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Morning Rounds Shraddha Chakradhar

Dear readers: Starting on Tuesday, Jan. 19, I will be going on family leave for three months. My colleague Elizabeth Cooney, who has filled in for me often in the past, will be writing the newsletter during that period. My deepest thanks to her for stepping in with the latest in health and science. I’m looking forward to reading Liz’s take every morning, and I’ll be back in your inboxes this spring!

U.S. plan to expand access to Covid-19 vaccine likely sets up new debacles

HHS Secretary Alex Azar is asking states to vastly expand Covid-19 vaccine access to tens of millions more U.S. residents who were otherwise further down in the priority list. If states follow his guidance, anyone over the age of 65 and anyone older than 16 with a medical condition that puts them at higher risk of severe Covid-19 infection is eligible to be vaccinated now. The announcement throws a wrench into states’ existing Covid-19 vaccine priorities, which were based on months of work by CDC advisers. The new plan would add 128 million people to the 24 million health workers and residents and staff of long-term care facilities who were already being prioritized for a vaccine — daunting figures amid a shortage of vaccine supplies and an already-slow immunization campaign. 

Cancer mortality rate in the U.S. continues to decline

Cancer deaths in the U.S. have continued to drop, according to the 2021 cancer statistics and facts report from the American Cancer Society. These improvements are largely due to a nearly 50% drop in lung cancer deaths in the past five years, leading to a record 2.4% drop in overall cancer deaths between 2017-2018. The report said that better treatment for the most common lung cancer subtype, non-small cell lung cancer, was likely the reason for the trend; the two-year survival rate for that type of cancer is now more than 40%. At the same time, the report — which says the impact of Covid-19 on cancer is still unclear — estimates that nearly 2 million people will be newly diagnosed with cancer this year, and more than 600,000 will die from cancer in 2021. 

Supreme Court reinstates in-person medication abortion requirements

The Supreme Court late yesterday restored federal requirements that people seeking medication abortions must obtain the drugs in person at a hospital or clinic, rather than through the mail or delivery. Abortion pills do not have to be taken at a medical facility, and they are allowed during the first 10 weeks of pregnancy — with a majority of people opting to take the drugs rather than have surgery. In a 6-3 ruling, the court sided with the Trump administration, which sought to bring back the FDA’s in-person rule in August last year. A lower court judge had previously blocked the requirement, arguing that having it in place during the Covid-19 pandemic would be unduly burdensome. 

Inside STAT: Medical students call on ICE to provide Covid-19 vaccines to all detained migrants


A recreation yard used by detained individuals at the U.S. Immigration and Customs Enforcement detention center in Tacoma, Wash. (TED S. WARREN/AP)

The U.S. has slowly begun vaccinating incarcerated individuals against Covid-19, but those detained by Immigration and Customs Enforcement are still being overlooked, write three Harvard Medical School students in a new First Opinion. A recent survey found ICE facilities failed to comply with their own rules for Covid-19 pandemic response requirements, often denying consistent access to soap and masks. “The vaccine rollout is an opportunity for ICE to recognize that it is accountable for the health of detainees, who are at a similar risk level for Covid-19 as incarcerated individuals,” the authors write. ICE detainees stay in cramped quarters ripe for infection, and current plans for vaccines make it unclear where will be included in campaigns. “Only by vaccinating the people most vulnerable to Covid-19 can we move closer towards an equitable post-pandemic future,” the authors write

40% of U.S. residents are still wary of doctors’ offices over Covid-19 fears

A series of small surveys from the Society for Cardiovascular Angiography & Interventions finds that a year into the Covid-19 pandemic, 40% of people in the U.S. are still uncomfortable with going to a doctor’s office for routine care over concerns of infection. More than 30% of those surveyed also said they haven’t been to see their physician since the start of the pandemic. Large majorities of Black and Hispanic people expressed discomfort with scheduling a medical procedure. These groups were also far less comfortable going to the ER during the pandemic compared to the general population.

Fewer than half of people view racism as a factor in health outcomes

A new RAND Corporation survey finds that a majority of people don’t believe that racism is a barrier to good health. Only 42% of the more than 4,100 people surveyed believe that systemic racism is a contributing factor to poorer health outcomes among people of color. Black respondents were much more likely than white respondents to say systemic racism impacts health. Looking at the disproportionate impact of Covid-19 on communities of color, 70% believe that this pandemic can be a turning point for positive change such as improving health care access. And while two-thirds of respondents also endorsed the view that the government ought to ensure health care as a right, white individuals included in the survey were less likely to hold this view than those of other races and ethnicities. 

Covid-19 in the U.S.

Cases yesterday: 215,805
Deaths yesterday: 4,327 (a new record)

Correction: Yesterday's item on the best jobs incorrectly stated the top three highest-paid jobs. Those jobs are orthodontist, anesthesiologist, and oral and maxillofacial surgeon. 

What to read around the web today

  • A day in the life of a Navajo Nation health worker. Medium
  • I wanted to give my daughter a sibling. I got Covid instead. The New York Times
  • Scott Atlas, controversial former Trump adviser, deletes Twitter account. STAT
  • As pandemic worsens, most US states resist restrictions. Associated Press
  • 22 orphans gave up everything to distribute the world’s first vaccine. The Atlantic

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, January 13, 2021

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