MedicalResearch.com Interview with:
Steve Kanters, PhD MSc
President and Lead Analyst
RainCity Analytics
School of Population and Public Health, University of British Columbia
Vancouver, British Columbia, Canada
MedicalResearch.com: What is the background for this study?
[caption id="attachment_55676" align="alignleft" width="200"]
Dr. KantersA[/caption]
Response: A watershed moment for the fight against HIV was the antiretroviral treatment (ART) scale-up that made HIV treatments available around the world. While HIV activism led to its initiation, two key ingredients to the ART scale-up were the advent of a once-daily single-pill HIV treatment and the creation of the World Health Organization (WHO) clinical guidelines for treatment and prevention of HIV. The HIV treatment in question combines three drugs in a single pill and centers around a drug called efavirenz.
The WHO guidelines use a public health framework, which is to say that it uses a treatment algorithm that is both equitable and simple enough to allow some task-shifting to less specialized workers. As such, the guidelines suggest a single preferred treatment for people initiating HIV treatment. While resource rich countries can use a personalized medicine approach, many settings where HIV is endemic cannot.
In 2015, our review found strong evidence that a newer HIV drug, called dolutegravir, was better than efavirenz in respect to efficacy, tolerability and safety; however, there was not enough evidence to support its use in key populations, such as people with HIV-tuberculosis co-infections and pregnant women. For this and other reasons, the WHO could not recommend its use as the preferred treatment at initiation.
Since then, we have continued to dynamically assess the evidence to determine the best treatment to have as the preferred ART for first-time HIV treatment. This is the culmination of 6 years of work and its findings have helped the WHO change its recommended preferred first-line therapy from an efavirenz-based ART to a dolutegravir-based ART.
President and Lead Analyst
RainCity Analytics
School of Population and Public Health, University of British Columbia
Vancouver, British Columbia, Canada
MedicalResearch.com: What is the background for this study?
[caption id="attachment_55676" align="alignleft" width="200"] Dr. KantersA[/caption]
Response: A watershed moment for the fight against HIV was the antiretroviral treatment (ART) scale-up that made HIV treatments available around the world. While HIV activism led to its initiation, two key ingredients to the ART scale-up were the advent of a once-daily single-pill HIV treatment and the creation of the World Health Organization (WHO) clinical guidelines for treatment and prevention of HIV. The HIV treatment in question combines three drugs in a single pill and centers around a drug called efavirenz.
The WHO guidelines use a public health framework, which is to say that it uses a treatment algorithm that is both equitable and simple enough to allow some task-shifting to less specialized workers. As such, the guidelines suggest a single preferred treatment for people initiating HIV treatment. While resource rich countries can use a personalized medicine approach, many settings where HIV is endemic cannot.
In 2015, our review found strong evidence that a newer HIV drug, called dolutegravir, was better than efavirenz in respect to efficacy, tolerability and safety; however, there was not enough evidence to support its use in key populations, such as people with HIV-tuberculosis co-infections and pregnant women. For this and other reasons, the WHO could not recommend its use as the preferred treatment at initiation.
Since then, we have continued to dynamically assess the evidence to determine the best treatment to have as the preferred ART for first-time HIV treatment. This is the culmination of 6 years of work and its findings have helped the WHO change its recommended preferred first-line therapy from an efavirenz-based ART to a dolutegravir-based ART. 
Dr. Profeta[/caption]
Paola Profeta, PhD
Professor of Public Economics, Department of Social and Political Sciences
Bocconi University
Director, Msc Politics and Policy Analysis, Bocconi University
Coordinator, Dondena Gender Initiative, Dondena Research Center
President, European Public Choice Society
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We interview more than 20000 men and women in 8 OECD countries in two periods during the lockdown.
Using two waves from 8 OECD countries, we find that women are more likely to perceive the pandemic as a very serious health problem, to agree with restraining measures and to comply with public health rules, such as using facemasks. This gender differences are less strong for married individuals and for individuals who have been directly exposed to COVID, for instance by knowing someone who was infected.
Shane Riddell[/caption]
Shane Riddell MSc
CSIRO—Australian Animal Health Laboratory
Geelong, Australia
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: While it is generally considered that SARS-CoV-2 is spread via aerosol and respiratory droplets, we still need to investigate how much of a role fomites play in transmission.
Understanding the risk first requires you to know how long the virus can survive on a surface. We therefore wanted to assess how long the virus would remain viable on various common surfaces such as stainless steel, glass and banknotes. We found that, under controlled conditions, we could recover infectious virus at 28 days for all non-porous surfaces at 20 degrees Celsius. When the temperature was raised to 40 degrees Celsius, SARS-CoV-2 only remained viable for 24hrs on most surfaces.
Dr. Nagata, MD[/caption]
Jason Nagata, MD, MSc
Assistant Professor of Pediatrics
University of California, San Francisco
San Francisco, California, USA
MedicalResearch.com: What is the background for this study?
Response: During the COVID-19 pandemic, food insecurity is expected to rise given economic uncertainty and job losses. Vulnerable and marginalized populations are disproportionately affected by both COVID-19 and food insecurity.
MedicalResearch.com: What are the main findings?
Response: In this perspective, we argue that food insecurity and COVID-19 can exacerbate one another via bidirectional links. Experiencing food insecurity can lead to nutritional deficiencies and weakened host defenses, increasing susceptibility to COVID-19 infection. Food insecurity is also associated with chronic medical conditions which may lead to a higher risk of severe COVID-19 illness.
Conversely, people with COVID-19 may not be able to work, generate income, or procure food while quarantined, which may worsen food insecurity.
Dr. Garg[/caption]
Dr. Madhur Garg, MD MBA
Clinical director, Radiation Oncology
Montefiore Health System and Professor
Departments of Otorhinolaryngology - Head & Neck Surgery - and Urology
Albert Einstein College of Medicine
MedicalResearch.com: What is the background for this study?
Response: The Bronx was hit particularly hard with Covid-19 - making up one of the highest per capita cases and deaths in the country. Montefiore Health System and Albert Einstein College of Medicine, care for a large population of ethnic minorities (non-Hispanic Black and Hispanic individuals make up 65% of our patient population).
Dr. Auger[/caption]
Katherine A. S. Auger, MD, MSc
Division of Hospital Medicine
James M. Anderson Center for Health Systems Excellence,
Cincinnati Children’s Hospital Medical Center
Department of Pediatrics, University of Cincinnati College of Medicine
Pediatric Research in Inpatient Settings Network
Cincinnati, Ohio
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: All states closed schools in the spring of 2020 to try to mitigate the spread of COVID-19. Our study demonstrated a large, significant association between school closure and fewer COVID-19 cases and deaths even when accounting for other state policies.
Dr. Glicksberg[/caption]
Benjamin Glicksberg, PhD
Assistant Professor of Genetics and Genomic Sciences
Member of the Mount Sinai COVID Informatics Center
Member of the Hasso Plattner Institute for Digital Healt
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study?
Response: Reports from health systems that detailed the clinical characteristics and outcomes of their COVID-19 patients were instrumental in helping other health systems rapidly adapt and know what to expect. There are few studies, however, that assess what happens to these patients after they were discharged from the hospital.
In our work, we address this gap by determining both how many individuals re-present to the hospital within 14 days, and what clinical characteristics of these patients differ from those who do not. Such information is critical in order to continue to refine optimal treatment plans and discharge decisions for patients of all backgrounds and clinical profiles. To provide more context to the question, we also determined if and how these factors changed between initial presentation and readmission to the hospital.