Interest grows in low-dose radiation for Covid-19, but experts are divided 

As Covid-19 has continued to snowball and researchers continue to search every possible avenue for a treatment for the infection, an old idea for treating inflammation in the lungs has resurfaced: low-dose radiation therapy. The idea originally emerged after scientists found data suggesting that small amounts of radiation could combat pneumonia, and now at least a dozen trials worldwide are testing whether low doses of radiation could help reduce inflammation in the lungs of those with Covid-19. But experts are divided on the issue, with some suggesting that radiation to the lungs could exacerbate damage to the organ. Read more from STAT's Juliet Isselbacher. 

Here's what else is new with the pandemic: 

• “I cannot figure out in my wildest dreams why they would want to do that,” top infectious disease official Anthony Fauci told The Atlantic in a series of interviews in response to recent attacks from the White House on his credibility. “I think they realize now that that was not a prudent thing to do, because it’s only reflecting negatively on them,” he said.  
• Fixing the U.S.' coronavirus testing system is going to take $75 billion, according to a new report from The Rockefeller Foundation, which is also committing $100 million to the global fight against Covid-19. The report suggests ramping up two types of tests — PCR and antigen — as solutions to addressing the problem in the U.S. Read more here. 
• The National Academies of Science, Engineering and Medicine released a report yesterday encouraging schools to prioritize opening in the fall, especially for kids in grades 5 and under and kids with special needs. "[Y]oung children in particular will be impacted by not having in-person learning and may suffer long-term academic consequences if they fall behind as a result," a statement from NASEM says. While the new report is in line with other groups, such as the CDC, also calling for schools to reopen, the NASEM guidelines are among the first to distinguish between older and younger children.
• The WHO and UNICEF are warning of the decline in children getting needed vaccinations due to supply disruptions caused by Covid-19. Even before the pandemic hit, vaccination rates for some diseases had stalled at 85%, with 14 million children going unvaccinated last year. 

Infant mortality rate was at a record low in 2018

The U.S. infant mortality rate in 2018 hit another historic low, according to new CDC data. Here's more: 

• Overall trends: There were nearly 21,500 infant deaths in 2018, for a rate of around 5.7 deaths per 1,000 live births. In contrast, there were more than 22,300 deaths in 2017 — a rate of 5.8 deaths per 1,000 live births.
• Race and ethnicity: The mortality rate in 2018 was highest among infants born to Black women, and lowest among those born to Asian women. Infants born to Native Hawaiian or Pacific Islander women were the only group that experienced an increase in mortality rate in 2018.
• Cause of death: Like in 2017, congenital malformations were the leading cause of death for infants in 2018. There were fewer deaths due to unintentional injuries and maternal complications in 2018 compared to the previous year. 

Conditions that increase risk of colorectal cancer are on the rise among millennials

Conditions that pose a risk for developing colorectal cancer — which is on the rise among millennials — are also increasing in that age group, according to new report from Blue Cross Blue Shield. Rates of obesity — which raises risk of colorectal cancer by a factor of 1.3  —  rose 100% between 2014-2018 among those ages 24-39, according to the report. Incidence of type 1 and 2 diabetes and Crohn's disease or ulcerative colitis, which nearly double the risk of colon cancer, also increased. Even before the Covid-19 pandemic hit, many people in the U.S. did not get screened as recommended, the report states, emphasizing the need to get this preventive service as practices around the country slowly reopen from the pandemic. 

Inside STAT: States slash addiction treatment budgets, even as overdoses spike

Hypodermic needles litter the ground in the South Bronx on March 13, 2019 in New York City. (SPENCER PLATT/GETTY IMAGES)

Even as the U.S. reports skyrocketing rates of opioid overdoses in the wake of the Covid-19 pandemic, states are still moving forward with plans to slash their budgets for opioid crisis programs. Some states such as Colorado and Florida had already cut millions from programs to combat substance use disorders, and the economic effects of the pandemic have other states poised to follow suit. These budget cuts are likely to hurt behavioral health services at a moment when they're most needed, experts tell STAT's Amy Sokolow. “It was already a significant issue for cities to support this. Post-Covid, you have higher rates of opioid use and overdoses and less resources,” Sue Polis, director of health and wellness for the National League of Cities, says. Read more here. 

Q&A: Providing structural support to underrepresented minorities in academia

A new paper in the New England Journal of Medicine outlines some of the systemic hurdles that underrepresented minorities (URM) in academic medicine face, and offers suggestions for institutions to address these challenges. I spoke with Kemi Doll, a gynecologic oncologist at the University of Washington and one of the co-authors of the paper to learn more. 

What are some of the struggles that underrepresented minorities in academic medicine face?
There’s a real issue with isolation and hypervisibility. It’s difficult to be the only person in the group because of a lack of shared perspective and the extra burden it places on you to adapt. But all your moves are highly visible. While institutions are promoting you and putting you on brochures, you’re dealing with your skills being under a microscopic lens. You don't want to mess up because you're a stand-in for all people who look like you.

What would structural support from universities look like? 
Leaders recruiting URMs [should] educate themselves about what it means to have these people come in and be the only ones in the department. Second thing is support outside the department — such as specific coaching and training to navigate things experienced by minorities. A lot of the training such as on implicit bias and microaggressions is actually aimed at the majority, versus equipping URM faculty on navigating around them. Finally, we need support from departments in the form of more in-person meetings or additional time to apply for different funding mechanisms specifically aimed at addressing racial bias in the current peer review system [such as in the NIH grant system]. URM are more likely to seek other funding opportunities and departments have to show they're supportive of this. 

How does this fit in with the recent uprisings in support of the Black Lives Matter movement? 
This paper was written and accepted before Covid-19 and the recent uprisings. If I wrote this today, I would underscore that asking URM faculty to do diversity, equity, and inclusion (DEI) work is another burden. In medicine, when we have someone who can do rare and highly specialized work, that work is highly prized and that person is usually paid more — except DEI work. We need to treat DEI work the way we treat other special skills in medicine. 

Few pediatricians fully implement recommendations for preventing peanut allergies

Fewer than a third of pediatricians say they follow guidelines issued by the National Institute of Allergy and Infectious Diseases for peanut allergies in kids. Researchers surveyed more than 1,700 pediatricians in the U.S. about their knowledge of the guidelines — which were issued in 2017 and include three recommendations for safely introducing peanuts into the diet of infants with other allergies — and 93% of those surveyed said they were aware of the guidelines. At the same time, only about 29% reported fully implementing the guidelines, while 64% reported partial implementation. Parents' concerns about allergies were the top reason for not fully implementing the recommendations. Nearly two-thirds of doctors also said they could use more training on the guidelines.