An Open Letter to Gay Men on COVID-19 from 205 Gay Physicians

July 29, 2020
An Open Letter to Gay Men on COVID-19 from 205 Gay Physicians

To our fellow gay men,

It's time we reach out to you.

In recent months, we have watched our friends and families repost on social media "news" articles, YouTube videos, questionable websites and other sources on the topic of the Novel Coronavirus 2019, also called SARS-CoV-2, the virus that causes COVID-19 syndrome. This last week [NOTE: Week of July 10, 2020], we watched our Facebook and Twitter feeds explode with conversation responding to images of large gatherings of gay men on Fire Island and other common "gay" destinations over the 4th of July weekend. These men appear to be ignoring recommendations for social distancing and not wearing facemasks during the current pandemic. We feel it is our duty as physicians who are also gay men to write this letter to address the pandemic as it relates to you, our fellow gay men.

We will use "COVID-19" in this letter to refer to the SARS-CoV-2 virus as well as the syndrome it causes for the purpose of simplicity.

Before we go further, however, we want to recognize COVID-19 has affected all groups under the LGBTQIAP+ rainbow as well as cis-gender heterosexuals. But it has not affected all demographic groups the same, particularly in the United States. COVID-19 has disproportionately affected the Black and Latinx communities compared to other racial groups, as well as people with lower incomes. Trying to address the multitude of health disparities this pandemic has highlighted cannot be done in one letter, and we feel attempting to do so would do those communities a great disservice. Medicine is guilty of many of the race-related and societal problems brought forth by the Black Lives Matter movement. Doctors and other healthcare professionals still have a great deal of work to do to better care for these communities and populations.

That said, we would like to share the following based on our experience in medicine. We want you to know:

1. COVID-19 is real.
The first case of COVID-19 in the United States was identified in January of this year. As of the date of this letter, there are over 3 million total confirmed cases of COVID-19 in the U.S., which is roughly the size of the entire population of Puerto Rico. COVID-19 has killed over 135,000 Americans. These are confirmed infections — we are not incentivized to attribute a patient's death to COVID-19 if the diagnosis is not confirmed with laboratory studies. This pandemic is real, and we are very concerned about it.

2. Otherwise healthy people are at risk for infection, death and long-term health problems because of COVID-19.
Older adults and people with underlying health conditions are at greatest risk of dying from this disease or having severe health complications. But younger people (middle-aged and younger adults) are not immune to death and severe debilitation from COVID-19. Even in children with COVID-19 some develop severe COVID-19-related illness called multisystem inflammatory syndrome.

For instance, in a recent report printed in the Journal of the American Medical Association (JAMA), over 16,000 patients in the Northern California Kaiser Permanente health system were tested for COVID-19 in March 2020. 1299 tested positive, and about 500 of those patients were admitted to the hospital. A quarter of the admitted patients were under the age of 50.

When we discuss underlying health conditions, many people envision advanced cancers, heart disease, dementia and other diseases with high rates of mortality on their own. However, most of the underlying conditions of patients requiring hospitalization are common in younger demographics. Another study out of JAMA looked at 5700 New Yorkers hospitalized with COVID-19. Like Northern California, roughly a quarter of these patients were under the age of 50. Over 56% had underlying high blood pressure, 9% had asthma, and 84% had never smoked a cigarette in their life. There are, however, many serious and even fatal cases in people with no prior medical history.

It is important to realize that having an underlying health condition does not mean you are imminently dying. People with underlying health conditions, such as diabetes, high blood pressure, heart disease or cancer, live normal lives. Many of them may not even know that they have an underlying illness at all. However, COVID-19 infection can cause a rapid, tragic death in these susceptible populations.

We do not yet know enough about COVID-19 to predict who will get sick and who will die. Even if you are fortunate to be asymptomatic or only mildly ill from COVID-19, you may easily pass it on to someone you love or a stranger who will die, regardless of your intentions.

3. We do not fully understand the long-term effects of COVID-19; however, they can be very serious.
Death counts dominate much of the public discussion around COVID-19, and yet it is too soon to understand the intermediate and long-term effects experienced by COVID-19 survivors. It seems apparent that there will be long-lasting health consequences of COVID-19 for some. We are seeing neurologic impairment from large strokes, even in young people without other symptoms. Others develop chronic lung damage requiring long-term dependence on a ventilator (breathing machine), cognitive impairment, and/or blood clots resulting in the need for limb amputation.

People with chronic diseases who survive COVID-19 are at high risk of worsening health, even if they had a mild case of COVID-19. As a result, COVID-19 can yield significant deterioration in quality of life after surviving infection.

4. We are only just beginning to understand what medications may be effective against COVID-19.
There are no FDA-approved therapies for treatment or prevention of COVID-19.

Over the last five months, there has been an avalanche of information about possible treatments in the press and scientific literature; there are ~800 active studies of treatments related to COVID-19 on, a federal registry required of all clinical trials. It is important to remember that information is in constant flux. Here's what we know:

Remdesivir (Veklury) , a drug used to treat HIV, may shorten the time it takes for symptoms to resolve and may reduce the risk of dying from COVID-19. Much more research is needed to better understand who might benefit from this medication.

Hydroxychloroquine (Plaquenil) received attention in the media and from politicians. Because of the severity of rare side-effects and lack of evidence of therapeutic benefit, national guidelines now recommend against its use for treatment of COVID-19. Additionally, there is no evidence that hydroxychloroquine is effective as a preventive agent, either.

There are additional medications that may be effective in some situations, like tocilizumab (Actemra), dexamethasone (a common corticosteroid), and convalescent plasma from COVID-19-recovered donors, all for people with severe COVID-19 admitted to a hospital, and more research is still needed.

5. There is no definitive evidence that HIV and HIV PrEP medications are protective against COVID-19.
Many gay men are prescribed emtricitabine/tenofovir disoproxil fumarate (also known as Truvada, or simply, PrEP) as pre-exposure prophylaxis to help reduce the risk of HIV transmission to HIV-negative individuals. Truvada is part of a class of medications known as antiretrovirals. These medications are also used to treat people infected with HIV.

A recent study of more than 75,000 HIV-positive people in Spain showed an apparently lower risk of getting or being hospitalized with COVID-19 for those people taking Truvada over other antiretrovirals. However, the study did not account for the underlying reasons that people might be on one anti-retroviral versus another, which may also affect their risk of getting COVID-19. Further, in evaluating studies, we always use great caution against assuming results in one population (here, people with HIV) would be seen in another population (people without HIV).

In other words, there is no conclusive evidence that Truvada will prevent COVID-19 and clinical trials are needed.

6. Continue to social distance, wear a facemask, wash your hands, and seek medical aid if you feel ill.
Let's be honest: adjusting your daily routines and habits to help slow the spread of COVID-19 is frustrating and annoying for all of us, but it should also not be considered optional.

Continue to social distance:
It is understandable that many of us have strong urges for increased socialization after months of isolation, especially as temperatures rise in many parts of the country. Several men within our community were upset by the images of large social gatherings on the 4th of July, not only for the risks that attendees posed to the vulnerable members of our community, but also to our family and friends outside of the gay community.

We strongly recommend continued social distancing whenever possible. Studies have shown it is possible to spread the virus even before your symptoms develop, or even if you are asymptomatic and never develop symptoms at all. Several states that have reopened are now seeing spikes in not only positive tests, but also hospitalizations, including the filling of intensive care units. This phenomenon cannot be attributed to increased testing alone. There is still great concern that asymptomatic people who feel well are spreading COVID-19 to vulnerable people.

Even small gatherings pose a risk. This is particularly true if you spend time with multiple different small groups, which increases your risk exponentially. Just because you know a person does not mean that you know all of that person's social and casual contacts. Encounters with the people you see regularly, like roommates or family members, come with renewed risks in every new encounter, and it is up to each of us to mitigate those risks.

This advice applies to your sex life, too. The more partners and encounters you have, the higher your risk of COVID-19. We refer you to the New York Department of Health's Safe Sex and COVID-19

Wear a face mask:
COVID-19 is a respiratory-born illness that you contract primarily through your mouth and nose, which is why it is imperative to wear face masks or other facial coverings when around others who also should be wearing masks. Masks are safe to wear, even with severe, underlying respiratory illness, like asthma or allergies. The mask needs to cover both your nose and mouth. Anatomically, our nasal passages and mouth meet to form the oropharynx, which then leads down to the trachea and ultimately the lungs. The mask you are wearing is rendered useless if your nose is exposed.

And contrary to what many people are spreading on social media, face masks do not pose a risk to your health. Our heart, lungs and kidneys work together to keep our bodies' levels of oxygen and carbon dioxide in balance. A mask will not interfere with this process. Further, you cannot get sick by breathing in your own "fumes" — if you're already infected, breathing in your own air will not make you more prone to getting sick.

It can be hard to be the person who asks others to mask up, but this is a time for leadership. A concern for others should be our guiding principle.

Perform frequent hand hygiene:
We also strongly encourage the frequent use of hand sanitizer and especially hand washing. The COVID-19 virus can affect nearly every organ in the body, including our digestive tract. Unfortunately, and disturbingly, fecal matter is virtually everywhere, and hand washing is the best way to clean your hands of it.

If you feel ill, contact your doctor or call 9-1-1:
Finally, if you are feeling ill, contact your doctor or local health department to be evaluated and possibly tested for COVID-19. Symptoms include fever, coughing, shortness of breath, nausea, vomiting, diarrhea, fatigue, body aches, nasal congestion, sore throat, headache, and loss of the sense of taste and/or smell. You may have several or just one of these symptoms if infected, or even none. Access to lab tests vary, and we wish we could test everyone who wants to be tested. Please understand that your healthcare provider may not be able to obtain a test for you. For the same reason, emergency departments may also not be able to test patients if they have only mild symptoms.

Seek immediate medical attention via 9-1-1 or your nearest emergency room if you are having trouble breathing, blue coloration to your lips or face, persistent pain/pressure in your chest, confusion, severe or sudden onset headache, slurred speech, drooping of your face, dizziness or weakness in your extremities. Extreme fatigue and dehydration are also concerning.

7. Face masks are safe even while exercising indoors.
Exercise is good for endorphin generation which leads to improved self-esteem, better coping skills, and disease reduction. The health benefits of exercise are numerous, and for many, exercise is also a way to socialize.

Unfortunately, there is an unfounded belief among some people that wearing a cloth facemask will endanger their personal well-being while exercising. Are they uncomfortable? Yes. But there is zero physiological basis to believe this practice can lead to toxic levels of carbon dioxide in the body.

A facemask will not protect you from contracting the virus, but it will aid in curtailing your moist air droplets, with any adherent infectious agents, from infecting others, particularly those also wearing masks. During exercise, your respiratory rate and volume go up, increasing your release of droplets/aerosolized agents. We applaud establishments that are doing things like requiring masks, checking temperatures, limiting entry and lowering class sizes. Use your best judgment to do the things you enjoy.

8. The COVID-19 pandemic has profoundly impacted many people beyond its immediate health effects.
For many, COVID-19 has caused significant distress due to social distancing, restrictions on businesses being open, disruption in financial income, political concerns and a multitude of other reasons. These disruptions to normal life affect both physical health and wellness, with potential for repercussions long-after the pandemic is over. Like you, our lives have also been disrupted, and we want the pandemic to end as soon as possible.

Perhaps with a few exceptions, we who sign below are not economists, business experts, or politicians. We are all physicians. Among us are diverse experts in the diagnosis and treatment of disease with extensive training in human biology and pathophysiology, microbiology, immunology, epidemiology, public health, pharmacology, and performing (and critically evaluating) scientific research. By signing below, we attest to the information in this letter.

As members of your community, we implore you to reduce the spread of COVID-19. We ask that you be considerate and supportive of the people around you. Be critical of what you read and hear, and try to ensure your information is coming from reputable sources. And when in doubt, we hope you will defer to us, we who put our own health and the health of our loved ones at risk treating people with COVID-19. By June 6, 2020, over 600 US healthcare workers died from this virus, a number that is undoubtedly significantly higher today.

We will continue to better understand and combat this disease on our end so that you can keep yourselves, your loved ones, your community and society safer. We wish you great health, and we ask you for your trust and faith in our efforts. And when you need us, have no doubt that we will be here for you.

Wishing you good health and with great sincerity, we sign this letter to you,
Michael Casner, MD, MA, Emergency Medicine, Kansas City MO — Peter M. Sadow, MD, PhD, Head & Neck Pathology, Mass General Hospital, Harvard Medical School, Boston MA -?Christopher Woodrell, MD, Hospice and Palliative Medicine, New York NY -?Jay Wong, Medical Student, Baldwin NY -?Michael Petrus-Jones, DO, MPH, Pediatrics, Houston TX -?Peter Tomaselli, MD, Emergency Medicine Philadelphia PA -?Eric Kaiser, MD, PhD, Neurology, Philadelphia PA -?Adnan Karavelic, Pathology, Corner Brook, Newfoundland CANADA -?David Goodyear, MD, OB/GYN, Chicago IL?- Daniel W. Hicks, MD, Psychiatry, Washington DC?- Benjamin Gardner, MD, Emergency Medicine, Omaha NE -?David Rowen, MD, Medical Officer, Sydney, New South Wales AUSTRALIA -?Ross Gaudet, MD, Anesthesia Critical Care, San Francisco CA?- Connor Ratchford, MD, Washington DC?- Lawrence E. Fried, MD, Pediatric Neurology, Epilepsy, Philadelphia PA -?Ron Balassanian, MD, Pathology, University of California San Francisco, San Francisco CA -?Nicholas Orozco, MD, MS, Emergency Medicine, Los Angeles CA — Bryan Knight, BSc, MB, ChB, M Med Path, PhD, FRCPA, FIAC, Pathology, Wollongong, New South Wales AUSTRALIA — Derrick Nitsche, MD, Emergency Medicine, New York NY?- Abdallah Karam, MD, Internal Medicine, USA -?Zach Spoehr-Labutta, MD, Pediatrics, La Grande OR — Adam Weeks, DNP, FNP-BC, Family Practice, Longview WA?- Ken Sutha, MD, PhD, Pediatric Nephrology, Menlo Park CA?- Gregg Helland, MD, Emergency Medicine, Atlanta/Chicago/Boston — Adam Safdi, MD, Nephrology, Reno NV — Ludwing Salamanca, MD, PhD, Psychiatrist, New York NY -?Philipp Hannan, MD, Emergency Medicine, Emergency Medical Services, Tucson AZ -?Tyler Scoresby, MD, Otolaryngology, Arlington TX?- Erick MelĂ©ndez, MD, Psychiatry, New York NY -?P.J. Tiberio, MD, PhD, Pulmonary and Critical Care Medicine Pittsburgh PA?- Ryan Stork, MD, Physical Medicine & Rehabilitation Houston TX -?Paul G. Stevens MD, Radiology, San Francisco CA -?Corey Tapper, MD, MS, Internal Medicine, Washington DC?- Erick Ducut, MD, Psychiatry, San Francisco CA?- Gregg Cohan, MD, Pulmonary/Internal Medicine, Long Beach CA -?Matthew Truesdale, MD, Urologist, Clearwater FL -?Brian Thomas Fletcher, MD, Emergency Medicine, West Hollywood CA?- Henry Ng, MD, MPH, Internal Medicine and Pediatrics, Cleveland OH -?Kevin A. Slavin, MD, Pediatric Infectious Diseases, Hackensack NJ?- Brian Vu, DO, OB/GYN, USA -?Mick Kastner, MD, Emergency Medicine, NJ -?Dan Nguyen, MD, Family/HIV/Addiction Medicine, Austin TX?- Franco Chevalier, MD, Internal Medicine, Boca Raton FL — Joseph R. Lewis, DO, Surgical Critical Care, Acute Care Surgery, Southampton NY?- Gregory K. Todd, JD, MD, FACP, Internal Medicine, Tallhassee FL?- Matthew Hutcherson, MD, Physical Medicine and Rehabilitation, Toledo OH -?Kory Tillery, MD, MBA, Internal Medicine, Albuquerque NM -?Aaron F. Grober, MD, Cardiology and Internal Medicine, San Francisco CA -?Garrett Snoeyenbos, MD, Pediatrics, SOUTH KOREA -?Michael Daniels, Podiatry, USA — Danny Choy, DO, Emergency Medicine, New York NY -?Shayne Ladak, MD, CMD, Physical Medicine and Rehabilitate, Durham NC -?Jose L. Aguilar, MD, Psychiatry, Addiction Medicine, San Bernardino CA?- Nigel Stippa, MD, Ophthalmology, Pittsfield MA -?Chris Esguerra, MD, MBA, Psychiatry, Pasadena CA -?Nick Powers, MD, Infectious Diseases, Greensboro NC — Richard Mehlman, MD, Internal Medicine, Los Angeles CA -?Adam Lerman, MS3 Medical Student, Livingston NJ?- H. Todd Kepler, DO, MBA, Family Medicine, Dayton OH -?Daniel Simpson, DO, Emergency Medicine, Philadelphia PA — James Touchstone, MD, Anesthesiologist, San Diego CA -?Brad Deal, MD, CCHP, Adult, Child, Adolescent & Correctional Psychiatry, San Francisco CA?- Jose Perez-Coste, MD, Internal Medicine, Charlotte NC — Matthew Riddle, MD, Emergency Medicine and Medical Toxicology, San Diego CA — Luca Pauselli, MD, Psychiatry, New York NY -?Shubham Agrawal, MBBS, Vadodara, Gujarat INDIA -?William Korey, MD, Emergency Medicine, Fort Lauderdale FL — John M. Cruz, MD, Child, Adolescent and Adult Psychiatry, Union City CA?- Andrew O'Brien, MD, Hematology, Indianapolis IN -?Paul Krieger, MD, Emergency Medicine, New York NY?- Thomas Klein, MD, Family Practice/HIV, Chicago IL -?Reza Safavi, MD, Psychiatry, Houston TX -?Ron Carzoli, MD and Julius Gorospe, MD, Neonatology/Family Medicine, Jacksonville Beach FL?- Tom Klarquist, MD, Internal Medicine and HIV Chicago IL -?Oscar A. Sanchez, MD, Physical Medicine and Rehabilitation, Denver CO -?J. Harrison Collins, MD, Psychiatry, Visalia CA?- Derek Blechinger, MD, MPH, Internal Medicine, Preventive Medicine, HIV Specialist, San Francisco CA — Bojan Hrpka, DO, Family Medicine, Kalamazoo MI -?Tomas Lazo, MD, Anesthesiology and Perioperative Medicine, Portland OR — Keith A. Chadwick, MD, Otolaryngology, New York NY — Alan Drucker, MD, Psychiatry, Palm Springs CA -?Kalvin Yu, MD, Infectious Disease & Epidemiology, Los Angeles CA -?Gideon Levinson, Medical Student, Chicago IL — Hafiz Hussein, MRCPI, Cardiology, IRELAND -?Dan Karasic, MD, Psychiatrist, San Francisco CA -?Joseph Reses, MD, Anesthesiology, Augusta GA and Livingston UK -?Humberto Temporini, MD, Psychiatry, Sacramento CA — Mike Tracy, DO, Physical Medicine and Rehabilitation, Denver CO -?Bruce Kaczmarek, MD, Emergency Medicine, Washington DC?- Carlos Julio Aponte, MD, FACP, Rheumatology, Fairview Park OH -?Tyler Shapiro, MD, Emergency Medicine Philadelphia PA -?Timothy Hembree, DO, PhD, Internal Medicine, USA -?Albert Phan, DO, Family Medicine, USA -?Joseph Bautista, MD, FHM, FACP, Internal Medicine/Hospitalist, Exeter NH?- Mark J Milstein, MD, FAAN, Neurology, New York NY — Nick Okeson, DO, Family Medicine, Largo FL?- Francesco Laterza, MD, Internal Medicine, Philadelphia PA -?Joseph D. Zibrak, MD, Pulmonary and Critical Care, Boston MA?- Flavio Casoy, MD, Psychiatry New York NY?- Fred Gonzales, MD, Obstetrics & Gynecology, Cincinnati OH -?Brice Morey, DO, Family Medicine, Florence SC — John A Manos, MD, Internal Medicine, Salt Lake City UT?- Shant Adamian, DO, OB/GYN, Milwaukee WI -?Miguel Dario Cantu, MD, Pathology/Hematopathology, New York NY?- Philip Cheng, MD, Urology, Men's Health, Basking Ridge NJ -?Jason D. Hall, MD, JD, Anesthesiology, Tampa FL — Joshua St. Louis, MD, MPH, AAHIVS Family Medicine, HIV Primary Care, Cambridge MA — Jacob W Charny, MD, Dermatology, Chicago IL?- Christopher Ruland, MD, MS, Orthopedic Surgery, New York NY -?Edward S. Goldberg, MD, Internal Medicine/Gastroenterology, New York NY -?Rhodes Hambrick, MD, Pediatrics, Boston MA?- Justin Geisler, MD, Internal Medicine/Emergency Medicine, Augusta GA -?Hein Latt, MD, Psychiatry, New York NY -?Joshua M. Cohen, MD, MPH, FAHS, Neurology and Headache Medicine, New York NY?- David S. Reitman, MD, Adolescent Medicine, Pediatrics, Washington DC -?David Doobin, MD, Ophthalmology, New York NY?- Ben Sokoloff, DO, AAHIVM, Internal Medicine, Portland OR?- Matthew Molin, DO, Family Medicine, Des Moines IA?- Jacob Tigner MD, Internal Medicine, Minneapolis MN?- G. Scott Sawyer, MD, Ophthalmologist Houston TX -?Duane Dilworth, MD, Dermatology, St. Louis MO?- Taylor Dean Carlsen, MBS, MD/MBA Candidate, Undetermined, Jersey City NJ — Austin Vangelena, Medical Student, USA -?Jonathan Ausman, MSC, MD, OB/GYN, Kingston, Ontario CANADA -?Phillip Nguyen, MD, DABFM, Family Medicine, Washington DC — Zachary Pittsenbarger, MD, Pediatric Emergency Medicine, Chicago IL — James Montgomery, MD, Psychiatry, Dallas TX — Matthew Hernandez, MD, PhD, Pathology, Microbiology New York NY -?Michael Kung, MD, Pediatrics, Los Angeles CA?- Brian C. Chen, MD, FASA, FAACD, Anesthesiology, Anchorage AK — Troy Gurney, MD, Ophthalmology, Houston TX?- Nathan B. Williams, DO, Family Medicine/Osteopathic Neuromusculoskeletal Medicine, Fort Worth TX — Brian D. Robinson, MD, Anatomic Pathology, New York NY — Kenneth Leong, DO, MPH, HIV Specialist, Internal Medicine, San Francisco CA?- Aaron K. Jenkins, MD, Child Psychiatry, Pittsburgh PA?- Dorjee Norbu, MD, Psychiatry/Family Medicine, Cincinnati OH?- John H Purvis, MD, Pediatrics, Memphis TN -?Alex Mauricio Gale, MD, Pediatrics, Worcester MA — Naresh Ramarajan, MD, Emergency Medicine, Internal Medicine, Boston MA -?Ronnie Rivera, Emergency Medicine, Los Angeles CA -?Michael H. Secrist, MD, Interventional Radiology, Seal Beach CA — Matthew Gill, DO, Family Medicine, Los Angeles CA -?Daniel Kirkley, PA-C, Internal Medicine & Trauma, Charlotte NC -?Steven Kahn, MD, Dermatology, Chicago IL?- Michael Morris, Family Medicine, Minneapolis MN?- Adam Z. Kawalek, MD, Internal Medicine, Los Angeles CA?- Robert Bright, MD, Psychiatry, Scottsdale AZ?- Steven Edens, MD, Ophthalmology, Little Rock AR?- Robert Killian, MD/MPH, Family Medicine, USA -?Lonny J. Behar, MD, Psychiatry, Summit NJ -?Amilcar A. Tirado, MD, MBA, Psychiatry, New York NY — Farzad Alikozai, Internal Medicine, Kentucky -?Kenneth Schultz, DPM, Podiatric Physician, Kansas City MO?- Hirak Der-Torossian, MD, San Diego CA?- Ravi Saksena, MD, Pediatrics, Brooklyn NY — Jeffrey D Mariano, MD, AGSF, Internal/Geriatrics & Palliative Medicine, Los Angeles CA -?David Witzel, MD, MPH, Ophthalmology, Poughkeepsie NY — Felipe Espinoza, MD, Radiology, Palm Springs CA?- Erik Eckhert, MD, MS, Internal Medicine, Palo Alto CA — Keith Luckett, MD, Infectious Diseases, Cincinnati OH — Van Hung Nguyen, MD, Pediatric Pathology, CANADA -?Rashaan Marsan, MD/PhD, Internal Medicine & Sports Medicine, Atlanta GA -?Nathan Steiner, MD, Anesthesiology, Chicago IL?- Jean-Luc Banks, Medical Student, Chapel Hill NC — Tyler Darnell, MD, Emergency Medicine, Portland OR?- Neil Modi, DO, Internal Medicine, Los Angeles CA?- Joshua R Gonzalez, MD, Urology & Sexual Medicine, Los Angeles CA — Jeremy Applebaum, MD, Obstetrics and Gynecology, Philadelphia PA?- Zachary Long, MD, Family Medicine, USA — Scott Walker MD, MPH, Psychiatry, Fort Lauderdale FL — Mark Shamoun, MD, Pediatric Hematology/Oncology, Detroit MI — Andrew Lelin, MD, MA, Psychiatry, New York NY?- Ram Sharma, MD, MPH, OB/GYN, Orlando FL?- Ryan Perdomo, MD, Emergency Medicine, Riverside CA?- Patrick McLendon, DO, Pulmonology/Intensive Care, Colorado -?Jeremy Kidd, MD, MPH, Psychiatry, New York NY — Nikhil Ranadive, MD, MS, Emergency Medicine, Fresno CA — Ryan L Musolf, DO, Diagnostic/Interventional Radiology, Grand Rapids MI -?Travis Roark, MD, Internal Medicine, San Diego CA?- Richard Strathmann, MD, FACOG, OB/GYN, Naples, FL?- Mauricio Chacon, General Physician, Chicago IL — R. Voisine, MD, BS, Pharmacy Anesthesiology, Cape Elizabeth ME?- Daniel Fast, MD, Psychiatry, Palm Springs CA?- Russell Simons, BSm Fourth Year Medical Student, Chicago IL?- Dr. Aakash Goyal, DO, Family Medicine, Washington DC -?Joseph Di Vito, MD, Professor of Radiology & OB/GYN, AECOM, New York NY?- Perry Tsai, MD, PhD, Psychiatry, Chicago IL — Timothy Chandler, DO, Internal Medicine, Lancaster CA?- Cristian Serna-Tamayo, MD, Medical Oncology/Palliative Care/Geriatrics, Washington DC?- A. Ryan Sharma, MD, MPH, Hospital Medicine, San Francisco CA — Daniel Robinson, MD, FACEP, Emergency Medicine, Seattle WA?- Derrick A. Strunk, MD, Palliative Medicine, Cincinnati OH — Chase TM Anderson, MD, MS, Psychiatry, San Francisco CA -?Joseph Ho, MD, Ophthalmology-Vitreoretinal Surgery, La Jolla CA?- I.J. Frame, MD, PhD, Clinical Pathology, Medical Microbiology, Jackson MS — David Wayne Tindle, MD, MEd, BS, Aerospace Medicine, Sumter SC — Joel Nkosi, MBCHB Cum Laude, DABIM, FRCP(C), Internal/Emergency Medicine, Winnipeg, Manitoba CANADA -?Justin Cohenour, MD, Internal Medicine, Hospitalist, Minneapolis MN — Maximilian Staebler, MD, Resident, General Surgery, New York City NY — Eric Colletti, MD, Family Medicine, Odessa TX?- Daniel Fuchs, DO, Emergency Medicine, Denver CO?- James C. League-Pascual, MD, MS, Pediatrics, Alexandria VA?- Kusuma Nio, MD, Trauma Surgery/Surgical Critical Care, New York NY?- Orlando R. Ortiz, MD, Adult, Child, and Adolescent Psychiatry, Portland OR

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Courtesy of TWR, NYCHealth