COVID19 and What We Failed to Learn from the HIV Pandemic

By Dr. Nick van Terheyden aka Dr. Nick
Twitter: @drnic1
Host of Dr. Nick: The Incrementalist#TheIncrementalist

On this episode I talked to Monica Gandhi, MD, MPH (@MonicaGandhi9), Professor of Medicine and Associate Chief Division of HIV, Infectious Diseases, and Global Medicine, and Director of the UCSF-Gladstone Center for AIDS Research (CFAR) and Medical Director of “Ward 86” HIV Clinic, San Francisco General Hospital. She has many articles published on the pandemic, details of our immunity to the disease and what the future might look like living with COVID19.

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Monica came to prominence during the course of the COVID19 pandemic speaking out on the policies she saw being imposed in her community that were causing more disease and problems than they were solving. As noted in our discussion, it was 40 years ago HIV was first described and despite all the progress we have made in treating the disease it remains a killer with over 36 Million people dead and millions more living in its shadow.

Despite years of experience and science we failed to learn from these lessons and apply the knowledge to the pandemic unfolding. We failed to learn form the experience from the 1918 pandemic which was as politicized as the SARS-CoV-2 pandemic has been. This time around we messed up our messaging creating more confusion and fear than was necessary, much the same as we saw when the original HIV pandemic unfolded.

It took some stand out characters like Lady Diana Spencer, the Princess of Wales to bravely stand up to the general thinking

and show with her personal actions that the risk of HIV was not linked to contact. We talk in detail about the school closure and the lasting impact this has had on our children and will continue to have and how we broke the trust between the parents, teachers and the children with poor communications and lack of transparency in the messages.

You can read the article she co-published: Revisiting COVID-19 policies: 10 evidence-based recommendations for where to go from here, that reviews the latest evidence concerning 10 key COVID-19 policy and strategic areas for deeper insights.

Risk Stratification
We discuss the importance of risk stratification when considering groups and the responses – especially important relative to children, who by virtue of the lack of the receptors to the spike protein found in the noses of children, are much less susceptible to the disease and at much lower risk.

Listen in to hear Monica’s views on the inequity of vaccine distribution and how we should mitigate that and her clear and simple solution on how we need to deal with this pandemic, based on years of experience working with HIV patients. It starts with a focus on hospitalization numbers and using this as the guide to response levels and then stratifying population based on risk to get to a manageable status for endemicity.

About the Show
For years Dr. Nick van Terheyden aka Dr. Nick, has served as a voice on the impact of new technologies on healthcare, earning a reputation as a leading authority on where the future of medicine is going. Combining powers of observation and real world experience, Dr. Nick has seen many predictions come true and makes the case that innovations in healthcare can be accomplished incrementally, not just by moonshot events. Tune in to hear Dr. Nick: The Incrementalist and his guests discuss what the future of healthcare looks like, how we will get there, and what it will take to improve healthcare for all.

This article was originally published on the Dr. Nick – The Incrementalist blog and is republished here with permission.