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Morning Rounds Shraddha Chakradhar

Covid phobia keeping people with heart symptoms away from ERs

Many patients with heart problems are staying away from ERs over fears of contracting the virus, and the trend has many cardiologists worried that delays in getting treatment might cause a second wave of deaths among cardiac patients that are not directly related to Covid-19. A survey released earlier this month showed that 40% fewer heart attacks are being treated at hospitals. And it's not just heart patients who are putting off seeking care — physicians are also reporting seeing fewer stroke and appendicitis patients. STAT contributor Usha Lee McFarling has more here.

Here's more of the latest Covid-19 news: 

  • Rick Bright, who was ousted this week as the head of BARDA, is claiming that President Trump is politicizing science, and that being removed from the position at the U.S. agency was a result of refusing to invest federal money to investigate an unproven Covid-19 therapy that Trump was nonetheless pushing. STAT's Nicholas Florko has more here
  • As tech giants such as Google and Apple speed up efforts to help with the Covid-19 crisis, experts are increasingly worried that many of these companies may be duplicating each others' efforts or competing for limited resources. The result: The companies' may inadvertently be undermining the common goal of quickly helping the pandemic response. Read more here.  
  • In a conversation with STAT's Ed Silverman, Unitaid's interim executive director Philippe Duneton warns that those working to fight Covid-19 shouldn't forget about vulnerable populations, especially those in poor countries. Read more here
  • As hospital systems, cities, and other local authorities figure out the best way to treat Covid-19 patients and keep uninfected individuals from falling sick, the writers behind a new STAT First Opinion share how a community-based management model — one that relies on primary care via telephone as the first point of contact — could help ensure patients are seen in a timely fashion without overwhelming hospitals. Read more here

Half of the public believes the worst of Covid-19 in the U.S. is yet to come

A new Kaiser Family Foundation poll finds that about half the public still believes that the worst of the Covid-19 outbreak in the U.S. is yet to come. Here's more from the poll, which surveyed around 1,200 U.S. adults between April 15-20: 

  • Outbreak outlook: 51% of those surveyed believed "the worst is yet to come," down 23 percentage points since a similar poll conducted earlier in April. 
  • Distancing measures: 80% of respondents say that strict stay-in-place measures are worth it to curb the spread of the virus. About 1 in 5 people say that distancing measures are causing more harm than good. 
  • Contact tracing: 68% of people said that if they were tested for the coronavirus, they would be willing to use a phone app to share the results with public health officials to help them trace contacts and track the outbreak's spread. 

Chemotherapy drug is effective against graft-versus-host disease, data show

The results of a Phase 3 trial could give hope to the many cancer patients who depend on bone marrow transplants to help restore their weakened immune systems. Although these transplants can be helpful, cancer patients often have to deal with graft-versus-host disease, in which the newly injected cells turn on the patient's body and cause severe symptoms. In the 309-person trial, scientists tested the chemotherapy drug ruxolitinib in approximately half of those enrolled, who had a specific type of graft-versus-host disease. After 28 days, 62% of those who received the drug showed an improvement in symptoms of their disease compared to only 39% of those in the control arm who experienced a similar improvement taking any of nine drugs commonly used to treat GVHD. Ruxolitinib's success in the trial confirms what many oncologists have anecdotally known about the drug's benefit for years, writes STAT's Meghana Keshavan. STAT Plus subscribers can read more here.  

Inside STAT: Catheter shortage boosts work, and risk, for respiratory therapists


Carolyn LaVita, an assistant director for respiratory care at Massachusetts General Hospital. (PAT GREENHOUSE/THE BOSTON GLOBE)

Shortages in hospitals as a result of the Covid-19 pandemic are all but common now. Health workers making do with less than is the new norm. But what happens when a stopgap measure to deal with a shortage of supplies leads to possible contagion? That's the latest dilemma that some workers at Massachusetts General Hospital in Boston are facing: A type of catheter that is routinely used to help clear gunk out of an infected patient's stuffed-up lungs is in low supply, which means that hospital staff are having to rely on other tubes that need to be switched out regularly. And for people like Carolyn LaVita, whose job involves making these regular switches, the surge in patients needing the procedures has not only added to her workload, but also increased the constant risk of contracting Covid-19. STAT's Eric Boodman has more here

Addiction treatment clinics more common in counties where different racial groups interact less

A new study suggests that addiction treatment facilities are more common in communities where different racial groups interact less. In the study, researchers looked at clinics that provided buprenorphine or methadone — both medication-assisted treatments for addiction — in 3,100 U.S. counties. They also looked at what's known as the index of interaction, or the probability that a member of one racial group would encounter someone from another. There were fewer methadone facilities in counties where Black or Hispanic residents were more likely to interact with white residents. However, in counties with a lower likelihood of white individuals interacting with Black individuals, there were far more facilities offering buprenorphine than in counties with higher rates of interaction. The scientists behind the study said there's a need to make sure there is equal access to the medications across all communities.

CRISPR'd stem cells show promise in treating diabetes in mice

The results of a new mouse study suggest that the gene editing technique known as CRISPR could one day be combined with stem cell technology to help treat diabetes. Researchers derived a specific type of stem cell from a patient with a rare form of type 1 diabetes. The stem cells were then edited to remove the faulty gene that caused the disorder. The edited stem cells then grew into insulin-producing pancreatic beta cells, and were transplanted into mice that were engineered to have diabetes. Compared to diabetic mice who were injected with unedited beta cells, the mice that received the CRISPR'd cells were able to control their blood sugar levels for longer and even reversed their diabetes due to more efficient insulin production from the transplanted beta cells. The therapy only used stem cells from one patient, and will still need to be studied in humans to test its viability. 

What to read around the web today

  • The coronavirus truthers don't believe in public health. Vice
  • Former Labradoodle breeder tapped to lead U.S. pandemic task force. Reuters
  • How the Covid-19 pandemic will leave its mark on U.S. health care. Vox
  • Iceland is a perfect laboratory for studying Covid-19. Bloomberg Businessweek
  • Under Trump, coronavirus scientists can speak — as long as they mostly toe the line. The Washington Post

Thanks for reading! More tomorrow,

Shraddha

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Thursday, April 23, 2020

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