The third lecture in Massachusetts General Hospital’s Medical Grand Rounds’ COVID-19 series focused on the clinical care of acute respiratory failure and the potential for new therapies and treatment strategies. The event was cohosted by Beth Israel Deaconess Medical Center (BIDMC) and Brigham and Women’s Hospital (BWH).

Speakers from Mass General included Benjamin Medoff, MD, chief of Pulmonary and Critical Care Medicine, Jehan Alladina, MD, Division of Pulmonary and Critical Care, Taylor Thompson, MD, Division of Pulmonary and Critical Care, Jay Rajagopal, MD, Center of Regenerative Medicine, and Jason Griffith, MD, PhD, Division of Pulmonary and Critical Care.

They were joined by Richard Schwartzstein, MD, Center of Education at BIDMC, Ari Moskowitz, MD, Medical ICU at BIDMC, and Robert Hallowell, MD, Pulmonary Clinic at BIDMC and Rebecca Baron, MD, Division of Pulmonary and Critical Care at BWH.  The event was moderated by Katrina Armstrong, MD, chief of Medicine at Mass General.

Among the themes that emerged during the 90-minute event were the importance of sticking to the established fundamentals for taking care of patients in respiratory distress, the importance of identifying new biomarkers that can help to predict which COVID-19 patients are likely to worsen and the crucial role that randomized clinical trials will play in identifying the best treatments.

Below are some of the key messages that participants delivered at the event. You can also watch the full video here.

Benjamin Medoff, MD (Mass General)

“When there's great anxiety about this disease—we're worried about its course, its effect on people of all ages, and we're not quite sure how to treat it, it is very easy for us to grasp at treatments and try to do something because we feel we need to. But we should always go back to our first principles here and do what we know that works, take our time, be thoughtful about it and not rush to judgment.”

“I think that's what we're seeing is really the best medicine for these patients is sticking to what we know, protective ventilation, careful ventilation and careful care. Hopefully, as we learn more, we will be able to apply new therapies in a directed way.”

Richard Schwartzstein, MD (BIDMC)

“There are different phenotypes we're seeing in this disease, partly from different host factors, partly from the particular responses we have to this virus. As much as we're pushed to say what the right thing is for every patient, there's probably not going to be a single right thing to do. We have to avoid those traps, maintain some flexibility and continue to be great observers.”

Taylor Thompson, MD (Mass General)

“We will get through this. This is a challenging but exciting time, and we'll get back to our families, our beach, our favorite restaurant. But for now, we’ve just got to keep our heads down and keep plugging.”

Jay Rajagopal, MD (Mass General)

“There are actionable molecular targets [within the virus], and maybe this is a character flaw, but I think we've come to the point in biology where this is a subject we can tackle. We have the right cell types, we can grow them, we have the virology, we have the computational biology and we have the entire world scientific community focused on this. So I'm optimistic.”

Jason Griffith, MD, PhD (Mass General)

“We should continue with our fundamentals of science and remember that we need to be thoughtful and careful and that we already know a lot about respiratory viral infection. We need to methodically develop mouse models and animal models of this disease, in addition to studying this in patients, so we can better understand the differences and similarities to what we already know.”

Robert Hallowell, MD (BIDMC)

“I just want to thank the community [at large], because I think everybody out there is helping us do our jobs. Social distancing is hard. There are people who lost their jobs, who can't work and they're doing that to try to help us by keeping the numbers down. We really appreciate that.”

Rebecca Baron, MD (BWH)

“A lot of what helped us get to where we are now with [the HIV] epidemic was public health and patients themselves taking advice in order to curtail the spread.”

Katrina Armstrong, MD (Mass General)

“This is an incredible challenge that we will face together as a health care community, as a society, and we are all committed to working together to ensure we come out of this stronger.”