key: cord-0786775-tm8yl4q1
authors: Muenke, Maximilian
title: Love in the time of COVID‐19
date: 2020-05-19
journal: Am J Med Genet A
DOI: 10.1002/ajmg.a.61623
sha: d840e38630467e583d670d3efd33f0a14ad3837c
doc_id: 786775
cord_uid: tm8yl4q1

nan

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 COVID-19, 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 circum-stances…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 easythey 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 vulnerablefrom the elderly and individuals with underlying medical conditions to healthcare workers, grocery staff, and delivery drivers, to name just a few. I think it is fair to say that none of us would have wanted to learn these lessons in such a hard way, but perhaps we can apply knowledge we gain from facing the current challenges to improving society and helping more people.

Other lessons learned during the COVID-19 pandemic for medical genetics practice include the utility of telemedicine, which until now was largely used only for patients in remote locations, but which may well become the new norm after being employed successfully while patients, their families and healthcare providers are isolated at home. Likewise, the use of distance learning -from high-school through college and beyondhas skyrocketed as students and teachers are home-bound. As an exam- Change can be good for the Journal as well. Some changes have been outlined previously (Muenke, 2019) and include international additions of experts in the field, with more colleagues from around the world appointed to the editorial leadership team of the AJMG. As the field of genetics impacts more areas of science and medicine, the goal of my successors will be to continue to expand the clinical, scientific, and demographic diversity of this dedicated and passionate group to ensure that important topics are examined from a variety of lenses, and in ways that will resonate with an even broader audience.

In a similar spirit of globalization, the AJMG was the first to publish an entire series on children and adults with common genetic syndromes from geographical regions that have been thus far underrepresented in the literature and which may be underrecognized by healthcare professionals (Koretzky et al., 2016; . The first of these articles, which was followed by many others, studied individuals with Down syndrome (Kruszka et al., 2017) . A new series of case reports has been added to the AJMG: Case Reports in Diverse Populations (Girisha, Wonkam, & Muenke, 2018) , focusing on less common genetic conditions that are not well delineated in non-European ancestries.

An expansion of the scope of articles also includes papers that expand the phenotypes of congenital genetic disorders to prenatal and adult descriptions: Genetic Syndromes Prenatally (planned) and

Genetic Syndromes in Adults (Slavotinek & Muenke, 2019) . The goal of this expansion was to ensure that the AJMG can be true to its roots, but also that it can evolve, reach, and be relevant to a wider readership than ever. Last but not least, we have published a small number of articles to date in the new series: Beyond the Double Helix Wiley. Last, but not least, a sincere thanks goes to the many friends of the Journal -the authors and readers -for their continued support, as they, like me value the American Journal of Medical Genetics simply as the best journal in medical genetics.

The author is grateful to friends and colleagues who generously gave their time to discuss ideas for this Editorial.

F I G U R E 2 Book cover of the original publication of "Love in the Time of Cholera"

Here and now: ancient cauterization and developmental delay

Case reports in diverse populations

Towards a more representative morphology: Clinical and ethical considerations for including diverse populations in diagnostic genetic atlases

Down syndrome in diverse populations

Standing on the shoulder of giants

Onward and upward

An electronic atlas of human malformation syndromes in diverse populations

Medical genetics education in the midst of the COVID-19 pandemic: shared resources

Introducing in AJMG Part A: Genetic syndromes in adults