IDWeek 2020
Authors: Farooq Kazi, Ammara Mushtaq
Journal: The Lancet Infectious Diseases (2020)

The COVID-19 pandemic dominated the topics discussed at the first virtual annual IDWeek conference in October. Farooq Kazi and Ammara Mushtaq report. The annual IDWeek conference was held virtually for the first time, on Oct 21–25, 2020. It featured notable speakers from the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, the HIV Medical Association, the Pediatric Infectious Diseases Society, and the Society of Infectious Diseases Pharmacists. Anthony Fauci (National Institutes of Health, USA) was the keynote speaker and gave an overview of the COVID-19 pandemic in the US. Fauci began by contrasting the severe acute respiratory syndrome (SARS) outbreak in 2002 with the current global COVID-19 pandemic. Though the current pandemic is caused by SARS coronavirus 2 (SARS-CoV-2) that is similar to the original SARS CoV, the outcomes have been radically different. The original SARS pandemic in 2002–03 had limited human-to-human transmission and was effectively controlled by public health measures; it infected about 8000 people and killed 800. Comparatively, there have been 40 million cases and over 1·1 million deaths globally due to COVID-19 as of Oct 19, 2020, according to Fauci. Furthermore, the USA was “hit harder than virtually any other country” and has 8·1 million cases and 220 000 deaths. Fauci attributed these grim statistics to the lack of a nationwide shutdown and the “opening up America again” initiative, which reversed progress. Fauci stressed the importance of transmission prevention by reiterating the importance of face coverings, social distancing, avoidance of crowds, washing of hands, and abstaining from large indoor gatherings. Public mistrust of a potential COVID-19 vaccine was also underlined as a major public health concern. Mary-Margaret Fill (Tennessee Department of Health, TN) spoke about the transmission of COVID-19 in community and work settings. Fill stated that the case rate in prisons is three times higher than the US national average, with 147 000 inmates testing positive out of a total prison population of 1·5 million. In addition, there have been 1246 confirmed deaths. Overcrowding, poor infection control procedures, infected staff members, and dormitory-based units are considered major sources of transmission. Fill then spoke about the risks facing food production; there have been 65 000 confirmed cases and 270 deaths, with 80% of deaths, in the meat packing and processing industry. Lastly, Fill spoke about group homes which provide shelter to many vulnerable populations, such as intellectually and developmentally disabled (IDD) people. The case rate in the IDD population is four times higher than in the general population and the fatality rate is eight times higher. Fill recommends a “hierarchy of controls”, which can limit the spread of infection by implementing engineering and administrative controls. Mark Rupp (University of Nebraska, USA) was the recipient of the Shea Lectureship Award and discussed racial inequities and disparities. Rupp stated that the COVID-19 pandemic has disproportionately impacted Black Americans, Latinos, Indigenous People, and Pacific Islanders. He urged fellow hospital epidemiologists to become better informed about unconscious biases and their impact on quality of care. Rupp then discussed the “rush to publication” of weak studies in medical journals due to media sensationalisation. Rupp urged experts to serve as peer reviewers and ensure quality research without politicising of public health. Rupp also urged collaboration with architects and engineers to develop improved air filtration and safety systems, personal protective equipment designed for decontamination, and reusable isolation gowns. Rupp also lamented that the USA lacks a clear national testing strategy while limited testing resources are being allocated to wealthy athletes in professional sports leagues. He concludes by stating that the public health apparatus must be strengthened in order to prepare for the next pandemic. Javeed Siddiqui (TeleMed2u, Roseville, CA, USA) spoke about the increased demand for telemedicine. Siddiqui stated that virtual visits to ambulatory settings increased 149% between March and May, compared to the prior 9-month, pre-pandemic weekly average. In addition, one in four older Americans had a virtual medical consultation in the first 3 months of the pandemic. Siddiqui stated that COVID-19 rapidly eliminated the stigma attached to telemedicine. He shared that physicians no longer have to be located in rural locations, providers can practice from their home, and reimbursement is now at in-person visitation rates. Siddiqui highlighted that telemedicine expands physician reach by removing geographical barriers, acts as a workforce multiplier, improves productivity by removing commute time, and could be an invaluable tool for clinical trials. The conference also featured many other experts who shared their expertise in various areas of infectious diseases, such as, microbiology, infection prevention and control, epidemiology, HIV, antimicrobial resistance and global health.