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Morning Rounds Shraddha Chakradhar

STAT just published its 2,000th First Opinion piece, on the need for physician-scientists — like the Vietnam War's "yellow berets" — to quickly turn bedside observations in patients into Covid-19 therapies. For more such writing, sign up for the First Opinion newsletter, delivered Sunday mornings. 

U.S. advisory group lays out detailed recommendations on prioritizing Covid-19 vaccine

The National Academies of Sciences, Engineering, and Medicine yesterday issued recommendations for public health agencies to think through which groups ought to be the priority for a Covid-19 vaccine when one becomes available. Consistent with others' thinking on the subject, the report puts health care workers in high-risk settings and other first responders at the front of the line. While many have argued for priority access for people of color, the NASEM report instead focuses on the factors that have led to minority groups being among the most affected by Covid-19. Those with underlying or comorbid conditions that are high-risk — regardless of age and ethnicity — are next on the list as are those who live in overcrowded settings. A virtual public meeting on these recommendations is being held this afternoon, while the committee's final report will be ready later this month. 

Lawmakers send a letter to AAMC questioning in-person MCAT testing

Leading members of Congress are now questioning the Association of American Medical Colleges' stance on mandated in-person MCAT testing this year. As I shared earlier this summerStudents for Ethical Admissions, has been calling for the AAMC to reconsider in-person MCAT testing due to the pandemic. At least 11 students tested positive for Covid-19 after going to an MCAT testing center, SEA tells me, and others have complained of poor safety measures, including inconsistent enforcement of mask requirements. Rep. Ro Khanna (D-Calif.) and Sen. Elizabeth Warren (D-Mass.) sent AAMC a letter asking about safety protocols for students taking the nearly eight-hour-long test, the process for responding to complaints, and about offering an at-home MCAT test like other standardized tests have opted to do. In response, AAMC tells me that it believes the safety protocols it has put in place "minimize risk for examinees and are consistent with current public health guidance," and that the organization will respond to the lawmakers by the Sept. 15 deadline mentioned in the letter. 

Medical school graduates from minority groups still aren't representative of U.S. population

Even as historically underrepresented groups have come to make up a larger proportion of the U.S. population, they are not represented in equal numbers among U.S. medical school graduates, new research suggests. The proportion of graduates from underrepresented racial groups has nearly doubled since 1980, but they still only made up about a fifth of all graduates in 2018. At the same time, almost a third of the U.S. population in 2018 was made up of those from underrepresented racial groups. The study also looked at internal medicine faculty and found similar discrepancies: Although the overall number of faculty in this specialty increased nearly fourfold by 2018, only about 1 in 10 were from a minority group. 

Inside STAT: Experts see a chance for a Covid-19 vaccine approval this fall — if it’s done right

What happens if the FDA, under political pressure, approves a Covid-19 vaccine before there are robust safety and efficacy data to suggest its wide use in people? Giving the green light to a vaccine that doesn't live up to the potential shown by early data could have devastating consequences, but waiting for data from large, Phase 3 trials may not also be the only other option. Experts think there could be a middle ground, especially since the FDA has laid out some criteria for what it will take for vaccine approval, such as reducing the rate of symptomatic Covid-19 by at least 50%. "There are mechanisms by which products that have a good amount of data can be made available in a controlled way,” vaccine design expert Natalie Dean tells STAT's Matthew Herper. Read more here

In middle-aged mice, scientists find a metabolite that leads to a longer, healthier life

A mouse given AKG — a naturally occurring metabolite shown to increase lifespan in roundworms — is shown on the left. A mouse from the control group, which didn't receive AKG, is shown on the right. (BUCK INSTITUTE)

A metabolite naturally found in the human body seemed to help middle-aged mice stay healthier as they grew older but also be sick for only a short period of time before death. The metabolite, called alpha-ketoglutarate or AKG, is naturally involved in a lot of biological processes including metabolism and protein synthesis. Scientists fed 18-month-old mice (the equivalent of humans aged 55-60) AKG and tracked the mice's health until death. Mice fed AKG walked better, had better posture, and maintained a healthier coat than control mice on a regular diet. Female mice also seemed to have lower cytokine levels, which suggested lower inflammation. While the research was only in mice, scientists are hopeful these findings could pave the way for future research in humans. STAT Plus subscribers can read more here

Using AI to identify high-risk liver cancer patients 

An AI model was better than standard statistical models at predicting whether those with liver cirrhosis were likely to develop liver cancer, according to a new study. Scientists retroactively looked at VA data in nearly 11,000 individuals who had hepatitis C-related cirrhosis and who went on to develop liver cancer by the three-year follow-up, and found that a neural network-based model was better able to discriminate between those who were likely to develop cancer and those who weren't — allowing it to find more cases — and also had higher accuracy scores for predicting these results. The scientists also found that the AI model could be used to predict those with the highest risk of developing cancer so that these patients could be prioritized for treatment. 

What to read around the web today

  • U.S. says it won’t join WHO-linked effort to develop, distribute coronavirus vaccine. The Washington Post
  • HHS cancelling ventilator contracts, says stockpile is full. Associated Press
  • For home care workers, COVID-19 is a health crisis — and an economic one. The 19th
  • How foundational moments In Medicaid’s history reinforced rather than eliminated racial health disparities. Health Affairs
  • America doesn’t have a coherent strategy for asymptomatic testing. It needs one. ProPublica

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, September 2, 2020

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