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Morning Rounds Shraddha Chakradhar

The next round of voting is underway in STAT Madness, our bracket-style competition to identify the most innovative biomedical research. Vote on which 16 scientific teams ought to move on to the next round here

People 'shed' coronavirus early, but likely don't remain infectious after recovery

The Covid-19 situation remains in flux, but a group of German scientists think they've tracked down the window in which infected individuals are most likely to pass on the virus to others. Here's the latest: 

  • The current situation: One possible explanation for why the novel coronavirus is spreading so quickly is that people who are infected emit high quantities of the virus early on in the infection, new research finds. And although this may mean that people are still going about their daily lives because they don't yet have symptoms, scientists also found that people are likely no longer contagious by the time the symptoms subside. 
  • The near future: The Bill and Melinda Gates Foundation, Wellcome, and Mastercard are launching a $125 million initiative known as the Covid-19 Therapeutics Accelerator to spur the development of therapies against the new virus that could be available in the next year to 18 months. 
  • The long term: Top CDC official Nancy Messonnier said that the outbreak in the U.S. could continue into 2021, although taking precautions such as avoiding crowds and washing hands could still reduce the severity of illness and prevent deaths. 

New rules aim to fuel sharing of patient health records by smartphone

The Trump administration announced yesterday that it was moving forward with rules that require insurance companies and health care providers to make health records available in an easily accessible digital format for patients, in much the same way they can now access banking and other sensitive information. These companies had expressed concern that the policy, which was first announced last year, could violate patient privacy. The administration has since tweaked the rules to specify that app developers and other companies looking to use patient data from more accessible health records will have to sign an attestation that they will protect patient privacy. Patients will also have to be clearly informed about how their data may be used by third parties. The rules are scheduled to go into effect in 2022. 

STAT’s Casey Ross spoke with CMS Administrator Seema Verma to learn about the new rules and their implications for patients and companies trying to access patient data. STAT Plus subscribers can read their conversation here

The least risky time to have twins? A new study says 37 weeks into pregnancy

Twin pregnancies are extremely rare, yet such pregnancies also carry the highest risk for infant mortality and complications. Now, a new study finds that delivering twins after 37 weeks of gestation carries the lowest risk of deadly complications. Looking at a cohort of more than 43,100 twins born in Scotland between January 1980 and December 2015, scientists found that twins born between 34-37 weeks into the pregnancy had more than twice as much of a risk at dying shortly before or after birth than twins who remained in utero during that time period. Those born at 36 weeks also had a 40% increased chance of having special education needs during their schooling compared to those born after 37 weeks. However, researchers found that the risk for neonatal deaths was lowest at 38 weeks. 

Inside STAT: Coronavirus outbreak tests nation's emergency medical stockpile


N-95 face masks (EVA HAMBACH/AFP VIA GETTY IMAGES)

After the 9/11 terror attacks, when anthrax was a threat later in 2001, and when homes needed insecticide to guard against possible Zika infections, a secretive $7 billion stash of emergency medical equipment was what the U.S. government relied on to respond to each of those emergencies. The stash, known as the Strategic National Stockpile, is now facing one of the biggest challenges yet in its 21-year history as the U.S. faces a possible pandemic as a result of Covid-19. The stockpile has already been called on to help repatriate and quarantine Americans who were in China and Japan when they were infected, but things are already shaky. The entity has come under fire for a perceived shortage of respiratory masks, especially since as many as 5 million of the 13 million masks in its stores may be past their expiration date. STAT's Lev Facher has more here

Majority of adults want to age in their home, but few see it as feasible

A new survey of nearly 3,000 U.S. adults finds that although two-thirds want to grow old in their current home or community, only a third believe that they will be able to do so. Here's more: 

  • Overall trends: Those from the Greatest Generation (born between 1901-1927) and baby boomers (born 1946-1964) were most likely to want to age in their current homes, but these two groups were also the likeliest to believe they would meet that goal. 
  • Demographics: Low-income individuals and those who are Asian or Asian American are the least likely to believe they can age in place. 
  • Barriers: A quarter of respondents don't believe their home is suitable for the elderly, while nearly 30% say they don't have the funds to be able to carry on in their current setting. And 19% say they would feel alone if they aged in their current homes. 

Few residency programs train physicians on treating pregnant women with opioid use disorder

Few family residency programs in the U.S. are providing training on prescribing medication for opioid use disorder to pregnant women, according to a new survey. Looking at data from more than 5,100 family medicine physicians who responded to American Board of Family Medicine surveys in 2016, 2017, and 2018, researchers found that only 153 said they both deliver babies and prescribe the opioid use disorder medication buprenorphine. Another 108 said they provide maternity care and prescribe buprenorphine, but do not deliver babies. At the same time, 25% of those who said they prescribe buprenorphine to expectant mothers came from a minority of family medicine residency programs. The authors emphasize creating incentives for training programs to integrate opioid use disorder treatment with maternal care to improve access to the vulnerable population of mothers with substance use disorder. 

Correction: Yesterday's item on the coronavirus outlook misspelled the name of the former homeland security official who was at the Harvard forum on Friday. Her name is spelled Juliette Kayyem. 

What to read around the web today

  • A recently approved Gilead HIV prevention pill is not cost-effective and price should be cut in half, study says. STAT Plus
  • FDA and FTC crack down on coronavirus ‘fraudulent prevention and treatment claims.’ Washington Post
  • Publishers roll out alternative routes to open access. Science
  • Haunted by a gene. New York Times
  • Want to do better science? Admit you’re not objective. Nature

Thanks for reading! I'm out of the office for the next couple of weeks, but rest assured that my colleagues will still bring you this newsletter every morning! 

Shraddha

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Tuesday, March 10, 2020

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