CM. A Review of Annals of the National Academy of Medicine. 12/30/2020

Rafael Rangel-Aldao, Editor

The Electronic Yearbook 2020 registers in a single volume the publications of the National Academy of Medicine in three main categories, Medicine, Surgery, and Science, which appear in the Caracas Medical Gazette, CientMed, Covid-19, the Razetti Collection, and the Monthly Bulletin. This is a recount of the pandemic through the 21 CientMed Synopses, the Covid-19 Section, and the two Supplements of the Caracas Medical Gazette. In addition, there are the four issues of volume 128 of this centennial magazine, the Monthly Bulletin, all the Zoom Sessions and their links to the respective YouTube channel, Books, Speeches, and Press Releases, which for the first time bring together the plethora of knowledge that each year manages the National Academy of Medicine. The Electronic Yearbook through the Digital Portal reached 12,241 users in 972 cities and 81 countries on five continents, with 32,799 views of the publications of the National Academy of Medicine. A curious fact of the geographical extension of our audience was the reach to remote cities such as Bator in Mongolia, Tbilisi in Eurasia (Georgia), Cotonou in Benin (Africa), and Varna in Bulgaria, among other remote cities.

A year of great revelations of a pandemic that left the world in disarray, with little political and social preparation, from advances and setbacks, trials and errors, and very little memory of previous pandemics, at a high cost driven by the individual supremacy over the collective interest. The Covid-19 equally exposed the failures and successes of suboptimal systems of public health care, without distinction of rich or poor countries; and in the same way, the Covid-19 demonstrated that there is a direct relationship between human well-being and economic prosperity.

The most advanced countries showed live and direct, their sway of its corresponding public policies of containment and mitigation, with some being ineffective and others not very successful, with the single exception of those who used scientific knowledge as an expeditious way to control the pandemic. Science provided the solutions with extreme acceleration, and proof of this was that in just five days, from 10 to 15 of January, it was possible to advance from the genomic sequence of the virus that causes Covid-19, SARS-CoV-2, to design a successful mRNA vaccine, in just a few months, by the end of the year when it reached the rigorous regulatory approval. The + 95% efficacy of a safe vaccine, which became possible through the application of frontier sciences, was published on 11/16/2020, based on the atomic-scale structure of the viral spike. As if that were not enough, the scientists were able to decipher, through genomic engineering, the best way to produce and expose the most vulnerable surface of this viral protein, produced by human cells, and making it prone to the attack of a variety of neutralizing antibodies to avoid future resistance to mRNA-based vaccines. Similarly, the use of deep immunology allowed vaccinologists to find the best formula to stimulate the immune system of vaccinated people. The use of systems medicine filled the gap in how to understand and formulate smart and timely therapies for this multi-organ disease.

Now, in the middle of the vaccination campaign in several countries of America, the European Union, the United Kingdom, Asia, and Oceania, there seems to be unequal access to vaccination programs in the most vulnerable countries of Africa, and also in our own region, Latin America, although the respective vaccination campaigns are already underway in Mexico, Chile, Costa Rica, Argentina, Colombia and, soon, Brazil. Synopsis 21 can be found on the pages of the Electronic Yearbook, which explains how it is possible to solve this possible inequity in vaccination throughout the world, at least in part.

Another interesting fact that Covid-19 revealed, was the immediate response of the scientific establishment to the dissemination of information in real-time and without cost barriers unattainable for most researchers. Since the beginning of the year, an innovative and fast way of producing scientific publications emerged, the so-called preprints, that is, research papers with important information, published immediately without first filling the indispensable requirement of peer review, which would be done at a later date. Key to this was global philanthropy that would cover the costs that made free online access possible. There it is worth mentioning medRxiv supported by philanthropic organizations such as the Chan Zuckerberg Initiative in consortium with the BMJ, Yale University, and Cold Spring Harbor. Access to leading journals changed for the benefit of the entire scientific community in the world, so the advent of Covid-19 turned it into a free service to the medical community. Thus, overnight, it was possible to freely download articles from leading journals such as NEJM, Lancet, BMJ, Science, Nature, Cell, JAMA, among others previously unreachable for many in Venezuela. The frequency of publications was also adjusted to the rate of Covid-19, from weekly to daily, with express and free newsletters to subscribers by email.

The major international press echoed the changes, and immediately adopted a structure similar to the scientific one with the increase of technical information, well explained and better illustrated in newspapers such as The New York Times, Washington Post, Le Monde, The Guardian, El País, among others, as well as in global magazines such as The Economist, Time, Atlantic and Foreign Affairs. Social media became a source of science news with Twitter, and influencers of the caliber of Eric Topol, and Nicholas Christakis, among a group of leading researchers with hundreds of high-impact publications. Scientific journals such as JAMA, NEJM, and Medscape also increased the frequency and content of video interviews, with key scientists such as experts in infectious diseases and vaccines, including Anthony Fauci of the NIAID, and the respective directors of the WHO, FDA, or members of advisory committees of regulatory institutions in the United States and the European Union. But not everything was beneficial, social networks also became disseminators of conspiracy theories about the origin of SARS-CoV-2, as well as an anti-vaccination campaign, and bizarre explanations of the supposed science behind these important advances against the pandemic.

In Venezuela, meanwhile, the academies adopted a courageous and determined attitude to explain the pandemic and its consequences, as well as developing mathematical models that were correct in their projections about the extent of confirmed Covid-19 cases. The Electronic Yearbook in its Medicine section, collects the articles, press releases, webinars, sessions, and modeling of the Acfiman, for example, on Covid-19 in the country. Similarly, the CientMed editorials were combined with the two Supplements of volume 128 of Gaceta Médica de Caracas, and with AsoVAC symposia, to expose the progress and setbacks of the pandemic in Venezuela and, consequently, provided the corresponding scientific explanations as guidance to the country’s health care community. In fact, the note that individually captured the largest audience of the Digital Portal was the scientific response to the presidential announcement of 10/26/2020, about a plant extract, DR10, with in vitro activity against SARS-CoV-2. Second, there was the publication of the Portal on the inter-academic forum, Impact of Covid-19: Vision of the Academies, on 05/13/2020. Third place was held by Supplement 2 and its 22 articles from volume 128 of the Caracas Medical Gazette, dated 12/15/2020.

The 2020 Yearbook also records the main innovations of the Digital Portal of the National Academy of Medicine, where, in addition to the Covid-19 section, and of the Yearbook itself, the electronic journal CientMed, a high-frequency publication, with daily broadcasts through from editorials, with weekly and monthly abstracts (Synopsis), scientific articles by invitation, in English, with peer review, free access, and without printing costs for the authors. The primary objective of the journal is Research, Dissemination, and Updating of topics on the biomedical frontier, in fields such as genetic editing, omics, intestinal microbiota, circadian rhythm, artificial intelligence, digital medicine, telemedicine, virtual reality, augmented reality, and robotic automation, among other translational and/or precision medicine technologies.

CientMed also deals with humanistic and historical issues of medicine and is linked by hypertext to the content of the other sections such as editorials, and articles from prestigious national and international journals in areas, and authors of interest for the training and updating of Venezuelans in the medical sciences. These, include direct links to pre-prints and electronic databases such as PubMed, dashboards, and the National Library of Medicine. The journal also publishes interviews, international video conferences, Academy webinars, critical reviews, clinical cases, and advanced methods of biomedical and epidemiology research. The impact on the audience in five months since the first issue of CientMed came out, managed to accumulate the highest number of queries from the Digital Portal during 2020 (3,250 readings), followed by the Gaceta Médica de Caracas (3,222) and Covid-19 (1,615).

Through the Synopsis Covid-19 and the article The Year in Review referred to in the Electronic Yearbook, it is possible to reconstruct the main events that filled the attention of this traumatic and sobering year for humanity. The Electronic Yearbook will remain as a historical record of the National Academy of Medicine, on the great scientific advances of 2020 in the fight against the virus and the pandemic.