Call to arms during disruption

My fellow AAP members, welcome to my virtual Presidential Address. Who would have imagined just 2 months ago when we were putting the final touches on the 2020 meeting in Chicago and I was starting to plan my address that we would be where we are today.

Our personal and professional lives and our institutions have been upended by the SARS-CoV-2 pandemic with enormous disruption. While I personally experienced the early years of HIV, 9/11 in New York City, and a number of other crises, nothing I have experienced matches the rapid cycle of decision-making and change in the setting of enormous uncertainty.

And yet, nothing has given me greater clarity and sense of purpose to the missions that we have all embraced. Our missions of clinical care and community health, research, and education are absolutely essential to getting the nation through this crisis.

Our AAP mission statement is quite germane to our challenge — we seek to “inspire the full breadth of physician-led research across all fields of science related to medicine and health, and to build a community of physician scientists in support of the principle that objective science and evidence are essential foundations for improving patient care and the health of Americans” (1).

And this is exactly what we must do with both a sense of urgency to focus our efforts on the current challenge but also the imperative to apply lessons learned from this experience to better prepare for the future.

So my Presidential Address is more like a call to arms!

The faculty, students, trainees, and staff of our institutions have responded in remarkable ways that should inspire us all.

Our extraordinary clinicians and health care providers are providing frontline care often under extremely challenging conditions. In some of the hardest hit sites, the academic health systems are playing an essential role in providing care, particularly to some of the most vulnerable members of the community — at the same time educating their communities; developing and sharing a myriad of new policies around testing, use of personal protective equipment (PPE), and infection control; and innovating on the fly.

We have seen a remarkable pivot to telemedicine, the standing up of drive-through clinics, and establishment of field hospital and care facilities overnight. I hope I can speak for our Society that we are extremely grateful and in awe of our clinical workforce. And I encourage each of you to advocate for their needs using all of your personal and professional connections and power.

Most of us have seen our laboratory efforts change dramatically as well. The Association of American Medical Colleges (AAMC) real-time COVID-19 Response Dashboard indicates that 64% of institutions have shuttered almost all of their on-site laboratories and clinical research with the exception of what is considered essential or critical research (2). There is remarkable innovation utilizing online tools and virtual interactions to keep research moving forward.

At the same time, our institutions have pivoted efforts and expertise to research on COVID-19, getting protocols up and running at record pace and disseminating that information also at record pace. This should certainly inform us how to do things differently in the future.

And while collaboration and partnerships have always been key components of science, this virus has sparked unprecedented collaboration and sharing information locally and globally leading to an extraordinary cycle of discovery. That being said, the commitment to rigor and scientific validation must prevail…a message that each of us can champion.

I personally have seen, as I am sure many of you have, a remarkable spirit of camaraderie and crossing of institutional barriers...our laboratory investigators emptied their stockpiles of PPE to their clinical colleagues. They have adjusted their research PCR assay platforms for clinical use, and our engineers have jumped in to innovate around PPE and respiratory support.

And our funding institutions have heeded the call as well…on March 27, the Senate enacted the third emergency $2.2 trillion funding package that included $945 million overall to support COVID-19 research — with $706 million to the National Institute of Allergy and Infectious Diseases (3).

The NIH has adjusted requirements and deadlines for research grants to address the challenges researchers are facing and has issued almost daily new opportunities for our investigators. Lead your institutions in organizing around these opportunities to put the best science forward.

The commitment to our students and trainees has not and cannot be lost in the disruption, and that is certainly something we all can own. They are facing enormous stress and uncertainty. Our faculty have shown remarkable flexibility and innovation as they have embraced virtual classrooms, journal clubs, lectures, chat rooms, data sessions, and mentoring.

My call to arms here is keep it up! They are our future and need to be engaged and supported!

I want to end by recognizing our 72 new members now posted on the AAP website (www.aap-online.org). We were quite pleased to see a significant increase in nominations from institutions across the country and a broad range of specialties.

These are extraordinary physician-scientists representing 43 institutions. The address I had planned was focused on highlighting the remarkable change in membership that has occurred over the last two decades showing broadening of geographic representation, broadening of specialties represented, and closing the gender gap with 38% of this year’s entering class being women.

I wholeheartedly embrace the notion that diversity is excellence and will lead to better solutions. I know you join me in welcoming our new members who will be invited to next year’s meeting and banquet.

In closing, I want to recognize our society’s highest honors. The Kober Award is given to an AAP member whose lifetime efforts have had an enormous impact on his or her field of specialty through the scientific discipline they have brought to the field and the many outstanding scientists that they have trained.

This year’s recipient is Michael J. Welsh from the University of Iowa. He will participate in the 2021 meeting and join next year’s Kober Medal recipient, Jeffrey Gordon, from Washington University in St. Louis and next year’s Kober Lecturer, Jean Bennett, from the University of Pennsylvania Perelman School of Medicine. Congratulations to Michael, Jeff, and Jean.

I also want to note how proud I am of our 2007 Kober Medal awardee, Tony Fauci, whose steady and inspired leadership is guiding our country through this pandemic.

Perhaps the leadership of AAP, ASCI, and APSA were somewhat prophetic in choosing disruption as our theme this year! Our stellar program of speakers will be included in next year’s program when we can share what we have learned from this seismic disruption we are experiencing!

It has been an honor to serve in this role and work with such an amazing group of people. Thank you for all you are doing and remember we are in this together and are very much a part of the solution.

Version 1. 06/01/2020

Print issue publication