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Morning Rounds Elizabeth Cooney

On the brink of 500,000 Covid-19 deaths in the U.S.

It feels both incomprehensible and inevitable that the U.S. death toll would reach this many people lost to the coronavirus. A year into the pandemic, the running total of lives lost is about 498,800, or, as the Associated Press notes, roughly the population of Kansas City, Mo., and just shy of the size of Atlanta. The figure compiled by Johns Hopkins University surpasses the number of people who died in 2019 of chronic lower respiratory diseases, stroke, Alzheimer's, flu, and pneumonia combined. "People will be talking about this decades and decades and decades from now," the nation's top infectious disease expert, Anthony Fauci, said yesterday on "Meet the Press."

FDA issues alert on ‘limitations’ of pulse oximeters, but omits racial differences

Without explicitly mentioning racial disparities, the FDA issued a public warning on Friday about potentially inaccurate readings from pulse oximeter devices. “Be aware that multiple factors can affect the accuracy of a pulse oximeter reading, such as poor circulation, skin pigmentation, skin thickness, skin temperature, current tobacco use, and use of fingernail polish,” the FDA’s alert reads. A December 2020 letter in the New England Journal of Medicine said the oximeters were nearly three times as likely to miss hypoxemia — below-normal blood oxygen levels — in Black patients versus white patients. “I am hopeful that the FDA will … reconsider the standards they use for determining whether these devices work the same for people of all skin tones,” Michael Sjoding, an author of that NEJM letter, told STAT.

Most vaccine clinical trials fail to report data on participants’ ethnicity or race

Maybe it’s not surprising that an analysis of a decade’s worth of vaccine clinical trials found that Black Americans, Latinos, American Indians, and Alaskan Natives, as well as people 65 and older, were underrepresented as participants in these studies. More striking, the researchers say, was that of the 230 trials — encompassing some 220,000 people — more than 40% did not record participants’ race and about 65% did not report their ethnicity. “This is a massive gap in information, and if we want to improve enrollment in clinical trials and we want to see diversity in clinical trials, we need the data,” study author Steven Pergam tells STAT’s Nicholas St. Fleur. “It’s amazing that we don’t have the data.”

Inside STAT: Diversifying medicine and democratizing research, too

 (alex hogan/stat)

All of Us, a $1.5 billion federal initiative to collect health data from 1 million Americans of diverse backgrounds, has been heralded as an ambitious bet to broaden the reach of precision medicine. But the technology being developed in lockstep with All of Us also stands to democratize research. The project is working with the Broad Institute, Vanderbilt University Medical Center, and Alphabet’s life science company Verily to build Researcher Workbench, a cloud-based analytics platform now opened up to more researchers around the country. “We want to bring this research to an audience who’s been denied access. That is a participant problem, but it’s also a researcher problem,” All of Us chief technology officer Chris Lunt tells STAT’s Katie Palmer.

Inequalities show up in which health care workers get Covid-19 vaccine 

Health care workers have been the first in line to receive Covid-19 vaccine, but what kind of health care worker matters in who actually gets the shots. A new survey concludes that a 50-year-old white male doctor in the Northeast making more than $200,000 a year had a 45% chance of being vaccinated but a 45-year-old Black female nursing assistant in the South earning less than $50,000 had only a 6% chance. The survey did not look into questions of availability, such as whether hospitals were more likely to have vaccine than nursing homes. But it did ask about vaccine hesitancy, finding that attitudes among health care workers almost mirror the rest of Americans’ on hesitancy (37% vs. 41%) and resistance (21% vs. 23%).

Prenatal diet linked to obesity in late childhood

Studies exploring potential connections between a mother’s diet during pregnancy and a child’s health have found associations between maternal malnutrition and a higher risk of obesity and diabetes in children. A new observational trial of more than 16,000 mother-child pairs in seven European countries analyzed the quality of prenatal diets, looking for any link between foods that increase chronic inflammation and later overweight, obesity, and body composition in children. While not able to show cause and effect, the results suggest such a diet during pregnancy was associated with obesity and lower muscle mass in children at age 10. “Promoting an overall healthy diet, high in fruit and vegetables and low in refined carbohydrates and red and processed meat, throughout pregnancy may help prevent childhood obesity,” study author Catherine Phillips says.

Covid-19 cases in the U.S.

Cases yesterday: 56,495
Deaths yesterday
: 1,249
Vaccine doses distributed, per CDC: 75,204,965
Total doses administered: 63,090,634

What to read around the web today

  • ‘We are going to keep you safe, even if it kills your spirit.’ New York Times
  • The Covid conundrum: Why does the pandemic seem far deadlier in some countries than in others? The New Yorker
  • ‘A doozy of a year’: Experts worry screen time during Covid-19 could increase vision problems in kids. STAT
  • Hospitals confront water shortages in winter storm aftermath. Associated Press
  • The youngest victims of a national calamity, and the people they left behind. Washington Post

Thanks for reading! More tomorrow,

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