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Morning Rounds Shraddha Chakradhar

Welcome to a new week — and a new month. Here's what's happening today.

Anthony Fauci on Covid-19 reopenings, vaccines, and 'warp speed'

In a wide-ranging new interview with STAT's Helen Branswell, top infectious disease expert Anthony Fauci shares his thoughts on vaccine development, including his displeasure with Moderna's decision to only release snippets of early data on its Covid-19 vaccine. "I didn't like that," said Fauci, who has been among the most visible government officials handling the U.S. response to the pandemic. "What we would have preferred to do, quite frankly, is to wait until we had the data from the entire Phase 1 — which I hear is quite similar to the data that they showed — and publish it in a reputable journal and show all the data." Read the rest of the interview, including Fauci's thoughts on the scenes of people crowding in public spaces as states reopen, here

Here's what else is going on with Covid-19: 

  • The big news over the weekend was President Trump's announcement that the U.S. will cut ties with the WHO, accusing the agency of protecting China as the pandemic took off. And although it's not immediately clear whether the U.S. can completely withdraw WHO funding without congressional approval, experts are warning of dire consequences for global health if the U.S. moves forward with the decision. The current pandemic could possibly be prolonged, for instance, because the funding gap would hinder the WHO's ability to respond adequately to the crisis. 
  • A new CDC analysis using flu surveillance data suggest that the earliest transmission of SARS-CoV-2 occurred sometime in January this year, disputing recent evidence from outside the agency that the earliest transmission was in mid-February. The CDC director said these new findings reinforce that the agency had always keeping an eye on Covid-19, but experts argue that the flu samples were not being tested for the coronavirus in real time, when the agency could have helped public health efforts to stop infection. 
  • Restrictions on places of worship have been a point of contention as states to look to reopen. In a 5-4 ruling late Friday, the U.S. Supreme Court rejected a request by a California Pentecostal church to be relieved from rules in the state that prohibit in-person religious services. The Supreme Court also rejected similar requests from two churches in Illinois, where the state had limited religious services to only 10 worshipers (although the order was later modified by the governor to allow for up to 100 people). 

Commission rules in favor of renewing license for Missouri's only abortion clinic 

A Missouri commission that acts as an independent mediator in cases involving state agencies and private entities ruled on Friday that a Planned Parenthood clinic in St. Louis can remain open, ending a yearlong dispute between the clinic and Missouri's health department. Last May, Missouri didn't renew a permit application for the facility, Missouri's only abortion provider, alleging that the clinic violated several safety standards. In a 96-page document issued Friday, the Missouri Administrative Hearing Commission said that the clinic's operations were safe — in over 4,000 abortions performed there since 2018, the state was only able to identify two causes to deny a license — and that the state health department was wrong in withholding the facility's license. The clinic can now continue to operate through at least May 2021. 

Parents of small children don't have a good estimate of their screen time

A small survey of parents with young children who use cellphones or tablets finds that many parents are often unaware of exactly how much screen time their child is getting. Researchers recruited nearly 350 parents of children ages 3-5, and implemented a "sampling" method that involved tracking time spent with a frequently used device. They found that 35% of children had their own electronic device, and the average daily usage was a little under two hours, even though the American Academy of Pediatricians suggests limiting screen time in this age group to an hour. The scientists also found that a majority of parents either overestimated or underestimated their child's screen time, while only about 29% of parents were able to accurately tell how much time their child spent on a phone or tablet. One caveat: The researchers weren't able to distinguish between users on shared devices, but relied on the apps being used to narrow down whether a child was using the device. 

Inside STAT: When her mom's time came, Covid-19 kept them apart

Sharon Levine, head of geriatrics at Massachusetts General Hospital, outside of her home in Brookline, Mass. (KAYANA SZYMCZAK FOR STAT)

When Sharon Levine picked up, the person on the other end was sobbing. It was the nurse practitioner at her mother’s nursing home outside of New York. She was calling about a dark sore at the base of Levine’s mom’s back, which doctors call a Kennedy ulcer. Levine knew that meant her mother was dying. As a geriatrician, Levine had spent three decades making house calls to frail, homebound elders, often discussing what kind of care they wanted at the end. She wished she could be with her mom, but the nursing home had barred visitors, to try to contain the coronavirus that was spreading among residents. Her mother, though, couldn’t understand why her family wasn’t there in person, and refused to talk over the phone. STAT’s Eric Boodman tells this story of loss made harder by the pandemic.

EHRs detect basic drug safety issues less than 70% of the time

A major reason for the widespread adoption of electronic health records was to reduce human error in prescribing medicines, as software built in to the system could alert physicians if they were about to prescribe drugs that could be harmful based on their patient's profile. But a new study finds that such safety issues still persist at hospitals that use EHRs. The study looked at data from more than 2,300 hospitals who had at least one year of results from a test evaluating their EHR system's safety profile. Over a 10-year period, scientists found that EHRs went from correctly detecting errors 54% of the time in 2009 to 66% of the time in 2018. The systems were best at detecting drug allergy information (more than 98% of the time in 2018), but were least successful with flagging drugs that would be harmful for people based on their diagnosis. The findings show "critical deficiencies in these systems to detect and prevent critical safety issues," the authors write. 

Sickle cell disease patients report dissatisfaction with emergency care

A small, new survey of patients with sickle cell disease finds that although many go to emergency departments for help managing pain, only half report being satisfied with the experience. Here's more: 

  • The study: 440 patients aged 15-50 and with sickle cell disease completed a survey that asked them about their perceptions of outpatient and ED care for their illness. 
  • The findings: Although two-thirds said they went to an ED in the previous year for pain related to their illness, about 30% said they had the worst possible experience. More than half overall said their bad experience at EDs kept them from seeking care. An overwhelming majority were happy with the care they received from their usual physician, however.
  • The implications: The authors suggest that the findings offer an opportunity to streamline communication between patients' regular physician and providers at EDs. 

What to read around the web today

  • How Iceland managed to beat the curve. The New Yorker
  • Covid-19 spreads deportation fears among immigrant doctors in U.S. The Wall Street Journal
  • Overdose deaths have skyrocketed in Chicago, and the coronavirus pandemic may be making it worse. ProPublica
  • Two crises convulse a nation: A pandemic and police violence. The New York Times
  • Better fertility treatments can mean much older parents. But how does this affect their offspring? The Washington Post

Thanks for reading! More tomorrow,


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Monday, June 1, 2020


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