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Morning Rounds Shraddha Chakradhar

Covid-19's three potential futures: small outbreaks, monster wave, or ongoing crisis 

(HYACINTH EMPINADO/STAT)

What will Covid-19 bring for the U.S. this summer and beyond? While there are points of contention among public health experts, three likely scenarios have emerged: one where the current large wave of infection is followed by smaller waves of infection every few months; another where there is a second, bigger wave than the current one later this year; and, finally, a scenario where the outbreak now lasts in its current magnitude through 2022. Despite these different visions, many experts seem to agree that the world we knew before Covid-19 is unlikely to return anytime soon. STAT's Sharon Begley has more here

Here's what else is new with Covid-19: 

  • The FDA on Friday announced that it would be authorizing emergency use of Gilead's drug remdesivir, based on positive results in a government-sponsored trial. And watch a video here from STAT's Alex Hogan on how remdesivir works against Covid-19. 
  • Seven states in the Northeast, including New York and Massachusetts, are part of a new consortium that will work together to purchase $5 billion worth of necessary medical equipment, including PPE for health workers and ventilators.  
  • In addition to the thousands of medical staff on the frontlines of the battle against Covid-19 are crisis center counselors, who are fielding an increased number of calls from individuals struggling with their mental health during the pandemic. STAT contributor Gabrielle Glaser has more on one group of counselors in the St. Louis area here.
  • The writers behind a new STAT First Opinion argue that before the U.S. can reasonably deal with the shortage of ventilators, it will need a system in place — including a database of available ones — to ensure proper and equitable distribution of these lifesaving machines. 

Routine cancer screenings have plummeted during the pandemic

Cancer screenings in the U.S. have plummeted since the start of the Covid-19 pandemic, according to a newly published white paper. As the U.S. government and cancer societies urged the public to refrain from going to see their doctors for non-urgent and non-coronavirus-related procedures, including routine mammograms and colonoscopies, the new findings — based on a review of electronic medical record company Epic's data — show that people have been heeding that advice. Compared to the past three years, appointments for cervix, colon, and breast cancer screenings were down by 86%-94% in March this year. The overall benefit of such screenings in saving lives is still a topic of contention among cancer experts, but oncologists nonetheless worry that the drastic dip in these preventive checks could lead to deadly cancers going undetected. 

As some residents protest Covid-19 restrictions, state governors take different tacks 

As state officials continue to urge the public to comply with restrictions to curb the spread of Covid-19, some residents are pushing back and getting different responses from their governors. In Michigan, for instance, where Gov. Gretchen Whitmer has issued a stay-at-home order until May 15, protesters have twice taken to the state capitol, often defying social distancing measures. But yesterday, Whitmer defended her order, saying that the measures in place have continued to save lives and that the protesters represent only a small minority of Michiganders. In Ohio, where retail and other stores will open May 11, Gov. Mike DeWine issued an order last week asking residents to wear masks in public, but was met with backlash from some Ohioans. DeWine subsequently reversed course, telling ABC that the mask order was going too far and that "people were not going to accept the government telling them what to do." 

Inside STAT: Covid-19 has shuttered labs. It could put a generation of researchers at risk

Among the scores of disruptions brought on by Covid-19 are the unprecedented shuttering of scientific labs around the world. Scientists are having to contend with losing data from months- or even years-long experiments and uncertainty over when they will be able to resume their work. Early-career scientists, whose moving up in the world of academia depends on quickly gathering data to publish in prestigious journals, are being hit particularly hard. Without additional support — in the form of pausing tenure clocks or more funding — these up-and-coming researchers worry that the delays caused by Covid-19 may be too big to overcome. STAT contributor Justin Chen has more on some of these researchers' stories here

Room charges account for majority of pediatric hospital costs

A retrospective analysis of costs associated with pediatric hospitalizations reveals that just room charges make up between half to three-quarters of the medical bill. Looking at nearly 200,000 hospitalizations across 48 children's hospitals in 2017, scientists found that just room charges made up between 52%-70% of the full cost of the medical bill. When it came to non-room charges, there was a wide range of costs among different possible conditions. For example, costs for seizure-related treatment varied from 25%-81% of non-room costs, while diagnoses for gastrointestinal conditions ranged from 28%-69% of non-room costs. In an accompanying editorial, physicians write that although the main findings indicate that improvements to room charges could help alleviate the high cost of medical care, it's difficult to know which services get labeled under the "room charge" umbrella, and call for more standardization among billing practices. 

Warning labels on alcohol packaging could improve knowledge of risks, healthy consumption limits

(Courtesy Erin Hobin)

 

A series of newly published papers shows that labeling alcohol bottles with the harms associated with drinking as well as recommended consumption limits makes people more aware of such information. In one study, researchers found that including labels with warnings about drinking during pregnancy and a possible link to cancer on some alcohol bottles in one Canadian province reduced alcohol sales there by almost 7% compared to before the labels were introduced. In another study that surveyed more than 2,000 participants, people's knowledge about daily drink recommendations increased in areas where alcohol labels contained these guidelines versus areas without such information. In another survey, only 25% of respondents in an 836-person survey were aware of the link between cancer and alcohol consumption, but the majority agreed that alcohol containers should contain warning labels and information on recommended consumption amounts. 

What to read around the web today

  • Theranos would be thriving in the Covid-19 pandemic. Elemental
  • U.S. coronavirus stimulus went to some healthcare providers facing criminal inquiries. Reuters
  • Disabled, elderly going without home care amid shortage of protective gear and tests. Politico
  • China’s coronavirus vaccine drive empowers a troubled industry. The New York Times
  • The essential workers filling New York’s coronavirus wards. The New Yorker

Thanks for reading! More tomorrow,

Shraddha

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Monday, May 4, 2020

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