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Morning Rounds Elizabeth Cooney

AstraZeneca's Covid-19 vaccine information may have been 'outdated,' safety board says

The positive data that AstraZeneca announced yesterday from a Phase 3 trial of its Covid-19 vaccine “may have included outdated information,” stated an unusual, two-paragraph midnight press release issued by the National Institute for Allergy and Infectious Diseases. “Late Monday, the Data and Safety Monitoring Board (DSMB) notified NIAID, BARDA, and AstraZeneca that it was concerned by information released by AstraZeneca on initial data from its COVID-19 vaccine clinical trial,” the statement reads. “The DSMB expressed concern that AstraZeneca may have included outdated information from that trial, which may have provided an incomplete view of the efficacy data.”

A spokesperson from the drug company told the Associated Press it was “looking into it.” AstraZeneca reported the vaccine, which it developed with the University of Oxford, reduced the number of infected people who had symptoms of Covid-19 by 79% and reduced severe cases of Covid-19 by 100%. At the time, one analyst called the data “surprisingly positive.”

Frontline health care workers’ Covid risk linked to sleep problems and burnout

By the very nature of their work, frontline health care workers are at high risk of Covid-19 infection. A new study in six countries (France, Germany, Italy, Spain, the U.K., and the U.S.) links the sleep problems and burnout that can come with that demanding work to an even higher risk of health care professionals becoming infected. Among 2,884 workers exposed to Covid patients daily who responded to a survey last summer, 568 developed Covid. For each hour longer that they slept, workers' odds of contracting Covid fell 12%. Having severe sleep problems upped the odds by 88%. People who reported daily burnout were more than twice as likely to have Covid and three times as likely to say it was severe.

What we know and don't know about long Covid

Long Covid — the constellation of prolonged symptoms after infection — has no formal name or definition. I talked with Kartik Sehgal, author of a review published yesterday that culled the scientific literature to guide treatment. Our full conversation is here.

What is the most pressing problem to address about long Covid?
The most important question right now is, how can we help identify patients who may be at higher risk of long Covid?

Some people with long Covid feel better after vaccination. Why?
If there are low levels of virus hiding in a reservoir in the body or viral genetic material, the immune system may be activated by the vaccine. But this is not proven. The vaccine may also have an effect on the immune system and may help in terms of redirecting it from whatever may be causing long Covid. There is scientific feasibility behind this, but not enough data. We recommend everyone get their Covid vaccine, and this could be another reason for patients who may have had Covid.

Inside STAT: The scramble to bring Covid-19 vaccines to homebound Americans

Sherri Young monitors Elanda Fauber after administering the Johnson & Johnson Covid-19 vaccine at her home outside Charleston, W.Va. (CHRISTOPHER JONES FOR STAT)

While most homebound Americans have been vaccine-eligible for months, many have been forgotten by a system that prioritized mass vaccination sites and assisted living facilities. “I could not stand in line and go to the Civic Center,” Karen Meadows told Sherri Young, her county’s top health official and the doctor who inoculated her  during a house call. The homebound have little chance of receiving a vaccine if not for the heroism from individual health workers, and their choice to spend precious hours making painstaking, door-to-door treks to administer doses one at a time. Young’s West Virginia journey to deliver barely a dozen vaccines required a day of driving and hours of planning beforehand, too. STAT’s Lev Facher has more.

Wildfire smoke is especially harmful to children

Last year’s wildfire season was one of the worst in California’s history. New research takes a closer look at how the particulates in smoke from such fires is particularly bad for children who breathe them in, leading to far more pediatric respiratory care visits than other airborne fine particles. A 10-unit increase of airborne particles less than 2.5 micrometers wide from wildfire smoke was associated with a 30% spike in hospital admissions, compared to 3.7% from non-smoke sources, such as traffic emissions. The study in San Diego County from 2011 to 2017 — a period when wildfires were mild — led the authors to conclude that fires do not have to be extreme to produce impacts in children’s health.

There are Covid-19 stamps?

There are. Twenty-one countries and the U.N. have released 68 postage stamps marking the coronavirus pandemic. Like the speedy sequencing of the virus and development of vaccines, the stamps raced ahead of the first AIDS-related stamp, which appeared years after the discovery of HIV. This time Iran was first out of the chute last March, followed by the rest of the world in honoring clinicians, patients, hand-washing, and other health measures. French Polynesia's shows two women wearing matching floral print masks, sitting six coconuts apart. Some images mix their health care worker/soldier metaphors: Ukraine’s sports a split masked face, half-caregiver, half-soldier. The Isle of Man simply gives its superhero health care worker a floating red cape. See them all here.

Lorem Covid-19 cases in the U.S.

Cases yesterday: 50,584
Deaths yesterday
: 590

 

What to read around the web today

  • The coal plant next door. ProPublica
  • Lawmakers introduce a bill to prevent Sacklers from using bankruptcy ‘loophole’ to evade liability. STAT+
  • Hospitals hide pricing data from search results. Wall Street Journal 
  • Relearning to smell after Covid-19 is its own strange experience. The Atlantic
  • Opinion: Vaccine passports won’t get us out of the pandemic. New York Times

Thanks for reading! More tomorrow,

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