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Morning Rounds Elizabeth Cooney

What’s the future of the coronavirus?

(Hyacinth Empinado/STAT)

Many experts predict the coronavirus will become a seasonal pathogen that won’t bother most of us who have been vaccinated or exposed to it. But that transition to a mild endemic virus is unlikely to be a straight line. Some researchers envision a healthier summer — with low circulation of the virus and more people vaccinated — but a more tenuous fall. How long vaccines’ protection will last, who gets them, and whether variants of the virus sap the strength of vaccines will determine the outcome. These are not predictions that people fed up with the pandemic will want to hear, STAT’s Andrew Joseph and Helen Branswell write. But some experts are optimistic. Read more about the short-, middle-, and long-term future of the virus.

Children's cancer care suffers around the world during Covid

Covid-19 is not the only threat to children with cancer. A global survey of pediatric oncologists at more than 200 medical centers in 79 countries reveals wide disruption in cancer services over last summer, including late diagnosis, unavailable chemotherapy, and patients leaving treatment. The problems were widespread in low- and middle-income countries, but to some degree, all countries experienced declines in surgical care, blood product shortages, chemotherapy modifications, and interruptions to radiotherapy. In high-income countries like the U.S. and Italy, doctors noted unusual cancer cases they thought stemmed from delayed diagnoses. “Our findings suggest that Covid-19 has had a greater impact on childhood cancer care globally than single-region studies had suggested,” study author Daniel Moreira said in a statement.

Tracking mental health visits during shelter in place

Early in the pandemic, when Californians were told to shelter in place, mental health visits rose 7% compared to the same time period a year earlier, with spikes in virtual visits for substance use up 51%, adjustment disorder (defined as sadness and hopelessness in response to stress) up 15%, anxiety up 12%, bipolar disorder up 9%, and psychotic disorder up 6%. Not all groups embraced the shift to telehealth, the retrospective observational study of nearly 100,000 patients found. Numbers of older adults, children and adolescents, and new patients were lower than the year before. “A challenge highlighted by the current work is how to reach individuals with emerging psychiatric symptoms who lack prior contact with psychiatric services,” the authors write.

Inside STAT: In Palm Beach, vaccines intended for rural Black people go to wealthy white Floridians

Community health workers at the Anquan Boldin Stadium where Covid-19 vaccines were available to the community. (Bethany Mollenkof for STAT)

A single highway connects the billionaire’s club Mar-a-Lago to Pahokee, the working-class western edge of Palm Beach County, Fla. In Pahokee, where vaccinations were administered at the high school football stadium last month, more than a third of the population lives in poverty. But the people who arrived, individually desperate for a life-protecting injection, reflected a pattern that has played out within Florida and across the United States, where the Black and Hispanic populations disproportionately affected by Covid-19 have been left behind in the vaccine rollout. Plenty of locals were vaccinated too, but they were outnumbered by the out-of-towners. They simply had to head west on Route 98. STAT’s Olivia Goldhill and Bethany Mollenkof have more in this special report.

Concussions linked to later sleep problems

People who have experienced a traumatic brain injury are more likely to develop a sleep disorder later, a new study reports. The researchers draw their conclusions from studying nearly 200,000 people in the VA health system for 14 years; half had TBIs and none had previous sleep issues. After adjusting for factors that affect sleep such as diabetes, tobacco use, or substance use disorder, the TBI group had a 40% greater risk of sleep disorders. Surprisingly, milder injuries like concussions were more strongly linked to insomnia, sleep apnea, sleep-related movement disorders, and excessive daytime sleepiness than more serious injuries. The diffuse injury and inflammation in concussions, as opposed to direct blows to the head in severe injuries, may explain the difference.

A hint to how the APOE4 gene raises the risk of Alzheimer's disease

Almost half of people with Alzheimer’s disease carry a mutation in the APOE4 gene, but scientists don’t know how the variant is connected to the disease. New research performed in lab dishes shows how this APOE4 disrupts brain cells’ ability to metabolize lipids and suggests a way to reverse this impairment. In two kinds of brain cells engineered to have APOE4, accumulating lipids made cells less able to carry out essential functions. Increasing choline, a nutrient cells need to make their membranes, overcame this problem. Choline is found in eggs, meat, fish, and some beans and nuts, and it’s sold as a supplement. Much more research needs to be done — next in mice, followed by clinical trials — before recommendations can be made.

Covid-19 cases in the U.S.

Cases yesterday: 65,909
Deaths yesterday: 2,468

In this week's episode of STAT’s “First Opinion Podcast,” First Opinion editor Pat Skerrett talks with Haider Warraich, a physician, writer, and clinical researcher, about his first experience with an American hospital after finishing medical school in Pakistan and how it seemingly turned its back on the surrounding neighborhood. Listen here.

What to read around the web today

  • Biden calls states’ moves to ease virus rules ‘Neanderthal thinking.’ New York Times
  • ID requirements are preventing some of the most vulnerable people in the U.S. from getting Covid vaccines. Buzzfeed
  • How Covid devastated a generation. Washington Post
  • Some experience delayed rashes after Moderna shots, report says. Bloomberg
  • CDC's draft guidelines for vaccinated Americans call for small steps toward normal life. Politico

Thanks for reading! More tomorrow,

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