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Morning Rounds Shraddha Chakradhar

Race for Covid-19 vaccine slows, at least a tad, as officials tap the brakes

The FDA issued new, strengthened rules for Covid-19 vaccine makers yesterday, which could effectively push back the first emergency authorization past Election Day to mid- or late November. According to the revised rules, the FDA wants vaccine manufacturers of two-dose vaccines to collect safety data on at least half of their clinical trial subjects for two months after they have received their second dose. All but one of the current frontrunners follow a two-dose regimen. Also ever so slowly tapping the brakes on the race to a Covid-19 vaccine was Operation Warp Speed co-chair Moncef Slaoui, who revealed yesterday that OWS has urged manufacturers to not apply for emergency use authorization until they have significant amounts of vaccines to deploy.

Here's what else is happening with Covid-19: 

  • President Trump may have returned to the White House from Walter Reed, but there are still several unanswered questions about his Covid-19 diagnosis. For instance, when did he contract the virus? The best guess would suggest the weekend before he tested positive or sometime in the last full week of September. But that raises another question: When was his last negative test? Trump and his medical team have been cagey about this, which implies that he may not have been regularly tested, even as he continued to attend political events. 
  • It's been a month since AstraZeneca and the University of Oxford's Covid-19 vaccine trial was placed on hold globally due to safety concerns in a participant in the U.K. The U.S., however, is the only place where that hold still remains and many patients enrolled in the trial here are stuck in limbo. They've received the first round of shots — placebo or treatment — but it's unclear when, if ever, these participants will get their second dose. STAT's Rebecca Robbins has more here
  • In a new First Opinion for STAT, medical student Harry Paul writes about how Covid-19 is exposing a lack of widespread understanding and accommodation for individuals with nonmobility disabilities. Paul writes that his congenital scoliosis isn't immediately apparent, and that could mean that his inability to quickly clear respiratory infections like Covid-19 could also go unnoticed. "It is pivotally important to learn about hidden disabilities now," he writes, as Covid long-haulers and even those who have technically cleared the infection deal with ongoing symptoms such as muscle pain and brain fog.  

CRISPR scientists win Nobel prize in chemistry

This year's Nobel Prize in chemistry was awarded this morning to two female scientists — the first time for any Nobel award — who helped develop the genome editing method known as CRISPR-Cas9. The laureates are Emmanuelle Charpentier, who is at the Max Planck Institute of Infection Biology in Berlin, and Jennifer Doudna, a Howard Hughes Medical Institute investigator at the University of California, Berkeley. The Nobel committee highlighted how the use of CRISPR has exploded since its discovery nearly a decade ago, including by plant researchers looking to alter the genetic code of crops to be drought- or pest-tolerant. The committee also talked about how CRISPR has the potential for altering the course of many medical conditions, especially genetic diseases.  

Harris, Pence to take the stage at VP debate tonight

As President Trump continues treatment for Covid-19 and more than three dozen people in the White House orbit have tested positive, Vice President Mike Pence and Democratic vice presidential nominee Sen. Kamala Harris (D-Calif.) are set to take the stage at 9 p.m. ET tonight for a debate at the University of Utah. Moderated by USA Today’s Susan Page, Pence and Harris will now be spaced 12 feet apart with plexiglass between them — which Pence's team has opposed — amid concerns about coronavirus transmission. Pence was at the now-infamous Rose Garden ceremony for Supreme Court nominee Amy Coney Barrett on Sept. 26, as were other members of the administration and GOP leaders who now have Covid-19. Pence — who has since tested negative — has not chosen to quarantine for the recommended 14-day period and has instead attended campaign events across the country.

Several scientists among latest class of MacArthur 'Geniuses'

The latest class of MacArthur "Genius" grant winners was just announced, and there are a handful of scientists among the 21 honorees. Evolutionary geneticist Nels Elde is one of this year's winners, and his work looks at host-pathogen interactions and how evolution has allowed organisms to fight against other beings. Also in the 2020 class is cognitive neuroscientist Damien Fair, whose research investigates brain function during development. Other notable names: Polina Lishko, who is studying mammalian fertilization and new therapies for infertility; biochemist Mohammad Seyedsayamdost, who is investigating new antibiotics; and environmental health advocate Catherine Coleman Flowers, whose work brings attention to failing sanitation infrastructure in rural areas and how this perpetuates health disparities.

Inside STAT: Can a recruiter for a Covid-19 vaccine trial overcome distrust?


Covid-19 vaccine trial recruiter Jorge David Gutierrez. (KAYANA SZYMCZAK FOR STAT)

Jorge David Gutierrez truly believes in his work as a recruiter at Brigham and Women's Hospital for Moderna's Covid-19 vaccine trial. A recent neuroscience graduate of Brown University and a medical school hopeful, he understands that building trust is everything, especially in the communities of color that have been alienated by decades of racism in medicine. Yet his thinking has also been shaped by his mom, who's told him that Covid-19 vaccines are "the work of the devil, to get a chip in us, to track us." When he's outside a community health center, talking to strangers, he can't help thinking about the conspiracy theories he hears from family members, what's managed to convince them — and what hasn't. STAT's Eric Boodman has more here

Insurance of up to 15 million people may have been affected by pandemic-related job losses

A new Commonwealth Fund report finds that nearly 8 million people in the U.S. with employer-sponsored health insurance lost their jobs as of June this year due to the Covid-19 recession. An additional 6.9 million people were dependents on these plans, leading to almost 15 million people total possibly affected. Not all industries were equally affected: Nearly 1 in 5 manufacturing jobs that offered insurance were lost, compared to 11% of those in the food service and hotel industries (which don't often offer insurance). Those ages 35-54 and women bore the brunt of these job losses, especially because they are also likely to have dependents on their insurance. The report only looked at job losses, so the total number of people who actually lost health insurance could still depend on whether furloughed employees were still insured or whether people chose to be insured outside their employer's plan after losing their job. 

What to read around the web today

  • Pregnant during the pandemic: Three stories. Hazlitt
  • Campus dorm resident assistants adjust to a new role: Covid cop. Kaiser Health News
  • Rick Bright, Trump administration vaccine expert turned whistleblower, resigns NIH post. STAT
  • Sed do eiusmod tempor incididunt ut labore et dolore magna. The Atlantic
  • Face masks: what the data say. Nature

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, October 7, 2020

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