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Morning Rounds Elizabeth Cooney

U.S. deaths from Covid-19 forecast to rise by 90,000 by Feb. 20

Federal health officials predict as many as 90,000 more people in the U.S. will die from the coronavirus in the next four weeks — a sobering warning as the government strains to improve delivery and injection of vaccines. The projection, coming from the Biden administration’s first health briefing yesterday, does not break new ground but reflects a different approach to sharing information than the previous administration's. “I know this is not news we all want to hear, but this is something we must say so we are all aware,” CDC Director Rochelle Walensky said. Her agency forecasts between 479,000 and 514,000 deaths in the U.S. by Feb. 20. “If we are united in action, we can turn things around.”

‘A circular nightmare’: Short-staffed nursing homes spark Covid-19 outbreaks, report says

Nursing homes have suffered grievously in the coronavirus pandemic. Chronically understaffed, that’s getting worse, a new analysis says. The shortage of direct-care workers rose from 20% of U.S. nursing homes in May to 23% in December. Too few workers raises stress among staff, the authors argue, making them and the residents they care for more vulnerable to Covid-19 infections, reducing staff further in “a circular nightmare.” Between September and December, rates of Covid-19 deaths and cases in nursing homes each increased nearly fourfold. “There is a long literature documenting that facilities with higher patient/staff ratios have lower quality and worse outcomes,” Harvard’s Michael Barnett says in the report. “The magnitude of these shortfalls poses a major threat to public health.”

Study: Schizophrenia increases risk of dying from Covid-19

People with schizophrenia have an almost three times greater risk of dying from Covid-19 than people without the mental disorder, a new study finds, even after accounting for higher rates of heart disease, diabetes, and smoking. Schizophrenia ranks second — after age — in the odds of dying after Covid-19 infection. People with mood or anxiety disorders had no increased risk of death from coronavirus infection in the cohort study of more than 7,300 patients treated in New York last spring. Researchers in the field previously thought underlying conditions were to blame because people with schizophrenia, on average, die 15 years earlier than those without the disorder. Now the authors wonder if genetic variation in immune response might be at fault.

Inside STAT: The chaotic and frustrating search for Covid-19 shots

Arghavan Salles (Dominic Valente for STAT)

As an intensive care physician in Phoenix, Arghavan Salles has spent the past several months desperately trying to keep Covid-19 patients alive. She knows all too well how terrifying it is for them to be alone in a hospital room, away from their family and dependent on a machine for their every breath. That’s why earlier this month she was feverishly searching online and poring over state public health websites in an attempt to book a vaccination appointment for her elderly mother in California. But like so many other Americans trying to navigate the vaccination process for themselves and for loved ones, Salles found herself drowning in an ocean of false leads and dead ends. “It's just utter chaos,” said Salles. STAT’s Nicholas St. Fleur has more on the search for coveted vaccination appointments.

How long do Ebola survivors keep their immunity?

While the world learns more about Covid-19 each day, new research may hold lessons from an older scourge. Antibody levels in 39 of 51 Ebola survivors’ blood samples surged and dropped nearly a year after recovery. No virus was detected, hinting that it might lurk in their bodies — known Ebola reservoirs are the eyes, central nervous system, and testes — stimulating immune memory of the original infection. Antibody levels tend to fluctuate, but the later rise causes concern. “Recurrent vaccine boosters in survivors (in addition to heightened surveillance) might be needed,” a related commentary suggests. “The mechanisms of antibody decay have not yet been defined for Covid-19, but recurrent vaccination might be necessary here, too, to achieve durable immunity.”

Cannabis dispensaries associated with lower opioid deaths, study suggests

U.S. counties where legal cannabis stores operate had fewer deaths from opioid use, a new study says. Previous research examining any relationship between cannabis consumption and opioid use has been mixed, but the authors say their analysis, drawn from CDC data and Weedmaps, does a better job measuring the possible impact of dispensaries in 23 states from 2014 through 2018. When a county went from one to two dispensaries, there was an estimated 17% decline in opioid-related mortality rates, and for fentanyl, an estimated drop of 21%. The study can’t show cause and effect between stores and deaths, and an editorial warns that easier access to cannabis "cannot be regarded as a remedy to the opioid crisis until a robust evidence base is available."

Covid-19 in the U.S.

Cases yesterday: 176,395
Deaths yesterday
: 3,125

What to read around the web today

  • With all eyes on Covid-19, drug-resistant infections crept in. New York Times
  • Oklahoma seeking to return $2M worth of hydroxychloroquine. Associated Press
  • Opinion: Denied treatment, some Covid long-haulers could become lifelong-haulers. STAT
  • Watchdog says officials misused biomedical research funds for years. Washington Post
  • These doctors are using AI to screen for breast cancer. Wired

Thanks for reading! More tomorrow,

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Thursday, January 28, 2021

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