University of Wisconsin–Madison ⋅ Medical College of Wisconsin
WMJ

Nine Months and Going Strong: Reflecting on an Unprecedented Year

Sarina Schrager, MD, MS, WMJ Editor-in-Chief

WMJ. 2020;119(4): 220-221.

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As the COVID-19 pandemic enters its ninth month, Wisconsin is currently in the midst of a surge of cases, and hospitals throughout the state are full of patients with COVID symptoms. Meanwhile, research abounds looking at all aspects of this new virus and its impact on health. The WMJ continues to publish articles about COVID in Wisconsin written by Wisconsin researchers—papers we have posted in a special section on our website: wmjonline.org—including six new papers from this issue.

Topics in this issue include research about the early days of the pandemic, with papers describing patients who presented with COVID to the VA hospital in Milwaukee and patients with cancer presenting for surgery. In a study by Ebert et al, patients most commonly admitted for COVID-related symptoms at the VA in the spring of 2020 were Black men with hypertension.1 At the same time, in Madison, Puckett et al report there was a very low rate of COVID among patients presenting for cancer surgery.2 Researchers found only 2 positive tests out of the 227 patients with cancer who presented to the hospital for routine cancer surgery. These papers are examples of Wisconsin researchers studying and writing about the early stages of the pandemic, while a third paper by Singh et al describes the end of the 2018-2019 influenza season with the advent of COVID.3 Interestingly, positive tests for influenza decreased suddenly with the occurrence of more COVID cases.

In “The Great Mask Debate,” Raymond presents a comprehensive review of the evidence behind mask-wearing.4 The paper provides ample evidence of how masks can reduce the risk of transmission of multiple viruses, including COVID, thereby making wearing them not really a debate at all.

A commentary in this issue by Hansmann et al describes how the pandemic has heightened challenges faced by rural communities.5 Many people who live in rural areas depend on community resources for social support and interaction. Unfortunately, many of these resources (such as community centers or religious institutions) have been suspended during the pandemic. Further, internet services can be unreliable in rural areas, making it even harder for people to stay connected. In a poignant narrative essay, a primary care physician describes a morning of doing telemedicine,6 highlighting the challenges for clinicians who have transformed their patient care days from face-to-face visits into telephone or video visits. For many clinicians, the rapport and communication with patients over the phone or a screen can be very challenging.

In addition to the COVID-related papers, this issue also includes several papers focusing on medical education. One report looks at how internal medicine residents experience writing and presenting case reports.7 Another describes the development of a curriculum to teach residents about empathy, with the goal of reducing burnout rates.8

The year 2020 has been a busy one for the WMJ. We have received more than twice as many submissions as in the previous several years, including many about COVID. In response to the pandemic and another critical topic in 2020—the impact of race and racism on health—we have added two topic collections on the website (wmjonline.org). The first is a COVID repository, featuring 17 papers (to date) that cover a broad range of topics related to the pandemic. In addition to the papers from this issue, this section features several more case studies, brief reports, commentaries, and original research looking at the early days of the pandemic in Wisconsin, including two commentaries that explore its effect on medical student education.9,10 In the spring of 2020, most in-person clinical experiences for medical students were halted temporarily due to the great uncertainties surrounding the pandemic. Authors discuss the educational implications of pulling students out of clinical rotations while at the same time focusing on the importance of keeping students healthy. In another commentary, authors address the pandemic’s potential effects on immigrant physicians with a discussion of visa implications.11

As mentioned above, the second collection brings together papers that explore the impact of race and racism on health. Published over the last several years, these 17 papers explore specific issues related to race in Wisconsin. Topics covered include social determinants of health, racial disparities in breast cancer, and other health equity issues. To expand on this topic, the WMJ is publishing a special theme issue in early 2021. We have assembled a distinguished panel of experts to serve as a special advisory group to the editors for this issue that includes scientists from the University of Wisconsin (UW) School of Medicine and Public Health, the Medical College of Wisconsin, and UW-Milwaukee who have volunteered their time and expertise. Currently, we are soliciting artwork to include in this special issue. Visit our website for more information.

The WMJ also has teamed up with the UW-Madison Interprofessional Continuing Education Partnership (ICEP) to offer continuing education credit for certain original research papers published in the journal. Look for articles that display a blue “CE” button at wmjonline.org, and to register, click on the “earn continuing education credit” links or visit the ICEP website (https://ce.icep.wisc.edu/). There are no fees for participating in or receiving credit for this online enduring educational activity.

Finally, as 2020 comes to a close, we want to thank all of our reviewers who have dedicated their time and expertise to allow the WMJ to publish high-quality scholarship from local scientists. We could not publish the journal without their help. If you have never reviewed for the WMJ, please consider signing up on the website today.

REFERENCES

  1. Ebert TJ, Dugan S, Barta L, Gordon B, Nguyen-Ho C, Pagel PS. Clinical features of COVID-19 infection in patients treated at a large veterans affairs medical center. WMJ. 2020;119(4):248-252.
  2. Puckett Y, Wilke L, Weber S, Parkes A, LoConte NK. Low rate of SARS-CoV-2 infection in adults with active cancer in non-endemic region of the United States. WMJ. 2020;119(4):286-288.
  3. Singh S, Ledeboer NA, Laud PW, Hanson R, Truwit JD. Decrease in positivity rate of influenza tests coinciding with outbreak of SARS-CoV-2: data from a southeastern Wisconsin laboratory. WMJ. 2020;119(4):275-277.
  4. Raymond J. The great mask debate: a debate that shouldn’t be a debate at all. WMJ. 2020;119(4):229-239.
  5. Hansmann KJ, Cotton QD, Kind AJH. Mind the gaps: supporting key social safety nets across the digital divide in rural Wisconsin. WMJ. 2020;119(4):227-228.
  6. Tumerman M. Good morning doctor, welcome to a new day. WMJ. 2020;119(4):225.
  7. Tumilty H, Henning R, Obasi J, Pfeifer K, Bhandari S, Jha P. Internal medicine residents’ perceptions of writing and presenting case reports. WMJ. 2020;119(4):270-274.
  8. Quinn MA, Grant LM, Sampene E, Zelenski AB. A curriculum to increase empathy and reduce burnout. WMJ. 2020;119(4):258-262.
  9. Hueston WJ, Petty EM. The impact of the COVID-19 pandemic on medical student education in Wisconsin. WMJ. 2020;119(2):80-82.
  10. Kalet AL, Jotterand F, Muntz M, Thapa B, Campbell B. Hearing the call of duty: what we must do to allow medical students to respond to the COVID-19 pandemic. WMJ. 2020;119(1):6-7.
  11. Chandratre S, Soman A. COVID-19 poses challenges to immigrant physicians in the United States. WMJ. 2020;119(2):77-78.

 

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