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Morning Rounds Elizabeth Cooney

In states with the biggest wealth gaps, the rich are vaccinated at higher rates than the poor


The affluent town of Woodbridge, Conn., has less than half the population of neighboring Ansonia, and yet it is home to more people who have received at least one dose of the Covid-19 vaccine. Connecticut has the most glaring disparity in vaccination rates between its richest and poorest communities — a difference of 65% — according to a STAT analysis of local-level vaccine data in 10 states with the biggest wealth gaps. The data back up anecdotal reports from around the country. “We’re seeing individuals who have privilege and access who are edging out the people who don't," said Tekisha Dwan Everette, executive director of Health Equity Solutions in Connecticut. STAT’s Olivia Goldhill has more.

Why do nursing homes with the fewest white residents have three times as many Covid deaths?

Covid-19 has dealt a crushing blow to nursing home residents. At risk because of age and shared living conditions, they account for 4 out of 10 pandemic deaths. A new study asks why deaths were three times higher in places with fewer than 60% white residents compared to those with more than 97% white residents. Differences were linked to nursing home size — Black people are more likely to live in larger facilities and enter in worse health — and how severe Covid-19 was around them. “Because minority communities experience the highest rates of Covid-19 infection and nursing homes in those communities are generally of lower quality, non-White nursing home residents are in the eye of that perfect storm,” the researchers write.

Masks are good. Double-masking — or tucking and knotting — work even better

 (CDC)

There’s a better way to mask up, the CDC tells us. In a series of simulations, researchers discovered double-masking with one cloth mask covering a medical mask blocked particles from a cough by 96%. The same was true for wearing a medical mask with strings knotted and tied and sides tucked in close to eliminate gaps. That increased protection — twice as high as cloth mask alone or medical mask alone — came when both “sender” (cougher) and receiver were either double-masked or wore a single tucked and knotted medical mask. But a double-masked receiver’s exposure from an unmasked cougher was still cut by 83% and the knotted and tucked medical mask wearer's by 65%. “Until vaccine-induced population immunity is achieved, universal masking is a highly effective means to slow the spread of SARS-CoV-2,” the report says.

Inside STAT: ‘A natural experiment’: Drop in cancer screening may aid research on overdiagnosis

(KIMBERLY P. MITCHELL/DETROIT FREE PRESS VIA AP)

It’s counterintuitive, but catching cancer early isn’t always for the best. And the coronavirus pandemic might leave lessons for future cancer screening in its wake. Cancer diagnoses fell off a cliff in the pandemic’s first surge, and so did cancer screening tests, alarming NCI Director Ned Sharpless about a future public health crisis. Come January, he mused about the flip side of early detection: overdiagnosis, when asymptomatic cancers are found that may not grow to harm the patient, and  its companion, overtreatment. “This pandemic has provided ... a natural experiment, where now we can look at some of these tumors that are going to be diagnosed at a later stage. Do they really do worse because of being diagnosed later?” I have more in STAT+.

Type 2 diabetes drug helped some people lose weight, study says

A drug approved to treat type 2 diabetes has shown promise in weight loss. People who had weekly injections of the appetite-suppressing semaglutide and also modified their diet and exercise had a mean loss of 15% of their body weight compared to a mean loss of 2% by people on placebo. Those results, from a study of almost 2,000 obese or overweight people in 16 countries, are better than current weight loss drugs and approach the effects of weight loss surgery, but there are caveats. The participants were mostly female and mostly white. While participants improved their blood pressure, lipid levels, and other risk factors, the trial was too short at 68 weeks to establish long-term success in the battle against obesity.

Fewer older people are having strokes, Danish study finds

Some good news, from Denmark: People age 70 and older are having fewer strokes, and fewer people of all ages are dying from them. The study, which pulled data from the country’s national health system and its stroke registry from 2005 through 2018, found drops in both ischemic strokes, when blood flow to the brain is blocked, and intracerebral hemorrhage, when a blood vessel in the brain ruptures. The incidence of strokes in adults under 50 was stable, but for people over 50, the incidence fell, mostly in people 70 or older. The results may not apply in other countries, but possible contributing factors could be widespread: better treatment of hypertension and atrial fibrillation, as well as less smoking.

Covid-19 cases in the U.S.

Cases yesterday: 94,704
Deaths yesterday: 3,364

What to read around the web today

  • Can’t find an N95 mask? This company has 30 million that it can’t sell. New York Times
  • What the WHO coronavirus experts learned in Wuhan. Associated Press
  • Leave your antibodies alone. The Atlantic
  • CVS and Walmart decide who gets leftover Covid-19 vaccine doses. Wall Street Journal
  • The broken promise that undermines human genome research. Nature

Thanks for reading! More tomorrow,

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