing the feelings that many others were experiencing. Noting the health disparities made apparent by the pandemic, she ended her talk by emphasizing the need to incorporate human feelings into public messaging, focusing on the ultimate goal of collective unity.
Dr. Andrés Bendesky began by explaining the lack of appropriate and adequate testing of who exactly was sick and who was contagious at the beginning of the pandemic. Much contagion occurs before the onset of symptoms when the viral load is at its peak, and the symptoms themselves were variable from person to person. For medical and epidemiological purposes, a more sensitive test is needed; the PCR test is an example. Meanwhile, for determining whether a person is infected or not, a less sensitive test is sufficient; for example, a rapid antigen test. To best combat the virus, daily testing has the highest ability to remove infectiousness, but issues arise with the lag of time after a test and the lab equipment needed to produce a result.
With volunteers, he formed an interdisciplinary team to develop a simple, affordable COVID-19 test. Their idea came about through LAMP (Loop-mediated isothermal AMPlification) testing, where only one tube and a constant temperature were needed. Using specific chemical reagents, test-takers could simply input their saliva, and the resulting color of the tube would indicate whether they were infected or not. With an easy-to-use apparatus, the ease of this test has huge advantages for everyday usage, and Dr. Bendesky reported the validation of his lab’s work by testing people with varied viral loads.
After the speaker’s presentations, Natalie Steinemann, PhD, moderated the discussion with some questions from the audience. One frequently requested topic was immunity and vaccines. The speakers noted that, based on preliminary data, the COVID-19 vaccines in progress seem to have a high effectiveness.
A question arose about the possibility of a disturbance of the COVID-19 vaccine with the flu vaccine, but Dr. Bendesky noted that combining vaccines is actually normal: many young children get multiple vaccines at a time. As of now, there are no signs that there would be a disturbance between the two. Dr. Bendesky also noted that although there have been some mutations of the virus, they have not had large impacts on the ability to form a vaccine, unlike with HIV.
As for air travel, indoor dining, and family gatherings, Dr. Kass said that air travel looks to be relatively fine due to the diligence of passengers, mask mandates, and air filters. Indoor dining, however, is dangerous when the tables are too close and guests are dining with people that they don’t usually interact with, which could facilitate the spread of the virus. Home events, if necessary, should be capped at a minimal number of people to maintain safety.
To help out in your own communities during this time, Dr. Bendesky talked about finding your strengths and using them to your advantage, as well as being creative with your efforts. Of course, the best thing you can do is follow all public health guidelines, making sure that you are not transmitting the virus.
Dr. Steinemann finished by asking the speakers whether they were hopeful for the future. Dr. Kass and Dr. Bendesky both answered positively, inspired by the unity that New Yorkers showed during the pandemic. They hoped that new leadership, better communication, and transparency about the pandemic would be successful in uniting our communities and combating the virus.