COVID-19 in Prisons; Time to Move Away From RCTs?

— Also, cognitive bias and public health during a pandemic

by Fred Pelzman, MD July 5, 2020

Fred Pelzman is an associate professor of medicine at Weill Cornell, and has been a practicing internist for nearly 30 years. He is medical director of Weill Cornell Internal Medicine Associates.

California is infusing the state's prisons with significant financial resources, but this investment is not containing or preventing COVID outbreaks, Dan Morain writes ~ California Prisons Are COVID Hotbeds Despite Billions Spent On Inmate Health (Kaiser Health News)
"Safety concerns among residents and fellows are complicated by the recognition that their decisions have implications for their loved ones and others outside the hospital," write Thomas H. Gallagher, MD, and Anneliese M. Schleyer, MD, MHA, who interviewed medical students and trainees to learn how COVID-19 is impacting their learning and emotional well-being ~ "We Signed Up for This!" -- Student and Trainee Responses to the Covid-19 Pandemic (New England Journal of Medicine)
Why do many people seem so distressed about a potential ventilator shortfall, but do not show similar concern about life-saving strategies such as social distancing, testing, and contact tracing? Scott D. Halpern, MD, PhD, and colleagues discuss how these inconsistent responses reflect errors in our thinking ~ Cognitive Bias and Public Health Policy During the COVID-19 Pandemic (JAMA)
Arjun Gupta, MD, recalls how the pandemic upended end-of-life care for one cancer patient but also how the pandemic allowed that patient and her former oncologist to reconnect ~ Plans and Pandemics (New England Journal of Medicine)
Given time constraints during the pandemic, researchers may consider turning from randomized controlled trials to natural experiments, which can get doctors answers about COVID faster and bypass hidden biases that may impede observational studies, according to Anupam B. Jena and Christopher M. Worsham ~ What Coronavirus Researchers Can Learn From Economists (New York Times)
"I have worked on two different continents and in a variety of medical systems and settings. But one thing has always remained constant: the practice of medicine as an in-person endeavor," writes Marcin Chwistek, MD, reflecting on how the patient-physician encounter has changed during the pandemic ~ "Are You Wearing Your White Coat?": Telemedicine in the Time of Pandemic (JAMA)
In a new analysis, Ali Rowhani-Rahbar, MD, MPH, PhD, and colleagues explore how extreme risk protection order laws can help protect people from harm by firearm ~ Extreme Risk Protection Orders in Washington (Annals of Internal Medicine)

Fred N. Pelzman, MD, of Weill Cornell Internal Medicine Associates and weekly blogger for MedPage Today, follows what's going on in the world of primary care medicine. Pelzman's Picks is a compilation of links to blogs, articles, tweets, journal studies, opinion pieces, and news briefs related to primary care that caught his eye.