Morning Rounds Elizabeth Cooney

Good morning! Programming note: Morning Rounds will take a break in observance of Presidents Day, but we'll be back on Tuesday.

Biden administration makes deal for 200 million additional Covid vaccine doses

Coming through on a promise made last month, the Biden administration has used options in existing contracts to nail down 200 million more Covid-19 vaccine doses — 100 million each from Pfizer/BioNTech and Moderna — the Washington Post first reported as the president toured the NIH. The additional shipments would increase supply by 50%, to a total of 600 million doses. At two doses per person, that would offer protection to 300 million people. Meanwhile, as the world focuses on vaccines and variants, STAT’s Matthew Herper reports that tocilizumab, a drug ordinarily used to treat rheumatoid arthritis, reduced the rate for death in Covid-19 patients by 14%, according to a major clinical trial.

Early use of blood thinners in Covid-19 patients tied to better survival

Evidence has been building for giving blood thinners to hospitalized Covid-19 patients because the disease causes unusual blood clotting. Now a new study drawn from electronic health records makes the case for prompt use of anticoagulants such as heparin. Among more than 4,000 hospital patients in the VA health system treated for Covid-19 from March through July, those who received preventive anticoagulants within 24 hours of being admitted to a hospital were less likely to die in 30 days compared with those who didn’t receive them. Among those who got blood thinners early, the death rate was 14% compared with 19% among those who did not. The authors urge randomized clinical trials to be sure, but think this real-world evidence supports the practice.

Pediatricians urge parents not to forget other vaccinations

Yesterday a CDC advisory panel released its annual recommendations on immunizations for children and adolescents with few changes. There were two exceptions: interim recommendations for the Pfizer-BioNTech Covid-19 vaccine in people 16 and older, and the Moderna Covid-19 vaccine in people 18 and older. Today the American Academy of Pediatrics encourages parents to catch up on regular immunizations their children might have missed. “While there is not yet a Covid-19 vaccine that has been approved for children, there are vaccines that prevent against other deadly diseases,” the group’s president Lee Savio Beers, said in a statement. “These diseases have not gone away during the pandemic, and so it is very important that children stay up to date on all their immunizations, in partnership with their pediatrician.”

Inside STAT: For pharmacists, vaccines mean overloaded schedules and ‘Covid cowbells’ 

Pharmacy technician Sonia Rojas in the P&P Pharmacy in Miami. (Joe Raedle/Getty Images)

The nationwide frenzy to get Covid-19 vaccines has been complicated, frustrating, and downright exhausting for millions of Americans. But take a moment to consider the plight of your local pharmacist. Working with limited supplies and imperfect scheduling systems, many are drowning under a flood of inquiries. Wait lists, where they exist, are getting longer. And even creative solutions are succumbing to the cold realities of the day. Bartle’s Pharmacy of Oxford, N.Y., hired college students on winter break to schedule appointments, but the phone system was quickly overwhelmed. To lighten the mood, patients can ring a “Covid cowbell” after they get their shot. “It’s pretty amazing to see the relief on people’s faces,” says pharmacist and co-owner Heather Bartle-Ferrarese. STAT’s Rebecca Sohn has more.

Neanderthal mini-brains yield clues to modern human evolution 

Hoping to learn what sets our brains apart from Neanderthals’, scientists inserted a gene from our extinct cousins into human brain organoids — miniature versions of the real thing — and watched them grow in a lab dish. Modern humans share much of their genetic code with archaic species like the Neanderthals and Denisovans, but the genes that aren’t shared might have been important for evolution. Researchers noticed changes in neurodevelopment after inserting the archaic gene in place of the modern one, but they’re careful not to qualify changes as better or worse. “The idea of what makes us human is an important question for anyone, whether you’re a scientist or not,” study author Michael Gregory tells STAT’s Theresa Gaffney

Drug overdose deaths up sharply, driven by synthetic drugs

There’s another epidemic going on, and it’s getting worse. Drug overdoses caused more than 70,000 deaths in 2019, the CDC reports, a 57% increase since 2013. The surge has been driven largely by potent synthetic drugs such as fentanyl, often combined with other substances. In nine states, more than 70% of overdose deaths involved synthetic opioids; the highest was 84%, in New Hampshire. The age-adjusted death rate for synthetic opioids increased by 1,040% over that time span and the death rate from psychostimulants such as methamphetamine rose by 317%. “The worsening and expanding drug overdose epidemic in the United States now involves potent synthetic drugs, often in combination with other substances, and requires urgent action,” the CDC says.

Covid-19 cases in the U.S.

Cases yesterday: 105,353
Deaths yesterday: 3,877

What to read around the web today

  • Trump was sicker than acknowledged with Covid-19. New York Times
  • Scientists use machine learning to tackle a big challenge in gene therapy. STAT
  • Biden moving to withdraw Trump-approved Medicaid work rules. Politico
  • Why it’s so hard to make antiviral drugs for Covid and other diseases. Scientific American
  • How much does a C-section cost? At one hospital, anywhere from $6,241 to $60,584. Wall Street Journal

Thanks for reading! Til Tuesday,

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