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Morning Rounds Shraddha Chakradhar

Good morning and welcome to what's another work-at-home week for many of us. I'm Elizabeth Cooney and I'll be bringing you this newsletter for a few more days.

Covid-19: Gilead pauses access to experimental drug and a president odds with medical experts

Gilead Sciences has temporarily stopped granting patients access (with some exceptions) to remdesivir, its experimental drug against the novel coronavirus that causes Covid-19, citing “overwhelming demand.” And while hope has emerged around two anti-malaria drugs, chloroquine and hydroxychloroquine, President Trump is at odds with his medical experts over using the drugs against Covid-19.

More developments:

  • A dozen physicians at the epicenter of Italy’s Covid-19 outbreak issued a plea to the rest of the world: Because hospitals “are themselves becoming sources of [coronavirus] infection,” they urge other countries to deliver care to many patients in their homes. 
  • Sen. Rand Paul (R-Ky.) said he has tested positive for the disease caused by the new coronavirus, becoming the first member of the Senate to report a case of Covid-19. Two House members, Reps. Mario Diaz Balart (R-Fla.) and Ben McAdams (D-Utah),  have tested positive.
  • The FDA warns that new at-home coronavirus tests are “unauthorized” while some of the startups selling them insist they are permitted under government rules loosened to expand desperately needed testing for Covid-19.
  • A coronavirus test from Cepheid will make only a small dent in the number of diagnostic tests available. It's not meant for the worried well.
  • Courage alone isn't enough for health care workers to get through the Covid-19 pandemic, Adam Levine writes in a First Opinion. He speaks from experience: He fought Ebola in 2014. 
  • Across the country, health care workers aren't being given the proper equipment to stay safe while treating patients. Give them what they need to fight Covid-19, Jennifer Hushion says in a First Opinion.
     

We tried out online symptom checkers for Covid-19. We’re not impressed

It seems like a good idea. Enter your symptoms online and let a chatbot tell you if you should seek medical care for what you worry might be Covid-19. So STAT’s Casey Ross (who is not ill) drilled eight chatbots on a common set of symptoms — fever, sore throat, runny nose — to assess how they worked and the consistency and clarity of their advice. What he got back was a conflicting, sometimes confusing patchwork of information about the level of risk posed by these symptoms and what he should do about them. And that’s not trivial: Putting out conflicting information in the middle of a public health crisis can result in severe consequences, an expert told him. Here’s more.

How worried are Americans?

The serious nature of the coronavirus pandemic is sinking in among Americans, a new poll indicates. Two-thirds of respondents said they are at least somewhat concerned about someone in their family being infected by the virus, up from 45% in February, when more were worried about the flu. They also said they aren’t traveling: More than half of those planning trips in the U.S. or abroad said they had canceled or would cancel. Most are washing their hands more often, trying not to touch their faces, and avoiding crowds. A minority say they are stocking up on food, buying extra cleaning supplies, or contacting a health care provider. Only 7% are doing nothing at all related to the virus. 

Inside STAT: Caring for the most vulnerable


Louisa Pietrowsky (courtesy andrea pietrowsky)

An infection from the coronavirus can be a formidable threat to anyone. But it is especially pernicious for people whose health is always vulnerable. For Andrea Pietrowsky, that means her husband is not coming home. The couple’s daughter, 5 ½-year-old Louisa, has heart and lung conditions. Andrea’s husband, Tom, is a dietician at a Detroit hospital. If he picks up the virus at work and then unknowingly brings it home, he could get Louisa sick. Overall, the older people are, the greater the danger an infection poses to them. But people of all ages with weakened immune systems or certain diseases also face higher risks and are experiencing the coronavirus pandemic with particular anxieties. STAT’s Andrew Joseph has more here.

Toward a universal blood cell anyone can receive

This research is early, and it’s just in rodents, but at a time when Covid-19 is canceling blood drives, a new study takes on added interest. Scientists have built a hydrogel “sheath” that when bolted to the surface of red blood cells can hide an antigen from the body’s immune system. The researchers cloaked RhD-negative blood cells, a rare variant that can be life-threatening to people given RhD-positive blood. The camouflaged RhD-positive cells transfused into RhD-negative mice did not cause reactions, nor did human RhD-positive blood cells affect RhD-negative rabbits. If it works in people — a big leap from small animals — it could make conceivable a universal blood cell anyone could receive, no matter their blood type.

Molecular imaging looks potentially more accurate in prostate cancer

Men with localized prostate cancer whose biopsies put them at high risk for their disease spreading typically get CT and bone scans after surgery. A new study of 300 men suggests molecular imaging might be more accurate at spotting metastasis. The technique combines PET scans with CT: PET lights up when it sees a radioactive substance that detects prostate-specific membrane antigen, a molecule high in prostate cancer cells; CT reveals organs in greater detail. Half the men got molecular imaging and half got standard CT; then the groups switched. The molecular PET imaging was more accurate than CT alone at detecting cancer spread, by 92% versus 65%. Two unanswered questions: How much more would it cost and will the men live longer?

What to read around the web today

  • 'I’m going to keep pushing.' Anthony Fauci tries to make the White House listen to facts of the pandemic. Science
  • The coronavirus's rampage through a suburban nursing home. New York Times
  • I’m pregnant during the coronavirus pandemic, and I’m terrified. Boston Globe
  • Millions of older Americans live in counties with no ICU beds as pandemic intensifies. Kaiser Health News
  • A popular anti-clotting device may do more harm than good. Undark
  • Reiki can’t possibly work. So why does it? The Atlantic

Thanks for reading! Back tomorrow,

Shraddha

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Monday, March 23, 2020

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