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Morning Rounds Elizabeth Cooney

Fully vaccinated people can gather indoors and unmasked with certain others

It’s official: People who have been fully vaccinated against Covid-19 can spend time together indoors and unmasked, CDC says in highly anticipated guidelines issued yesterday. Fully immunized Americans — defined as two weeks past their final vaccine doses — can also visit low-risk individuals from other households even if they’re unvaccinated. And if vaccinated individuals are exposed to Covid-19, there’s no need to quarantine or get tested. But masks are still needed in public. “There are some activities that fully vaccinated people can begin to resume now in the privacy of their own homes,” Rochelle Walensky, the CDC director, said in prepared remarks. “Everyone — even those who are vaccinated — should continue with all mitigation strategies when in public settings.” STAT’s Lev Facher has more.

The risk of severe Covid illness rises with BMI, study finds

Obesity is a known risk factor for Covid-19. A new study looking at almost 200,000 Covid-19 patients admitted to 800 hospitals from April through December last year — one of the largest studies to date — found people with overweight and obesity were more likely to need a ventilator to breathe. And among people over 65, obesity was also a risk factor for hospitalization and death. These risks rose with BMI. The metabolic disease likely makes people more vulnerable because they live with chronic inflammation that weakens their immune response as well as with lung function impaired by excess weight. The Covid risk factors type 2 diabetes, heart disease, and some cancers frequently coexist in people with obesity. The authors call for “continued vaccine prioritization and masking.”

Online symptom checkers may fall short

It was only a test, but it’s still not a good look for national symptom checkers from the U.S. and the U.K. Researchers compared Covid-19 online symptom checkers from Japan, Singapore, the U.S., and the U.K. in a simulation trial of 52 cases representing typical mild, moderate, severe, and critical disease. The self-triage tools being used in Japan and Singapore were twice as likely to recommend seeking medical help as the ones from the U.S. and U.K. when presented with hypothetical patients showing signs of sepsis, bacterial pneumonia, and severe Covid-19. While acknowledging Covid-19 symptoms can resemble other conditions, the researchers worry patients might dangerously delay care if they use a symptom checker that advises them to stay home when they shouldn’t.

Inside STAT: With Manchin’s ear, West Virginia hospitals helped win billions in Covid relief

Sen. Joe Manchin, D-W.Va. (J. Scott Applewhite)

West Virginia University Health System doesn’t have the name recognition of the Mayo Clinic or Massachusetts General Hospital. It doesn’t have the lobbying firepower in Washington, either. But this year the hospital chain and others in the state are the reason why rural hospitals across the country will get a last-minute cash influx of more than $8 billion from Congress in the Covid-19 package that represents President Biden’s first major legislative push. The hospitals’ longshot lobbying victory came out of their relationships with Sen. Joe Manchin, the West Virginia Democrat who is taking a sudden star turn as a coveted moderate vote in the new, narrowly divided Democratic Senate. STAT’s Rachel Cohrs has more on Manchin’s drive to fund vulnerable health providers.

Post-concussion headaches aren't all alike

Headaches commonly follow concussions, but a new study of adolescents suggests when they resemble migraines, they may predict lingering injury. Nearly 300 participants ages 5-18 were asked if they had headaches three and six months after their concussions. Patients with any headache took longer to recover, but those with migraine-like ones — marked by nausea and sensitivity to light and sound — took even longer. More than two-thirds of the adolescents with migraine-like headaches were girls, which may explain why girls, who are more likely to suffer from migraines in general, do poorly post-concussion compared to boys. These headaches “could be a target for early intervention to prevent persistent and disabling symptoms,” the authors write.

For some people, eating fish is linked to lower risk of cardiovascular disease

If you thought the fish story was settled, think again. Researchers combing through studies evaluating diets rich in fish for any cardiovascular benefit have found inconsistent results. A new analysis of four cohort studies in nearly 200,000 people in 58 countries concludes that eating two servings of fish a week is associated with a lower risk of heart attack, stroke, heart failure, and sudden cardiac death in people with a history of vascular disease — but not in other people. Benefits were greater when people ate oily fish such as salmon, sardines, mackerel, and tuna. “However, our findings require confirmation from randomized clinical trials evaluating the effects of increasing fish consumption,” the authors write. Case not closed.

Covid-19 cases in the U.S.

Cases yesterday: 50,800
Deaths yesterday
: 721

 

What to read around the web today

  • Biden’s silence on an FDA nominee underscores how tough it is to fill that job. STAT
  • Women report worse side effects after a Covid vaccine. New York Times
  • WHO's Ryan says some countries didn't hear early COVID-19 warning. Reuters
  • Opinion: Meghan Markle described racism as a toxic stressor during her pregnancy. I can relate. STAT
  • Hoover fellow Scott Atlas uses Stanford College Republicans event to rewrite history. The Stanford Daily

Thanks for reading! More tomorrow,

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