medical school covid essay

How to Write About COVID-19 in Your Medical School Personal Statement

Don’t Make Your Personal Statement All About COVID

COVID-centered personal statements are sure to inundate current and future admissions cycles. The pandemic has indelibly altered public health, virology studies, the forms and pace of medical education as well as life in general.

Since your medical school admissions readers are likely also physicians treating COVID-19 patients and guiding the community toward best practices for reducing transmission, there’s not a lot they haven’t already heard about the virus. They likely teach on campuses that suspended instruction or shifted it online last year and are well aware your MCATs were canceled or moved. They may even know first-hand how much more help is needed around the house back home, including consoling folks who are afraid of the vaccine for a variety of reasons.

That’s why it’s all the more important for your medical school essay to illustrate a life that centers on you.

Show Instead of Tell to Illustrate Your Story Personally

The applicant’s life should be the main idea of the personal statement, even though COVID can play the role of literary foil. COVID is an unfortunate part of your daily life, but you can still keep your personal statement about yourself, not the pandemic. This way, you allow your reader to feel the aggravation and doom of these moments while enabling you to emerge as the story’s main character. Don’t just “tell” your story. “Show” your story. See what I mean.

Telling – “COVID disrupted my MCAT.” 

Note: Can you write about this in a more personal way? 

Revised to Showing : “My phone vibrated with a notification that the MCAT was canceled. And here’s what I did to overcome that obstacle.”

Telling – “Among the public are vaccination skeptics.”

Note: Who from the public have you talked to and what was the history and context of their medical fear? 

Revised to Showing – “Grammy and I had a looooong conversation about her grandmother’s flu from the 1918 pandemic .”  Then compare and contrast the public’s reaction between then and now, and the importance of vaccinations.

Telling – “I’ve been taking care of my little brother and my father.”

Note: What was asked of you? How did you respond?

Revised to Showing – “From his basement lair, my dad hollered, ‘Test tomorrow! Place Values and Number Sense!’ I searched upstairs for my little brother who was hiding from Math under all the laundry. My dad’s in quarantine, the dairy’s in the snow. And Paris in springtime means I’m Mom now while blackouts are rolling through Texas.”

When you show the core competencies suggested by AAMC , you create a picture for your reader to visualize how you could be an excellent physician in a way that makes your personality shine through.

You: Resilient and adaptable at a push notification’s notice.

You: E thical and moral with the vulnerable.

You: Taking on extra responsibility. COVID is still prevalent, just decentered because yours is a story about teamwork. 

Set COVID-19 as the Supporting Character in Your Personal Statement 

Set the scene with the pandemic details that help you tell your story.

If your narrative anecdote is about ice hockey team practice, let it be that. Surely there are NHL COVID protocols the team has made and adjustments to uphold, whether it’s “minimize handshakes, high fives and fist bumps” or (courtesy of Highly Questionable on ESPN) “don’t lick opponents in the face.”

These are the details that should provide context and are important for illustrating life distinctly to ensure you haven’t stated the obvious or something that other applicants have already covered. Since it’s about you, personally. 

Another way to include COVID in your story is to consider how it relates to your work in STEM. For instance, Scientific American rendered COVID in 3D . Maybe you have similar accomplishments you’d like to showcase. In your personal statement, include some of the technical details of the project but focus on what it was like to work with your lab partners and perhaps highlight your own sense of reliability and dependability. 

A whopping topic like COVID-19 has the capacity to overshadow even the best pre-med if allowed to dominate an essay.

Customary topics and redundant statements will undercut what the Personal Comments Essay is designed by AAMC for you to be able to do. See their Application Guide to see how you can distinguish yourself from other applicants .

Make your essay all about you and write the daily life details that make your story personal. That will get you accepted, and hopefully, we can put the pandemic behind us.

If you’re still feeling stuck on your personal statement or want expert feedback on an existing personal statement, check out MedSchoolCoach. With MedSchoolCoach, you get the benefit of working with a professional writing advisor to help you develop your essays into a great application. 98% of students who used MedSchoolCoach last year to develop their personal statement received at least 1 interview invite.

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Applying During and After the COVID-19 Pandemic — What’s Changed?

New section.

Read answers to some of the most frequently asked questions from our information session on applying to medical school during and after COVID-19.

Even in the best of times, applying to medical school is difficult, but the COVID-19 pandemic has thrown new obstacles into the paths of thousands of aspiring doctors. Many applicants worry how COVID-19 will alter their ability to participate in clinical experiences, obtain letters of recommendation, sit for the MCAT® exam, and more. 

To support applicants, the AAMC hosted a live information session with three medical school admissions professionals during the April Virtual Medical School Fair to address many of these concerns and field questions from premeds and prospective applicants. Read the answers to some of the most frequently asked questions below or watch the entire presentation here .  

In general, how have admissions committees adapted their processes due to COVID-19? Will there be differences to consider this application cycle?

Christina Grabowski, PhD : Admissions officers across the country understand that there has been an impact on applications due to COVID-19. We understand that your application isn’t going to look like an application from two years ago. You may have fewer clinical experiences during the time period of the pandemic, or you may have a combination of virtual and in-person experiences. We are going to do our very best to figure out how COVID-19 may have disadvantaged people — particularly those who were already at a disadvantage.

Also, keep in mind that we’ll be reviewing applications holistically. In a holistic review process, we look at each individual applicant and we consider what they’ve been able to do in their space with the opportunities and resources at their disposal — holistic review is not about comparing applicants against each other.  

Enrique Jasso, MA : In addition to this advice, TMDSAS member institutions extended the application timeline, extended flexibility for pass/fail courses and online courses, and several schools added additional interview days. These practices are outlined in our newsroom at Inside Health Education . 

During last year’s application cycle, it seemed that deadlines were more lenient due to COVID-19, especially for rolling admissions. Generally speaking, what about this year?

Rafael Rivera, MD, MBA : We understand there may still be some delays this year, and we will be deliberate in terms of reviewing later applications. 

We usually see the largest number of applicants in the months of July – August. However, every applicant that applies by our deadline is fully reviewed. We typically hold off on interviews and portion them out as the application season progresses. Although, the most important thing is to apply when you feel ready — when you can put your best foot forward. The right time to apply might be different for everyone — we encourage you to discuss this with your prehealth advisor and decide on the best time for you. 

Enrique Jasso, MA : TMDSAS encourages you to submit your application as soon as you have put together a quality application. Applicants may submit an application even if their letters of evaluation, MCAT scores, and/or transcripts are not yet submitted. Many schools begin interviewing in August, and while there are a few spots reserved for applicants that submit closer to the application deadline, submitting earlier allows the schools to consider your application for a larger pool of interview dates. We encourage you to work with your health professions advisor to develop a plan for submitting your application within the TMDSAS application timeline .

Do you anticipate an increase in applicants again this year? What are some ways applicants can stand out?

Christina Grabowski, PhD : We’re not sure what to expect in terms of number of applicants this year. We had a large increase for the 2021 cycle, and we do suspect that interest in medicine in the future will increase. … For 2022, we are not really sure what to expect. At the same time, some students may not feel prepared to apply based on the impact of the pandemic on activities and schooling. Even if applications were to be lower than usual, we will undoubtedly still have a robust pool of applicants for medical school.

How can your application stand out? Take all the opportunities you can (in your application) to tell us about your growth and your journey. In terms of your experiences, think about what you’ve done, why you’ve done it, what you learned, and how you grew. In other words, make sure that your application tells a story. I worry about the students who just give the facts on their application — for example, an applicant who says, “I shadowed this kind of doctor for X number of hours,” without giving additional information about the impact of the experience. What did you witness? How did it affect your thoughts about medicine; what did you observe that you’ll take with you going forward in the profession? Think more broadly about why you are choosing your experiences, how those activities have impacted you, and tell us stories about your journey. 

Continue growing and learning even after you submit your application because those lessons will be useful in your training — not just for getting admitted to medical school. And, if you aren’t able to get a seat in medical school in this cycle, you will have more to include in your next application cycle.

How do you feel about asynchronous virtual experiences? 

Christina Grabowski, PhD : If asynchronous experiences are what you had access to, and in-person experiences haven’t been safe or available to you, we will understand. Don’t discount virtual experiences or learning materials, especially if you’ve had “aha” moments or lessons from them. In the end, it’s the lessons we’re looking for, not necessarily the amount of time you’ve spent doing something in person. 

Perhaps there are additional experiences you can participate in virtually that you haven’t considered — for example, interviewing a physician over Zoom or shadowing over Zoom (or some other telehealth platform). If you have family members or friends with chronic illness, interview them virtually and ask them about their experiences with health care. It’s valuable to understand the patient perspective, even if you haven’t been able to observe patients and physicians together.

Have more questions about COVID-19 and this year’s application cycle? Tweet your questions to @AAMCPremed or write to us at [email protected] . 

Thank you to the following contributors: 

Christina Grabowski, PhD Associate dean for admissions and enrollment management Assistant professor University of Alabama Medical School

Enrique Jasso, Jr., MA  Associate director of the Texas Health Education Service 

Rafael Rivera, MD, MBA Associate dean for admissions and financial aid  Associate professor of radiology NYU Grossman School of Medicine

A qualitative analysis of third-year medical students' reflection essays regarding the impact of COVID-19 on their education

Affiliations.

• 1 Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Curtis Building, Suite 400, Philadelphia, PA, 19107, USA. [email protected].
• 2 Department of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, 1015 Walnut Street, Curtis Building, Suite 400, Philadelphia, PA, 19107, USA.
• PMID: 34496820
• PMCID: PMC8425993
• DOI: 10.1186/s12909-021-02906-2

Background: The COVID-19 pandemic fundamentally changed every aspect of healthcare delivery and training. Few studies have reported on the impact of these changes on the experiences, skill development, and career expectations of medical students.

Method: Using 59 responses to a short reflection essay prompt, 3rd year medical students in Philadelphia described how the COVID-19 pandemic affected their education in mid-2020. Using conventional content analysis, six main themes were identified across 14 codes.

Results: Students reported concerns regarding their decreased clinical skill training and specialty exposure on their career development due to the loss of in-person experience during their family medicine clerkship. A small number felt very let down and exploited by the continued high cost of tuition while missing clinical interactions. However, many students also expressed professional pride and derived meaning from limited patient and mentorship opportunities. Many students developed a new sense of purpose and a call to become stronger public health and patient advocates.

Conclusions: The medical field will need to adapt to support medical students adversely impacted by the COVID-19 pandemic, from an educational and mental health standpoint. However, there are encouraging signs that this may also galvanize many students to engage in leadership roles in their communities, to become more empathetic and thoughtful physicians, and to redesign healthcare in the future to better meet the needs of their most vulnerable patients.

Keywords: COVID-19; Clinical training; Undergraduate medical education; Workforce development.

© 2021. The Author(s).

• Education, Medical, Undergraduate*
• Students, Medical*

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The Transformational Effects of COVID-19 on Medical Education

• 1 Department of Medicine, University of California San Francisco School of Medicine
• 2 Dell Medical School, University of Texas at Austin
• Editorial Is Medical Education a Public or a Private Good? Catherine R. Lucey, MD JAMA
• Appendix Graduate Medical Education, 2019-2020 Sarah E. Brotherton, PhD; Sylvia I. Etzel JAMA
• Appendix Medical Schools in the United States, 2019-2020 Barbara Barzansky, PhD; Sylvia I. Etzel JAMA
• Special Communication Medical Education Catherine Reinis Lucey, MD JAMA Internal Medicine

In 2010, a Global Independent Commission on Education of Health Professionals for the 21st Century, composed of experts in public health and health care from around the world, asserted that the purpose of health professions education was to improve the health of communities. 1 The commission called for the educational institutions of health professions to design curricula to address the major causes of morbidity and mortality in their communities. The coronavirus disease 2019 (COVID-19) pandemic brought both clarity and urgency to this purpose and many academic health systems in the US have responded. 2

While many will remember the COVID-19 pandemic as a source of disruption, it is likely that it will also be viewed as a catalyst for the transformation of medical education that had been brewing for the past decade. Educators across the country recognized that the physician workforce needed for the 21st century not only must embrace the enduring competencies of professionalism, service to patients, and personal accountability, but also must embrace new competencies that are better suited to addressing today’s health challenges. 3 These emerging competencies include the ability to address population and public health issues; design and continuously improve health care systems; incorporate data and technology in service to patient care, research, and education; and eliminate health care disparities and discrimination in medicine. 4 Across the country, medical schools have embarked on curricular redesign to ensure that the physician workforce being trained is the workforce needed. 5 The pace of change has been steady but slow, constrained by concerns about balancing curricular time among the many important subject areas and legacy support for traditional courses and content.

The onset of the COVID-19 pandemic and the public health response required to minimize the catastrophic spread of the disease required an immediate change in the traditional approach to medical education and clearly amplified the need for expanding the competencies of the US physician workforce. Medical educators responded at the local and national levels to outline concerns and offer guiding principles so that academic health systems could support a robust public health response while ensuring that physician graduates are prepared to contribute to addressing current and future threats to the health of communities. While each school approached their response somewhat differently, several common themes have emerged.

Support a Robust Public Health Response to the Pandemic

Shelter-in-place orders enacted by multiple public health organizations demanded that all educational institutions eliminate large gatherings. With only days to prepare, faculty and staff shifted all didactics, discussion groups, and assessments to remote platforms. Learners were coached to serve as ambassadors for factual information about COVID-19, producing evidence reviews for clinical teams and public health leaders and preparing public service announcements in different languages for diverse communities. Electives were created to allow testing, case characterization, and contact tracing to become learning experiences while supporting the local public health response.

Adapt Curriculum to Current Issues in Real Time

The pandemic provided an opportunity for learners to realize the dynamic nature of medical knowledge and appreciate how mastery of key concepts in human biology, sociology, psychology, and systems science are essential for physicians to respond to a novel threat to human health. Students were immersed in institutional learning experiences, demonstrating the commitment that physicians make to lifelong learning. Town halls led by basic, clinical, and translational scientists; epidemiologists and public health officials; and health systems leaders and frontline clinicians demonstrated to students how physicians with diverse skill sets and different disciplinary lenses come together to solve complex health care problems. Faculty used foundational knowledge in psychology, sociology, and humanities to analyze ethical challenges in rationing care; professionalism challenges of caring for patients during a pandemic; sociologic challenges of homelessness, food insecurity, and poor access to health care for many populations; and policy challenges of restriction of personal autonomy.

Graduate a Class of Well-Prepared Physicians Each Year, on Time and Without Lowering Standards

A particularly challenging aspect of education during the pandemic was the substantial restriction of clinical learning experiences for medical students. Given the shortage of personal protective equipment, limited COVID-19 testing abilities, and uncertainty about how easily the virus could be spread, medical schools were reluctant to engage learners in care of patients with or suspected of having COVID-19. Further complicating the issue was the decline in numbers of patients seeking care for conditions other than COVID-19. Faculty and residents, coping with patient surges and novel care delivery methods such as telemedicine, had limited bandwidth for supervising medical students.

These restrictions on the usual medical education model of clinical workplace learning required medical educators to outline priorities for the limited clinical learning experiences and design different approaches to competency attainment. Guided by their established graduation competencies, schools prioritized clinical learning experiences for those students close to graduation, ensuring adequate preparation of the 2020 intern workforce. Some schools graduated students early so they could join the workforce. 6

In the absence of sufficient clinical learning sites, medical educators redesigned core clerkships to allow students to continue to advance their clinical knowledge through faculty-guided, remote learning strategies involving didactics, case conferences, and, in some instances, participation in videoconferences of inpatient and outpatient encounters. The pedagogical principles of competency-based, time variable education were quickly operationalized to enable schools to shorten traditional time-bound block clerkships without lowering performance standards. 7

Protect Limited Educational Resources and Treat Learners Equitably

Geographically variable travel and quarantine restrictions along with institutional challenges in identifying sufficient clinical training sites for their own students led many schools to suspend their usual practice of offering visiting rotations for senior students. The inconsistent availability of visiting rotations presented a threat to equity in residency selection because residency programs frequently use these rotations as an element in their selection process. In response, educators from across the country recommended that residency programs forgo the use of visiting rotations to select candidates for this residency cycle. The Coalition for Physician Accountability provided important support for this recommendation. 8

Engage in Crisis Communication and Active Change Leadership

Principled decision-making, change leadership, and crisis communication were essential to the educational response to the pandemic. Educational leaders, like their health systems counterparts, opened command centers to bring together experts on a daily basis to respond to the shifting environment, often working in concert with other health professions schools to share learning resources. Many schools held daily learner town halls in the early phase of the pandemic and regularly thereafter, using frameworks such as the Centers for Disease Control and Prevention’s Crisis and Emergency Risk Communication approach to provide up-to-the-minute information (competency and expertise), acknowledge uncertainty (honesty and openness), demonstrate concern for the emotional stress of the situation (empathy and caring), and reassure all that people were working on their behalf (commitment and dedication). 9

Professional organizations, accrediting bodies, licensing boards, and government agencies were important partners to medical schools during this pandemic response. Public health departments allowed health care institutions to define senior students as essential so that they could complete their rotations and graduate on time. The Liaison Committee on Medical Education accommodated changes in instructional methods as long as competency standards remained unchanged. State governments used regulatory statutes to enable early medical school graduates to work temporarily in the COVID-19 responses. Specialty societies supported decisions about visiting rotations and virtual interviews. The Association of American Medical Colleges issued national guidance documents reminding schools of the need to protect students from unreasonable personal risk and coercion but supporting deans of medical schools to make decisions based on their understanding of local circumstances and needs.

Despite the disruption of the pandemic, medical students not only continued to learn but, in many circumstances, accelerated their attainment of the types of competencies that 21st-century physicians must master to meet this pandemic and address other complex problems in health and health care. In supporting learning during these times, schools and learners pilot tested new methods of instruction, rethought their approach to assessment, identified different methods to build community, and adopted new strategies for recruitment and admission in a travel-constricted world. All of these new approaches have the potential to catalyze the modernization of US medical education that is underway, with faculty, learners, and staff increasingly recognizing that new approaches may be better than the old (eTable in the Supplement ).

Decades from now, a student may ask, “Where were you in the pandemic of 2020? What was it like? What did you learn?” Students today will be able to answer that they were not on the sidelines but rather a part of the response when the medical profession proved its worth to a struggling country and learned so much about how to rise up and reach new levels of caring. These formative lessons are likely to be even more important and influential to today’s medical students than they have been to the rest of the profession. There may be no better time in history to learn what it means to be a physician.

Corresponding Author: Catherine R. Lucey, MD, Department of Medicine, University of California San Francisco School of Medicine, 533 Parnassus Ave, Ste U-80, San Francisco, CA 94118 ( [email protected] ).

Published Online: August 26, 2020. doi:10.1001/jama.2020.14136

Conflict of Interest Disclosures: Dr Lucey reported serving as the site principal investigator for a Kern Family Foundation grant to the Medical College of Wisconsin for the Transformation of Medical Education. No other disclosures were reported.

eTable. The Potential of COVID-19 Disruptions to Catalyze the Transformation of Medical Education

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Lucey CR , Johnston SC. The Transformational Effects of COVID-19 on Medical Education. JAMA. 2020;324(11):1033–1034. doi:10.1001/jama.2020.14136

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Shortened MCAT® exams, extended AMCAS® deadlines: How the pandemic has upended medical school admissions

Medical school applicants have been struggling with many unknowns, from when they can take the mcat® exam to how they'll gather recommendations. here's how schools are working to put together an admissions process that's both safe and fair..

While preparing for the MCAT ® exam, 2018 college graduate Lauren Pinchbeck has been working 40-hour weeks as a medical scribe to squirrel away money to apply to medical school. Her former job in a Phoenix, Arizona, hospital made it tough to squeeze in study time, and she didn’t score as well as she wanted the first time she took the test.

“I need to take the MCAT again, and I'm really hoping they won’t cancel more test dates,” she says. “I can’t go spending all the money I've saved for applications unless I’m sure I have a high chance of getting in.” Even as an undergrad at Virginia Commonwealth University, Pinchbeck worked full-time. “I have to finance everything myself,” she explains. “My dad’s unemployed, and there are three other kids back home.”

Applying to medical school is always time-consuming and stress-inducing — in addition to the MCAT exam, there are essays to write, recommendations to accumulate, interviews to ace, and more — but the COVID-19 pandemic has thrown many new obstacles into the paths of thousands of aspiring doctors. And medical schools face their own issues as they try to build classes that will serve their missions and the nation’s need for talented future physicians.

“There are so many unknowns now,” says Geoffrey Young, PhD, AAMC senior director for student affairs and programs. “This causes significant anxiety for students who need information from schools, which all have their own policies. And it causes concerns for admissions deans who will be reviewing applications that won’t be as complete as in previous years.”

Admissions officials aren’t terribly concerned about 2020 applicants who already went through most of the process before the pandemic hit, but instead are worried about the many essential steps in the 2021 application cycle.

That means academic medicine leaders are scouring options to move the process forward as quickly, fairly, and effectively as possible.

On April 20, after conferring with admissions deans, college prehealth advisors, and other stakeholders, the AAMC’s American Medical College Application Service ® (AMCAS ® ) announced that it would postpone the date that schools can access applicants’ files — which include GPAs, MCAT scores, essays, and other key indicators — from June 26 to July 10. That’s to give students more time to complete their applications before the AMCAS release date.

“Due to the pandemic, this cycle is going to be like no cycle we’ve ever experienced before. We may not even know what some of the stages will look like until we get there.” Geoffrey Young, PhD AAMC Senior Director for Student Affairs and Programs

Individual schools are also contemplating and making COVID-19-related changes daily, and dozens of schools have posted policy changes on the AAMC’s Medical School Admission Requirements ® page.

So far , a recent AAMC survey shows that 78% of respondents say they will accept pass/fail grades for prerequisite coursework taken between January and August this year, and 76% say they will accept online lab courses for spring 2020 and any subsequent semesters affected by the global pandemic. Other schools are also considering these options. In addition, many are considering extending application deadlines, and more than 30% of responding schools have done so. Yale, for example, has moved its secondary application — meant to supplement the AMCAS package — back a full month, from Nov. 15 to Dec. 15.

And more changes likely lie ahead for both students and schools.

“Due to the pandemic, this cycle is going to be like no cycle we’ve ever experienced before. We may not even know what some of the stages will look like until we get there,” says Young.

Still, he adds, “the admissions community is really trying to listen to and provide support to applicants and prehealth advisors. They are doubling down on their use of holistic review to ensure they have a thorough picture of applicants.  Collectively, they are really coming together to try to get through this together.”

What about the MCAT exam?

Even in ordinary times, the MCAT exam — the rigorous multiple-choice test that helps schools evaluate applicants’ problem-solving skills, scientific knowledge, and more — often tops lists of concerns about admissions.

In an attempt to protect examinees and halt the spread of the novel coronavirus, MCAT exams were suspended from March 27 through May 21. To compensate, the AAMC has announced three new testing dates — June 28, September 27, and September 28. There will be a total of 21 dates between now and the end of September.

To further accommodate more test-takers, all 2020 sessions will offer three sittings per day: an early morning, an afternoon, and an evening option. To pull that off, the exam will be trimmed for the remainder of the calendar year from 7 ½ hours to 5 hours and 45 minutes. The cuts will come from parts of the exam that don’t impact scores, such as some questions that are being given a test run and an end-of-day survey. The plan is to return to the regular format in January.

In addition, MCAT officials are reducing the results-reporting timeframe from one month to two weeks for the June 19 through August 1 dates to allow examinees to include MCAT scores in their package earlier in the application cycle.

Given the unclear course of the pandemic, it’s impossible to predict whether all upcoming exams will be available, notes Valerie Parkas, MD, senior associate dean of admissions and recruitment for the Icahn School of Medicine at Mount Sinai. “Each school needs to figure out how they want to handle the MCAT,” she says. “If they used to accept scores only up until September, maybe they will take them in October or even January,” she notes. “Here, one change we’ve made is that we will allow older scores than we had previously.”

“ This is a rapidly evolving situation, and we thank examinees for their patience. We want to work to ensure the use of safe practices in the test centers . ” Karen Mitchell, PhD AAMC Senior Director of Admissions Testing

Elsewhere, schools are considering whether they would screen applicants — or even interview them — without MCAT scores for now and then require the scores later in the process.

The MCAT serves as a bit of an equalizer, admissions leaders say. “It allows us to compare applicants from different schools and who have taken different courses,” explains Iris Gibbs, MD, associate dean of admissions for Stanford University School of Medicine, which signed a pandemic-related admissions statement together with all other California medical schools. “Of course, we always view the MCAT in the context of a holistic review of the entire application ,” she says.

Meanwhile, MCAT officials are focused on balancing speed and safety.

“This is a rapidly evolving situation, and we thank examinees for their patience. We want to work to ensure the use of safe practices in the test centers,” says Karen Mitchell, PhD, AAMC senior director of admissions testing. Once centers open up, they will practice social distancing measures and rigorous cleaning protocols, and they will allow test-takers to wear gloves and masks.

What about an online exam? Mitchell says that while her team has been evaluating various options to deal with the outbreak, online testing raises possible concerns, including that some students may face obstacles to an online offering, such as not having the right display resolution, reliable internet coverage, or a quiet spot to take the test. “ Fairness must be central to any solutions,” she says.

What about everything else in the application process?

Certainly, the MCAT exam is only one portion of the application process, experts note. Most schools take a holistic approach, looking at GPA, letters of recommendation, volunteer activities, and “a broad range of other information, such as the context in which you were learning,” says Steven Gay, MD, assistant dean for admissions at the University of Michigan Medical School.

Students, therefore, have many concerns about this multifaceted process. Below are some key issues.

Pass/fail grades

As undergraduate institutions shuttered campuses and moved courses online, many switched to pass/fail grades — or at least offered the option.

Although these changes were meant to serve students, they have also generated some stress. Kaitlyn Tindall, a junior at Ohio State University, notes that she didn’t feel comfortable opting for pass/fail. “ Depending on the class, a passing grade can sometimes be anywhere from an A to a D,” she notes. “I don’t know how medical schools will view transcripts, so I didn’t want to take any chances.”

Medical schools are taking a range of approaches to pass/fail, with some saying they prefer letter grades in prerequisite courses and others explicitly declaring no negative consequences for anyone who chooses the option this spring.

Meanwhile, says Young, the AAMC is developing resources to help medical schools and prehealth advisors understand how to work with changes caused by online courses and pass/fail grading. “Above all,” he says, “we are encouraging schools to be flexible and transparent with students who are trying to figure out how to apply at an unprecedented time.”

Letters of recommendation

Some students worry about their ability to solicit all-important recommendation letters from professors, mentors, and prehealth advisors given the current circumstances.

“I was hoping to have enough time to show professors that I could make a good medical school candidate, but we only really got to meet for the first half of the semester,” says Tindall. “Some of my classes have something like 500 people in them, so although a professor might recognize my face if I went to office hours, I’m not sure that he would recognize my name in an email.”

Another concern is whether students can garner gold-standard “committee letters” — a composite document capturing an applicant’s overall preparation — given that campuses have shut down.

In response, several schools have loosened their rules around recommendation letters. “We will take a packet of letters rather than a committee letter, for example, and it won’t hurt applicants,” says Christina Grabowski, PhD, associate dean for admissions and enrollment management at the University of Alabama School of Medicine. “We completely understand that the recommendation process has really been disrupted.”

Medical experiences and volunteer activities

The COVID-19 outbreak has also severely limited applicants’ ability to access health care and research-related experiences.

“O pportunities to get clinical experience, to volunteer in hospitals, and even to work in communities have been greatly reduced,” says Gibbs. “We are completely understanding about those opportunities not being available, and if a student is ready to apply in other areas, we will still take that person's application quite seriously.”

But experts note that recent experiences might have made a significant difference for some candidates. “For most students, applying isn’t about the last three months,” notes Grabowski. “My fear is for students who are really counting on this time to make their applications more competitive. Unfortunately, those students may feel like they shouldn’t apply now.”

In fact, she adds, “I’m interested to see whether our application volumes will go down because of students who decide, ‘I’m just not ready, and I’m going to wait another year to apply.’”

Admissions interviews

In a March 19 statement , the AAMC strongly encouraged medical schools and teaching hospitals to conduct all interviews virtually to help promote public health. While students may understand the need to move online, some consider it a setback.

“I would be disappointed to do an interview on camera. I like to be able to get a sense of someone’s demeanor and to read them during the interaction,” says John Thurber, a University of Alabama student working on his master’s degree in biomedical and health sciences. “I’d be frustrated because I think I could crush an in-person interview.”

Others, though, would welcome the shift. “Taking off work and having to pay for flights, a place to stay, and food would put me in a bad place financially,” says Pinchbeck. “Sure, it would be great to see the campus, but I’d rather do virtual interviews.”

Schools have their own issues to consider. Grabowski offers one scenario: Say there’s a dip in the pandemic when her school launches in-person interviews in August but then they have to switch to online interviews during a resurgence. “That means we would be giving different students different interview experiences, which isn’t completely equitable,” she says.

“The question then becomes if we should offer virtual interviews the whole season, or if it isn’t really necessary to jump to that level from the get-go. Both options have disadvantages, but we want to try to mitigate the downsides as best we can.”

The greatest impacts

Admissions officers say they’re committed to focusing on how the COVID-19 pandemic has taken a toll on the applications — and the lives — of medical school applicants.

“We’ve always had a question on our application asking students to describe any adversity that might have impacted their journey,” notes Parkas. “Now, though, we have explicitly indicated that applicants should let us know about anything they feel was impacted by the pandemic.”

In addition, leaders recognize that some students are harder hit than others. “We need to look through the lens of equity as we think about how this has impacted communities of color more, urban communities more,” Parkas says.

In some cases, experts note, students are back home studying in increasingly impoverished conditions, in locations with poor Wi-Fi connections, or while acting as caregivers for younger siblings. “I need to keep all this in mind as I try to understand what students have gone through during these last few months,” says Gay. “If I ignore this, I do so to the detriment of the applicant and my school.”

What’s more, schools need to recognize that current concerns will not evaporate with this round of applications, Parkas notes.

“We’ve lost thousands of people during this pandemic,” she says. “Those people were parents and grandparents and parts of an applicant’s community. We have to remember that these effects will linger into many upcoming application cycles, too.”

By Ross Douthat

Opinion Columnist

Let me tell you a medical story; you decide what you make of it. A person has a routine medical experience, the kind that all the person’s neighbors have had as well. But afterward the person has weird symptoms, odd forms of pain, fatigue that just goes on and on and on.

The medical system can’t help the person, so the person joins online communities that provide validation but not a cure. And the person develops a strong sense of betrayal, a belief that the system knew this was possible and just let it happen to them.

Now, let me give you a few more details. The person I’m describing is an overweight 50-something Indiana man who watches Fox News and refused to wear a mask in the fall of 2020. The routine medical experience that preceded his mystery illness was his taking — because his employer required it — the Covid vaccine.

Are you suddenly forming a theory of what’s wrong with him? Are you inclined toward psychosomatic explanations, thinking that he’s taking the aches and pains of age and blaming them on the liberals and their vax?

Well, hold on, because I’ve deceived you: Actually the person is a 35-year-old college-educated woman living in Brooklyn who works out five days a week, takes anti-anxiety medication and marched, fully masked, in the 2020 George Floyd protests. Her medical experience was getting Covid itself, despite her multiple vaccinations, and thereafter falling into a long-Covid trough she can’t escape.

Now if you are, like her, a liberal professional, maybe you’re less likely to default to psychosomatic explanations. On the other hand, if you’re a conservative, her description may be what you expect to hear: Another blue-state long-Covid hypochondriac, obsessing over every twinge the way she obsesses over every passing mood, all to justify her desire to keep everybody in a mask.

Maybe you default to neither stereotype, in which case I apologize for stereotyping you. But you probably recognize the interpretations I’ve just presented, the bipartisan tendency to be dismissive of outlying medical cases when they threaten your side’s narrative of the Covid era.

I’m thinking about this because of my colleague Apoorva Mandavilli’s new story about people who have suffered, or claim to have suffered, life-altering vaccine injuries after getting the Covid shot. These long-haul afflicted naturally feel abandoned by a medical establishment that’s uncomfortable with outlying cases in the best of times, but in this case is especially resistant to conceding anything that might seem to empower anti-vaccine paranoia.

And no doubt vaccine skeptics will seize on my colleague’s story, while many staunch vaccine supporters will be made uncomfortable at the idea of too much attention being paid to these cases. But again, were this a story about the similar kinds of chronic symptoms that cluster around some people after they’ve had Covid itself, the lines of skepticism could easily reverse. (A figure like Alex Berenson, for instance, the one-man band of dissent from every anti-Covid strategy, is full of warnings about unknown long-term effects of the vaccines and full of scorn for people who claim long-term effects from Covid itself.)

As someone who’s suffered from a controversial chronic illness that isn’t Covid-related, a message that I try to bring to this conversation is that you should be able to extend sympathy to people with difficult conditions first, before you worry about how that sympathy might threaten your medical worldview or policy regime.

Sometimes these people will vindicate your skepticism: Hypochondria certainly exists; ideology and psychogenic conditions no doubt interact.

But often chronic illness falls in patterns that reflect the deep mysteries of the body more than the assumptions of the mind. In my colleague’s story about vaccine side effects, some of the afflicted are exactly the kind of liberal professional people you’d expect to be eager vaccine advocates. Likewise with long Covid: I have personally counseled a couple of young, fit, right-wing men embarrassed to acknowledge their long-haul symptoms within a conservative-leaning peer group.

Accepting the credibility of these outliers doesn’t have to overthrow your overall perspective on Covid-era issues. The existence of vaccine side effects, and any incentive there might be to undercount them, doesn’t undermine the evidence that vaccination saved a lot of lives. The risks of long Covid don’t prove that the pandemic emergency should never end .

The outliers should, however, shake your certainty that the mysteries of the human body can fit perfectly into any simple biopolitics and should give you more sympathy for the desire to to opt out of any given health regime.

You won’t be the outlier, don’t worry, and if you are, it’s probably in your head is a natural mode of thinking for healthy people.

But once you’ve been the outlier, or had an outlier in your life, you know the real territory is different than any biopolitical map, and there are more ways than most people realize to get lost.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow the New York Times Opinion section on Facebook , Instagram , TikTok , WhatsApp , X and Threads .

Ross Douthat has been an Opinion columnist for The Times since 2009. He is the author, most recently, of “The Deep Places: A Memoir of Illness and Discovery.” @ DouthatNYT • Facebook

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Perspective

When pto stands for 'pretend time off': doctors struggle to take real breaks.

Mara Gordon

A survey shows that doctors have trouble taking full vacations from their high-stress jobs. Even when they do, they often still do work on their time off. Wolfgang Kaehler/LightRocket via Getty Images hide caption

A survey shows that doctors have trouble taking full vacations from their high-stress jobs. Even when they do, they often still do work on their time off.

A few weeks ago, I took a vacation with my family. We went hiking in the national parks of southern Utah, and I was blissfully disconnected from work.

I'm a family physician, so taking a break from my job meant not seeing patients. It also meant not responding to patients' messages or checking my work email. For a full week, I was free.

Taking a real break — with no sneaky computer time to bang out a few prescription refill requests — left me feeling reenergized and ready to take care of my patients when I returned.

But apparently, being a doctor who doesn't work on vacation puts me squarely in the minority of U.S. physicians.

Research published in JAMA Network Open this year set out to quantify exactly how doctors use their vacation time — and what the implications might be for a health care workforce plagued by burnout, dissatisfaction and doctors who are thinking about leaving medicine.

"There is a strong business case for supporting taking real vacation," says Dr. Christine Sinsky , the lead author of the paper. "Burnout is incredibly expensive for organizations."

Shots - Health News

Health workers know what good care is. pandemic burnout is getting in the way.

Researchers surveyed 3,024 doctors, part of an American Medical Association cohort designed to represent the American physician workforce. They found that 59.6% of American physicians took 15 days of vacation or less per year. That's a little more than the average American: Most workers who have been at a job for a year or more get between 10 and 14 days of paid vacation time , according to the U.S. Bureau of Labor Statistics.

However, most doctors don't take real vacation. Over 70% of doctors surveyed said they worked on a typical vacation day.

"I have heard physicians refer to PTO as 'pretend time off,'" Sinsky says, referring to the acronym for "paid time off."

Sinsky and co-authors found that physicians who took more than three weeks of vacation a year had lower rates of burnout than those who took less, since vacation time is linked to well-being and job satisfaction .

And all those doctors toiling away on vacation, sitting poolside with their laptops? Sinsky argues it has serious consequences for health care.

Physician burnout is linked to high job turnover and excess health care costs , among other problems.

Still, it can be hard to change the culture of workaholism in medicine. Even the study authors confessed that they, too, worked on vacation.

"I remember when one of our first well-being papers was published," says Dr. Colin West , a co-author of the new study and a health care workforce researcher at the Mayo Clinic. "I responded to the revisions up at the family cabin in northern Minnesota on vacation."

Sinsky agreed. "I do not take all my vacation, which I recognize as a delicious irony of the whole thing," she says.

She's the American Medical Association's vice president of professional satisfaction. If she can't take a real vacation, is there any hope for the rest of us?

I interviewed a half dozen fellow physicians and chatted off the record with many friends and colleagues to get a sense of why it feels so hard to give ourselves a break. Here, I offer a few theories about why doctors are so terrible at taking time off.

We don't want to make more work for our colleagues

The authors of the study in JAMA Network Open didn't explore exactly what type of work doctors did on vacation, but the physicians I spoke to had some ideas.

"If I am not doing anything, I will triage my email a little bit," says Jocelyn Fitzgerald , a urogynecologist at the University of Pittsburgh who was not involved in the study. "I also find that certain high-priority virtual meetings sometimes find their way into my vacations."

Even if doctors aren't scheduled to see patients, there's almost always plenty of work to be done: dealing with emergencies, medication refills, paperwork. For many of us, the electronic medical record (EMR) is an unrelenting taskmaster , delivering a near-constant flow of bureaucratic to-dos.

When I go on vacation, my fellow primary care doctors handle that work for me, and I do the same for them.

But it can sometimes feel like a lot to ask, especially when colleagues are doing that work on top of their normal workload.

"You end up putting people in kind of a sticky situation, asking for favors, and they [feel they] need to pay it back," says Jay-Sheree Allen , a family physician and fellow in preventive medicine at the Mayo Clinic.

She says her practice has a "doctor of the day" who covers all urgent calls and messages, which helps reduce some of the guilt she feels about taking time off.

Still, non-urgent tasks are left for her to complete when she gets back. She says she usually logs in to the EMR when she's on vacation so the tasks don't pile up upon her return. If she doesn't, Allen estimates there will be about eight hours of paperwork awaiting her after a week or so of vacation.

"My strategy, I absolutely do not recommend," Allen says. But "I would prefer that than coming back to the total storm."

We have too little flexibility about when we take vacation

Lawren Wooten , a resident physician in pediatrics at the University of California San Francisco, says she takes 100% of her vacation time. But there are a lot of stipulations about exactly how she uses it.

She has to take it in two-week blocks — "that's a long time at once," she says — and it's hard to change the schedule once her chief residents assign her dates.

"Sometimes I wish I had vacation in the middle of two really emotionally challenging rotations like an ICU rotation and an oncology rotation," she says, referring to the intensive care unit. "We don't really get to control our schedules at this point in our careers."

Once Wooten finishes residency and becomes an attending physician, it's likely she'll have more autonomy over her vacation time — but not necessarily all that much more.

"We generally have to know when our vacations are far in advance because patients schedule with us far in advance," says Fitzgerald, the gynecologist.

Taking vacation means giving up potential pay

Many physicians are paid based on the number of patients they see or procedures they complete. If they take time off work, they make less money.

"Vacation is money off your table," says West, the physician well-being researcher. "People have a hard time stepping off of the treadmill."

A 2022 research brief from the American Medical Association estimated that over 55% of U.S. physicians were paid at least in part based on "productivity," as opposed to earning a flat amount regardless of patient volume. That means the more patients doctors cram into their schedules, the more money they make. Going on vacation could decrease their take-home pay.

But West says it's important to weigh the financial benefits of skipping vacation against the risk of burnout from working too much.

Physician burnout is linked not only to excess health care costs but also to higher rates of medical errors. In one large survey of American surgeons , for example, surgeons experiencing burnout were more likely to report being involved in a major medical error. (It's unclear to what extent the burnout caused the errors or the errors caused the burnout, however.)

Doctors think they're the only one who can do their jobs

When I go on vacation, my colleagues see my patients for me. I work in a small office, so I know the other doctors well and I trust that my patients are in good hands when I'm away.

Doctors have their own diagnosis: 'Moral distress' from an inhumane health system

But ceding that control to colleagues might be difficult for some doctors, especially when it comes to challenging patients or big research projects.

"I think we need to learn to be better at trusting our colleagues," says Adi Shah , an infectious disease doctor at the Mayo Clinic. "You don't have to micromanage every slide on the PowerPoint — it's OK."

West, the well-being researcher, says health care is moving toward a team-based model and away from a culture where an individual doctor is responsible for everything. Still, he adds, it can be hard for some doctors to accept help.

"You can be a neurosurgeon, you're supposed to go on vacation tomorrow and you operate on a patient. And there are complications or risk of complications, and you're the one who has the relationship with that family," West says. "It is really, really hard for us to say ... 'You're in great hands with the rest of my team.'"

What doctors need, says West, is "a little bit less of the God complex."

We don't have any interests other than medicine

Shah, the infectious disease doctor, frequently posts tongue-in-cheek memes on X (formerly known as Twitter) about the culture of medicine. Unplugging during vacation is one of his favorite topics, despite his struggles to follow his own advice.

His recommendation to doctors is to get a hobby, so we can find something better to do than work all the time.

"Stop taking yourself too seriously," he says. Shah argues that medical training is so busy that many physicians neglect to develop any interests other than medicine. When fully trained doctors are finally finished with their education, he says, they're at a loss for what to do with their newfound freedom.

Since completing his training a few years ago, Shah has committed himself to new hobbies, such as salsa dancing. He has plans to go to a kite festival next year.

Shah has also prioritized making the long trip from Minnesota to see his family in India at least twice a year — a journey that requires significant time off work. He has a trip there planned this month.

"This is the first time in 11 years I'm making it to India in summer so that I can have a mango in May," the peak season for the fruit, Shah says.

Wooten, the pediatrician, agrees. She works hard to develop a full life outside her career.

"Throughout our secondary and medical education, I believe we've really been indoctrinated into putting institutions above ourselves," Wooten adds. "It takes work to overcome that."

Mara Gordon is a family physician in Camden, N.J., and a contributor to NPR. She's on X as @MaraGordonMD .

• American Medical Association

Link Between Generalized Joint Hypermobility and Increased Long COVID Risk: Study Insights

R ecent research indicates that people who exhibit generalized joint hypermobility (GJH) , or double-jointedness, may be more susceptible to long-term complications following COVID-19 infection, known as long COVID.

Investigators from King’s College London along with Brighton and Sussex Medical School (BSMS) in the UK based their findings on a survey which included 3,064 participants with a history of COVID-19 infection. The data revealed a roughly 30 percent increase in long COVID risk among individuals presenting with GJH, who also tended to suffer from higher levels of persistent fatigue, a common symptom of long COVID.

“The study reveals that generalized joint hypermobility is a potential risk factor for prolonged COVID symptoms, and particularly amplifies fatigue in individuals,” mentions Jessica Eccles, a neuroscientist from BSMS.

Previous research has already established connections between GJH and other health issues such as fibromyalgia , chronic pain, irritable bowel syndrome, migraines, and depression , which are also considered risk factors for long COVID. GJH is characterized by an abnormal range of motion in the joints, stemming from variances in connective tissue that could also impact the body’s response to COVID-19.

While there is a recognition that further research is needed to establish a direct causal link—owing to limited scope in the surveyed data—researchers emphasize the significance of the relationship found between GJH and long COVID. In the UK alone, where this study was conducted, about 20 percent of individuals have GJH, signaling a substantial proportion of the population potentially at greater risk.

Understanding the nuances of long COVID is critical, with evidence suggesting autonomic, inflammatory, and metabolic dysregulation play roles in the condition. Such insights inform and improve strategies for identifying high-risk individuals, providing support, and probing the biological mechanisms that possibly prolong COVID-19 recovery in predisposed individuals.

“Discovering that joint hypermobility may lead to longer recovery times is crucial, as it guides us towards understanding the biological differences that might explain why some people experience more severe consequences,” states King’s College London data scientist Nathan Cheetham.

The findings have been duly recorded in the journal BMJ Public Health .

FAQ Section

What is generalized joint hypermobility.

Generalized joint hypermobility (GJH) is a condition in which individuals have joints that can move beyond the normal range expected for a particular joint, often referred to as being double-jointed.

How does GJH increase the risk of long COVID?

The study suggests that differences in connective tissue related to GJH might influence the body’s response to COVID-19, potentially making an infection more severe or long-lasting. However, more research is needed to understand the exact causal relationship.

What percentage of the UK population has generalized joint hypermobility?

Approximately 20 percent of the people in the UK are believed to have GJH.

What are other health issues associated with GJH?

GJH has been linked to conditions like fibromyalgia, chronic pain, irritable bowel syndrome, migraines, and depression.

Is there a direct causal link between GJH and long COVID?

The current study’s data is not comprehensive enough to definitively establish a direct causal link between GJH and long COVID, which means further research is necessary.

The intriguing association between generalized joint hypermobility and an increased risk of experiencing long COVID underscores the complexity of this emerging health concern. As researchers delve deeper into this connection, a clearer picture may emerge, potentially leading to targeted approaches in treating and preventing long-term repercussions of COVID-19 in at-risk populations. The study’s implications suggest imperative avenues for future research to uncover the precise biological underpinnings that might explain the continuum of COVID-19 symptomatology among different individuals.

Ketchum doctor dies in Idaho avalanche

A Ketchum doctor, known as an avid adventurer, died last week in an avalanche in Idaho’s backcountry.

Dr. Terrence “Terry” O’Connor, 48, was a physician in the Emergency Department at St. Luke’s Wood River Medical Center in Ketchum.

He coordinated the local medical response during the COVID-19 pandemic, provided healthcare overseas in Nepal and India, helped start a medical school program focused on climate change and summited Mount Everest.

“His loss will be missed not only in the valley itself but throughout the entire state and region,” wrote the Idaho EMS Physician Commission in a Facebook post.

On Friday, May 10, O’Connor and another experienced skier were downclimbing to their descent point on Donaldson Peak in the Lost River Range, when he was caught in a small wind slab avalanche, which carried him downhill and triggered a larger avalanche, according to a preliminary report by the Sawtooth Avalanche Center.

His skiing partner called for help via a satellite device, found O’Connor with her transceiver and probe and was able to dig him out of five feet of snow and perform CPR. Search and rescue teams responded and evacuated O’Connor, but he did not survive.

In addition to O’Connor’s role in the ER, he was also previously the Blaine County and Sawtooth Regional EMS Director, serving as a liaison between first responders, local government officials, and the medical and public health communities during the COVID-19 pandemic. At one point in March of 2020, the Sun Valley area had the highest-in-the-nation rate of COVID-19 infections per-capita.

O’Connor was also a director for the University of Colorado School of Medicine’s Diploma in Climate Medicine, preparing doctors for the health impacts caused by extreme heat and wildfires.

At other times, he was a ski patroller, a National Park Service Climbing Ranger and an ultramarathoner.

In a 2017 Ted Talk, O’Connor emphasized the importance of adventure in fostering altruism.

“Yes, Everest was significant,” he said, “but it was really about me feeling insignificant, but connected to something greater.”

Find reporter Rachel Cohen on X  @racheld_cohen

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Startling Findings – Entirely New COVID-Related Syndrome Discovered

By University of California - San Diego May 12, 2024

In an international collaboration, scientists have discovered a new COVID-related syndrome, MDA5-autoimmunity and Interstitial Pneumonitis Contemporaneous with COVID-19 (MIP-C). This syndrome, characterized by severe lung scarring and high mortality, was identified using a computational tool, BoNE, which highlighted the role of interleukin-15 in the disease’s progression. The syndrome appears to be a global issue, prompting further research into potential treatments. Credit: SciTechDaily.com

UC San Diego collaborates with UK researchers on a retrospective observational study to unravel a medical mystery.

Pradipta Ghosh, M.D., sat down in her office at the University of California San Diego School of Medicine and considered a request from the other side of the world.

Ghosh, a professor in the Departments of Medicine and Cellular and Molecular Medicine at UC San Diego School of Medicine, received an email from Dennis McGonagle, Ph.D., professor of investigative rheumatology at the University of Leeds in the United Kingdom. It began an international collaboration, one that uncovered a previously overlooked COVID-related syndrome and resulted in a paper in eBioMedicine , a journal published by The Lancet .

McGonagle asked if she was interested in collaborating on a COVID-related mystery. “He told me they were seeing mild COVID cases,” Ghosh said. “They had vaccinated around 90 percent of the Yorkshire population, but now they were seeing this very rare autoimmune disease called MDA5 — autoantibody associated dermatomyositis (DM) in patients who may or may not have contracted COVID, or even remember if they were exposed to it.”

A high-resolution computed tomography of the lungs of a patient with a fatal case of MDA5-autoimmunity and Interstitial Pneumonitis Contemporaneous with the COVID-19 Pandemic (MIP-C). Credit: Image courtesy of Gabriele De Marco, Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust

McGonagle told of patients with severe lung scarring, some of whom presented rheumatologic symptoms — rashes, arthritis, muscle pain — that often accompany interstitial lung disease. He was curious to know if there was a connection between MDA5-positive dermatomyositis and COVID-19 .

“DM is more common in individuals of Asian descent, particularly Japanese and Chinese,” Ghosh said. “However, Dr. McGonagle was noting this explosive trend of cases in Caucasians.”

“But that’s the least of the problem,” Ghosh said. “Because he said, ‘Oh, and by the way, some of these patients are progressing rapidly to death.’”

Leveraging Computational Power in Medical Research

Ghosh is the founding director of the Institute for Network Medicine at UC San Diego School of Medicine, home to the Center for Precision Computational Systems Network (PreCSN — the computational pillar within the Institute for Network Medicine). PreCSN’s signature asset is BoNE — the Boolean Network Explorer, a powerful computational framework for extracting actionable insights from any form of big data.

“BoNE is designed to ignore factors that differentiate patients in a group while selectively identifying what is common (shared) across everybody in the group,” Ghosh explained. Previous applications of BoNE allowed Ghosh and her team to identify other COVID-related lung and heart-afflicting syndromes in adults and children , respectively.

As a rheumatologist, McGonagle specializes in inflammatory and autoimmune conditions. His expertise, combined with the computational power of the Institute for Network Medicine, proved to be an excellent collaboration for probing the post-pandemic upsurge in inflammatory and autoimmune diagnoses. Ghosh said that McGonagle’s roster of patients, all within the U.K.’s National Health System (NHS), helped to facilitate the investigation.

Members of the UC San Diego component of the international team that discovered (and named) MIP-C are (from left) Saptarshi Sinha, Ella McLaren and Pradipta Ghosh. MIP-C is a previously unknown post-COVID syndrome that results in lung scarring, sometimes progressing to death. Credit: UC San Diego Health Sciences

“The NHS has a centralized health care database with comprehensive medical records for a large population, making it easier to access and analyze health data for research purposes,” Ghosh explained.

Ghosh and McGonagle put together a team to probe what they found was indeed an entirely new syndrome. The UC San Diego team included Saptarshi Sinha, Ph.D., interim director of PreCSN, who was a co-first author on the paper, along with Paula David Ramos, M.D., who was conducting research fellowship in experimental rheumatology, at the Leeds Institute of Rheumatic and Musculoskeletal Medicine. The UC San Diego team also included two PreCSN-affiliated students, Ella McLaren, an undergraduate student and aspiring physician-scientist, and Sahar Taheri, a graduate student in the Jacobs School of Engineering Department of Computer Science and Engineering.

The study began with McGonagle lab’s detection of autoantibodies to MDA5 — an RNA -sensing enzyme whose functions include detecting COVID-19 and other RNA viruses. A total of 25 patients from the group of 60 developed lung scarring, also known as interstitial lung disease. Ghosh noted that the lung scarring was bad enough to cause eight people in the group to die due to progressive fibrosis. She said that there are established clinical profiles of MDA5 autoimmune diseases.

“But this was different,” Ghosh said. “It was different in behavior and rate of progression — and in the number of deaths.”

Ghosh and the UC San Diego team explored McGonagle’s data with BoNE. They found that the patients who showed the highest level of MDA5 response also showed high levels of interleukin-15.

“Interleukin-15 is a cytokine that can cause two major immune cell types,” she explained. “These can push cells to the brink of exhaustion and create an immunologic phenotype that is very, very often seen as a hallmark of progressive interstitial lung disease, or fibrosis of the lung.”

BoNE allowed the team to establish the cause of the Yorkshire syndrome — and pinpoint a specific single nucleotide polymorphism that is protective. By right of discovery, the group was able to give the condition a name: MDA5-autoimmunity and Interstitial Pneumonitis Contemporaneous with COVID-19. It’s MIP-C for short, “Pronounced ‘mipsy,’” Ghosh said, adding that the name was coined to make a connection with MIS-C, a separate COVID-related condition of children.

Ghosh said that it’s extremely unlikely that MIP-C is confined to the United Kingdom. Reports of MIP-C symptoms are coming from all over the world. She said she hopes the team’s identification of interleukin-15 as a causative link will jump-start research into treatment.

Reference: “MDA5-autoimmunity and interstitial pneumonitis contemporaneous with the COVID-19 pandemic (MIP-C)” by Paula David, Saptarshi Sinha, Khizer Iqbal, Gabriele De Marco, Sahar Taheri, Ella McLaren, Sheetal Maisuria, Gururaj Arumugakani, Zoe Ash, Catrin Buckley, Lauren Coles, Chamila Hettiarachchi, Emma Payne, Sinisa Savic, Gayle Smithson, Maria Slade, Rahul Shah, Helena Marzo-Ortega, Mansoor Keen, Catherine Lawson, Joanna Mclorinan, Sharmin Nizam, Hanu Reddy, Omer Sharif, Shabina Sultan, Gui Tran, Mark Wood, Samuel Wood, Pradipta Ghosh and Dennis McGonagle, 8 May 2024, eBioMedicine . DOI: 10.1016/j.ebiom.2024.105136

This work was supported in part by the National Institute for Health Research (NIHR) Leeds Biomedical Research Centre (BRC), and in part by the National Institutes for Health (NIH) grant R01-AI155696 and pilot awards from the University of California Office of the President Research Grants Program Office (R00RG2628, R00RG2642 and R01RG3780) to Pradipta Ghosh. Saptarshi Sinha was supported in part by R01-AI141630 (to Pradipta Ghosh) and in part through funds from the American Association of Immunologists (AAI) Intersect Fellowship Program for Computational Scientists and Immunologists.

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1 comment on "startling findings – entirely new covid-related syndrome discovered".

As a senior lay American male investigating official US chronic disease and mortality statistics in late 2019 for allergy, FDA approved food poisoning and excessive medical error reasons, I knew early in 2020 that most of the reports of Covid-19 related deaths in the US were greatly exaggerated (e.g., preexisting conditions, comorbidities and innately frail individuals). As to the study cited in the “Re:” lines above, there are at least three fatal flaws in all of “big data.” First, it doesn’t factor-in Dr. Arthur F. Coca’s (by 1935; my) kind of food (minimally) allergy reactions. Second, it doesn’t factor-in officially (FDA in the US approved food poisoning. Third, it doesn’t factor-in excessive related/resultant medical errors. Given the high (e.g., 90) percentage of vaccinated persons in the Yorkshire population, a fourth fatal error could be that the illnesses were caused by the vaccines. Statistically, there never was a Covid-19 pandemic, just a ‘plan-scam-demonic’ of biblical proportions among corporate interests and their pawns and puppets in various national government agencies. Regardless, the first three fatal flaws are sufficient for most serious scientists to completely disregard the results and implications of such a BoNE-head study.

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Exclusive-Biden to Put Tariffs on China Medical Supplies - Sources

FILE PHOTO: U.S. President Joe Biden speaks about student protests at U.S. universities, amid the ongoing conflict between Israel and Hamas, during brief remarks in the Roosevelt Room at the White House in Washington, U.S., May 2, 2024. REUTERS/Nathan Howard/File Photo

By Jarrett Renshaw and Trevor Hunnicutt

(Reuters) - The Biden administration is expected to issue new tariffs on Chinese-made medical devices like syringes and personal protective equipment when it unveils its new trade strategy next week, according to two sources familiar with the decision.

The expected moves are part of the administration's broader strategy to protect the U.S. against supply shortages seen during the COVID pandemic that left hospitals scrambling to find critical equipment, the sources said.

President Joe Biden is set to announce new China tariffs as soon as next week targeting strategic sectors including electric vehicles, solar panels and steel. The size and the scale of the tariffs on medical equipment is unclear.

The White House declined to comment.

For years, China’s leaders have worried that the country depended too much on foreign sources for everything from medical supplies to microchips and used subsidies, economic targets and other government inducements to emerge as a powerhouse in those important industries.

The COVID pandemic exposed a lack of U.S. production of critical medical equipment from gowns and masks to ventilators and the U.S. turned to China for help to fill the gap.

Imports of syringes from China peaked at $348 million in 2021, but have declined since to about $167 million last year, according to U.S. Census Bureau data.

(Reporting By Jarrett Renshaw and Trevor Hunnicutt; additional reporting by David Lawder. Editing by Heather Timmons and Caitlin Webber)

Copyright 2024 Thomson Reuters .

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