Alasdair Munro: Communicating Risk

In the clinical work I do in urgent care pediatrics, most of the kids I see come in with an injury or an infection – a fever, cough, runny nose, GI symptoms. That means that – as is the case for many pediatricians – so much of what I do revolves around diagnosing infections and counseling families about them. It’s often routine work, but it has its challenges. The most difficult thing, I think, is seeing parents who are desperate for relief, exhausted from a few sleepless nights with a sick, crying child, and having to tell them that their child isn’t in danger, that nothing more needs to be done, and that this too, shall pass on its own. That disconnect between the distress – which I too have felt as a parent – and the routine nature of these illnesses, is tricky to navigate.In the last few months, and in particular this past Fall, it seems all of society and much of the news cycle in Canada and the US turned its attention to childhood infections. With an extraordinary wave of RSV and then influenza, pediatric emergency rooms and hospitals were overwhelmed with sick patients. Coming in the midst of the Covid pandemic, this wave of viral infections had health systems reeling. In Canada, shortages of medications like common antibiotics and pediatric formulations of ibuprofen and acetaminophen compounded the sense of chaos and of a breakdown in health services. 
All that has now passed, but I wanted to revisit those events and talk a little about what happened. My next guest is someone I’ve come to trust on this subject for his abilities as a communicator. 
Alasdair Munro is a senior clinical research fellow in pediatric infectious diseases at the UK National Institute for Health and Care Research (NIHR) in Southampton, England and a medical doctor. He’s currently a senior trainee in pediatrics working in pediatric emergency medicine. During the pandemic he led the live evidence review of COVID-19 in children with the Royal College of Paediatrics and Child Health while running a number of different COVID-19 vaccine clinical trials. He also sat on The Lancet commission on COVID-19 (safe work, travel and schools) as well as the NIHR working group for the study of transmission of COVID-19 in schools. 
Alasdair’s gained a large Twitter following, and his substack newsletter, the Munro Report, is widely shared. Whenever I read Alasdair, I feel he captures the way I and most pediatricians I know think, about covid, other infections, and pediatrics more broadly. We cover all of that in our conversation, and I hope you enjoy it as much as I did. 
Although I never provide medical advice on this show, since this episode is about my area of clinical expertise, I wanted to make it extra clear that nothing in the following discussion should be construed as direct medical advice to you or a child you know. For those questions, you should see a health care provider yourself. 
And now, here’s my conversation with Alasdair Munro.


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Links:
Alasdair's newsletter
Alasdair's Twitter: @apsmunro
Don't Forget the Bubbles (pediatric evidence review site)
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Recorded February 9th, 2022
Music: Mr. Smith
Art: Jeff Landman
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