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Morning Rounds Shraddha Chakradhar

Inside the NIH’s controversial decision to stop its big remdesivir study

A top official at NIAID, which conducted the closely watched trial of remdesivir to treat Covid-19, has described to STAT in new detail how the agency made the tough decision to stop the study and start giving the drug to patients randomly assigned to receive a placebo. In testing remdesivir, the first treatment to show even a small effect against Covid-19, the agency had to balance maintaining rigorous standards to properly find if the drug is safe and effective with making sure patients get a treatment that works as fast as possible. Stopping the study essentially means that researchers won't be able to collect more data about whether the drug saves lives, but the agency's clinical director H. Clifford Lane tells STAT's Matthew Herper that it was "the right thing to do." Read more here

Here's what else is new with Covid-19: 

  • The Trump administration over the weekend shared its plans for distributing remdesivir, after confusion over how the government's limited supply of the drug was going to be allocated to hospitals around the country. The plan involves sharing the drug with individual states' health departments, and letting them in turn decide how best to divide the supply. 
  • Three members of the White House's coronavirus task force — top infectious disease expert Anthony Fauci, CDC Director Robert Redfield, and FDA chief Stephen Hahn — will quarantine themselves for two weeks out of caution after learning that they were exposed to someone who had tested positive for the virus. And Vice President Mike Pence is self-isolating after his press secretary tested positive for Covid-19 last week. 
  • As many parts of the country slowly reopen businesses and other sectors of daily life, there are still many questions swirling about the state of testing and how places will keep the virus in check. Check out this guide for what two infectious disease experts had to say about some of them, including who ought to get tested and which kind of test is best. 
  • The coronavirus stimulus package known as the CARES Act may have been well-intentioned in its goals of helping keep people and businesses afloat, but the writers behind a new STAT First Opinion say that the legislation sets up three traps for the unwary, including the lack of a suitable application for providers to determine their eligibility for funding.

Atul Gawande to depart as CEO of splashy health venture

Atul Gawande is leaving his position as CEO at Haven, the health venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase & Co., a role he had held since the company's formation two years ago. The departure, first reported by The Wall Street Journal, threatens to upend an initiative that is still in its infancy and that has not made much progress against the problems that it set out to solve, mainly improving health care delivery in the U.S. Although Gawande plans to stay on as chairman, many experts are concerned that his departure from his daily role — which comes a year after the company's COO left after eight months on the job — may make it difficult for Haven to recover. "I don’t know if this is a death knell, but it’s certainly a retardant," Robert Burns, a professor of health care management at the University of Pennsylvania, tells STAT's Casey Ross and Erin Brodwin, adding, "When you have turnover like this at the senior level, it undermines the long-term play." STAT Plus subscribers can read more here

Routine vaccinations for U.S. children have plummeted amid the pandemic

Routine vaccinations for children plummeted in March and April this year, according to a new study. Compared to the first four months of 2019, there were 2.5 million fewer doses of childhood vaccines ordered this year — not counting the influenza vaccine — and a drop of 250,000 doses in orders for the measles vaccine. And vaccination campaigns nearly ground to a halt between March 13, when a national coronavirus emergency was declared, and April 19. The new findings represent another development in the trend of disruptions to regular health checkups as a result of Covid-19. Those under the age of 2 experienced less of a sharp decline in vaccinations during this period than those ages 2-18. But pediatricians are nonetheless urging families to maintain well-child appointments to stay on track with scheduled vaccinations. “The usual childhood diseases are still around and we need to protect our children from them,” pediatrician Kathryn Edwards tells STAT's Helen Branswell

Inside STAT: 14 questions for Fauci, Redfield, and the other Trump officials on Covid-19


Tomorrow, some of the most prominent figures coordinating the national Covid-19 response will appear before a congressional panel to answer questions about the efforts so far. Top infectious disease expert Anthony Fauci, CDC Director Robert Redfield, FDA chief Stephen Hahn, and White House "testing czar" Brett Giroir will be grilled by lawmakers on the Senate's main health committee, many of whom have been critical of the federal government's response thus far. We at STAT also have questions for this lineup of officials. As these experts contemplate the best way to reopen the country, we want to know everything from whether there is sufficient testing to whether the CDC — which has largely been sidelined thus far — will play a more prominent role in this next phase of the pandemic. Read more here

EDs see spike in pediatric mental health visits

Emergency department visits for mental health disorders among children have spiked in recent years, according to new data. Here's more from the study, which looked at national emergency room data between 2007-2016 among those ages 5-17: 

  • Overall trends: For all mental health issues in this age group, ED visits rose by 60%. The increase was highest in those ages 10 and older. 
  • Types of mental distress: Visits related to anxiety and impulse control increased by 117% during the 10-year study period, while visits for deliberate self-harm spiked by nearly 330%. 
  • Demographic trends: Urban areas saw a larger increase in mental health visits to EDs than rural areas. Girls also made visits more than their male peers. 

More than half of cancer researchers say their work has been paused

A new survey of researchers funded by the American Cancer Society finds that more than half of them have had to put their projects on hold due to Covid-19. The ACS got responses from nearly 490 of its almost 750 funded scientists, and 51% of respondents said that the crisis has had "a high impact" on their work, meaning that any research or training activities have been paused until further notice. When asked about how their institutions had responded to the crisis, nearly 60% also said their institutions had closed laboratories, while only 4% said their institutions remained entirely open. About a third of those surveyed said that they were able to make occasional visits to their lab, while around 8% said that they were working in near-normal settings. 

What to read around the web today

  • Breathing room: Engineers take on the ventilator shortage. The New Yorker
  • Covid-19 survivors’ blood plasma is a sought-after new commodity. Kaiser Health News
  • Bacteria bombs, fat tongues and microrobots: The winners of our STEM writing contest. The New York Times
  • In the early days of the pandemic, the U.S. government turned down an offer to manufacture millions of N95 masks in America. The Washington Post
  • How much is a human life actually worth? Wired

Thanks for reading! More tomorrow,


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Monday, May 11, 2020


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