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Morning Rounds Shraddha Chakradhar

There won't be a newsletter tomorrow in observance of the July 4 holiday here in the U.S. Here's what you need to know before the long weekend.

Fever checks can't catch all Covid-19 cases. Smell tests might help

Airports, restaurants, and retail stores have started to use temperature checks to see if a person has a fever — and therefore possibly symptomatic for Covid-19 — but the technique is notoriously unreliably. Increasingly, experts are suggesting that smell tests ought to also be part of routine screenings. Research suggests that the loss of smell, called anosmia, is an even earlier symptom of Covid-19 than a fever, and some people who never go on to develop a fever still lose their sense of smell. “[I]t’s potentially a more sensitive screen for asymptomatic patients,” Mayo Clinic physician Andrew Badley tells STAT's Sharon Begley. Read more here

Here's what else is new with the pandemic today:

  • The U.S. hit a new single-day record, posting nearly 53,000 new Covid-19 cases yesterday. The surge was largely driven by states in the South and West, prompting several states to reverse course on reopening plans. California Gov. Gavin Newsom announced that bars, movie theaters and other public places for at least three weeks, while New York City delayed indoor dining as part of its reopening plan. 
  • There were 122,300 additional deaths between March 1 and May 30 this year than is typical for those months, possibly due to Covid-19, according to a new study. That figure is 28% higher than the official death tally for Covid-19 reported during that time because these deaths happened before diagnostic tests were widely available in many states to confirm any presence of SARS-CoV-2. 
  • An experimental vaccine being developed by Pfizer and BioNTech generated immune responses in volunteers enrolled in a 45-person trial, according to data shared on the preprint and non-peer-reviewed site medRXiv. The vaccine also triggered side effects such as fever and sleep disturbances, especially when it was given at higher doses. 
  • People began limiting their movements even before statewide restrictions were put into place, according to a new study of the 25 U.S. counties hardest hit by Covid-19 through April 20. New York City saw a 35% drop in regular movements, as tracked through phone data, while Harris County, Texas, saw a 63% drop in regular movement. 

New reports highlight increase in drug overdoses amid pandemic

Drug overdose calls to emergency services are soaring during the pandemic, possibly due to increased levels of anxiety and social isolation, according to recent reports from Politico and the Washington Post. Earlier this week, Politico reported that a White House drug policy office analysis showed that drug overdose deaths had increased 11.4% in the first four months of this year compared to the same period last year. Kentucky saw a 25% increase in overdose deaths between January and March this year, while EMS calls and emergency department visits related to overdoses also increased between March and June. West Virginia also reported a 50% increase in emergency calls in May. The Post similarly reports that suspected overdoses have steadily increased, from an 18% jump in May 2020 compared to May 2019 to a 42% increase in May this year compared to last May. 

Experimental HIV drug seems effective at a twice-a-year dose, study finds

Researchers at Gilead Sciences have developed a new therapy for HIV that could reduce the amount of virus in an infected person for up to six months. The therapy works to target the capsid protein on HIV, which protects the virus from attacks from the human body's immune system as well as helps the virus enter human cells. In a study published yesterday, scientists described how traces of the drug — called lenacapavir — was still found in 40 healthy individuals enrolled in a trial six months after injection. And the amount of virus in 32 HIV-positive individuals was significantly reduced only nine days after being injected with a low concentration of the drug. Still, experts are unsure of how valuable lenacapavir will be, especially since current HIV drugs are highly effective and convincing doctors to switch to a new drug may be a tough sell. 

Inside STAT: Does asthma raise Covid-19 risk? Research points to complex connection


(ADOBE)

When the Covid-19 pandemic first hit, experts thought that asthmatics might be at an increased risk of contracting serious infection. After all, the coronavirus works by attacking the lungs, and other viruses in the lungs have been known to set off serious asthma attacks. But six months into the pandemic, the picture seems complicated: A recent analysis of data from more than 1,500 people found that Covid-19 patients with asthma didn't fare any worse than those without asthma. But not all asthmatics are the same, and another study found that those whose asthma is triggered by factors such as weather and stress (versus allergens like pollen) had a higher likelihood of contracting Covid-19. STAT's Juliet Isselbacher has more here

More adults are receiving treatment for depression in recent years

More adults are getting treatment for depression, according to a new analysis. Researchers looked at national health survey data from 2007-2016, and found that although the rates of depression among U.S. adults has remained relatively unchanged during that time period, nearly 53% of people reported receiving any treatment during 2015-2016, compared to 44% a decade prior. Around 51% of people with depression in 2007 reported seeing a mental health specialist or receiving some medication, but that increased to 60% by 2016. Although the study didn't measure changes in insurance status and how it corresponded to accessing mental health treatment, expansion of mental health services under the Affordable Care Act in 2014 could explain the study's findings, the authors suggest. 

Medical groups urge caution this Fourth of July to curb Covid-19's spread

Fourth of July is likely to look different this year given the pandemic, and some medical organizations have offered advice on how best to proceed. The American Academy of Pediatrics, for instance, suggests viewing the few planned fireworks shows this year from a distance. Some places are only planning televised shows, while others are holding fireworks displays in parking lots so families can view them from cars. The American Medical Association and two other organizations put out a joint statement urging Americans to take precautions including limiting the size of gatherings to only those who are already in close contact. "[A] typical Fourth of July celebration could further spread the virus, endanger lives, overwhelm our health system, and undo the progress made toward reopening sectors of our economy," the statement says. 

What to read around the web today

  • Novartis pays $678 million to settle a long-running case over alleged kickbacks to doctors. STAT Plus
  • She needed lifesaving medication, but the only hospital in town did not have it. ProPublica
  • Babies could be drinking lab-grown breast milk by 2021. Vice
  • Inside Moderna: The covid vaccine front-runner with no track record and an unsparing CEO. The Wall Street Journal
  • How secret deals could keep a Covid-19 drug out of reach for millions. Los Angeles Times

Please have a safe weekend! More next week,

Shraddha

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Thursday, July 2, 2020

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