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Morning Rounds Shraddha Chakradhar

Good morning, this is multimedia producer Theresa Gaffney filling in for Shraddha, who will be back tomorrow.

Vaccinated people can doff face coverings outside, away from crowds, federal health officials say

People who are fully vaccinated against Covid-19 no longer need to wear masks while outside in uncrowded areas or in small groups, federal health officials said Tuesday as part of updated guidance. They urged people — even those who are vaccinated — to continue wearing masks in indoor settings like the grocery store or houses of worship as a way to protect others who are not yet vaccinated and to reduce transmission. They also said people should continue to use face coverings in crowded areas even if outdoors, at events like sports games or concerts where distancing is more difficult. The message from federal health officials is likely to lead to policy changes around the country. Already, some states have lifted mask mandates entirely as their cases counts have fallen after the devastating winter surge.

Biden ducks big health care fight in next legislative push

As he closes in on 100 days in office, President Biden will give his first speech before a joint session of Congress tonight, one that will likely highlight the administration’s progress against Covid-19 but may be light on health care initiatives. Despite frantic lobbying by Democrats over the past week, Biden will leave several high-profile health care reform policies, including allowing Medicare to negotiate prescription drug prices, out of his next legislative proposal. The only health policy he will include is making permanent increased subsidies for insurance bought on Affordable Care Act exchanges. Though in a call yesterday evening with reporters, senior administration officials said he remains “fully committed” to drug pricing reform and that it’s “something he deems urgent.” The snub leaves the timeline of Congress’ next drug pricing fight unclear — Democrats on Capitol Hill may choose to take on the issue anyway, or the debate could get kicked down the road.

Involuntary youth admissions to psychiatric hospitals could set up a cycle of inequality

Nearly a quarter of all child and adolescent admissions to psychiatric hospitals are involuntary, according to a new study. Children admitted against their will more often had a diagnosis of psychosis, substance misuse, or intellectual disability. Researchers performed a systematic review and analysis of 23 existing studies in 11 countries on psychiatric admissions for people under 18. Few studies focused on racial disparities, but those that did revealed that youths admitted involuntarily were almost three times more likely to be Black than white. This mirrors disparities seen in adults, where Black patients are more likely to be hospitalized against their will than white patients. But since previous involuntary hospitalizations increase odds of experiencing another, the study authors write that the disparities found may indicate a cycle of inequality starting in childhood that continues into adulthood.

Inside STAT: A shortage of tiny pipette tips is creating huge problems for science


The humble pipette tip is tiny, cheap, and utterly essential to science. It powers research into new medicines, Covid-19 diagnostics, and every blood test ever run. It is also, ordinarily, abundant — a typical bench scientist might grab dozens every day. But now, a series of ill-timed breaks along the pipette tip supply chain — spurred by blackouts, fires, and pandemic-related demand — have created a global shortage that is threatening nearly every corner of the scientific world. Researchers responsible for screening infants for potentially deadly conditions, who use 30-40 pipettes per child, are particularly concerned. Even just delays in the screening process has resulted in some infant deaths, according to a 2013 investigation. “The idea of being able to do science without them is laughable,” one scientist tells Kate Sheridan. More here.

Biden administration will allow nearly all providers to prescribe buprenorphine

The Biden administration announced yesterday it would move forward with a dramatic deregulation of addiction medicine first proposed by the Trump administration in January. The change would allow almost any prescriber to treat patients using the drug buprenorphine, the most effective medication for opioid addiction. The move comes amid a worse-than-ever drug overdose crisis, which has taken a dire turn amid the Covid-19 pandemic. Currently, doctors, physician assistants, and nurse practitioners must undergo a separate training and apply for a waiver before they’re allowed to prescribe the drug to patients. Physicians and advocates have long argued that the waiver poses a barrier to basic care for patients with opioid addiction. In particular, many have argued that if a doctor can prescribe potentially addictive prescription pain drugs, they should also be able to prescribe the medicine used to treat the addiction.

How one state lowered its C-section rate for low-risk, first births

A C-section can be lifesaving in emergency cases, but it’s still a major surgery with myriad potential complications and a longer recovery time than vaginal birth. The CDC has set a target for 23.9% of low-risk, first births to be C-sections, and a new observational study details how statewide initiatives at California hospitals brought the state below that benchmark. In 2014, California was at 26% — also the national average — and the rate dropped to 22.8% by 2019. For three years starting in 2016, a majority of hospitals with rates higher than the target joined a free program with collaborative learning sessions and materials, mentorship and site visits, and data on each hospital’s and even individual physicians’ rates. The decreased rates didn’t come at the expense of safe births, as severe unexpected newborn complications also decreased from over 2% in 2015 to 1.4% in 2019.

Covid-19 in the U.S.

Cases yesterday: 50,856
Deaths yesterday: 707

What to read around the web today

  • We don’t really know if vaccines have been distributed equitably. The 19th
  • They Call It a ‘Women’s Disease.’ She Wants to Redefine It. New York Times
  • Opinion: In Covid’s grip, India gasps for air: ‘If there is an apocalypse, this has to be one.’ STAT
  • The Pandemic Made Her Sick, Even Before She Caught Covid-19. The Atlantic
  • Biogen to expand access to its ALS drug, but move may come too late for some patients. STAT

Thanks for reading! More tomorrow,

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