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Morning Rounds Shraddha Chakradhar

Researchers report nearly 300 cases of mysterious syndrome tied to Covid-19 in kids

Nearly 300 cases of an alarming apparent side effect known as multisystem inflammation syndrome, or MIS-C, have occurred in children with Covid-19, according to new research published by two groups. One group found that 80% of children who developed the condition needed intensive care, 20% required mechanical ventilation, and four children died. In the other study, more than 60% needed respirator support, and two children died. The author of an accompanying editorial writes that, “There is concern that children meeting current diagnostic criteria for MIS-C are the ‘tip of the iceberg,’ and a bigger problem may be lurking below the waterline.” Read more here

Here's what else is happening with the pandemic today:
  • The WHO is planning on sending a team of experts to China to investigate the origins of SARS-CoV-2, the agency's director-general, Tedros Adhanom Ghebreyesus, said in a news briefing yesterday. “We can fight the virus better when we know everything about the virus, including how it started,” he said. Tedros also dismissed complaints from countries claiming contact tracing efforts were too difficult to implement. "If contact tracing helps you to win the fight, you do it, even [when] risking your life," he said. "If any country is saying contact tracing is difficult, it is a lame excuse."
  • Congress is continuing hearings about the U.S. response to the pandemic and how the country can get back to more normal operations. Top federal Covid-19 experts — Anthony Fauci, Robert Redfield, Brett Giroir, and Stephen Hahn — will be back in front of a Senate committee this morning to discuss how the country can safely get back to work and to school. Meanwhile, a different Senate committee will hear from global health experts on the U.S.'s pandemic preparedness. 
  • The writers of a new First Opinion argue that the U.S. could learn a lot from Taiwan's response to the pandemic. The island nation has only seen a Covid-19 death rate of 0.03 deaths per 100,000, compared to the U.S.'s rate of 36 deaths per 100,000 people. Every person in Taiwan has a health ID card as part of an expansive digital health infrastructure that was quickly employed to respond to the pandemic by tracking travelers and monitoring trends in physician visits among patients. 

SCOTUS strikes down Louisiana law that limited access to abortion

In a 5-4 decision, the Supreme Court yesterday struck down a 2014 Louisiana law that requires physicians who perform abortions to have admitting privileges at nearby hospitals. If the law had been upheld, it would have left the state  — which only has five doctors who perform abortions — with one operating abortion clinic and could have set a precedent for other states to enact similar laws to limit access to abortion. The latter may still be case: The Louisiana law, for instance, was similar to a Texas law that was also struck down by the Supreme Court in 2016 on the basis that the law created more burdens than benefits. “Even with today’s decision, we are under no illusion that the future of abortion rights in this country is secure," Guttmacher Institute President Herminia Palacio said in a statement. 

Inside STAT: In the Covid-19 death of a hospital food worker, a microcosm of the pandemic

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Yolanda Desir displays a photograph of her late sister, Marie Deus, who died of Covid-19. (Kayana Szymczak for STAT)

The hospital’s first employee to die of Covid-19 was a kitchen worker named Marie Deus. She was 65, a workaholic, and a germophobe — obsessions she’d only acquired when she came from Haiti to Boston 40 years ago. The clinicians who cared for her were petrified. They knew her from the halls, knew she didn’t have all that much patient contact. If she were this sick, what did that mean for them? But it turned out that her illness was part of a pattern — and it wasn’t what her doctors expected. In intertwining these two stories, from Port-au-Prince to Mattapan, hospital kitchen to incident command, reporter Eric Boodman shows what the smallest details of a life can reveal about the sweep of the pandemic. Read more.

Requiring HPV vaccination for school could improve immunization rates

HPV vaccination among adolescents is low compared to other vaccines recommended for that age group, and new research suggests mandating the vaccine — which protects against cervical and other genital cancers — in order to attend school could increase immunization rates. Scientists analyzed data from nearly 4,800 youth ages 13-17, and found that places such as Rhode Island and Washington, D.C., which require girls and boys to be vaccinated before starting school, had higher vaccination rates compared to states in those regions without such policies. Looking at a different dataset of more than 42,000 adolescents from 2008-2017, scientists also found that Rhode Island and D.C. saw higher rates of vaccination after they implemented school-entry policies for HPV vaccination, both within their own jurisdictions and compared to places without such policies. 

Black decedents are more likely to have clinical autopsies done

Clinical autopsies conducted to clarify cause of death have declined in recent years, but Black decedents are more likely than white individuals to undergo the procedure. Looking at data from 2008-2017, scientists found that around 13% of Black decedents in the sample had had a clinical autopsy, compared to 7% of white decedents. Black individuals whose underlying cause of death was cardiovascular disease or liver disease were especially more likely to have had an autopsy done. These discrepancies underscore health disparities between the two groups, the authors suggest, since Black individuals are also less likely to have access to quality care and therefore clear diagnoses at the time of death.

Early cognitive development may influence developing dementia later in life

A new study underscores the link between early life cognitive enrichment (ELCI) — things such as school performance and socioeconomic status in childhood — and dementia and Alzheimer's disease. Previous research has suggested that higher ELCI could also indicate a lower likelihood of dementia later in life. In the new study, researchers looked at post-mortem data from 813 participants and found that those with higher ELCI scores tended to have less cognitive decline as well as lower scores on a test that measures for Alzheimer's disease. Some caveats: The findings only represent an association, and the participants in the study were largely white and tended to have higher education levels, which may not be generalizable for the larger aging population. 

What to read around the web today

  • Wildland firefighters are risking their mental health. High Country News
  • A new FDA tool aims to inform cancer care, but experts say it has a glaring gap. STAT
  • The challenges of the pandemic for queer youth. The New York Times
  • The Lancet editor’s wild ride through the coronavirus pandemic. The New Yorker
  • Essential worker shoulders $1,840 debt for trying to get tested for Covid-19. NPR

Thanks for reading! More tomorrow,

Shraddha

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Tuesday, June 30, 2020

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