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Morning Rounds Elizabeth Cooney

Hi, this is reporter Eric Boodman, filling in again before Shraddha returns next week.

CDC advisory committee to discuss J&J vaccine after rare blood clotting cases

The CDC’s Advisory Committee of Immunization Practices is meeting today to discuss next steps on Johnson and Johnson’s Covid-19 vaccine after the CDC and FDA recommended yesterday that states stop using it while six serious cases of clotting problems are being investigated. These issues seem to be rare, and similar to those observed with the AstraZeneca vaccine in Europe. It’s possible that ACIP will suggest that the vaccine can remain in use, but with restrictions on who should receive it, as some countries did with AstraZeneca’s vaccine. Though the biology behind the clotting side effect remains murky, research on patients who got the AstraZeneca shot offers clues, STAT’s Matthew Herper reports. After the vaccine, the body produces tiny clusters in the blood. One element of those clumps — platelet factor 4 — in turn could trigger an immune response, and when antibodies stick on, clotting can ensue. The clots seem similar to those sparked by the blood thinner heparin, and so doctors should avoid that drug when treating these patients.

For sixth year in a row, U.S. reports record number of STDs

New data from the CDC show that the United States has been beating its own unenviable record: For the sixth year in a row, 2019 had the highest-ever number of reported sexually transmitted diseases, with some 2.5 million cases of chlamydia, gonorrhea, and syphilis. The number of newborns with congenital syphilis nearly quadrupled from 2015 to 2019. As with so many other medical issues, unequal access to resources and care has created racial and ethnic disparities in these data, and the research shows that youth and gay or bisexual men are at high risk. Tamping down on these trends will take staff and funding that are currently in short supply: Many of the public health professionals who would usually focus on preventing these infections have been redeployed to fight Covid-19. 

Gun injuries in kids surge during pandemic

Among the myriad tragedies of the Covid-19 pandemic is a surge of gun injuries in kids. A new study found that between March and August 2020, kids under 12 were at much higher risk of experiencing firearm wounds compared with the same period in previous years. For those six months in 2018, there were 2.76 firearm injuries per million children, in 2019 it was 2.70, but in 2020, it was a whopping 5.09. A similar upward trend was seen in gun injuries inflicted by children. This correlates with an uptick in firearm purchases, and the researchers hypothesized that situations of kids confined at home with parents unable to provide constant supervision may have contributed to these sorts of incidents, which left 89 kids dead and 158 injured.

Inside STAT: With Covid-19, a deathbed double standard for medical parole


The cover of the summary report of a parole review hearing for Joseph Messere, provided by his attorney, David Apfel. (Kayana Szymczak for STAT)

During his 39 years in prison, the closest Joseph “Cement Head” Messere ever came to walking free was when he was intubated, unconscious, and dying of Covid-19. Because his death was imminent, Massachustts authorities granted him medical parole — and wanted him “released as soon as possible.” But for prisoners with less newsworthy illnesses, almost nothing happens that quickly. Another man, with pancreatic cancer, who’d applied for medical parole that very same week, died waiting. To attorneys, it seemed like the Department of Correction was trying to reduce the number of coronavirus death statistics it would have to report. “They couldn’t have cared less when he was alive, and now that he’s a vegetable, they want to release him as soon as possible,” Cement Head’s lawyer said — a story I’ve spent months digging into. Read it here.

New documentary delves into gender and racial bias experienced by women in STEM

Science is full of racial and gender-based bias, some instances of harassment overt, others more subtle but just as detrimental. A new feature documentary from NOVA, “Picture A Scientist,” follows biologist Nancy Hopkins, chemist Raychelle Burks, and geologist Jane Willenbring to show just how pervasive these issues are for women — especially women of color — in science. Paula Johnson, president of Wellesley College, describes the “singular dependence of trainees, whether they are medical students, whether they are undergraduates, or if they are graduate students, on faculty for their funding, for their futures. … It really creates an environment where harassment can occur.” Morning Rounds readers can watch an exclusive clip here, before the film’s TV premiere tonight at 9 p.m. ET on PBS (it will also be streaming on NOVA’s website).

I scream, you scream, we all scream in more communicative ways than you'd expect

You’d think that scientists who study the human scream would be a pretty liberated bunch. But the field has a beaten path, it turns out, and researchers often stick to it, focusing on shrieks of fear and aggression, giving our other yowls short shrift. Now, some psychologists have rescued these sounds from the psycho-acoustical trash heap, asking 12 people to scream various genres of scream, and then playing them for 23 listeners while they were in a functional MRI machine. As the researchers report in a new study, listeners responded more quickly — and with greater frontal brain activity — to the nonalarming yelps, showing that our screams are more diverse and communicative than we tend to think. A good reminder to pause and ask yourself: Would this tweet or email be better expressed as a scream?

Covid-19 in the U.S.

Cases yesterday: 77,878
Deaths yesterday: 913

What to read around the web today

  • National academy may eject two famous scientists for sexual harassment. Science
  • PhRMA chief talks strategy — and he’s surprisingly optimistic about drug pricing reform. STAT+
  • Apparently just by talking about it, I’m super-spreading long Covid. The Guardian
  • Esther Perel goes off script. New York Magazine
  • Opinion: Building the perfect wearable for clinical trials. STAT+

Thanks for reading! More tomorrow,

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