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Morning Rounds Shraddha Chakradhar

A cancer patient reconsiders her end-of-life wishes amid Covid-19


Robin Hodges outside of her home in Littleton, Mass. (KAYANA SZYMCZAK FOR STAT)

Talk of rationing lifesaving drugs and machines for coronavirus patients has spurred many conversations about end-of-life wishes. Some people have told their doctors they don't want to be resuscitated if they're stricken with Covid-19. But because of their lower chance of survival, many cancer patients are wondering whether the very medical centers that have helped them live longer might now decide against providing care such as ventilators. This worry has led some, including lung cancer patient Robin Hodges, to revoke previous do-not-resuscitate orders. STAT's Eric Boodman has more here

Here's what else is happening with the pandemic:

  • The FDA yesterday announced that it would be requiring those manufacturing antibody tests for Covid-19 to provide data proving accuracy in the next 10 days or risk removal from market. The move comes after reports that only a minority of the currently available tests could reliably detect antibodies in those who had recovered from Covid-19. 
  • Fewer Covid-19 patients from public health officials reining in outbreaks also means fewer available participants for trials testing drugs and vaccines for the infection. Two different trials in recent weeks had to end early because of insufficient enrollment, and experts are concerned that other trials may suffer the same fate. 
  • Just weeks before the NIH announced results from its trial testing remdesivir, the agency changed the primary endpoint of the trial, from measuring how well patients were faring on the drug to how quickly those on the drug recovered compared to controls. And this change, though made without knowing what the data were going to say, may have led to the positive results that were shared, STAT's Matthew Herper writes.
  • In a new First Opinion for STAT, scientists caution that intubation boxes — file-crate-sized boxes that physicians can place on patients’ shoulders while they are intubated — may seem like they could protect against potential infections, but this invention may do more harm than good.

Antibodies, immunity, and what they mean for Covid-19, explained


(Hyacinth Empinado/STAT)

As researchers work on a vaccine for Covid-19, as public officials consider "immunity certificates" for those who have been already infected, and as companies roll out serologic tests, one thing that the three rely on is antibodies. In a new video, STAT's Hyacinth Empinado explains how the body creates "memories" of infections to fight them in the future, how just having antibodies isn't enough, and how the protection conferred by these proteins varies from disease to disease. Watch the video here

Youth believe vaping is dangerous. They also think it's trendy

A small, new survey of teens and young adults finds that although a majority of them perceive using Juul products to be dangerous, they also think vaping is trendy and cool. Scientists surveyed around 1,100 youths ages 14- 24 about their perceptions of Juul usage, including whether they'd ever heard of the e-cigarette maker, why folks their age vape, and whether vaping leads to using other substances. Nearly 80% believed that "juuling" was dangerous, and more than 70% said they believed that it could lead to the use of other substances including cigarettes and alcohol. Yet 62% cited "Because it's trendy and cool!" as the most common reason why youths use these devices. The authors conclude that anti-vaping campaigns shouldn't focus on only highlighting the dangers of e-cigarettes, but also address the social aspects of why kids choose to vape. 

Inside STAT: With remdesivir, Gilead finds itself at strategic crossroads

All eyes are on Gilead Sciences now after positive results from a trial testing its drug remdesivir in Covid-19 patients were released last week. The FDA soon after issued an emergency use authorization for the drug. But what comes next may be even more crucial. Gilead has a history of setting high prices for lifesaving medications, and how much it charges for remdesivir could determine whether the company is the hero of the pandemic or condemned for price gouging. The company's CEO Daniel O'Day told investors in a call last week that now was an opportunity to save the pharma industry's reputation. And as one pharma lobbyist tells STAT's Nicholas Florko and Damian Garde, “We’ve got a perfect opportunity to show our value — and not come across like greedy bastards.” STAT Plus subscribers can read more here

Majority of patients being treated for opioid use disorder don't take medications


A new analysis reveals that the majority of people being treated for opioid use disorder aren't receiving medication. While non-medication interventions such as therapy can help people with the condition, medications such as buprenorphine and methadone have proven to be particularly effective at helping with withdrawal and other symptoms. In the new study, scientists looked at data between 2015-2017, and found that nearly a third of those who were discharged from opioid treatment programs were neither in self-help groups nor on any kind of anti-opioid medication. Equal proportions of people — about 29% — used either only medication or only self-help groups, while only about 10% used both. Using only self-help groups for treatment was most common among those in inpatient or residential facilities, while Medicaid recipients were most likely to only rely on medications. 

Nonfatal injuries cost nearly $1,600 per employee from lost revenue every year

Nonfatal injuries cost nearly $1,600 and 11 days in lost time per employee every year, according to new research. Scientists looked at claims data in two databases based on nonfatal emergency department visits made between 2014-2015, and found that the amount of time and revenue lost to such injuries ranged from 1.5 days and $260 for bites and stings to about 44 days and nearly $6,200 for motorcycle injuries. When sorted by body area of injuries, those to the spine and back resulted in the most missed work days, of roughly 16 per year per employee. The per-employee annual cost when considering workplace absence, short-term disability, and workers' compensation for spine and back injuries was nearly $2,300. Some caveats: The data didn't include those who were on long-term disability, were unemployed, or those who didn't have employer-sponsored insurance. 

What to read around the web today

Thanks for reading! More tomorrow,

Shraddha

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Tuesday, May 5, 2020

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