Going Viral: Missouri Medicine During COVID-19

Is there anything about COVID-19 (“COVID”) and our century’s devastating pandemic that hasn’t been said or that would hold your interest for about 1,200 words? I hope so, and in that frame of mind, I plunge ahead with this editorial.

Adapting Missouri Medicine to the COVID Pandemic, March 2020

Missouri Medicine plans ahead more than a year for its acclaimed theme issues. In early March 2020, as COVID brutally struck in full force, already in publication pre-production were themes on telemedicine (MU May/June 2020) and infectious disease (UMKC July/August 2020). How fortuitous! Given these were then among the most relevant and critical areas in all of Medicine, we contacted the respective departments and asked that manuscripts be made as inclusive as possible with any pandemic interface. We asked authors to do last minute revisions or add epilogs to give our readership the timeliest COVID information. We were greeted with enthusiasm, professionalism, and scores of timely, well-written articles. Heartfelt thanks to these authors and coordinators.

The in-production March/April 2020 Journal theme of Frontiers of Surgery, (SLU) had to be temporarily set aside as we button-holed, called, texted, emailed and otherwise cajoled various national COVID experts to ask they write ‘on the fly’ articles for our upcoming issue. This was while they were dealing with burgeoning clinical loads of very ill patients. The ranks of authors that stepped forward are too numerous to individually thank here but their names can be found in the table of contents page 77, volume 117, 2020. Visit http://www.omagdigital.com/publication/?m=11307&i=656017&p=2&pre=1.

In the face of long hours and crushing clinical loads, to a person they graciously submitted timely and authoritative newly minted articles. The much-lauded issue of March/April 2020 COVID-19: A Worldwide Pandemic with its quickly produced but authoritative Special Report: COVID-19, was put together in slightly more than three frantic weeks (Figure 1).

Figure 1.

March/April 2020 Missouri Medicine

The telemedicine and infectious disease themes were given a COVID-19 orientation. In April 2020, a deluge of COVID-related perspective and scientific articles began to be received. So many, it was the proverbial ‘drinking from a firehose.’ The scientific articles needed peer-review; the perspectives needed sorting and editing. Our Editorial Board reviewers were quickly overwhelmed with submitted manuscripts. We turned to non-board reviewers who, similarly over-worked, found time to judge which manuscripts merited publishing. Peer reviews included detailed and extensive recommendations to elevate the article quality. These ‘invited peer-reviewers’ were listed in our November/December 2020 issue on page 535. Thanks, one and all, including those presently reviewing 2021 submissions.

Non-COVID articles in our publication queue had to be ‘bumped’ as pandemic material ‘went to the front of the line.’ We thank these bumped authors, some of whom are still waiting for their works to be published, for their infinite patience. Even with prioritization and lengthening our queue, we had to obtain permission from MSMA to generate several issues that were the largest page counts in our Journal’s 116-year history. Kudos to Patrick Mills and Jeff Howell of MSMA staff for these authorizations and absorbing the extra expense. A great example of MSMA’s unsurpassed service to all physicians.

For all its professional success and national reputation, our Journal singularly owes much to its ultra-competent, dedicated Managing Editor Liz Fleenor. For 19 years, Liz has worked with me on compilation and production of our Journal. During COVID, she worked at times at MSMA headquarters, at times from home. She had to use two different computers with no complete set of files. Hardware and software problems occurred. As throughout her tenure, she worked tirelessly and competently to get each issue composed and timely uploaded to PubMed/PubMed Central and Ovid Bell Press. The content was outstanding and had a polished, appealing appearance. I greatly enjoy working with Liz; she is a huge asset for Missouri Medicine and MSMA. She also serves as Director of Communications. Thank you, Liz, on behalf of a grateful Editor and MSMA.

Personal Musings on COVID

It is a matter of conjecture who first recognized the potential for a COVID pandemic. Some say Bill Gates, some Nostradamus, some a careless viral researcher at the Wuhan BSL-4 Viral Laboratory. My nod goes to an ophthalmologist in our Discover Vision Centers office who predicted in early January 2020 that this would be a pandemic. He warned all who would listen to prepare for something akin to the 1918 Influenza Pandemic. Me, being me, thought I had seen in all; Asian Flu, Hong Kong Flu, Swine Flu, SARS, MERS, Avian Flu. While serious, none had lived up to their predictions as the next 1918 Influenza Pandemic. Our staff would ask me if our ophthalmologist was a Casandra or on to something. I would shake my head knowingly and say, “None of the other flu epidemics in the last 60 years have been as bad as predicted; I think this will be more fizzle than sizzle.” I have apologized several times to my colleague. I’ve asked him if he has any thoughts about winning Power Ball numbers or stocks that will soar in 2021 to let me know.

My wife Becky and I moved frequently during training from Missouri to medical school (Chicago), internship (Milwaukee), USAF medical corps (North Dakota), and residency (Atlanta). We have endured blizzards, tornados, forest fires, widespread riots, floods, ice, and snow storms of Biblical proportions. Long ago we learned to stock our home with emergency provisions, something I wrote about in Missouri Medicine previously.¹ Visit http://www.omagdigital.com/publication/?m=11307&i=117278&p=24. Our current emergency amenities include natural gas-powered electricity generator, more stored water than a small swimming pool, and enough freeze dry food to feed two people and a voracious over-weight cat for a year. Yes, we even had an adequate supply of toilet paper and Lysol wipes. Consider reading the article and laying in your own emergency provisions.

Becky and I live in a lovely subdivision of Kansas City North called Briarcliff Estates. It was developed about 1982–83. We are the last of the original home owners. It is now populated with young and middle-aged families. We are among the oldest people in the neighborhood. Early in COVID, our younger neighbors came to check on us almost daily to see how we were doing. They brought us cookies and baked goods. Their children made us colored drawings with inspirational messages which we displayed in our window. We called this collection the “COVID Art Gallery” (Figure 2). As months passed the word got around that “the Hagans can fend for themselves.” Living on a cul-de-sac, spring, summer, and fall 2020 more than a dozen children rode their bikes and skateboards down our steep driveway. This diversion aside, 2020, as for many people, was one of the most difficult years of our lives.

Figure 2.

The Hagan’s COVID Art Gallery

Missouri Medicine Will Publish the Definitive History of the COVID Pandemic

In the centennial year of 2018, Missouri Medicine published^{2, 3} an award-winning series of articles on the Great Influenza Pandemic of 1918. The authors were David S. McKinsey, MD, Joel P. McKinsey, MD, infectious disease specialists, and Maithe Enriquez, PhD, APRN. Our Journal is delighted to announce that this trio of authors will write a similar series of articles for early 2022 documenting the pandemic of our time, COVID-19.

Hope This goes Viral: All Physicians Need to Belong to MSMA

By the way, there are many reasons to belong to MSMA. It is among the top three most effective state medical societies and among the lowest five in annual dues. MSMA is the “Big Tent” for all Missouri physicians. MSMA leads the way, in advocacy and education! Joining MSMA is a smart business decision. The return on investment that members receive is far more than the cost of dues. To every physician or physician-in-training not belonging to MSMA, especially those of you that publish in its Journal, I cordially and sincerely invite you to join MSMA in 2021. Please visit www.msma.org/joinrenew to become a member. You may contact MSMA’s Cassie Williams at cwilliams@msma.org if you have any questions.