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Morning Rounds Shraddha Chakradhar

Happy New Year, and hope everyone had a good holiday season under the circumstances. Let's catch up on the news. 

Britain takes a gamble with Covid-19 vaccines, upping the stakes for the rest of us

In recent days, the U.K. government has announced it will veer from the recommended Covid-19 vaccination regimen, but these detours could be costly for the country — and the world. The U.K. will lengthen the time in between doses to as much as three months (as opposed to the tried-and-tested one month). And in an effort to maximize the number of people who are immunized, the country will also allow the second vaccine dose to be from a different company than the first dose if supplies are limited. These moves aren't based on actual research from Covid-19 vaccine trials but on evidence from a small subset of patients and general vaccinology principles, making the U.K. akin to a "living laboratory," STAT's Helen Branswell writes.

The latest on the fight against Covid-19

Between the new variant of SARS-CoV-2 continuing to spread around the world and the ongoing vaccination campaigns, there's a lot to catch up on. Here's the latest: 

  • A third Covid-19 vaccine: The U.K., Argentina, and India have now approved a Covid-19 vaccine made by AstraZeneca and the University of Oxford for emergency use. India also approved Covaxin, a vaccine made by local company Bharat Biotech. At the same time, OWS leader Moncef Slaoui shared that U.S. approval of the AstraZeneca vaccine would probably come sometime in April. 
  • The new variant: At least 33 countries, including the U.S., have identified cases of the new Covid-19 variant that originated in the U.K., known as B.1.1.7. Although there isn't yet evidence that this variant causes more severe illness, it is more transmissible and experts have continued to urge caution about sticking with strict public health guidelines. 
  • Vaccination update: The U.S. vaccine rollout is not going as fast as experts had thought. Only about 20% of the 20 million vaccine doses that officials anticipated would be administered by the end of 2020 have been given thus far. But a recent uptick in vaccinations has infectious disease expert Anthony Fauci feeling slightly hopeful: He said yesterday that President-elect Biden's goal of administering 100 million doses within his first 100 days in office is "a realistic goal." 
  • The year ahead: In a new piece, STAT's Andrew Joseph takes a look at five milestones that could change the course of the pandemic, from the inauguration of Joe Biden later this month to how the Olympics in Japan over the summer could reveal a massive divide — and a different kind of competition — between wealthy and poorer nations in vaccine coverage. 

Kids with congenital heart defects more likely to also have mental health conditions

Children with congenital heart defects are more likely to also have mental health conditions, according to a new study. Researchers looked at data from nearly 120,000 patients at a single specialty hospital — more than 1,100 of whom had congenital heart defects. Nearly 20% of kids in this latter group were diagnosed with or prescribed drugs for anxiety or depression, compared to 5% of kids without congenital heart disorders who had an accompanying mental health diagnosis or prescription. The difference in added risk varied based on the type of congenital heart disorder, although minority or uninsured youth were significantly less likely to be diagnosed with a mental health condition in addition to their heart defects.

Inside STAT: Primary care doctors are being left behind in the vaccine rollout


The Pfizer/BioNTech Covid-19 vaccine is prepared before being administered. (BRENDAN SMIALOWSKI/GETTY IMAGES)

Primary care physicians are often the front line of medical care, and have continued in that role during the Covid-19 pandemic, often seeing infected patients before they need care at a bigger hospital. But the rollout of Covid-19 vaccines is showing that this essential group is being overlooked as doses flow to major hospitals. One survey of primary care doctors found that only about 1 in 4 know where they'll get their Covid-19 vaccine from, despite this speciality being classified 1a — the same as others who are first in line to get a vaccine — and despite being the group of physicians that may have seen the most deaths from Covid-19. “We want to make sure we’re not forgotten. It’s easy when you’re in a small corner of rural America to be left out,” one primary care specialist in Arkansas tells STAT's Olivia Goldhill. Read more here

The new year brings new health laws

With the start of 2021, a range of state health laws have gone into effect. Here’s a sampling: 

  • Price transparency: Hospitals nationwide are now subject to a new CMS rule mandating that pricing for services offered be made available online. Noncompliance could lead to a fine of up to $300 per day. 
  • Vaccine exemptions: A new California law now requires physicians to submit an electronic form to public health officials when granting a medical exemption to a child for skipping vaccines that are mandatory for school attendance. 
  • Insulin copay caps: Laws in at least seven states now cap the monthly copayment for insulin. The limits range from $100 for a 30-day supply in Illinois and Washington state to a $25 cap for a month's supply in New Mexico. 

Smoking cigarettes and vaping may be as harmful as only smoking 

Smoking traditional cigarettes as well as vaping may carry the same risk of harm as smoking alone, according to new research. Scientists looked at markers of inflammation and oxidative stress in more than 7,100 U.S. adults who were surveyed about their smoking habits. Those who reported smoking as well as using e-cigarettes had similar levels of damage as those who only smoked cigarettes. At the same time, those who only reported vaping had similar, and low, levels of damage as people who said they don't smoke or use e-cigarettes. The findings suggest that smokers ought to continue to be encouraged to switch to vaping or quit altogether, the authors write. 

Covid-19 in the U.S. 

Cases yesterday: 210,479
Deaths yesterday: 1,394 (pushing the total to more than 350,000 deaths overall)
Vaccine doses distributed, per CDC: 13,071,925
Number of people who received first dose: 4,225,756

What to read around the web today

  • How it started: A Q&A with Helen Branswell, one year after Covid-19 became a full-time job. STAT
  • Why an inflatable Christmas costume could be to blame for a Kaiser emergency room outbreak in San Jose. San Francisco Chronicle
  • A new mandate highlights costs, benefits of making all scientific articles free to read. Science
  • The cruise ship suicides. Bloomberg Businessweek

Thanks for reading! More tomorrow,

Shraddha

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Monday, January 4, 2021

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