April 2020

I sincerely hope that you and your families are, and stay, safe. Many of us are now several weeks into this crisis, and it is not hyperbolic to say that life has changed drastically, even for those who are not directly on the front-line. I have enormous admiration for the many ANA members who have stepped up to volunteer for new roles as bed-side clinicians, intensivists, virtual teachers, and COVID-19 researchers. I was moved by a recent perspective piece on volunteerism by Dr. Suzanne Koven in the NEJM and encourage each of you to read it: “They Call Us and We Go.”

I would like to address some of the impact of the pandemic on academic neurology, and how ANA, in collaboration with NINDS, AUPN and AAN, is trying to help our colleagues across the country.
 
• The neurological complications of COVID-19 are still being described, and we can anticipate unusual central and peripheral nervous system disorders to emerge in survivors. Increased cases of GBS, critical care polyneuropathy, functional decline after prolonged ventilation, and cognitive dysfunction will all need our attention, and further research1. The European Association of Neurology has developed a registry for COVID-19 neurological complications:

https://www.eanpages.org/2020/04/10/ean-survey-neurological-symptoms-in…

 
• The disruptions from COVID-19 will likely affect the careers of many neurology researchers, however, we can anticipate the greatest impact on early-career scientists. The ANA’s membership committee, led by Elizabeth Silberman and Eric Landsness with Michelle Johansen, are planning a series of podcasts and webinars to facilitate “research resilience”. A useful summary of the issues is presented in Science News2.

• All of us are now engaged with teleneurology, and recognizing the benefits and the limitations of this platform. Many ANA members are developing new methods to perform and quantify elements of the neurological examination in a televisit. Sharing best practices will be key as we can anticipate that teleneurology will continue even after the pandemic wanes.

• Much has been written about the disproportionate impact of COVID-19 on people of color, and underserved populations. This will only become worse as we see the infection spread into regions of the country that have limited healthcare facilities3. We need to ensure that ALL our patients can receive the neurological care that they need, whether it is in person or via telemedicine. Obviously, telemedicine is only a feasible option for people with an internet connection and an appropriate device.
 
• Our educational processes have also been disrupted, both medical and graduate students, and for residents and fellows. This disruption is likely to persist if application dates for ERAS/fellowships get extended. Again, sharing best practices for remote education will be key. The AAN Education committee have done a great job here, and are using this opportunity creatively to develop innovative techniques, many of which will likely continue after COVID.

Thank you all for what you are doing. Thank you for the encouragement and help that you have given to our colleagues in Medicine and Emergency Medicine during this challenging time.

 
Stay healthy.

Justin C. McArthur, MBBS, MPH
President, American Neurological Association
John W. Griffin Professor of Neurology and Director, Department of Neurology
Johns Hopkins Medicine