番茄社区

I am writing from Paris where I (along with Inside Medicine data guru Benjy Renton) took a much-needed break from it all to take in some Olympic action.

But while I was there, I did a little bit of on-the-ground work that you might be interested in...

My Interviews With Doctors for Team USA

As I mentioned before I left for Paris, I had the chance to interview a couple physicians for Team USA, which I will share once they're edited. I was fortunate to get to sit down with the lead physician for Team USA, Gloria Beim, MD. She was so friendly and enthusiastic about her role (though a little vague on my questions related to any COVID-19 protocols). But I will say that she certainly made me want to sign up to be a team physician for the Olympics in Los Angeles in 2028 (although, it's apparently a little more involved than just signing up, as you'll hear once the interview is out).

I also had the chance to speak with Jessica Bartley, PsyD, MA, MSSW, who is the senior director for psychological services for Team USA. That conversation was so enlightening and I can't wait to share it. The mental health side of sports performance has become a mainstream concept, but it wasn't long ago that this was not true. It was fascinating to dig into that. I look forward to sharing that one with you as well.

Breakfast With Tedros

While in Paris, I also had the great honor and privilege to meet and speak with Director-General of the World Health Organization (WHO), Tedros Ghebreyesus, PhD. "Dr. Tedros" (as everyone calls him) was extremely generous with his time, and we had a frank and substantive conversation over coffee and croissants about the world of public health and, of course, the ins-and-outs of the COVID-19 pandemic.

In order to get to know Tedros better (this was our first time meeting in person, though we have spoken on the phone in the past, and communicate occasionally otherwise), I promised him that I would not share much on the specific substance of our conversation. But I did get some insight and color on his with then-President Donald Trump. As you may recall, in spring 2020, then-President Trump said he would pull all U.S. funding to the WHO because Tedros stated that he would not bend to a list of seven demands that the U.S. had made (some of which the WHO went on to do by itself anyway). Through our conversation, I learned that Tedros is a person who believes that the arc of the universe bends towards justice; he felt that the WHO could survive anything -- even the loss of the U.S. as a paying member of the organization -- as long as they stuck to their morals and principles. Tedros took a huge gamble -- one that worked out. Nevertheless, his fortitude in that difficult moment was admirable; not all leaders have the conviction and steady hand that he demonstrated.

Meeting Tedros also reminded me of my fairly unusual history with the WHO -- which goes like this: Early in the COVID-19 pandemic, I blasted the WHO rather publicly for its guideline recommending that any patient with COVID-19 be hospitalized (and a couple of other things). This, I argued back then, was a terrible idea. Most hospitals needed to reserve beds for the sickest patients who needed hospital-level care. Everyone else needed someplace safe other than a hospital to isolate. The degree of asymptomatic spread was, at that time, not fully embraced by the WHO, but was something that the emerging medical literature had made clear to me. Because of that, I argued, the WHO didn't realize how many COVID-19 patients there really were, and how many more were coming. Plus, as testing increased, detected cases would skyrocket. Their outbreak policy simply didn't imagine a virus that was as prevalent as COVID-19 was becoming and one with such a wide spectrum of illness. In response, the WHO preached nuance, which I appreciated.

We emerged from the kerfuffle as friends, and it was the beginning of a handful of collaborative conversations I've had with leadership in the WHO since. I firmly believe that the WHO has the right core values and great expertise in its ranks. They aren't always right (nobody is), but I've found them to be responsive and committed to doing the right thing. Going forward, the participation and support by the U.S. should never be in question.

Hopefully, we can get Tedros to do an on-the-record interview sometime soon.

COVID-19 in Paris

A handful of athletes have come down with COVID-19 while at the Olympics. I can hardly say I'm surprised. I was one of the few people I saw ever wearing a mask, whether athlete or spectator, and I did it in some dense settings (subways, restrooms, some Olympic venues), but not others. So, there was bound to be some spread there, as there is everywhere.

Adam Peaty, a British swimmer who won a silver medal in the 100m breaststroke, found out he had COVID right after his race. And U.S. sprinter Noah Lyles managed to win bronze, despite having COVID. There's been a lot of chatter about whether these athletes should have been allowed to compete. If nothing else, I'd have advised these guys to mask and take other precautions against COVID-19 before their events, as getting sick might have literally cost them the gold. Seriously, folks, you have one job!

Now, in a perfect world, I'd advocate for widespread COVID-19 testing at the games, like they did in Tokyo. At a minimum, detecting cases would mean that athletes themselves could make a decision about whether to compete -- and I would certainly advocate that athletes should be required to isolate during the early contagious phase of their illnesses and wear good masks in any dense indoor settings while infected.

Could Peaty and Lyles have worn masks in the smaller rooms they were in right up until their races (and after), competed without masks, and not infected their competitors? Probably. Outdoor transmission is pretty unlikely (and the pool is a pretty tough place to get COVID). But that doesn't mean these athletes didn't put other people (including their fellow athletes who might have had more events in the coming days) at risk by not masking before and after their events.

Overall, I think there's a better way to approach COVID-19 control at large events like the Olympics in 2024; one that neither takes things to 2020-2021 extremes, nor shrugs it off altogether. Discuss in the comments. I'm interested in what you think.

Sidebar: The about the intense but effective Tokyo Olympics COVID-19 testing protocol back in 2021 holds a special place for us all, as it was the first time I'd ever worked with Benjy on anything! I shared a visualization in that piece, made by Kristen Panthagani, MD, PhD, from data that Benjy put together. It clearly shows that the Olympic Village in Tokyo in 2021 was one of the safest places on the planet, from the standpoint of COVID-19.

Anyway, it was a thrill to see the Olympics in person, and especially with Benjy. After all the work we've done over the last 3 years, it was fun to do something where we barely talked about data...unless you count the Olympic results!

Now I'm in California visiting family for a couple of weeks, but I'll be filing Inside Medicine pieces while I'm here. Please let me know what's on your mind, and I'll start to tackle those topics. Fall is around the corner...

This piece was originally published in .

Comment