Love in the time of COVID‐19

“Change is good” was the theme of an address given by Brian Napack, President and CEO of Wiley, the publisher of the American Journal Medical Genetics (AJMG), at a recent Wiley Editor Symposium in the Spring of 2019. And change is good for the AJMG as well (Muenke, 2017; Muenke, 2019). With this issue comes a change in leadership as the current Editor-in-Chief. (Figure 1) steps down from this position, which also allows a time for reflection. As part of a team of healthcare providers at the National Institutes of Health (NIH), I witnessed first-hand the suffering experienced during the active phase of the Ebola outbreak in West Africa, in Sierra Leone (November 2015) and as part of an NIH Ebola vaccination team in Liberia (August 2018). In contrast to our carefully planned work to assist with the Ebola outbreaks, most of us felt unprepared for the current Coronavirus Disease 2019 (COVID-19) pandemic. Over a quarter of confirmed global deaths (over 200,000) have occurred in the US (over 60,000 at the writing of this editorial at the end of April 2020). The personal tragedies compound the individual losses of life. COVID-19 precipitated a downturn in the global economy, with a record loss of jobs (more than 26 million have filed for unemployment in the US alone). Loss of life and loss of way of life lead to unprecedented challenges for people and society. The current situation has been compared by some to a fictional story told by Gabriel García Márquez in Love in the Time of Cholera, which was first published in Spanish in 1985 (see Figure 2). The connection between the reality of the COVID-19 in the US and around the world and the magical realism in a story set in a Caribbean Sea harbor town in Colombia is tenuous at best. There are some parallels, though: anxiety, fear, and suffering throughout the population, and the frantic search for a cure for those seriously affected by COVID19, similar to Dr. Urbino’s passion for finding a cholera cure in the book. Other similarities between the current COVID-19 pandemic and the fictional cholera outbreak described by García Márquez include personal resilience and indomitable spirit under trying circumstances...and that life after the pandemic is not the same. Many of us who work in the field of genetics regularly encounter patients and families who inspire us with their resilience and ability to face adversity. And many of us chose this field for the privilege of serving these families, helping them through difficult times, and working with them to improve outcomes and quality of life. On a personal note, I have worked with families who have a child with holoprosencephaly (HPE, supported by a group called Families for HoPE, www.familiesforhope.org) for over three decades. Many of them have taught me more about resilience through their personal example than I would have ever learned otherwise. In our fields, gains are not easy – they require great work, sacrifice, and usually take much longer than any of us would have anticipated. I do not mean to glibly compare the current pandemic to the field of genetics or imply that they are the same. But there are lessons that we can learn from both about perseverance in the face of adversity. Winston Churchill is credited with the quote, “Never let a good crisis go to waste”. Churchill was referring to the Yalta Conference in February 1945, which took place at the end of World War II. This conference involved a meeting between himself, Stalin, and Roosevelt, which led to the formation of the United Nations and created an opportunity in the midst of a crisis. While mentioning this quote may sound tone-deaf and insensitive to us now, some of the ideas may yet be helpful. The current pandemic is exposing many issues and challenges in our society. For medical fields, examples include disparities in access to healthcare, lack of optimal funding for important institutions like the Center for Disease Control and Prevention (CDC) or the National Institutes of Health (NIH), and lessons about preparedness. We also learn how important it is to care for and protect the most vulnerable – from the elderly and individuals with underlying medical F IGURE 1 Maximilian Muenke, outgoing Editor-in-Chief, photo at Weverton Cliffs, Maryland along the Appalachian Trail DOI: 10.1002/ajmg.a.61623