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Morning Rounds Shraddha Chakradhar

New data offer glimpse of efficacy of Oxford-AstraZeneca Covid-19 vaccine

A Covid-19 vaccine being developed by the University of Oxford and AstraZeneca produced an immune response in participants enrolled in a 1,000-person trial, according to data published yesterday in the Lancet. The vaccine also produced mild-to-moderate side effects in 60% of volunteers, including fever, headaches, and muscle aches. Results from a Phase 2 trial of Chinese biotech company CanSino's Covid-19 vaccine were also published in the Lancet yesterday, and showed that the vaccine induced neutralizing antibody responses. But the vaccine, like in a Phase 1 trial, worked better in some patients — notably those under the age of 55 — than others. The AstraZeneca and Oxford vaccine is already in a Phase 3 trial, while CanSino is currently planning for a late-stage trial of its product. 

New AMA report shows dip in opioid prescriptions

Although fatal opioid overdoses hit a record high in 2019 — and the Covid-19 pandemic threatens to make matters worse — the latest report from the American Medical Association's Opioid Task Force finds that prescriptions for these drugs decreased last year for the sixth year in a row. There was a 37% decrease in opioid prescriptions last year — from more than 244 million in 2014 to around 154 million in 2019. Other trends also point to higher scrutiny of these prescriptions: There was a 64% increase since 2018 in physicians' use of state drug monitoring programs, for instance, which are online databases meant to track prescriptions of controlled substances. And more doctors are also prescribing naloxone: More than 1 million prescriptions of the drug were dispensed last year, which is more than double the number in 2018. 

Uninsurance rate among Asian Americans more than halved since the ACA

A new report from the Commonwealth Fund further shows how 2010's passing of the Affordable Care Act helped to narrow racial disparities in insurance coverage. This report, which focused on the ACA's impact on Asian Americans, found that about 1 in 5 Asian American adults ages 19-64 was uninsured in 2010, but that figure has now dropped to around 1 in 13. Asian Americans are now the least likely to be uninsured. Among this group, Korean Americans and Vietnamese Americans saw the biggest gains in insurance coverage over the past decade. And regardless of whether a state expanded Medicaid under the ACA, Asian Americans saw rates of health insurance increase more than white Americans. 

Inside STAT: Lack of darker skin in textbooks, journals harms patients of color


(HYACINTH EMPINADO/STAT)

As the world, and particularly the U.S., grapples with racism and its systemic effects, the field of dermatology is also going through its own reckoning. The Covid-19 pandemic is shining a light on how the lack of images in textbooks and journals on various skin conditions among people of color is widening an already big gap between white and non-white patients. Dermatologist Jenna Lester became acutely aware of this when she went searching for images of a new symptom of Covid-19 — skin rashes — on Black skin so she could help her Black patients with the infection. But she couldn't find a single picture. “I felt like I was seeing a disparity being built right before my eyes,” Lester tells STAT contributor Usha Lee McFarling. Read more here

More people completed advance directives during Covid-19

Advance directives — to indicate a person's wishes for medical treatment should they not be able to communicate them — increased fivefold during the Covid-19 pandemic, according to new research. A website to help people plan medical care in advance had nearly five times more users between February and April this year compared to January 2020 (which the researchers designated as pre-Covid). While the overall number of users on the website was still low — 482 during the Covid-19 period — the authors suggest knowing visitors would be restricted for those hospitalized for Covid-19 may have prompted people to prepare in advance. Another caveat: The website in question is publicly available, but is largely used by patients within the University of Pennsylvania's health system and could skew the generalizability of the findings. 

The popularity of e-cigarette posts on Instagram featuring cartoons 

Promotions and flashy marketing for e-cigarettes appeal to youth, and a new study highlights how ads featuring cartoons could also play into that appeal. Scientists analyzed nearly 2,000 Instagram posts advertising e-cigarettes during a three-week period in 2019, and found that more than 7% contained at least one cartoon somewhere in the image, while the vast majority of the posts were marked as promotions. More than 100 different e-cigarette companies used cartoons in their marketing, and posts with cartoons received almost twice as many "likes" than posts without cartoons. Future research should look at whether these cartoons influenced attitudes about vaping, the authors suggest. 

What to read around the web today

  • Vulnerable border community battles virus on ‘a straight up trajectory.’ The New York Times
  • NIH project homes in on Covid racial disparities. Kaiser Health News
  • A mental-health crisis is burning across the American West. The Atlantic
  • What does it mean to say a new drug ‘works’? Wired
  • How Munich turned its coronavirus outbreak into a scientific study. The New Yorker

Thanks for reading! More tomorrow,

Shraddha

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Tuesday, July 21, 2020

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