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Morning Rounds Shraddha Chakradhar

A high plateau of U.S. Covid-19 cases portends more spread

The restrictive measures put into place in the U.S. to curb the spread of the coronavirus may have led to a flattening of the curve, but in a troubling sign, there is a high plateau of new Covid-19 cases. The U.S. in April confirmed nearly 25,000 cases every day, a rate that has not slowed so far this month. This trend means that there is plenty of virus still in the U.S., and so steps to slowly lift restrictions may lead to even more infections. “I don’t think at this point that it’s good public health advice to reopen in most parts of the United States, because cases numbers are high, and testing is poor," epidemiologist Marc Lipsitch tells STAT's Andrew Joseph. Read more here

Here's what else is new with the pandemic: 
  • Some physicians are calling for including more children in Covid-19 trials. In a new viewpoint article in JAMA Pediatrics, a trio of doctors argues that even if early data have shown children experience milder forms of infection, some research shows that the disease can be especially serious for certain pediatric populations, which underscores the need to have rigorous trials to study potential therapies in children. 
  • In the new episode of STAT’s "Readout LOUD" podcast, STAT’s Sharon Begley shares what Covid-19 in the U.S. may look like in the summer and beyond. Bay Area cardiologist Ethan Weiss also joins the hosts to share how he flew to New York City to treat Covid-19 patients and what it’s been like in the hardest-hit area of the country. 
  • In a new STAT First Opinion, infectious disease physician Sunil Parikh argues that nursing homes and other long-term care facilities are the overlooked epicenters of the U.S. Covid-19 outbreak. "It is past time to focus the full weight of our testing, supply chain for personal protective equipment, and workforce strengthening efforts to nursing homes, veterans’ homes, and other long-term care facilities," he writes.  

Health experts mark 40 years since smallpox was eradicated

Forty years ago, on May 8, 1980, the world celebrated the eradication of a centuries-old foe, smallpox. But William “Bill” Foege, the man credited with creating the strategy that led to the eradication of the virus, told STAT’s Helen Branswell yesterday that for him, the celebration started much earlier, when he realized that smallpox transmission could be stopped. The project, which began in earnest in 1967, saw Cold War adversaries working together to rid the world of a disease that killed 300 million people in the 20th century alone. “People from countries that weren’t even on speaking terms with each other worked together on this because it was the common enemy,” said Stewart Simonson, an assistant director-general of the WHO. “They changed the world.”

Hypertension much more common in rural areas than cities, CDC data finds


New CDC data reveal a large rural and urban divide when it comes to hypertension. More specifically, 2017 data from the agency finds that the prevalence of high blood pressure in the rural U.S. is 40%, compared to around 29% in more urban areas. When considered at the county level, scientists found that the prevalence among rural areas varied from around 18% in areas including parts of Colorado, New Hampshire, and southern California to 55% in parts of the Southeast, including in West Virginia and Louisiana. The report also looked how many people are on blood pressure medication: At the low end, around 54% of those in many Western states reported taking these medicines, compared to nearly 85% in several counties in the Midwest and South. 

Inside STAT: Could the porn industry offer a model for reopening amid Covid-19?

As states and employers grapple with many questions about safely reopening workplaces — including whom to test, how often to test them, and how to go about testing — there is one industry that can offer some guidance. Ever since an outbreak of HIV infections in the late 1990s threatened to shutter the lucrative porn industry, it put in place rigorous testing standards for performers, who have to be tested for HIV and other STIs every 14 days. And a single HIV-positive case shuts down all U.S. sets and propels contact tracing efforts until sets can safely reopen. "The adult film industry teaches us that as a proof of concept, this can work," public health expert and physician Ashish Jha tells STAT contributor Usha Lee McFarling. Read more from her Los Angeles dispatch here

Covid-19 could result in as many as 75,000 'deaths of despair'

The negative effects of the Covid-19 pandemic could result in as many as 75,000 "deaths of despair," or those from suicide or alcohol and other substance abuse, according to a new report. Unemployment is a risk factor for suicide and substance abuse, and so researchers at the Well Being Trust and the Robert Graham Center looked at projected rates of unemployment for 2020-2029 and combined it with the number of deaths of despair from 2018 as a baseline. Depending on how steep the unemployment figures could be, the projection for deaths of despair ranged from around 27,000 if the economy recovered quickly to more than 154,000 if the economic downturn lasted for a long time, with 75,000 deaths being the most likely scenario. To avoid this, policymakers should focus on providing meaningful work to those who are unemployed as a result of Covid-19 — such as by employing them as contact tracers — and should make accessing mental health care easier, the report concludes. 

Women who conceive through IVF have a good chance of success the second time around

A woman who has previously conceived through IVF has a pretty good chance of once again conceiving using the same process, according to new research. Researchers in Australia looked at a group of more than 35,000 women who had a child using IVF between 2009-2013 and who then tried to conceive again through IVF by the end of 2015. Women who used previously frozen embryos for their second treatment had a higher success rate than those who went through the egg retrieval process again: The birth rate among the former group was 61%-88%, while that rate in the latter group was 50%-70%. Even so, the odds of conceiving through IVF decreased for women aged 35 and older or those who waited three or more years before beginning their second IVF procedure. Some caveats: The study didn't look at individual differences among the women including how long they were infertile before conceiving. 

What to read around the web today

  • Is getting pregnant “medically necessary” right now? MIT Technology Review
  • These four startups got venture funding a year ago. Did it help? STAT Plus
  • Is the military prepared to handle Covid-19 within its ranks? Undark
  • Covid-19's scary blood clots aren't that surprising. Wired
  • The wide world of disease-based Dutch profanity. Atlas Obscura

There may not be many in-person Mother's Day brunches and picnics this year, but I hope everyone can find a safe way to celebrate motherhood — whatever that means to you and with whomever fulfills that role in your life — on Sunday! See you next week, 

Shraddha

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Friday, May 8, 2020

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