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Morning Rounds Shraddha Chakradhar

Hydroxychloroquine debate spills into congressional campaigns

The already polarized medical debate over using the antimalarial drug hydroxychloroquine for Covid-19 is becoming further politicized. The Democratic Congressional Campaign Committee in recent weeks has criticized four Republican congressional candidates for echoing President Trump's support for the drug. Even presumptive Democratic presidential nominee Joe Biden has seized on the moment, calling Trump's advocacy "totally irresponsible," after the president announced that he was taking the drug as a preventative measure. STAT's Lev Facher has more from Washington here

Here's what else is new with Covid-19: 

  • The AP reports that nearly 26,000 nursing home residents in the U.S. have died due to Covid-19, according to a CMS and CDC letter sent to state governors. That total makes up a fourth of all U.S. deaths. There have been more than 60,000 cases among this population, and the letter estimates that these numbers are likely to go higher. 
  • New data from Gilead show that its Covid-19 drug remdesivir is somewhat beneficial in those with "moderate" disease, meaning patients who were hospitalized but never needed mechanical ventilation. Patients who were given the drug for five days recovered more quickly than those who weren't given the drug, but the results among those who were treated for 10 days weren't statistically significant. 
  • In a new First Opinion, Lauren Powell describes how the confluence of current events in the U.S. marked by racism — the pandemic and the killing of a Black American by police — are a nightmare scenario for her as a Black woman and public health leader. The symptoms of both Covid-19 and racism are strikingly familiar, she writes: The coronavirus can lead to difficulty breathing, and several Black people killed by police experienced "shortness of breath" and "trouble breathing" in their final moments. And yet, "While a vaccine for Covid-19 is in development, no sweeping cure currently exists for racism."
  • The Carnegie Endowment for International Peace is hosting a virtual panel this morning featuring former HHS Secretary Kathleen Sebelius and others to discuss what lessons — including for avoiding a second wave — the 1918 flu epidemic has for combatting Covid-19. The event, which begins at 11 a.m. ET, will be broadcast live here

New Ebola outbreak in northwest DRC

The government of the Democratic Republic of the Congo has announced a new Ebola outbreak in the country. Although only one case was initially publicized, the WHO yesterday confirmed that six cases had been identified in Mbandaka, the capital of the northwestern province of Équateur. Of the six cases, four patients have died and two are still receiving care. The DRC has been fighting a separate Ebola outbreak in its northeastern provinces since August 2018, and was just days away from being able to declare the outbreak over in April this year before new cases were found and the goalposts had to once again be moved. May 14 began the new 42-day countdown there, and if no new cases are detected, that outbreak can be declared over.  

Inaccurate mental health provider directories more likely to yield surprise medical bills

New research further suggests that patients encounter inaccurate directories when trying to find mental health care providers. Previous research has identified "ghost networks" of psychiatrists — incorrect lists of providers who accept a particular type of health insurance — as a common phenomenon. In the new study, researchers surveyed a small group of people who had used outpatient mental health services in the previous year and found that more than half of those who used a directory to identify a provider ran into one of four common issues, such as incorrect contact information and the provider being out-of-network. These patients were also four times as likely to receive a surprise bill than those who didn't encounter issues with a provider directory. However, only 17% of those who encountered an inaccuracy reported lodging a complaint with a government agency or their insurance provider. 

Inside STAT: New research offers hope for a way through the blood-brain barrier


The blood-brain barrier has notoriously lived up to its protective features to not only keep invading pathogens and other unwanted molecules out of the brain, but it has also made it a challenge to ferry much-needed drugs into the brain. Now, a pair of preclinical studies from Denali Therapeutics suggest a way to overcome the barrier. The company's technique relies on having small fragments of antibodies with drugs attached to them slip past the gatekeeper molecules in the brain's cellular lining. "The blood-brain barrier has been a huge bottleneck for drug delivery, but Denali’s work is an example of how science is now breaching the brain’s defenses," bioengineer Jordan Green tells STAT's Meghana Keshavan, adding that this could open the door for medicines for conditions from Alzheimer's to several rare diseases. STAT Plus subscribers can read more here

Telehealth claims balloon by over 4,300% in a year

Echoing other reports that have looked at recent trends in telemedicine, a new FAIR Health study finds that insurance claim lines for telehealth increased by more than 4,300% from March 2019 to March this year. Here's more: 

  • Overall trends: 0.17% of medical claim lines in March 2019 were related to telehealth, compared to more than 7.5% this March, an increase by more than 4,300%. 
  • Conditions: Consistent with last year, mental health conditions made up the most telemedicine claim lines, followed by acute respiratory infections and diseases. 
  • Covid-19's influence: The influence of the pandemic was most pronounced when looking at geographic trends. Northeastern states in the U.S., which were among the hardest hit, saw a more than 15,500% increase in telehealth use. 

Congressional candidates websites rarely focus on child health policies

While health care is often featured prominently in U.S. election campaigns, a new study finds that pediatric health policy doesn't get featured prominently on campaign sites. Researchers looked at campaign websites for Democrats and Republicans running for the U.S. House of Representatives between 2008-2018  — for a total of around 4,600 candidate sites — and found that pediatric health was discussed on only about 14% of candidate sites in relation to health care or education issues. And only 11% of sites mentioned specific pediatric health policies. More than 18% of sites for Democratic candidates included such policies, compared to fewer than 4% of Republican candidates' sites.  

What to read around the web today

  • Warnings surface about new system to disinfect N95 masks. The Wall Street Journal
  • China delayed releasing coronavirus info, frustrating WHO. Associated Press
  • Monster or machine? A profile of the coronavirus at 6 months. The New York Times
  • The secret, absurd world of coronavirus mask traders and middlemen trying to get rich off government money. ProPublica
  • NIH-halted study unveils its massive analysis of bat coronaviruses. Science

Thanks for reading! More tomorrow,


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Tuesday, June 2, 2020


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