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Morning Rounds Shraddha Chakradhar

Good morning. Elizabeth Cooney here, subbing for Shraddha. Let’s get to the news.

N95s are still in a shortage,’ worrying hospitals

Early shortages of medical respirators known as N95 masks have persisted long past March, when the coronavirus surged in New York and first overwhelmed protective equipment supplies across the country. And while White House officials say U.S. hospitals have all the medical supplies they need, frontline health care workers and hospital officials told the Associated Press that’s not what they see. “N95s are still in a shortage,” said Mike Schiller, the American Hospital Association’s senior director for supply chains. “It’s certainly not anywhere near pre-Covid levels.”

In other Covid-19 news:

  • Racial disparities in the coronavirus pandemic extend to people who stayed home from work with probable Covid-19 symptoms, a new study concludes, based on data from the Census Bureau Pulse Survey. Compared to people still working or absent with other illnesses or disabilities, adults home sick with Covid-19 symptoms had lower incomes, were more likely to be Black, Hispanic, or Asian, had less education, and lacked health insurance and food security.
  • Nursing home residents account for about 40% of Covid-19 deaths in the U.S. A new study suggests an association between unionized workers, unions’ greater access to PPE and infection control policies, and reduced death rates in 335 New York state nursing homes.

Preventable deaths, racial disparities, and health care costs were getting worse, even before Covid

American life spans are projected to be shorter today than in 2014, Black people are twice as likely as white people to die of treatable conditions, and health care costs keep going up while gains in health insurance coverage have stalled. Those sobering statistics, from the Commonwealth Fund’s 2020 Scorecard on State Health Performance, are more deeply worrying because they are based on data collected before the Covid-19 pandemic began decimating the jobs people depend on for health insurance. Some states do better than others: Hawaii, Massachusetts, Minnesoate, Iowa, and Connecticut scored higher on 49 measures of health while West Virginia, Missouri, Nevada, Oklahoma, and Mississippi did the worst. “The novel coronavirus has exposed and exacerbated existing weakness,” the report says.

The ‘Oscars of Science’ carry on, without superstar presenters (yet)

This year’s Breakthrough Prizes honor luminaries in life sciences, mathematics, and physics. Here are the four life sciences winners, who will each receive $3 million, and perhaps attend a glitzy gala postponed until March with superstars of movies, music, sports, and tech entrepreneurship.

  • David Baker, University of Washington and Howard Hughes Medical Institute, for developing tools to unravel protein folding and design novel proteins.
  • Catherine Dulac, Harvard University and Howard Hughes Medical Institute, for mapping the neural pathways governing parenting behavior to the level of specific brain cells.
  • Yuk Ming Dennis Lo, the Chinese University of Hong Kong, for discovering that fetal DNA is present in maternal blood and can be used for the prenatal testing of genetic disorders.
  • Richard Youle, National Institutes of Health, for revealing a cellular pathway that clears damaged mitochondria and protects against Parkinson’s disease.

Inside STAT: A window into persistent post-Covid symptoms

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A recovering Covid-19 patient rides an exercise bike to strengthen her muscles at a rehab facility in Genoa, Italy. (MARCO DI LAURO/GETTY IMAGES)

For years, DePaul and Northwestern researchers collected personal information and blood samples from healthy college students to track who contracted mononucleosis and later developed chronic fatigue syndrome — the debilitating disease also known as myalgic encephalomyelitis that’s frequently triggered by an acute viral illness. As the team was analyzing data earlier this year, reports began emerging of troubling and prolonged medical complaints following cases of Covid-19. That’s when Leonard Jason and his colleagues realized the extensive baseline data and biological materials they had gathered created a unique opportunity to investigate risk factors for illness after infection with the novel coronavirus. “There might be characteristics of individuals that might be genetic or physiological or behavioral that in some ways predispose some people toward both getting an illness and then maybe not recovering from the illness,” Jason tells STAT contributor David Tuller. Read more.

Beyond chromosomes: Sex matters in gene expression

More than a third of human genes show sex-based differences in at least one type of tissue, a new study from the Genotype-Tissue Expression Consortium concludes, potentially explaining why biological processes look different in males and females, including immune responses and cancer. GTEx found modest but ubiquitous variations, but a commentary appearing with the study notes bias in the samples behind the research. Two-thirds came from men, the average age was 50, and nearly 85% were from white people of European ancestry. “Given these limitations of the samples, it is even more surprising — and should be motivating to human geneticists — how much interindividual variation is observed,” the commentary author writes.

Cutting opioid use for cesarean deliveries finds success

Opioids to relieve pain after surgery have become both a mainstay of hospital care and a potential risk for later addiction. A new study explores a different way to manage cesarean delivery, which for many patients is their first exposure to the drugs. Researchers compared how patients did before and after testing a policy using local anesthetics during surgery and starting postoperative treatment with non-opioid painkillers with the option to get opioids if needed. Among 2,171 deliveries before the new policy, 84% of patients received opioids while in the hospital, compared to 34% of the 1,508 patients who delivered babies after the policy was implemented. Patients took a median total of 56.5 milligrams of opioids before but 15 milligrams after the new policy. And patients in the non-opioid group went home about half a day sooner.

What to read around the web today

  • $2,933 for ‘Girl’s Night’: Medicaid chief’s consulting expenses revealed. Politico
  • Three star science writers discuss the Covid-19 beat — and how the media will cover a vaccine. Slate
  • Opinion: ‘Hell has frozen over’: The pharmaceutical industry stands in for a politically impaired FDA. STAT
  • What’s in wildfire smoke, and why is it so bad for your lungs? The Conversation
  • I got blown up in Iraq. Years later, amputating my leg set me free. New York Times

Thanks for reading! More on Monday,

Shraddha

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Friday, September 11, 2020

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