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Morning Rounds Elizabeth Cooney

Hi, this is reporter Eric Boodman, filling in for Liz for the next two days.

CDC's Messonnier: We can't change Covid-19 vaccine regimen unless we know it works

Covid-19 vaccinations involve a lot of variables, and some have wondered if the U.S. should change regimens to get more people protected faster. For those vaccines requiring two shots, should the doses be more spaced out? Should the amount of the Moderna vaccine in a single injection be reduced? No, not for now, said Nancy Messonnier, the director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, during a virtual STAT event yesterday. “We have to stick with what we know works,” she told reporter Helen Branswell. “This is the regimen that’s been carefully studied.” But she pointed out that more data are on their way, as are more doses. 

University of California, Elsevier settle long dispute over open-access research

Yesterday, the fight between the University of California and the scientific publishing giant Elsevier ended in a truce. The dispute arose at the end of 2018, over open-access research, which is freely available to the public, but which journals charge researchers to publish. Instead of paying over $10 million a year to subscribe to Elsevier journals while its researchers also doled out another $1 million in open-access fees, the UC system had proposed lumping those costs together, at a discount. The publisher balked. UC canceled its subscription. Negotiations broke down. Now, they’ve reached a deal, with Elsevier offering UC researchers lower open-access fees, the university system helping to pay those amounts, and its libraries renewing subscriptions. But the ultimate cost will depend on how many academics publish studies in front of a paywall. 

Lawmakers to question top federal health officials on vaccine rollout

President Biden has said he wants all Americans eligible for Covid-19 vaccinations by May 1, and today, lawmakers will get a chance to question administration officials about putting his promises into practice. Anthony Fauci of the NIH, Peter Marks of the FDA, and Rochelle Walensky of the CDC will testify at a House Subcommittee on Oversight and Investigations hearing. The challenges they face are not only issues of equitable distribution, but also of vaccine hesitancy — and the administration has announced a billion-dollar campaign focused on three groups in which access or skepticism might pose a barrier: young people, people of color, and conservatives. But how effective these efforts will be is still up in the air.

Inside STAT: Driven by the pandemic, applicants flood public health schools


Certified registered nurse anesthetist Lisa Taft enters a room to care for Covid-19 patients at Harbor-UCLA Medical Center in Torrance, Calif.  (Mario Tama/Getty Images)

The pandemic has had a range of effects on the public health workforce. On the one hand, those already in the field are ragged from a year of unheeded warnings and needless deaths. On the other, applications for public health degrees are up, TV and movie companies have created jobs for infection control experts, and the Biden administration has just put $7.66 billion toward helping underfunded health agencies — a boost that workers hope will be sustained. Though many medical students who will match into residencies this week likely chose their fields before the pandemic, the “Fauci effect” is already visible elsewhere, and infectious disease physicians hope that fewer and fewer fellowship slots in their specialty will go unfilled. STAT’s Andrew Joseph has more

Lab Chat: Improving postpartum hemorrhage care

When a person’s uterus begins hemorrhaging after giving birth, doctors have to act fast, providing medications and transfusions first, then often turning to other tools such as hysterectomy or a less-invasive procedure known as a uterine artery embolization (UAE). I spoke with Janice Newsome, division chief of interventional radiology, and Linzi Arndt, an MD-MBA candidate, both at Emory, about research they presented yesterday at the Society of Interventional Radiology Annual Scientific Meeting, which has not yet been peer-reviewed.

What is a UAE, and how often is it used in this situation?
Arndt: You put foam or gel in and block that blood vessel for a period of time. Things can heal and then it dissolves, so the woman can have a child again. It was initially slightly surprising to see that postpartum hemorrhage is treated with hysterectomy far more commonly than UAE.

How do you think care for postpartum hemorrhage could be improved?
Newsome: When a mother is starting to bleed to death, you should do everything at your disposal, and if that means removing the uterus, then that’s what should be done. By the time UAE is being considered, a lot of times it’s far down the line. It works, it’s just asking where in the algorithm it should be brought up, how quickly you can have a team in place. If this procedure is available, it must be considered as a way of saving someone’s life and of keeping their fertility.

New study analyzes electroconvulsive therapy use in England

Electroconvulsive therapy — which involves sending enough electricity through the brain to spark a seizure — has long been controversial. While some with severe depression report great benefits, others say the evidence is unconvincing and warn of severe side effects, including memory loss. To find out how it’s used today in England, researchers — a team of academics, plus a patient who’s received ECT herself — submitted Freedom of Information Act requests to 57 divisions within the National Health Service and received 37 responses. In a new study, they report 1,964 documented instances of ECT in 2019, and estimate the actual number is around 2,500. Nine regions were unable to say how many patients had received the treatment against their will, and in those that could, more than 450 people got ECT without giving consent. The authors worry such cases aren’t being adequately monitored.

Covid-19 cases in the U.S.

Cases yesterday: 53,579
Deaths yesterday
: 1,2863c3c03eb-ead2-4257-b1a7-8430ed411081.png

What to read around the web today

  • A Native American tribe in Oklahoma denied Black citizens Covide-19 vaccines and Financial relief. BuzzFeed
  • To dampen background noise, hearing aid makers tap AI to amplify the right sounds. STAT
  • Three feet or six? Distancing guideline for schools stirs sebate. New York Times
  • Trans girls belong on girls’ sports teams. Scientific American
  • Drawing a line in the mud: scientists debate when 'age of humans' began. NPR

Thanks for reading! More tomorrow,

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