Medical Intelligence Team Lessons Learned: Early Activation and Knowledge Product Development Mitigate COVID-19 Threats.

Leadership during the emergence of the novel coronavirus pandemic is complex and involves coordinated efforts between multiple levels of leadership from the medical, installation, local, state, and federal levels. Medical intelligence is critical to successful pandemic threat mitigation. We describe one of the first coronavirus (Coronavirus Disease-2019 (COVID-19)) impacted Department of Defense Medical Treatment Facility's strategic activation of a COVID-19 Medical Intelligence Team (MIT), the products developed, and lessons learned during the pandemic onset. The MIT bridged COVID-19 knowledge and policy gaps by developing and delivering daily intelligence briefings on four domains: epidemiology and infectious disease, healthcare capabilities and infrastructure, policy and regulations, and diagnostics and therapeutic interventions. Twenty-three products were developed and delivered to aid in leadership decision-making and local policy development in the absence of higher-level policy and guidance. Employing MITs in future pandemic response strategy may more effectively mitigate pandemic threats and improve force health protection.

Emerging role of human basophil biology in health and disease.

Basophils have emerged in recent years as a small but potent subpopulation of leukocytes capable of bridging innate and adaptive immunity. They can be activated through IgE-dependent and IgE-independent mechanisms to release preformed mediators and to produce Th2 cytokines. In addition to their role in protective immunity to helminths, basophils are major participants in allergic reactions as diverse as anaphylaxis and immediate hypersensitivity reactions, late-phase hypersensitivity reactions, and delayed hypersensitivity reactions. Additionally, basophils have been implicated in the pathophysiology of autoimmune diseases such as lupus nephritis and rheumatoid arthritis, and the modulation of immune responses to bacterial infections, as well as being a feature of myelogenous leukemias. Distinct signals for activation, degranulation, transendothelial migration, and immune regulation are being defined, and demonstrate the important role of basophils in promoting a Th2 microenvironment. These mechanistic insights are driving innovative approaches for diagnostic testing and therapeutic targeting of basophils.