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Morning Rounds Shraddha Chakradhar

Good morning. It's Elizabeth Cooney today, making the Morning Rounds while Shraddha is off. To the news:

CDC advisory body lists essential workers high on Covid-19 vaccine priority lists

As more results from clinical trials of Covid-19 vaccines come in, an influential body charged with making vaccine recommendations said yesterday essential workers are likely to move ahead of adults 65 and older and people with high-risk medical conditions — but behind health care workers and people living in long-term care facilities — when the CDC signs off on Covid-19 vaccine priority lists. The intention is to bring many people of color closer to the front of the line — should they want to be vaccinated — because the pandemic has disproportionately hit Black and Latino communities, according to the Advisory Committee on Immunization Practices. Essential workers include people who work in meat-packing plants, other food-processing facilities, municipal wastewater management operations, and transport. It also includes police and firefighters and, currently, teachers.

Despite WHO dismissal, remdesivir keeps some doctors’ backing for Covid-19 care

Last week, the WHO recommended that doctors not treat hospitalized Covid-19 patients with the antiviral remdesivir, arguing that the lack of evidence it improves survival and other outcomes meant it wasn't worth the cost and risks of using. But the drug, which is FDA approved, still has the endorsement of the Infectious Diseases Society of America in its latest Covid-19 treatment guidelines. On a call with reporters yesterday, Rajesh Gandhi, the co-chair of IDSA's guidelines panel, acknowledged the drug wasn't a "home run" and hasn't shown a reduction in mortality, but pointed to one clinical trial that demonstrated the antiviral helped patients recover and get out of the hospital faster than placebo. "We do think that has an important benefit as our hospitals fill up," said Gandhi, an infectious disease physician at Massachusetts General Hospital. He added, "We do need better drugs."

Clinical trial in Africa takes aim at mild Covid-19

In what it bills as the largest effort of its kind in Africa, the 26-member ANTICOV coalition is launching a clinical trial in 13 countries to test treatments for mild cases of Covid-19. The “adaptive platform trial” — one that can add or remove treatments as it proceeds — will begin by studying medicines currently used to treat malaria, HIV, hepatitis C, parasitic infections, and certain cancers. That includes the HIV antiretroviral combination lopinavir/ritonavir and the malaria drug hydroxychloroquine, which remains the standard of care for Covid-19 in many African countries although HCQ has been discredited in much of the world. Treating mild Covid-19 infections takes on added urgency in a region with low ICU capacity, the coalition says.

Inside STAT: His childhood defined by what he didn’t have, he wants ‘a good life’ for his patients

Mutlay Sayan (RUTGERS)

No one knows when, exactly, Mutlay Sayan was born. When describing his childhood in Turkey, he often starts with everything it didn’t have. There was no electricity or running water. He’d never seen a car or a television. He didn’t go to school, so he didn’t know what a weekend was, and never learned to read. He worked in a factory then fought his way into school, eventually landing in the U.S. Yet now his radiation oncology colleagues see him in a lab coat over a shirt and tie, detailing a treatment plan with a patient just diagnosed with cancer. It might involve snapping the strands of a tumor’s DNA, blasting energy from a device so big it has to be lowered into a hospital by crane, the roof rebuilt above it. It’s an astonishing story Eric Boodman tells about Sayan, recently named a STAT Wunderkind. Read more.

Hunger for social contact looks like food craving

Humans in isolation are hungry for social contact, which will surprise no one feeling alone during this pandemic. New research tells us the craving we feel for human companionship starts in the same part of the brain that drives desire for food. In experiments conducted long before Covid-19 emerged, scientists isolated people in windowless rooms for 10 hours (they were not working remotely). Later they fasted for the same amount of time. After each session their brains were scanned while they looked at three kinds of images: happy groups of people, food, or flowers. The same tiny midbrain structure linked to craving lit up when social interaction or food were displayed. “Acute isolation causes social craving, similar to the way fasting causes hunger,” the researchers write.

Spoiler alert: Don’t watch movies for nutritional advice

Speaking of hunger, the food and drinks we see depicted in movies fall far short of nutritional goals, a new study concludes. Researchers watched how food and beverages were portrayed in 250 top-grossing U.S. movies from 1994 through 2018. Depictions of food were unhealthy in nearly three-quarters of movies and unhealthy in 90% of movies showing drinks — meaning they would not have met food and beverage advertising standards in the U.K. or diet recommendations in the U.S. Sugar content was a bit higher than what Americans actually consume, but alcohol consumption was more than three times greater on the big screen. Food for thought from the researchers: “Movies represent a high-impact opportunity to promote healthy consumption.”  

Covid-19 in the U.S.

New cases yesterday: 169,190
Deaths yesterday: 889


What to read around the web today

  • CDC urges overwhelmed contact tracers to prioritize efforts as cases soar. Politico
  • Damaged sense of smell in Covid patients holds clues to how recovery might work. Wall Street Journal
  • Can an algorithm prevent suicide? New York Times
  • Opinion: CMS’s new rules on organ donation and transplantation ‘will bring chaos.’ STAT
  • Postdocs under pressure: ‘Can I even do this any more?’ Nature

Thanks for reading! More tomorrow,


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Tuesday, November 24, 2020


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