Public Health

How JAMA Network quickened pace to deliver critical COVID-19 info

If you have ever endured the tortuous waits between manuscript submission, review, acceptance and publication as a physician author, the pace at peer-reviewed medical journals can seem frustratingly slow.

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But in the face of COVID-19 pandemic that has killed more than 5,000 people around the world, the team at the AMA’s JAMA Network™ of journals have worked with blazing speed to deliver high-impact original research and perspectives to help physicians better understand the spread of SARS-CoV-2, testing and treatment of COVID-19, and the impact on health professionals.

Those resources can be found at the JAMA Network COVID-19 resource center, and they include several highly regarded one-on-one livestream interviews conducted with key physician experts by Howard Bauchner, MD, editor-in-chief of JAMA and senior vice president of AMA scientific publications and multimedia applications.

Dr. Bauchner said the need for speed and new modes of communicating key findings and insights to physicians is more urgent than ever.

“Clearly, the way in which we communicate now is so different than it was five years ago, not to mention around the time of SARS and MERS-CoV,” Dr. Bauchner said, referring to the 2002–2003 severe acute respiratory syndrome and the Middle East respiratory syndrome-related coronavirus first reported in 2012.

That has meant turning around COVID-19 manuscripts in two to four days instead of the typical week to 10 days. Dr. Bauchner gave special credit to JAMA Managing Editor Stacy L. Christiansen and Senior Editor Jody Zylke for their work to accomplish that speedier pace while maintaining accuracy and reliability. In addition to the faster turnaround times, a number of the key manuscripts have been translated into Mandarin.

The AMA also has developed, in conjunction with experts the Centers for Disease Control and Prevention, a COVID-19 resource center and a physician’s guide to COVID-19.

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JN Learning also is continually updating a collection of COVID-19 resources, with information on obtaining CME credit.


Focus on novel findings

Already, hundreds of submissions and author queries related to COVID-19 have come in, making it a challenge for Dr. Bauchner and his team to prioritize publication.

“We want novel findings, and as you get more and more manuscripts the barrier to publication at a journal such as JAMA increases with time,” he said.

“Early on, it was just a description of the phenomenon that we were interested in publishing,” Dr. Bauchner said. Subsequently, there were nearly 900,000 page “views for the China case series that showed what the disease looked like.” That JAMA Viewpoint summarizes a report from the Chinese Center for Disease Control and Prevention on more than 72,000 cases, has proven to be the foundation for understanding the severity and deadliness of COVID-19 in different age groups.

“Now, we’re expecting more from the reports we’re putting out,” Dr. Bauchner said. “We know it’s a particularly problematic and troublesome infection for the elderly, particularly for the elderly with comorbid conditions. We’ve received many case series that are continuing to report that issue, but they’re not telling us anything particularly new.

“Early on, we put out a report on asymptomatic transmission and that was very important, but we probably wouldn’t publish more about that,” he added.

Shedding light on Italy’s struggle

While there has, understandably, been widespread news media interest in obtaining interviews with knowledgeable physician experts to address the many urgent and developing questions of interest to the public with regard to COVID-19, Dr. Bauchner and his JAMA Network team have offered a place for them to address physicians directly and to answer the pressing concerns that they have.

Most recently, Dr. Bauchner interviewed Dr. Maurizio Cecconi of Humanitas University in Milan, who has led intensivists in Lombardy, Italy, to develop a COVID-19 ICU network to manage the surge of patients requiring critical care in the region. Dr. Cecconi co-wrote a JAMA Viewpoint essay, “Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response.”

Dr. Bauchner, reflecting on the interview, was struck by “the consistency of the data from China, Korea, and Italy—the case fatality rate for those under 60 is very very low and increases with age, particularly those with comorbid conditions.”

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He also said the interview made clear “the need for health care systems and areas to plan for a surge of critically ill patients, plan for the potential need for more ICU beds and more ventilators.” 

The Italian experience—in which more than 1,000 health professionals have been infected with COVID-19—also shows how critical it is “to protect the health of health care workers,” Dr. Bauchner said. A recent JAMA Viewpoint addresses how to support the health workforce during the COVID-19 global pandemic.


Expert pipeline to physicians

A frequent Dr. Bauchner interlocutor, since January, has been Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. Dr. Fauci co-wrote an early JAMA Viewpoint essay on the coronavirus and has taken part in three livestream Q&A interviews with Dr. Bauchner so far. He is a member of Vice President Mike Pence’s coronavirus task force and a frequent presence in White House briefings, TV news interviews and congressional hearings.

Dr. Bauchner believes he understands why Dr. Fauci has made the JAMA Network interviews a priority despite the hectic demands of helping to lead the nation’s COVID-19 response.

“Tony likes talking to another physician,” Dr. Bauchner said, “and I appreciate that he’s prioritized speaking to physicians through JAMA.”

“Tony is a national treasure,” he added, suggesting that if there were a Mount Rushmore of NIH figures Dr. Fauci’s face should the first one carved into the rock.

Dr. Fauci’s “ability to communicate clearly, concisely, with authority and expertise but without being pedantic—I think it’s a gift.”

Despite news reports to the contrary, Dr. Bauchner said he’s seen no evidence of any limitation on Dr. Fauci’s to speak forthrightly to physicians and the public about the COVID-19 pandemic and what’s needed to mitigate it.

For those on front lines

With the AMA beginning work from home today, Dr. Bauchner said the JAMA Network journals are prepared to continue publishing remotely. The aim is to ensure that the doctors, nurses and others handling the expected surge of patients have the information they need to save lives.

“I really want to thank the clinicians who are taking care of the patients, and I want to thank people like Dr. Fauci who are trying to bring organization and calmness and direction to what should be a national and international effort.”

Subscribe to the “Conversations with Dr. Bauchner” podcast. Each week, he interviews leading researchers and thinkers in health care about their recent JAMA articles. Go beyond an article recap, and delve into the background, context and implications of the study or editorial. One outstanding recent episode features Dr. Bauchner’s interview with China CDC Chief Epidemiologist Zunyou Wu, MD, PhD.

Learn more about Dr. Bauchner in this AMA Moving Medicine Magazine profile, “Digital designs for the age of evidence.”