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Morning Rounds Shraddha Chakradhar

To grasp who's dying of Covid-19, look to social factors like race

A new study from researchers at MIT's Sloan School of Management finds that social factors such as race — more than pre-existing biological conditions — explain why certain groups of people have been harder hit by Covid-19 than others. The higher the number of Black residents in a particular county, the higher the county's Covid-19 death rate, the study found, even after accounting for other factors such as insurance status and rates of diabetes and obesity. The new research comes as public health experts are learning more about how systemic and population-level factors are accounting for disparities in Covid-19 rates more than individual differences. “If I were a public official, I’d be looking at differences in the quality of insurance, conditions such as chronic stress, and systemic discrimination,” study author Chris Knittel tells STAT's Sharon Begley. Read more here

Here's what else is new with the pandemic: 

  • The Trump administration's announcement Friday about rolling back Obama-era health protections for transgendered individuals in health care is drawing criticism from some public health groups, especially in the face of the ongoing pandemic. "The federal government should never make it more difficult for individuals to access health care — during a pandemic or any other time," American Medical Association president Susan Bailey said in a statement. 
  • Preliminary data released by Sinovac Biotech shows that its experimental Covid-19 vaccine is safe and generated an immune response in the majority of the people enrolled in a 600-person Phase 2 trial. The China-based company is evaluating the vaccine in a different Phase 1 trial and is planning on getting approval from the Chinese version of the FDA to begin a Phase 3 trial. 
  • In more vaccine news, AstraZeneca announced over the weekend that it had struck a deal to provide up to 400 million doses of its experimental Covid-19 vaccine to countries in the European Union. The company plans to begin delivering the vaccine to European countries by the end of this year under an agreement with the Inclusive Vaccine Alliance, which was formed by France, Germany, Italy, and the Netherlands. Other EU countries will also have a chance to partake in the deal. 

Parents are more hesitant about seasonal flu shots than routine vaccines

A new survey of nearly 2,200 parents finds that more parents are more hesitant about the annual flu vaccine than about routine immunizations. About a quarter of those surveyed expressed hesitancy about giving their child influenza vaccinations, compared to 6% who were hesitant about routine childhood vaccines. Around 1 in 8 expressed serious concerns about side effects about the two vaccine groups. And while 70% agreed that routine immunizations are effective, only 26% said the same about influenza vaccines. The authors suggest that low efficacy rates of seasonal flu vaccines may be to blame for the higher hesitancy towards them. In a related editorial, experts suggest that influenza vaccines ought to be considered routine, and that primary care providers should presume giving these shots. "Instead of saying, 'Is it okay if your child receives the flu vaccine today?' providers could state, 'Today, your child will receive their recommended influenza vaccine,'" they suggest. 

HPV vaccine Gardasil approved to prevent head-and-neck cancer

The FDA approved the HPV vaccine Gardasil 9 for preventing throat cancer, a condition that affects 13,500 people in the U.S. annually. The vaccine has thus far been recommended for the prevention of cervical, vulvar, vaginal, and anal cancer, as well as genital warts, in males and females ages 9-45, and the new approval doesn't change that recommendation. Cancers of the head and neck are the most common malignancies caused by HPV, and the FDA granted accelerated approval to the vaccine for head-and-neck cancers based on data from a trial on preventing anogenital cancers. Gardasil maker Merck is now testing whether the vaccine helps prevent persistent HPV throat infections in a 6,000-person trial. 

Inside STAT: A rural getaway fears it may be next to fall in Covid-19 pandemic


Betsie Bay in Frankfort, Mich., on the shore of Lake Michigan. (MACKENNA KELLY FOR STAT)

As states move to reopen businesses and resume pre-pandemic activity, quiet corners of the U.S. that have thus far remained fairly untouched by Covid-19 fear an influx of new cases of the novel coronavirus. Take the case of Benzie County, Mich., which has thus far reported only four Covid-19 cases. Benzie is home to a transient summer population: More than 1,000 second-home owners and thousands of other vacationers are expected to come to town this summer for a few days or weeks at a time. And even though local hospitals say they're prepared for Covid-19, residents are unsure about the impact that out-of-towners will have. "The world is starting up again. I have to participate whether I’m comfortable or not," Mary Pitcher, a resident and restaurant worker, tells STAT contributor Keith Schneider. Read more here

Fewer young adults are having sex now than previous generations 

People, especially young adults, are not having as much sex compared to those previously in their age groups, according to a new study. Here's more:

  • The study: Researchers looked at nearly 20 years of data from a large national survey that asked people ages 18-44 about social, political, and health attitudes.
  • The findings: 19% of 18-24 year-old males in 2000-2002 reported no sexual activity in the past year compared to more than 30% by 2016-2018. By 2018, nearly twice as many men and women in the 25-34 age group reported sexual inactivity in the previous year as did at the beginning of the study period. Fewer people in this age group reported weekly sexual activity compared to those 25-34 in 2000.
  • The reasons: Adolescents postponing sex and dating, as well as higher rates of depression and anxiety, may be contributing factors, the authors suggest. An accompanying commentary also hypothesizes that the financial challenges faced by adolescents in recent years, unlike those of previous generations, could be impeding sexual activity. 

Survey finds parents divided on use of DEET-based repellants

As summer gets underway, a small, new survey of those with young children finds that parents are much more likely to take precautions with using bug repellant when out in the woods or swampy areas than if their child was playing in a park or out in their yard. More than half said they are usually likely to apply bug repellant to their children in wooded or swampy areas, compared to fewer than 20% who said the same about a park or backyard. Parents also seem divided on the use of repellant containing DEET — products that contain no more than 30% DEET are considered safe for children, but only about a third of parents say they use such a product. Equal numbers say they don't use DEET products or are unsure about it. Parents were also much more concerned about tick bites in their children than they are about mosquito bites, and majorities would seek medical care for telltale signs of tick bites include a fever and rash. 

What to read around the web today

  • The chaos of coronavirus in prison. The New Yorker
  • Fifty-four scientists have lost their jobs as a result of NIH probe into foreign ties. Science
  • Coronavirus created an obstacle course for safe abortions. The New York Times
  • A teen’s death From Covid-19. Kaiser Health News
  • A hospital’s secret coronavirus policy separated Native American mothers from their newborns. ProPublica

Thanks for reading! More tomorrow,

Shraddha

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Monday, June 15, 2020

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