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Morning Rounds Elizabeth Cooney

Good morning! Many thanks to Eric Boodman for filling in earlier this week as we await our colleague Shraddha Chakradhar's return.

AstraZeneca vaccine wins vote of confidence in Europe; U.S. exports it to Canada and Mexico

Europe’s drug regulatory agency has spoken: AstraZeneca’s Covid-19 vaccine does not increase the overall incidence of blood clots and its benefits outweigh potential risks. Shortly after yesterday’s announcement, France, Italy, and Germany said they’d resume vaccinations today while Spain, Portugal, and the Netherlands said they’d follow suit next week, albeit with certain groups excluded in Spain. These actions follow reports of clots in a few dozen of the millions of people across Europe who have gotten the shot. A description will be added to vaccine leaflets.

Not yet authorized in the U.S., the vaccine has nonetheless been stockpiled. President Biden yesterday announced plans to send 4 million of its tens of million AstraZeneca doses to Canada and Mexico to alleviate shortages there.

Vaccination alone won't be enough, model predicts

Vaccines may be having a moment, but they will not be enough by themselves to quell the coronavirus pandemic, according to new research that models vaccination and public health measures in the U.K. Policies such as limiting gatherings and encouraging social distancing must be adopted and adhered to, the researchers say. Gradually — not suddenly — relaxing such control measures can dampen another surge in infections. For example, they predict the partial release of control measures in the U.K. in February could lead to a wave of infection peaking at 1,670 deaths per day, but gradual release of measures over five or 10 months would mean peaks at 430 and 46 deaths per day, respectively. The analysis did not consider virus variants or waning immunity.

Antibiotic stewardship still has work to do 

Last Thursday STAT’s Ed Silverman told us about antibiotics being overprescribed to patients early in the pandemic, nearly always before a bacterial infection such as pneumonia was confirmed. Now he reports on new research looking further back: Nearly 56% of antibiotic prescriptions written in hospitals in 2015 were inappropriate, underscoring the need to provide added guidance to physicians and other health care providers to avoid resistance to the drugs. Sometimes the wrong antibiotic was prescribed, an antibiotic was prescribed for too long, or there was little evidence of an infection, the analysis found. Although not recent, the data provide a road map for improving antibiotic stewardship, the authors wrote.

Inside STAT: How the telehealth SPAC wave could create a ‘perfect storm’ for investors

 (Alex Hogan/STAT)

Telehealth has gone from a backwater of American health care to a booming business. Billion-dollar valuations are now common as companies seize on a dramatic increase in demand to raise money during the coronavirus pandemic. But the overnight change is raising alarms of a bubble, as more telehealth providers merge with SPACs — special purpose acquisition corporations — that offer a faster and easier road to going public. “You’ve really got to wonder what this is going to look like 24 months from now,” Erik Gordon of the University of Michigan told STAT’s Casey Ross. “You can guess ... there are going to be a lot more train wrecks than we would have seen if telehealth had developed at its normal pace.” More for STAT+ subscribers here.

Review bodies are pushed to improve research inclusion

The coronavirus pandemic has sharply underscored the haves and have-nots in health, disproportionately harming people of color, who more often are unable to work from home, live in crowded housing, and have poor access to health care. Early last year, data on the race and ethnicity of Covid patients was scant, mirroring a wider scarcity of research that includes and analyzes how diseases and treatments affect all people. What if there were a way to ensure better representation? A commentary argues one already exists: the institutional review board — often at a hospital or university — which safeguards the well-being and rights of clinical trial participants. “Subject selection cannot be equitable, and the requirements of justice cannot be met, when there is de facto exclusion of understudied populations,” the authors write.

Is there such a thing as too much exercise?

A new study raises the possibility that the beneficial effects of extreme intense activity may tail off when it comes to healthy glucose metabolism. To reach this conclusion, researchers asked six female and five male athletes to cycle all out in almost daily, progressively harder high-intensity interval workouts over four weeks. Oral glucose tolerance tests and muscle biopsies showed expected improvements in how mitochondria  — powerhouses of the cell — achieved maximal oxygen uptake, but after the hardest week, glucose tolerance and insulin secretion worsened. To their surprise, the scientists found that 15 elite endurance athletes also had impaired glucose control compared to people who didn’t exercise. But don’t give up intensive exercise: Former elite athletes seem to live longer than ordinary mortals.

Covid-19 cases in the U.S.

Cases yesterday: 59,822
Deaths yesterday: 1,611

What to read around the web today

  • New monkey model of Alzheimer’s disease may accelerate search for human treatments. STAT+
  • Becerra squeaks through confirmation vote to become HHS secretary. Washington Post
  • Biden administration to rewrite family planning program rules. Politico
  • America’s Covid swab supply depends on two cousins who hate each other. Bloomberg
  • Does a drug’s name affect how patients and doctors perceive it? The FDA wants to know. STAT+

Thanks for reading! More Monday,

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