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Morning Rounds Shraddha Chakradhar

U.S. to ship up to 60 million vaccine doses to the rest of the world

Following intense pressure and calls to help other countries combat the Covid-19 pandemic, the U.S. announced yesterday that it would ship up to 60 million doses of the AstraZeneca vaccine to the rest of the world. The shipment would be pending a safety review by the FDA. Many other countries in the world are already using the vaccine from AstraZeneca, called Covishield, but it has not yet been authorized by the FDA. About 10 million doses of the vaccine have been produced and pending the FDA's sign-off, could be shipped in the coming weeks. According to the Associated Press, which first reported the news, an additional 50 million doses are in various stages of production, and could be ready to ship in the next two months as long as the FDA gives the green light. 

World agencies launch initiative to combat Covid-related childhood vaccine disruptions 

Covid-19 is continuing to disrupt childhood vaccination programs around the globe, as new WHO data revealed that 228 million children are currently vulnerable to dangerous infectious diseases like measles, yellow fever, and polio. Sixty immunization campaigns in 50 countries have been suspended because of the pandemic. “We cannot trade one global health crisis for another,” UNICEF Executive Director Henrietta Fore said during a WHO press conference yesterday. The WHO, UNICEF, and other partners are launching a plan to maximize the impact of vaccination over the next decade. Immunization Agenda 2030 will aim to halve the number of children — currently estimated at 10 million — who receive no vaccinations at all and achieve 90% coverage for key vaccines. “We have no time to waste,” Fore said. “Lost ground means lost lives.”

FDA to weigh revoking approval of some cancer drugs

A three-day meeting at the FDA kicks off today to discuss whether cancer therapies that were approved based on early potential are continuing to help patients. In recent years, the FDA has taken to allowing shortcuts such as single-arm trials to ensure that potent drugs can get to patients quickly, but it hasn't regularly followed up on whether drugs approved this way lived up to their promise. During the meeting, the agency will hear from the makers of Keytruda, Opdivo, and Tecentriq, as well as from cancer experts about the clinical value of these drugs. Although these therapies have proven successful for the treatment of skin and lung cancers, their use for other conditions, including bladder, throat, and liver cancer, have been called into question, and this week's presentations will help the regulatory agency decide next steps with these drugs.

Inside STAT: Why aren’t more communities using door knocking to get out Covid info?


(HYACINTH EMPINADO/STAT)

Door-to-door knocking has long been established as an effective tool for getting information about community-wide happenings, especially to vulnerable groups such as immigrants. Yet, there hasn't been a concerted effort to use this strategy to get the word out about Covid-19 vaccinations. Experts point to the fact that state health department budgets are already stretched thin, limiting their ability to hire people to knock on doors. The practice also works best if those doing the outreach have established relationships within the community they're working with. “If you don’t have the systems already in place, it’s really difficult to build those systems up in a pandemic,” one expert tells STAT's Alicia Diaz, who has more here.

Shift workers may be more vulnerable to Covid-19 than those working regular business hours

Shift workers — those whose jobs require working outside the usual 9 a.m.-5 p.m. schedule or involve changing work schedules — seem more likely to be infected with Covid-19, according to a new study. Looking at data from more than 280,000 participants ages 40-69 in the U.K., researchers found that those doing some shift work were more than twice as likely to have had a positive Covid-19 test than those with regular work hours. Those whose jobs involved permanent shift work were 2.5 times likelier to have been diagnosed with Covid-19. These risks were largely unchanged even after the scientists accounted for BMI, smoking, and other known risk factors for Covid-19. One reason to explain these correlative findings: Shift work could alter the body's circadian rhythm and therefore immune response to an invading pathogen. 

Out-of-network bills for lab services more common than other medical services

Although out-of-network bills for lab services is still uncommon among patients with private insurance, a new study finds that such bills are far more common than other out-of-network services. Scientists analyzed insurance claims data from more than 12 million insured individuals in 2018, and found that 30% of them had at least one out-of-network bill. Those for lab services were five times more common than out-of-network emergency department bills and 34 times more common than such bills for anesthesiology services. On average, an out-of-network lab service was almost $25 higher than an in-network lab service, and patients who went to an out-of-network lab also had almost twice the number of services than those who went to in-network facilities. 

Covid-19 in the U.S.

Cases yesterday: 47,691
Deaths yesterday: 474

What to read around the web today

  • A revolution is sweeping the science of ancient diseases. The Atlantic
  • Parents want justice for birth injuries. Hospitals want to strip them of the right to make that decision. ProPublica/Miami Herald
  • ‘The next big one must be prevented’: The lessons the world can learn from epidemics that were contained. STAT
  • Black lives are shorter in Chicago. My family’s history shows why. New York Times
  • Drug pricing déjà vu: Now it’s Democrats struggling to unite on the issue. STAT+

Thanks for reading! More tomorrow,

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