Dr. Janaki Kuruppu of Rockville is a staff clinician in the critical care medicine department at the National Institutes of Health in Bethesda and previously trained under Dr. Anthony Fauci, who heads the NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and is President Donald Trump’s top expert on the White House COVID-19 task force.
1. In what ways is COVID-19 like AIDS?
COVID-19 shares several features that marked the spread of HIV, particularly the ability of people to become infected without showing symptoms for a long time, allowing the virus to spread undetected through the population. Even now, a significant number of people infected with HIV do not know they are infected.
Just like asymptomatic SARS-CoV-2 [the virus that causes COVID-19] infected individuals, undiagnosed people living with HIV (PLWH) prevent public health efforts from eradicating the virus from circulation.
In contrast, fortunately, most people do recover from COVID-19, whereas HIV infection is not yet curable, and PLWH must take medications for life to control the virus, and prevent progression of disease to immunocompromise and death.
In some ways, the spread of HIV in the 1980s was as intense as the current spread of COVID-19. We forget that our hospital beds, prior to the advent of effective antiretroviral therapy in 1995, were filled with people dying of opportunistic infections like PCP [Pneumocystis carinii pneumonia] and toxoplasmosis. The major difference between HIV and SARs-CoV-2 is that the former spread through specific risk behaviors, whereas SARS-CoV-2 spreads more easily, and less specifically — virtually everyone in the population can acquire COVID-19, and infected individuals who get sick, become ill much faster than with HIV.
2. What else would you like readers to know about COVID-19?
There is a lot of misinformation getting circulated, and I know that the general public has difficulty sorting out what is real from the false rumors. The Centers for Disease Control has a lot of good information, and the World Health Organization has a dedicated page to myth busters.
I think people need to be mindful of their level of stress around this difficult situation and take steps to avoid getting overwhelmed or panicked. Take a walk, read a book, talk on the phone to a friend or family member, indulge in a distracting movie — focusing all one’s attention on COVID-19 is not a healthy response for most of us.
3. How did you become interested in infectious diseases?
When I was a student at George Washington University, the worst years of the AIDS epidemic were in full swing. I was struck by the devastation of HIV on the patients we took care of. When I came to NIAID to train specifically in infectious disease, I had the great good fortune to work with Dr. Anthony Fauci, among many other experts at the Clinical Center, where I came to an appreciation of the fine interplay between infecting pathogen, the host’s immune response and the complexity of treating patients.
Infectious disease is a fascinating area of medicine to work in, because it requires that the physician consider factors related to the biology of the pathogen (e.g., HIV, or SARS-CoV-2), the immune and overall health status of the patient and the environment in which the patient lives and works to figure out the diagnosis and develop the most effective treatment plan.
I am currently working on research projects to study the long-term effects of HIV treatment and complications of antiretroviral treatment.
4. How does Judaism affect the way you view your work and life?
While I am dedicated to science and evidence-based medicine, I am at heart a deeply religious person. I think Judaism strongly influences my sense of ethics, respect for human dignity and autonomy, justice in allocating resources, especially when those resources might be scarce. I have also found that because I am religious, I can relate to my patients who find comfort in religion, even if it’s not Judaism. When I see patients struggling with their diagnosis or with stress in their lives, it is natural for me to ask them if a visit from the chaplain would be helpful. Even just talking on religious terms can add a dimension to the patient-physician relationship.
Suzanne Pollak is a Washington-area writer.