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Morning Rounds Shraddha Chakradhar

Good morning. Elizabeth Cooney sitting in for Shraddha this week.

Covid-19: A wartime measure and who gets sick

The pandemic picture is becoming clearer, along with responses to it. As understanding who gets sick comes into sharper focus, experts emphasize one message: Millennials are not invincible. New CDC data show up to one-fifth of infected people ages 20 to 44 have been hospitalized, including 2% to 4% who required ICU treatment. And in Washington, the Trump administration invoked a wartime law to avert medical supply shortages.

More of the latest developments:

Match Day goes virtual, too, for med students

Tomorrow’s Match Day, when medical students discover which residency program picked them for further training. Students got emails this week telling them if they had matched, but not where. At noon ET, they won’t rip open envelopes in traditional medical school celebrations but open emails instead. Julia Probert, a fourth-year medical student at NYU Grossman School of Medicine, will read her news at home, where she self-quarantined after possible Covid-19 exposure while working in a New York hospital. Medical students have been pulled from their clinical rotations; her patients later tested negative. “Now I’m just not leaving my apartment, like everyone else in New York,” Probert said. She expects her residency in psychiatry will start in the summer as planned. “They need interns, right?”

‘It’s been kind of rough’: A nurse at the pandemic’s epicenter

Nurse Stephanie Bandyk at Swedish Hospital in Seattle. (courtesy stephanie bandyk)

Stephanie Bandyk, a registered nurse working in the ICU of Seattle’s Swedish Hospital, has helped treat some of the first U.S. patients infected with Covid-19. STAT asked her what that’s like.

  • On being prepared: “When Ebola happened, we went through practice drills. This has been very different. Things are changing almost daily.”
  • On Covid-19 testing in Seattle: “It was terrible at first. The turnaround time had previously improved, but now it’s back to taking days.”
  • On patients: “Mostly older people, but we’ve even had some 20-year-olds in critical care. People think kids don’t get sick — but some of them do.”
  • On advice: “You can talk about your symptoms with a nurse over the phone. Don’t bombard the ER. And don’t panic.”

Inside STAT Plus: How do you rebrand a clinical trial?

For the better part of four years, Samantha Meltzer-Brody had been trying to recruit thousands of women for a large study she was leading to investigate the potential role of genetics in postpartum depression. After a promising start, signups waned. Then she heard from someone at a creative agency called Wongdoody who had read a story about the study’s lagging participation. “Your first question is, 'Who is Wongdoody?'” Meltzer-Brody said. But impressed with the agency’s understanding of postpartum depression, she took it up on its offer to rebrand her study, forging an unlikely partnership in a world where academic medical research and creative agencies rarely, if ever, cross paths. Megan Thielking explains what happened next on STAT Plus.

‘Chemoimmunotherapy’ for cervical cancer

The HPV vaccine, designed to prevent cervical cancer, is showing some promise to treat the disease when combined with standard chemotherapy, a new study says. Vaccine therapy on its own usually fails because patients’ immune systems are too weak to embrace it. But a small, early-phase "chemoimmunotherapy" trial found better outcomes for patients with advanced cervical cancer: 43% of the patients’ tumors regressed and another 43% saw their disease get no worse. The idea is to rev up anticancer immunity by increasing tumor-specific T cells — the job of the vaccine. Chemotherapy damps down myeloid cells, which can suppress the expansion of T cells. Patients in the trial with higher vaccine-induced immune responses lived longer. Two caveats: The study had no chemo-only arm for comparison and it did not collect pre- and post-vaccination tumor material to look at the tumor microenvironment.

High blood pressure common in female athletes

Nearly half of female collegiate athletes at two universities had high blood pressure, according to a small study to be presented later at a now-virtual American College of Cardiology conference. More than 300 female athletes playing sports at the University of Florida or University of Georgia had their blood pressure measured in a preseason exam. Based on guidelines defining readings lower than 120/80 as normal, 47% of the athletes had high blood pressure, which is much higher than the 5% to 10% expected for all college-age women. Blood pressure differed by sport: Softball players had higher readings than gymnasts, for example. The researchers say more study is needed to understand why, especially because female athletes aren’t as well-studied as their male counterparts.

What to read around the web today

  • Lessons from Italy’s hospital meltdown. ‘Every day you lose, the contagion gets worse.’ Wall Street Journal
  • US Air Force flew a half million coronavirus test kits from Italy to Tennessee. Defense One 
  • The Trump administration drove him back to China, where he invented a fast coronavirus test. ProPublica
  • Pandemic erodes gig economy work. New York Times
  • Photos: The quiet emptiness of a world under coronavirus. The Atlantic

Thanks for reading! More tomorrow,


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Thursday, March 19, 2020


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