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What I Did on Quarantine VacationAugust 15, 2020
I’m Jennifer Kasten, an assistant professor at Cincinnati Children’s Hospital, and I’ve been in practice as a pediatric pathologist for less than 2 years. I don’t run a laboratory, I’m no pulmonary pathology expert, nor am I employed as an epidemiologist. So, in the world of academic medicine and COVID-19 decision-making, I’m absolutely nobody (my parents are proud of me, though).
One thing I do possess is a rather unusual background, and I don’t mean in the whimsical Zoom call sense. I trained as an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine, worked for a year at Oxford as a postgraduate in mathematical modeling of epidemics, attained some fieldwork experience in epidemic control, earned a second Master’s degree in the history of medicine, and even spent a few years as an undergraduate in a virology laboratory. Like many of us, I have a robust autopsy practice and spend lots of time reading papers (in Pediatrics and Developmental Pathology, natch), reviewing papers, writing papers, having papers rejected, etc. If you smash all of that together and squint a bit, the shape of it comes out looking remarkably like I could provide useful commentary on the COVID-19 pandemic.
As the storm clouds started to gather back in February, the climate (medical and public) was one of fear, misinformation, and rampant speculation. It felt as though the most panicked voices were trapped in a room together, amplifying each other. The people who were actually running things were far too busy to respond to conspiracy theory videos or the latest tweetstorm. Putting out serious, real, validated data is a full-time occupation- there is little time to digest, interpret and communicate it to the public. The void howled to be filled. So, I did what any self-respecting Millennial would do and began expressing myself. My personal Facebook page switched over from kid pics and running shots to writing analyses of COVID-19. These pieces took off like a bottle rocket; within 10 days my personal life was completely overrun, and I segregated the COVID content out by launching a public Facebook page.
If you asked me three months ago to choose the more likely scenario among these options:
- I would launch a public Facebook page
- I would switch careers to become a cat milkmaid
- I would free solo El Capitan,
And, assuming you picked the correct answer (A), if you had asked me to bet my life’s savings on the ensuing response:
- The internet public would pat me on the head and say “that’s nice, dear, but no one cares”
- It would go massively viral and be seen by 1.6 million people a week,
The whole point of my Facebook page is science communication, pure and simple - collating, parsing, synthesizing, translating and passing on important advances – in order to better our understanding of COVID-19. There are few ground rules on my page. The first is that it’s rabidly, emphatically, apolitical. No discussions of policies, the economic impact of COVID, or anything remotely partisan (domestic or international) is permitted - only epidemiology, virology, pathology, and laboratory medicine. The second is that I almost never use the word “I,” except when making jokes, because it’s not “the world according to Jennifer.” The third is that sources are cited and only serious research is discussed, never journalism or opinion pieces. The fourth is jokes. They may not be good jokes or anything, but E for effort.
The response has been extraordinarily gratifying. As pathologists we are not patient-facing and as such rarely engage with the public, even though we have a lot to say. Pathology social media has tended to focus on diagnosing cases and as such has a rather “closed” audience, as most people simply can’t appreciate the staghorn vasculature of a hemangiopericytoma, etc. And even though clinical doctors depend on us, we don’t often find ourselves in the limelight with our clinical colleagues. Over 40,000 people now follow my page, interact with it quite extensively, and signal- over and over again- gratitude for a clear-headed rational tone for explaining abstruse topics in an easy-to-understand manner and keeping politics out.
Another area of discussion has been strict scientific debunking of the conspiracy theory du jour. These are the posts which have attracted the most attention but also the most vitriol, including discussions of the infamous “Plandemic” video, the Bakersfield ER doctors video, the “you can’t exercise because this guy in Holland thinks you’re a COVID spray nozzle” study, etc. I’ve learned how to deal with attack mobs, and even how to give snappy TV and print media interviews. Although we in medicine might find this stuff to be absolute nonsense, the public doesn’t know what to do with the content and really, really needs guidance. The people actually running our COVID-19 response are clearly otherwise occupied and can’t spend time trawling through the comments section on YouTube, so frequently, there is no official response whatsoever.
The other angle is that it’s been incredible PR for pathology in general. Besides the public, I’ve been very active in a separate 40,000+ member Facebook group for physicians discussing COVID-19, and I have recorded podcasts and given online lectures geared towards clinical doctors (including for the American College of Emergency Physicians). They were quite literally crying out for someone to discuss the laboratory medicine issues around testing and the pathophysiology as revealed by early autopsy studies (direct quote: “Where are the pathologists?!”). Being able to basically say—"Look, isn’t pathology rad?! Look at all this cool stuff we do and know!”—has also been rather delightful.
I circle back to the “Who the heck are you?” question rather frequently. I’m not anybody, but in a way that’s exactly what has allowed me to take on this science communication angle. If I were doing original research, had access to epidemiological data, or was validating diagnostic assays, I couldn’t discuss it on a Facebook page.
So, that’s What I Did on My COVID Vacation. Thanks for reading. If you’d like to visit the page (even to hurl abuse, you won’t be the first), try the first link below. If you’d like to listen to some podcasts, the links are also below.
Jennifer Kasten, MD, MSc
Cincinnati Children’s Hospital Medical Center