Dominant Infectious Disease

Thoughts from the COVE 

Dr. Jeffrey Chipman provides observations on disruptions during the COVID-19 pandemic.

Dear Colleagues, 

This last month was my 25^th anniversary of the Columbia University College of Physicians and Surgeons class of 1995.  It was a wonderful affair. But instead of fine New York dining, I ate take out Indian food as I participated on zoom. Not surprisingly, COVID-19 dominated the conversation. Many of my classmates practice in New York City and surrounding areas.  Each talked about how real and devastating the disease is and how it commanded the work attention of all.  I was surprised that many of them feel that the city needs to get to the new normal as quickly as possible because the fallout from not will be even greater. All said they were afraid New York City would never be the same.
 
HIV and AIDS were the dominant infectious disease in New York when I was a student. The majority of my patients during my 12 weeks of internal medicine were HIV positive. (I hope you are surprised by the 12 weeks of internal medicine and not the number of patients.) Medical students were the default phlebotomists if the team missed the daily blood draw window.  I became skilled at finding thumb veins large enough to get blood for a complete blood count.  For many, like COVID-19, HIV was an inpatient disease without a cure. Likewise, admission to the hospital had a grim mortality rate.
 
Two years later, I was a surgical intern at the University of Arizona in Tucson.  I was puzzled at the lack of inpatients with HIV/AIDS.  Highly active antiretroviral therapy (HAART) had been discovered and proven effective.  Overnight, HIV had become the chronic and outpatient disease we know today.  Instead of dying of HIV, patients were dying with HIV.  Let’s hope something similar is quickly discovered for COVID-19.  Wouldn’t it be ironic if our understanding of HIV, which seems so distant to some of us, will be the answer to this virus that has become so proximate. 

  

Jeffrey G. Chipman, MD, FACS

Frank B. Cerra Professor of Critical Care Surgery
Vice-chair of Education
Division Head, Critical Care and Acute Care Surgery, University of Minnesota
Executive Medical Director, Critical Care Domain, M Health Fairview