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Morning Rounds Shraddha Chakradhar

Hello — I'm back! There have certainly been a lot changes since when I left for vacation two weeks ago, but I'm safe and (thus far) sound, so on to today's news. 

Covid-19: Experts weigh safely relaxing coronavirus lockdowns

As public health and government officials the world over recognize that normalcy must slowly return, experts are crafting ways to safely ease Covid-19 lockdowns and restrictions. The approach that is garnering the most support? Aggressively finding cases, tracing any contacts these patients had, community surveillance, and quarantining and isolation. STAT's Sharon Begley takes a deep dive here

Here's what else is happening: 
  • Some biopharma employees, as essential workers, are still going into work to keep manufacturing plants and other lab equipment running. STAT's Rebecca Robbins and Kate Sheridan offer a look into what it's like to have to undertake daily risk to keep a company running. 
  • Responding to criticism, Gilead has asked the FDA to rescind the orphan drug status that was granted to its experimental Covid-19 drug remdesivir.
  • San Francisco's Vir Biotechnology reports that lab testing of two of its antibody drugs for Covid-19 appeared to neutralize the virus and that the drugs would be tested further in people. 
  • Nursing homes have gotten a lot of national attention since the first U.S. outbreak unfolded at one in Kirkland, Wash. But assisted living facilities, which offer long-term housing for at-risk patients, also deserve extra attention, write Kali Thomas, Paula Carder, and David Grabowski in a First Opinion for STAT. 

Hong Kong's lesson: Defeating Covid-19 demands persistence

Even though the coronavirus outbreak was still raging in mainland China in early March, the scene in Hong Kong fewer than 600 miles away looked much different. Before then, residents had hunkered down in their homes and taken the necessary protective measures so that earlier this month, the city recorded just four deaths and no new cases. Thinking the situation was under control, people there slowly returned to normal life. But Covid-19 cases surged last week, and the country has since reported more than 400 new cases. Experts are not surprised at the rebound: Many have been warning about such a resurgence if distancing measures are relaxed, and the situation currently unfolding in Hong Kong serves as a warning for other places looking to ease up on outbreak-related restrictions. STAT contributor Suzanne Sataline has more here.

Don't discontinue blood pressure drugs to protect against Covid-19, experts suggest

As experts continue learning about whether patients with certain preexisting conditions are more susceptible to Covid-19, researchers in a new editorial write that patients being treated for hypertension with a popular class of medications are not likelier to become infected with the disease. Some recent reports have suggested that because hypertension drugs called ACE inhibitors are related to an enzyme that allows the novel coronavirus into cells, patients taking these drugs may be at a higher risk of contracting Covid-19. However, the scientists write there is no evidence in humans or animals to suggest that taking the drugs allow the new virus into cells more easily. Data from previous research are also not consistent on the effect of ACE inhibitors on the related enzyme. Treatment with these blood pressure medications should therefore not be discontinued, the authors recommend. 

Inside STAT: What we've learned about the coronavirus — and what we need to know


A man walks in a business district in Wuhan, where the coronavirus first emerged. (STRINGER/GETTY IMAGES)

Compared to how things stood with previous outbreaks, the knowledge we have gained since the start of the ongoing Covid-19 pandemic is staggering. In 2003, when SARS first emerged, it took weeks for scientists to be able to even trace what was the culprit behind the illness that was wreaking havoc across parts of Asia and North America. But with Covid-19, rumors of a possible new virus leaked at around the same time that China alerted the WHO about the new pathogen. Sequences of the virus were available soon after, and hundreds of thousands of tests for the virus have been administered in the 10 weeks since. Despite this progress, there are still large gaps in what we know about Covid-19. STAT's Helen Branswell breaks down what is known about this new virus, pandemics in general, and most importantly, what critical knowledge gulfs still remain. Read more here

Studies comparing AI and physicians are often of poor quality

Many studies that tout the ability of artificial intelligence algorithms to perform as well as or better than physicians are not high-quality and often exaggerate findings, according to a new review. Scientists looked through a four major, global trial databases for studies that compared physician performance with AI programs, and found only two published randomized clinical trials — considered the gold standard for research — and eight such ongoing studies. Eighty-one other studies were non-randomized trials, of which only nine compared AI and physicians in a prospective manner, and six of which were conducted in an actual clinical setting. Still, 75% of these non-randomized studies touted that the AI programs being compared in the research were at least as good as physicians. Such positive language could be misleading and lead to inappropriate care for patients, the authors warn. 

Rates of STIs increase among pregnant women in recent years

Consistent with data in the general population, a new CDC study finds that rates of STIs including chlamydia, gonorrhea, and syphilis have increased among pregnant women in recent years. Such infections in pregnant mothers could be transmitted to their infants and cause complications at birth and in the children's development. Here's more: 

  • Overall trends: Between 2016-2018, rates of chlamydia increased by 2%, gonorrhea rates increased by 16%, and syphilis rates increased by 34%.
  • Age and race: In 2018, chlamydia and gonorrhea rates decreased with increasing maternal age, while syphilis was highest among those aged 24 and younger. Black women had higher rates of all three STIs compared to women of other races. 
  • Other demographics: In 2018, STIs were highest among those who did not get prenatal care or got prenatal care in the final trimester of pregnancy. Women who smoked during pregnancy also had higher STI rates. 

What to read around the web today

  • Widening coronavirus crisis threatens to shutter doctors’ offices nationwide. Los Angeles Times
  • California isn’t testing enough children for lead, prompting legislation. Kaiser Health News
  • 13 deaths in a day: An ‘apocalyptic’ coronavirus surge at an NYC hospital. The New York Times
  • Walmart was almost charged criminally over opioids. Trump appointees killed the indictment. ProPublica
  • 'Stop price gouging,' 33 Attorneys General tell Amazon, Walmart, others. NPR

Thanks for reading! More tomorrow,

Shraddha

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Thursday, March 26, 2020

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