I am one of 16 advisors on the Advisory Committee to the Director of the National Institutes of Health and wanted to share four things I heard in that virtual meeting (from midnight to 6 am Friday and Saturday):
1. COVID-19
Anthony Fauci reported on the COVID situation. Omicron has taken over globally.
It remains clear that white Americans fare better with COVID than non-white Americans, and I think the situation is similar in Australia.
Also in the US, the death rate remains many times higher for people who are unvaccinated.
He then discussed the fact that we are trying to control COVID-19, but it is infeasible to eradicate or eliminate it as we have done with Smallpox, Polio, and Measles.
2. Long COVID
The NIH has a new initiative to learn more about Long COVID (RECOVER). It has been a slow start, but some of the most interesting studies to date come from analysis of EHR data.
A CDC MMWR report (starting at page 27) analyzed Cerner Real-World Data, a US, de-identified data set of approximately 63.4 million unique adult records from 110 data contributors in the 50 states. The study showed that COVID-19 survivors have twice the risk for developing pulmonary embolism or respiratory conditions; one in five COVID-19 survivors aged 18–64 years and one in four survivors aged ≥65 years experienced at least one incident condition that might be attributable to previous COVID-19.
Another study used the National COVID Cohort Collaborative's (N3C) electronic health record repository to develop machine learning models to identify potential patients with long COVID. The models were quite successful and validated on a fourth health system. Here is a diagram demonstrating the machine learning output on three hypothetical patients:
3. Structural Racism
The UNITE program is a comprehensive effort to identify and address structural racism within the NIH-supported and the greater scientific community. I liked the Socioecological Model they are using to structure their listening sessions and categorize potential solutions.
I also appreciate that not seeing yourself in an organization is a barrier to feeling included, and they have replaced the long halls with pictures of old white leaders with graphical representations that include the people working there now.
Finally, have you heard of the minority tax? It’s the conundrum that a) we want to have more diversity in our committees and initiatives and b) there aren’t very many minority representatives, so they end up over-stretched on service, and their science suffers. I have heard this mentioned directly by women and by our Aboriginal and Torres Strait Islander colleagues at the University of Melbourne.
4. Data Sharing
There was a lot of discussion about the NIH’s upcoming data sharing requirements. Although the NIH doesn’t have huge influence on health services, I think there is growing pressure from journals, the public, and government agencies and there are successful examples of using large datasets across institutions (like N3C) to increase knowledge that benefits everyone. I predict the tide will be turning in the US and expect that will spread to Australia hopefully sooner rather than later!
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