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Morning Rounds Shraddha Chakradhar

Can contact tracing work to prevent another lockdown in the U.S.?

(ALEX HOGAN/STAT)

Even as states such as Alaska and New York are working to increase the number of trained contact tracers to keep track of Covid-19, experts are cautioning that for the method to work in the U.S., the country is going to need a lot more money, more people, and more cooperation than what's currently in place. There are many logistical complications: With around 20,000 new Covid-19 infections daily, that means a lot of new people to track down and trace, a big task given the limited number of tracers available. But even focusing on smaller clusters of cases could be useful. "[E]ven if we can’t stop all transmission, it’s still a really important effort to keep case counts low,” infectious disease epidemiologist Emily Gurley tells STAT's Andrew Joseph. More here


Here's more of the latest with Covid-19: 

  • The Boston Marathon has now been canceled after being rescheduled to September from April — the first time the race won't take place in 124 years. Mayor Marty Walsh said the event this year "is not feasible for public health reasons." Other major marathons may still be held: New York City's is still scheduled for November, while London's (also postponed from April) is on track for early October. 
  • Some of the biggest names in gene therapy, including pioneer James Wilson, are rallying behind using the technology to come up with a possible Covid-19 vaccine. A Massachusetts Eye and Ear team is collaborating with Wilson's team at UPenn to develop the vaccine, known as AAVCOVID, and Novartis' gene therapy arm has also signed on to manufacture supplies of the experimental vaccine at no cost for human trials. 
  • There have been 208 Covid-19-related attacks on health care workers across 13 countries since March, according to the International Committee of the Red Cross. The actual number of incidents, which have ranged from verbal threats to burning down facilities housing Covid-19 patients, are also likely to be much higher than what the agency calculated, ICRC President Peter Maurer shared

U.S. adults still afraid to go to a hospital over Covid-19 fears

A new survey reinforces the fact that many Americans' fears of contracting Covid-19 at a hospital are keeping them from seeking essential care. The new survey, conducted by the Society for Cardiovascular Angiography & Intervention, included responses from around 1,000 U.S. adults over the age of 30. It found that 36% of respondents view going to the hospital as risky behavior, which is higher than the number who view going to a salon as risky (27%) and those who would reconsider going to the beach (16%). Asked further about going to a hospital, 61% said they felt they were somewhat or very likely to acquire Covid-19 there. Half of respondents said they were more afraid of contracting the infection than they were of experiencing a heart attack or stroke, while nearly 60% said the same about a family member. 

CVS to test prescription delivery via self-driving vehicles

Self-driving vehicles may soon may be delivering prescriptions to homes. CVS Pharmacy announced yesterday that, starting next month, it would partner with technology company Nuro to test its self-driving vehicles to bring prescriptions and other products to some customers in the Houston area. Nuro has already tested its vehicles for Domino's Pizza delivery and grocery delivery with the Kroger chain. With the CVS partnership, customers will receive their prescriptions within an hour of placing the order. When the self-driving vehicle pulls up, customers will have to confirm their identity in order to unlock the vehicle and get their supplies. Self-driving vehicles are the latest attempt at automating delivery: CVS partnered with UPS to test delivering prescriptions via drone in one North Carolina city. Walgreens has also tested delivering orders via drone, although it hasn't yet included prescriptions. 

Inside STAT: Bacteria form distinct populations in tumors depending on the cancer type


Breast cancer cells (KHULOUD T. AL-JAMAL, DAVID MCCARTHY & IZZAT SUFFIAN/WELLCOME)

Research in recent years has turned up surprising relationships between cancer and the microbiome, including its ability to influence response to chemotherapy. And in a new study, scientists report that different tumors have their own microbiomes. And these microbial communities could be exploited to make the cancers more responsive to targeted therapies. Researchers looked at more than 1,500 samples that represented seven different types of cancers — and found seven sets of bacteria that corresponded with each tumor type, with breast tumors having the most diverse set of bacteria. STAT Plus subscribers can read more from STAT's Elizabeth Cooney here

Chronic disease associated with an increased likelihood of tooth loss

The risk of tooth loss seems to increase with the number of chronic diseases one has, according to new CDC data. Tooth loss can lead to poor diet and cause further health problems including fluctuations in weight. Researchers looked at data from a large national health survey and found that between 2011-2016, those with at least one chronic disease such as rheumatoid arthritis or emphysema had at least a 50% higher risk of also having tooth loss — in the form of either eight or fewer teeth or no teeth at all. The trend toward loss of functional teeth (having fewer than the standard set of 28 teeth) improved over a nearly 20-year period, from 43.5% of people lacking a full set of teeth in 1999 to less than 32% in 2016. Although the findings represent an association, health care professionals can warn their chronic disease patients about the risk of tooth loss and refer them to dental care, the scientists write. 

More than 1 in 10 new mothers are uninsured

A new report from the Urban Institute finds that more than 1 in 10 new mothers in the U.S. didn't have health insurance between 2015-2018, most of whom were Hispanic and lived in the South. Here's more from the report: 

  • Overall trends: 11.5% of new mothers between 2015-2018 were uninsured. More than half of these women were Hispanic, and close to two-thirds lived in the South. 
  • Access to care: About 20% of these new mothers reported not being able to get some kind of medical care in the past year because of cost, while more than half expressed concern about medical bills. 
  • Public insurance: Half of those who were uninsured said that they lost Medicaid coverage soon after their pregnancy, indicating a possible avenue for extending Medicaid benefits into the postpartum period. 

What to read around the web today

  • What the growing rift between the US and WHO means for Covid-19 and global health. Nature
  • Covid-19 study on hydroxychloroquine use questioned by 120 researchers and medical professionals. The Guardian
  • Covid-19 creates long, anxious waits for fertility treatments Wired
  • White House and CDC remove coronavirus warnings about choirs in faith guidance. The Washington Post
  • How we make decisions during a pandemic. Knowable Magazine

Thanks for reading! I'll be back with more on Monday, 

Shraddha

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Friday, May 29, 2020

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