How a piecemeal Covid-19 response in one prison fueled a fatal outbreak

With at least 767 cases, the Covid-19 outbreak at the California Institution of Men is among the largest across the state's 35 correctional facilities. In a new story, STAT contributor Eileen Guo spoke with inmates about how the prison's slow and piecemeal response — which stuck to standard operating procedures like crowding inmates into communal spaces — has fueled the spread of the virus. “Do prisoners still have a federally protected right to safe and humane conditions?” 56-year-old inmate Anthony Barker asked in a letter he wrote to the California Correctional Health Care Services, a copy of which he shared with STAT. Read more here. 

Here's what else is new with the pandemic: 

• Surgeons at Northwestern University in Chicago performed the first known lung transplant for a patient with Covid-19. The patient, a Hispanic woman in her 20s, had been in intensive care for her coronavirus infection and on a ventilator and life support machine to help supplement function of her heart and lungs for six weeks before her medical team decided to perform a double-lung transplant. 
• A review of nearly 1,400 scientific papers published on the novel coronavirus since the beginning of the pandemic has found that only 1 in 3 authors of these papers is female. And when the scientists behind the review adjusted for seniority, fewer than 30% of authors were female. "The disproportionate contribution of women to Covid-19 research reflects a broader gender bias in science that should be addressed for the benefit of men and women alike," the authors write. 
• In a new First Opinion, scientist Bonnielin Swenor, who is visually impaired, writes about how those with disabilities may be less likely to get tested for Covid-19 given barriers to care. But such barriers for the more than 61 million Americans living with a disability also mean that "data from this group are less likely to be included in surveillance estimates," which could impede response efforts. 
• A new analysis reveals that the mandate requiring masks in public alone was associated with 78,000 fewer infections in Italy between early April and early May. In New York City, a face covering mandate was associated with 66,000 fewer Covid-19 infections between April 17 and May 9. The authors of the analysis conclude that this inexpensive measure "corresponds to the most effective means to prevent interhuman transmission" of Covid-19. 

MIT ends negotiations with Elsevier over research access dispute

MIT is the latest institution to end negotiations with publishing giant Elsevier. Since the University of California system announced last year that it would not renew its contract with Elsevier over a dispute on payment for open-access research, other universities, including the University of North Carolina, have also followed suit. MIT's announcement didn't specify the details of why it was severing ties with Elsevier, but said that the terms proposed by the publisher "did not align" with the principles that MIT has set for contracts with academic publishers. These principles, which have also been undersigned by more than 100 other universities, call for transparency and fairness in pricing in an effort to foster open-access research. Although MIT said it hopes to resume negotiations, Elsevier journals won't be available to the university's community after July 1. 

Leaving hospital against medical advice more likely to lead to readmission within a month

Some people who are admitted to hospital leave before doctors recommend their discharge, and a new study finds that these patients are at a much higher risk of being readmitted to hospital within a month. The study looked at nearly 20 million hospital admissions in 2014, around 300,000 of which resulted in people leaving against medical advice. That patient group was almost twice as likely to be readmitted to hospital within 30 days of leaving, and was also more likely to be admitted to a different hospital. Nearly 1 in 5 of the readmissions among those who left against doctors' advice happened within a day of leaving hospital, compared to 6% among those who were discharged per doctors' orders. At the same time, those who left of their own accord were 20% less likely to die in hospital. 

Inside STAT: How some cells serve as unlikely heroes to defend the brain from viral invaders

Microglia in mouse brains. (THERESA GAFFNEY AND HYACINTH EMPINADO/STAT)

Microglial cells have long been thought of as immune cells in the brain, and a new study shows just how they work to fend off viruses that try to invade the brain. Researchers infected mice with a common respiratory virus known as vesicular stomatitis to track how the immune system responds, and found that microglial cells used antigens given off by the virus to alert T cells to the presence of the pathogens. When scientists repeated the experiment in mice with reduced microglia in their brains, T cells didn't seem as responsive to the virus, suggesting that there were less microglia-produced antigen to flag the presence of RSV. Read more — and watch a video showing how microglia recruit T cells to fight viruses — from STAT's Theresa Gaffney here. 

Occupational lung disease deaths have declined

Preventable lung diseases caused by inhaling dust or other harmful particles on a job site are known as pneumoconioses, and a new CDC report finds that deaths from the condition have decreased by 40% in recent years. The report looked at national death data between 1999-2018, and found that while there were more than 2,700 cases of pneumoconioses in 1999, that fell to around 1,600 in 2018. Those aged 75-84 made up the largest group of those who died from pneumoconioses, and the condition was also most common among males and those who were white. Asbestos was associated with about 60% of the deaths, followed by coal workers’ pneumoconiosis (also known as black lung disease). This last group also saw the biggest decline — of nearly 70% — in pneumoconioses deaths since 1999. 

Medication errors cost the U.K. nearly £100 million annually

Errors in medications — whether in prescribing or dispensing them — cost the U.K.'s National Health Service nearly £100 million a year, and leads to around 1,700 preventable deaths. To arrive at these estimates, scientists looked at a 2018 review of medication errors within the NHS, and found that approximately 237 million medication errors occur in England every year. While the majority of these errors seem to pose little to no harm, the authors estimate that 66 million are potentially significant. Adverse events from these errors were estimated to cost more than £98 million a year, from the NHS having to pay for hospital stays and care. More than half the errors were made when these medicines had to be administered to patients, while about 20% were prescription errors.