PRESIDENT'S COLUMN

Read archives from AAN Past President Orly Avitzur, MD, MBA, FAAN, who served from May 2021 to April 2023.

September 2021

Neurology in the Time of COVID-19

After 10 years of working at Consumer Reports, first as a medical advisor and later as medical director, I acquired advocacy in my blood. Campaigning on behalf of consumers to ensure access, safety, and equity in health was infinitely rewarding. So, when my division at Consumer Reports was sunsetted in 2018, and I began contemplating the next steps in my professional career, I was drawn to our mission-driven organization, the AAN, and the opportunity to serve in its leadership. For two decades, I had worked as a volunteer in the Medical Economics and Management Committee and witnessed firsthand how members could harness the power of their knowledge and experience to influence regulatory and legislative changes that preserved and enhanced the professional lives of our members and ensured quality care to our patients.

My journey as an advocate is far from unique in our field. The more than 700 volunteers who work on AAN committees—not just Advocacy, but Education, Science, Quality, Medical Economics and Practice, and more—do so because they too have a desire to effect change. They ask not what others can do for them but what they can do for others. They rise up in crisis and meet it head on. They spend their free time on initiatives, programs, and efforts, together with staff, to enhance your career well-being and to promote the highest quality care for your patients. They take on issues such as fair reimbursement, administrative burdens like prior authorization and step therapy requirements, telemedicine, drug affordability, neurologic research dollars, and health care disparities, among others. Although every specialty has its advocates, in neurology, they are so dedicated, so tenacious, and so impactful that a tiny organization like ours is often recognized as the leader on national as well as local platforms.

It came as no surprise that as the sudden and horrific appearance of COVID-19 shut down our practices, closed research labs, canceled our educational and scientific meetings, and threatened our future, neurologists were at the forefront of advocacy. Health care disparities present in our society became increasingly glaring, so as the pandemic unfolded and later, as vaccines became available, a cadre of neurologists went to work. They created informational videos, spoke in their communities, gave vaccines, and answered countless questions from people with doubts.

Kiran T. Thakur, MD, who is the Winifred Mercer Pitkin, MD, Assistant Professor in the department of neurology at Columbia University and inpatient neurologist and director of the program in neuroinfectious diseases, was concerned about the hospital's predominantly Latino community in Washington Heights and Inwood, which has been hit hard by the pandemic. When vaccines were offered at the Armory Track & Field Center, she joined others from New York-Presbyterian Hospital in administering them and lent her voice to the “Roll Up Your Sleeves New York” campaign by video. In her department, she pushed for routine vaccine histories so inpatients could get vaccinated prior to discharge, and she volunteered with others to receive professional training in effective dialogue methods to combat vaccine misinformation.

Charles C. Flippen II, MD, FAAN, vice chair for education in the department of neurology at the David Geffen School of Medicine at UCLA, who joined the Los Angeles department of public health community ambassador program earlier this year, was recruited by his high school friend Kerry Neal, founder of KeepingIt100. The organization, which had held programs discussing relationship challenges within the Black community, pivoted to holding webinars about COVID-19 and vaccination hesitancy last summer. Dr. Flippen, who serves as treasurer for the AAN, answered questions about the vaccine along with other panelists, addressed the disparity in infection rates, and tried to motivate the audience to engage with their primary care physicians and adhere to public health guidelines. Los Angeles, which is currently undergoing another surge due to the delta variant, is in crisis. “We can’t stop trying because the stakes are too high and the responsibility for getting the word out is still there,” he explained.

Omar A. Danoun, MD, a senior staff neurologist and epileptologist at Henry Ford Hospital in Detroit, took to social media to answer questions about the vaccine. He created a series of videos for YouTube in both Arabic and English covering vaccine designs and safety that have garnered over 300K views, and gives lectures to people in Detroit, which has large Black and Arab American communities, promoting vaccines.

A PGY-3 at NYU Langone Medical Center when the pandemic hit, Amadou Camara, MD, contacted the Senegalese association in New York to ask if he could be of help. He took part in radio shows presenting updates on the status of COVID-19 and answered questions on prevention and treatment. More recently, he attended meetings to discuss the safety and efficacy of the vaccine by another association which gathered representatives of several West African countries, as dissenting opinions were voiced about whether the vaccine is permissible in Muslim and other communities. Now a clinical neurophysiology-EEG fellow at Duke University Medical Center in Durham, NC, Dr. Camara said, “I understand that representation matters, and that was my biggest factor in reaching out. I presented myself to them as a member of the health care community and spoke with them in our native language, which helped established good rapport.”

Olajide A. Williams, MD, professor of neurology and associate dean of community research and engagement at Columbia University, is founder and board chair of Hip Hop Public Health, an organization that works with iconic hip-hop influencers and uses art, music, and science to promote healthy behaviors, health literacy, and health equity. “During the pandemic, mistrust in communities of color was energized by misinformation in social media,” he said. Striving to improve vaccine literacy, he helped organize Community Immunity, a collection of five animated rap songs, with veteran producer Artie Green, singer-songwriter Gerry Gunn, and hip-hop legend Darryl McDaniels, better known as DMC. A vaccinologist ensured the scientific accuracy of the lyrics and each verse addressed specific questions—what are vaccines; how do they work; are they safe; what to expect, and more. The results? Half a billion media impressions across the globe, including “PBS NewsHour,” “Entertainment Tonight,” and Vanity Fair.

As variants continue to rise and cases of breakthrough infection become more prevalent, many of us are considering the existential question of what it means to be a neurologist in the time of COVID. These five neurologists, and others like them, have already found the answer.

Orly Avitzur, MD, MBA, FAAN
President, AAN
@OrlyA on Twitter