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Morning Rounds Shraddha Chakradhar

Good morning! STAT reporter Andrew Joseph here, filling in for a few days. You can reach me at andrew.joseph@statnews.com.

Also! Lloyd Minor, the dean of Stanford's med school, is taking questions from STAT readers. You can submit your questions here through tomorrow. 

The latest on Covid-19

You've likely started to hear public health experts and officials discuss the importance of "flattening the curve." Here's a story from STAT's infectious diseases reporter Helen Branswell about what that means — and why it's so important to keeping people safe.

Here's what else is happening with the outbreak:

  • Testing: There's another issue with U.S. testing capacity: shortages of key chemicals needed to run the tests.
  • Nursing homes: Leaders of the nursing home industry told the New York Times that visitors to the facilities should be screened and that only essential visits be allowed. 
  • Cancellations: Joe Biden and Bernie Sanders both called off events set for Tuesday in Cleveland. More universities also moved classes online and told students not to return after spring break.
  • In states: Gov. Andrew Cuomo announced New York was imposing a 3-square-mile "containment area" in New Rochelle for two weeks. In Massachusetts, the Boston Globe tracked how a Biogen conference spread the virus.
  • FDA inspections: The FDA said it was postponing most of its inspections of foreign manufacturing facilities. 

The limits of dementia treatment in primary care

Half of primary care physicians say their field is not prepared to handle the increasing number of people with dementia they expect to be treating in the next five years, according to survey results from the Alzheimer’s Association. As the population with dementia grows, general practitioners are going to need to handle more of the responsibility of diagnosing and caring for people. But according to the survey, about 40% of primary care physicians say they are “never” or only “sometimes comfortable” diagnosing dementia, and 27% say they are uncomfortable answering questions from patients about dementia. One problem: Most of the physicians said they received only “very little” training on dementia in their residencies.

A brain jiggle points to neuronal identity3c3c03eb-ead2-4257-b1a7-8430ed411081.png

"This is my heartbeat song." — Kelly Clarkson (courtesy mosher et al, Cell reports)

Scientists have started to glean more information about the different types of neurons in the brain thanks to the slight pulsing of the brain every time the heart pumps. They made their discovery by studying neuronal activity recorded by electrodes, which had been implanted into patients who were already undergoing brain surgery and agreed to participate in the research. The researchers initially thought that the neurons’ firing patterns were changing with every heartbeat, but ultimately determined that the slight shift in the brain was creating that impression. Tracking the activity of a neuron as it jiggles locations could provide better insight into its particular role.

Inside STAT: Covid-19 in Seattle could be a preview for other U.S. communities


Selling masks outside a seattle sounders game Saturday. (JOVELLE TAMAYO For STAT)

To try to stem the spread of the coronavirus, authorities in the Seattle area have issued emergency declarations, set up quarantine sites, and asked the public to steer clear of large gatherings. King County even bought a motel to house people who are infected. But what’s happening in Washington state may just be a preview of what communities around the country will have to grapple with if the coronavirus continues its widening spread. The outbreak in Seattle has also made clear that authorities will struggle with deciding to cancel events like professional sports games and that even the best local health agencies face challenges with this type of disease. STAT contributor Jason Buch has the story from Seattle here.

Also, be sure to take a look back at our 2018 interview with Bill Gates, in which he discusses speaking with President Trump about pandemic preparedness.

The Texans least likely to vaccinate their children

Texas is one of more than a dozen states that allows families with a philosophical objection (as opposed to a medical reason or religious objection) to opt of vaccinating their children. And a new study shows that Texans who are college-educated, live in suburban or urban areas, have higher incomes, and are white are less likely than people from other demographic groups to vaccinate their children. The study, which focused on children from kindergarten to eighth grade, reported that the median percentage of philosophical vaccine exemptions at school systems in the state doubled from 2012 to 2018. It found that 5% of public, 28% of private, and 22% of charter schools in the state’s metro areas are at high risk of vaccine-preventable childhood diseases because of vaccine exemptions.

FDA warns stores selling unauthorized e-cigarettes

As part of the FDA’s ongoing, and sometimes halting, efforts to rein in youth vaping, the agency on Tuesday sent 22 warning letters to retailers and manufacturers that were selling e-cigarettes that had not received market authorization. The agency framed the letters as a first step in their enforcement, which is prioritizing sellers and manufactures of flavored e-cigarettes (other than tobacco- or menthol-flavored), and those that the agency determines haven’t done enough to prevent underage use. Some of the retailers that received the letters included a number of 7-Eleven stores and Shell locations. Companies that do not comply with the FDA’s regulations could ultimately face seizures or civil penalties; warning letters are seen as an initial enforcement action.

What to read around the web today

  • First Opinion: The U.S. needs a nationwide registry for traumatic brain injury. STAT
  • Obama strikes a serious tone in video celebrating Obamacare anniversary. CNN
  • Drug companies, Canadians, pharmacists, and more blast Trump’s drug importation plan. STAT Plus
  • When Purell is contraband, how do prisons contain coronavirus? The Marshall Project
  • A call to arms: Under attack, pro-vaccine doctors fight back. New York Times

Thanks for reading! 
Shraddha

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Wednesday, March 11, 2020

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