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Morning Rounds Shraddha Chakradhar

Our podcast, "The Readout Loud," is now 100 episodes strong! Listen to this week's episode, a special edition to commemorate the occasion here.

Single coronavirus case exposes a bigger failure to track spread

The new Covid-19 case in a California woman with no travel history to China and no known contact with a person with the infection exposes a bigger problem: The virus is likely spreading undetected within the U.S., and experts still don't know how broadly the spread is. Before this new case was announced, the CDC had been reluctant to expand its testing protocol — only 445 people had been tested for the virus in the U.S., a fraction of the number in other countries. Even the woman in California, because she had no travel history, was initially refused a CDC test. It was only after she had been in the hospital for more than 10 days and her conditioned worsened did the CDC agree to have her tested. Now, the agency has changed its protocol, saying that those whose symptoms are consistent with Covid-19 and have a travel history to four other high-risk countries beyond China ought to be tested. 

Anti-vaccine activists co-opt a populist slogan to try to repeal an immunization law

A state-wide initiative known as Question 1 in Maine is asking voters to decide whether to repeal an immunization law that requires all schoolchildren to be vaccinated with the necessary shots, unless granted an exemption from a doctor. The messaging from those in favor of repeal is "Reject Big Pharma," but the group pushing for repeal is a large network of anti-vaccination groups. This approach may persuade many Mainers to join what they may see as a populist attempt to reign in large drug corporations instead of an attempt to put personal vaccine exemptions back on the map. If the group is successful, it would be the first time that a vaccine mandate is repealed by popular vote, possibly jeopardizing other states' requirements. 

Majority of current and former smokers don't get recommended lung cancer screenings

The majority of those who ought to be getting annual lung cancer screenings aren't getting them, according to a new CDC analysis. Among those ages 55-80, the U.S. Preventive Services Task Force recommends annual screenings for current smokers or those who quit in the past 15 years and who have a history of smoking at least 30 packs of cigarettes a year. But according to data on screening collected by 10 states in 2017, around 12% of adults met the USPTF criteria, but only a small fraction of those individuals actually got a CT scan in the previous year to screen for cancer. Of the 10 states that reported the data, Florida had the highest rate of lung cancer screenings, with 16% reporting having had CT scans. The data is only from a minority of states, but indicate a need for better public health initiatives to educate people about screening, according to the report. 

Inside STAT: They have 'Alzheimer's brains' but no symptoms. Why?


PET scan results that are part of a study on Alzheimer's disease at Georgetown University Hospital. (EVAN VUCCI/AP)

For years, the prevailing theory among aging experts was that clumps of protein in the brain — either amyloid plaques or tau tangles — meant that memory and other cognitive function were on the decline. But a select group of elderly individuals had these so-called biological hallmarks of Alzheimer's disease, but showed none of its cognitive symptoms. These people were considered an anomaly, but the public-private partnership known as the Alzheimer’s Disease Neuroimaging Initiative and other large studies have found that individuals with Alzheimer's-like brains but regular cognitive function are far from rare. Researchers are still trying to understand how 30% of older adults seem to have the protein structures, but are somehow protected from their detrimental effects. STAT Plus subscribers can read more from Sharon Begley here

Opioid crisis could have resulted in nearly 100,000 more deaths

(University of Rochester Medical Center)

The actual number of deaths from the opioid crisis could be up to 28% higher than what's been reported, according to new research. In a new study, scientists describe how many death records that classify drug-related deaths don't specify which drugs were involved. Looking at death records between 1999-2016, scientists correlated the records of those whose drug-related deaths were unspecified with other indicators in their medical records, including chronic pain conditions and previous opioid use. All told, 72% of the unclassified drug deaths were likely due to opioid overuse, the scientists found, leading to an additional nearly 100,000 opioid-related deaths. The findings are based on correlative estimates and the discrepancy with actual reported opioid deaths decreased over time, which the authors attribute to officials being more aware of the opioid crisis and recording such deaths more carefully. 

New report outlines the harmful effects of social isolation in older adults

A new report from the National Academies of Sciences, Engineering, and Medicine and funded by the AARP Foundation finds that older adults who are socially isolated are at an increased risk of depression and heart disease. Here's more:

  • Prevalence: Nearly a quarter of adults aged 65 and older are socially isolated, and more than a third of adults aged 45 and older report feeling lonely. 
  • Health effects: Social isolation is associated with an increased risk of premature death. Poor social relationships are also associated with a 29% increased risk of heart disease and a 32% increased stroke risk. 
  • Recommendations: The report authors suggest including social isolation and loneliness as assessment measures in EHRs so physicians can look out for it as a risk factor. Another suggestion is that agencies like the NIH fund research looking at the health effects of isolation. 

What to read around the web today

  • Turned away from five clinical trials, a cancer patient waits for one that will take him. STAT Plus
  • The doctor of nearly lost causes. MIT Technology Review
  • When the billionaire family behind the opioid crisis needed PR help, they turned to Mike Bloomberg. ProPublica
  • Telehealth can help fight the novel coronavirus, but U.S. challenges could limit its potential. STAT
  • Scotland poised to become first country to make period products free. NPR

Thanks for reading! Have a great weekend,

Shraddha

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Friday, February 28, 2020

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