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Morning Rounds Elizabeth Cooney

Who got the first Covid-19 vaccinations?

When the first two Covid-19 vaccines became available in December, health care workers along with residents and staff of long-term care facilities were first in line. A new CDC report tells us something about these nearly 13 million people. Data were available on sex and age for almost all recipients: 63% were women and 55% were over 50. But race and ethnicity were reported for only half of them: 60% were white, 14% were categorized as multiple or other race/ethnicity, 12% Hispanic/Latino, 6% Asian, 5% Black, 2% American Indian/Alaska Native, and 0.3% Native Hawaiian/Pacific Islander. The report notes the need to reach "those at highest risk for infection and severe adverse health outcomes," many of whom are Black, American Indian/Alaska Native, or Hispanic. 

Who didn't get vaccinated?

Another CDC report said just a little over a third of nursing home staffers who were offered Covid-19 vaccine received it in the first month it was available through a partnership with CVS and Walgreens. That contrasts with more than three-quarters of the residents living in 11,000 nursing homes and skilled nursing facilities who got vaccinated. Some health care workers have previously been hesitant to get flu vaccination, receiving the shots at lower rates than hospital staff members. One CDC official holds out hope that later efforts will bear fruit: “Continuing to capture those staff who did not accept vaccine early will be really important as we try eliminate outbreaks and protect both staff and residents in long-term care facilities,” Amanda Cohn said.

ICU mortality rate for Covid patients has plateaued — for now

The good news: The mortality rate for Covid-19 patients admitted to hospital ICUs has fallen from a peak of 42% during last spring’s pandemic surge to 35% last fall. The caveat: That improvement is leveling off. The worry: These figures, based on a meta-analysis of 52 studies tracking more than 43,000 patients around the world, were calculated through October, before the emergence of several virus variants. The researchers credit better approaches to oxygen therapy, fluid management, and blood-thinner medications for the reduction in deaths. They also note differences in ICUs and patients' preexisting conditions were not accounted for in their study. As for variants, “vaccination is now available in many countries and we can hope that this too will, over several months, positively impact on the pandemic trajectory and demand on ICU care,” they write.

Inside STAT: Could AI help doctors better understand pain?

(mike reddy for stat)

For years, AI researchers have focused their energy on developing algorithms capable of sharpening or rapidly replicating a doctor’s own judgment. When it comes to pain, though, patients’ own judgement can be just as important, if not more so, in understanding a condition. A patient’s experience provides a level of nuance that doctors — and many technologies — struggle to capture. In a high-profile new effort, researchers set out to program an AI tool that could predict patients’ pain levels by analyzing their X-rays and comparing those results with their self-reported pain scores. STAT’s Erin Brodwin has more on how the findings suggest that teaching a tool to learn from patients might provide a way to peel away racial prejudice that can skew care.

How physicians view patients with disabilities

A new survey of U.S. doctors finds that more than 80% believe people with a significant disability have a worse quality of life than those who are not disabled, suggesting physicians’ perceptions across specialties could negatively influence the care of the more than 61 million Americans with disabilities. While there are disabilities that could worsen a person’s quality of life, study author Lisa Iezzoni told STAT’s Rebecca Sohn, previous research has shown that people with disabilities overall rate their quality of life as the same or better than those without a disability. Yet, the study reported, disabled people face persistent health disparities, including in screening and preventative services, reproductive and pregnancy care, and communication with clinicians.

Most head impacts come in college football practices, not games

A median of 415 head hits per player per season. More than 1 out of 10 players diagnosed with a concussion. The toll on college football players’ brains is high, but it’s disproportionately higher in preseason training than in actual games. A new analysis of more than half a million head impacts over five seasons recorded from 658 players wearing in-helmet sensors concludes that almost half of the concussions took place in the preseason. There were twice as many total head impacts in training or games, even though the preseason is one-fifth as long as the football season. “These data point to a powerful opportunity for policy, education, and other prevention strategies to make the greatest overall reduction in concussion incidence,” the researchers write.

Covid-19 in the U.S.

Cases yesterday: 158,379
Deaths yesterday
: 3,148

 

What to read around the web today

  • Pandemic wears on essential workers: 'Everybody forgets that you're still on the front line.' Wall Street Journal
  • How rich hospitals profit from patients in car crashes. New York Times
  • New diabetes cases linked to Covid-19. Washington Post
  • The vaccine line is illogical. The Atlantic
  • Amid a crush of Covid-19 research, scientists hone an AI tool to rapidly screen studies. STAT Plus

Thanks for reading! More tomorrow,

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Tuesday, February 2, 2021

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