March 2021 marks the one-year anniversary of the World Health Organization’s official designation of the outbreak of the COVID-19 pandemic. The response of the American College of Medical Toxicology (ACMT) to the pandemic has been immediate, urgent, and continuous. In March 2020, ACMT formed a task force of ACMT/medical toxicology professionals to lead its COVID-19 response and provide technical expertise. Over the course of the year, ACMT has developed a broad body of programming and resources that serve the public by providing timely, science-based information on the medical and public health aspects of the COVID-19 pandemic.

Addressing a Need in Times of Uncertainty: Webinar Series “The Medical and Public Health Considerations of COVID-19”

Beginnings

In early March of 2020, the medical community grappled with trying to understand the multitude of physiological impacts of the SARS-CoV-2 virus and explore possible treatments. At the same time, the public looked for ways they might protect themselves from getting sick. A need for clear, fact-based information from the medical community was born from this situation.

The off-label use of chloroquine and hydroxychloroquine as possible COVID-19 treatments became an early topic of discussion and debate in the media and the medical community. As medical toxicologists -- experts in the care of poisoned patients -- ACMT was aware of potential adverse effects of these substances. In rapid response to the developing situation, ACMT leadership organized a free, open-access webinar to discuss the documented toxicities and potential risks of use of these medications for purposes other than those they have been approved for. This first webinar was broadcast as a live stream on March 25, 2020.

Due to the positive response and feedback from that first webinar, ACMT made the decision to continue the series and explore emerging issues of critical importance for the public health and healthcare community. The webinar series “Medical and Public Health Considerations of COVID-19” was created. As of March 2021, the series continues, producing between 2-3 webinars each month with an average of between 600 -1000 attendees per broadcast.

ACMT has also created a number of responsive COVID-19 resources, such as position statements, FAQs, and resource links.

Forging New Partnerships and Collaborations

The “Medical and Public Health Considerations of COVID-19” webinar series quickly became a collaborative endeavor with support and contributions from multiple national and international partner societies including:

American Association of Clinical Toxicology (ACCT), American Academy of Emergency Medicine (AAEM), American Association of Poison Control Centers (AAPCC), European Association of Poison Control Centres and Clinical Toxicologists (EAPCCT), Middle East and North Africa Clinical Toxicology Association (MENATOX), and the Asia Pacific Association of Medical Toxicology (APAMT).

In later months, the group would be joined by the American Academy of Emergency Nurse Practitioners (AAENP), Association of Healthcare Emergency Preparedness Professionals (AHEPP), and the Emergency Nurses Association (ENA).

Beginning in December 2020, ACMT and the Pediatric Environmental Health Specialty Unit (PEHSU) developed a jointly hosted mini-webinar series predominantly focusing on safer disinfectant use in the new world of COVID-19.

Content Topics, Reach, and Impact

During each webinar, subject-matter experts and practitioners -- many of whom are caring for COVID-19 patients -- present on emerging issues, provide updates on what they are facing in their clinics and hospitals, and participate in a Q&A session. Questions addressed in each webinar are curated into a COVID-19 FAQ resource page on the ACMT website.

At the one-year mark, the webinar series has produced 40 webinars and reached over 57,000 registrants, ranging from physicians, public health officials, and pharmacists to the general public. 56 plenary presenters have represented the medical and public health communities, as well as many federal agencies including the CDC, FDA, FEMA, DHS, and DEA. Although the majority of regular attendees are from the U.S. and Canada, the series has attracted registrants from 76 countries.

The series has also offered numerous “front line update” segments to share real-time experiences from healthcare professionals in 10 locations in the U.S. and 13 countries across Africa, Europe, Western and Southern Asia, the Middle East, and South America.

Over 20 specific topics have been covered over the course of the series. Many topics were revisited as updates developed in key areas including clinical and toxicologic impacts, personal protective equipment (PPE), testing, treatments/therapies, vaccines, public health, and preparedness/response.

Members of health reporting and major media outlets have attended the webinar series, including representatives from the Associated Press, Bloomberg, Forbes, Fox News, NBC News, New York Times, NPR, and USA Today.

Meeting the Moment as Medical Toxicologists: ACMT Gains Funding to Support Projects on Addiction Medicine, Adverse Reactions from COVID-19 Therapies and Vaccines

Addiction Toxicology Case Conference Expands Reach, Focus on COVID-19

ACMT had been producing a monthly webinar series addressing addiction toxicology cases since 2018. The series was originally a collaboration jointly hosted by ACMT, the University of Rochester Medical Center Toxicology/Addiction program, and the SUNY Upstate Medical Toxicology fellowship. Since its inception, ACMT Board Member, Dr.Timothy Wiegand, FACMT has presented cases and moderated discussion along with co-moderator, Dr. Gloria Baciewicz, Professor of Clinical Psychiatry, University of Rochester Medical Center, and Medical Director of Strong Recovery.

With the onset of the COVID-19 pandemic, the Addiction Toxicology Case Conference expanded when a new partnership was formed in April 2020 between ACMT and the American Society of Addiction Medicine (ASAM) to present cases predominantly focused on addiction medicine in light of the new challenges experienced during COVID-19. With this new partnership, webinar attendance numbers grew from an average of several dozen per session to several hundred.

Collaborative efforts further expanded to include a partnership with the American Academy of Addiction Psychiatry/Opioid Response Network (AAAP/ORN) for webinars presented from September 2020 through January 2021. The ACMT/ASAM partnership is planned to continue through July of 2021. The series has developed its own set of resource materials including a page dedicated to FAQs.

FDA/ACMT COVID-19 ToxIC (FACT) Pharmacovigilance Project

In the fall of 2020, the FDA awarded a contract to ACMT’s Toxicology Investigators Consortium (ToxIC) to establish a COVID-19 Sub-Registry to collect data on the safety of drug products used for the prevention or treatment of COVID-19. ACMT’s ToxIC registry is a unique multicenter toxico surveillance and research network of physicians specifically qualified in the field of medical toxicology.

The FDA ACMT COVID-19 ToxIC (FACT) Pharmacovigilance Project consists of 15 designated medical centers across various geographic regions in the U.S. Case reports include data from reports of adverse effects from treatments, including antivirals and monoclonal antibodies, to those experienced from various COVID-19 vaccines. Data reports are updated regularly on the ToxIC FACT project webpage.

ACMT COVID-19 Response Task Force Acknowledgements

ACMT would like to acknowledge the contributions of its COVID-19 Task Force members. Primary webinar organizers and moderators include: Dr. Paul Wax, Executive Director of ACMT; Dr. Ziad Kazzi, Board Member of ACMT and President of the Middle East and North Africa Clinical Toxicology Association; and Dr. Charles McKay, Past President of ACMT. Staff members include Mukta Deia (COVID-19 Response Program Manager), Adrienne Dunavin (Education Program Manager), Jessica Irving (Communications Manager), and Alex Houck (Communications Assistant.)

Special thanks to Dr. Charles McKay for his work on the webinar series’ FAQs, to Dr. Andrew Stolbach for his work on ACMT’s COVID-19 Position Statements, and Tracy Kolian (ACMT’s Director of Strategic Innovation and Funding), who worked to secure several grants to support staffing and project development for our COVID-19 response activities.