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Morning Rounds Shraddha Chakradhar

The U.S. needs a federal review of the Covid-19 response. Here's where it should start

As the Covid-19 pandemic rages on in the U.S., the country's catastrophic response to the crisis has some experts calling for a review commission akin to the one that was formed in the wake of the 9/11 terror attacks. Nearly 126,00 people have died from Covid-19 in the U.S so far, and the commission could evaluate how prepared the U.S. was to handle the pandemic and where things went wrong. In a new story, STAT staff outline 10 issues that we think a commission like this would undoubtedly investigate, including how and why the CDC, as the country's top public health agency, was sidelined, and the FDA's decision to green light — and later revoke — the malaria drug hydroxychloroquine, which was unproven for Covid-19. Read our take here

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

  • Global coronavirus cases have officially crossed the 10 million mark, and nearly 500,000 people have died. The U.S. still has the most cases and deaths of any country — more than 2.5 million cases and around 125,800 deaths. Still, Vice President Mike Pence touted late last week the White House's initiatives to contain the damage from the virus, and claimed that in the U.S., “We slowed the spread, we flattened the curve, we saved lives.” 
  • The WHO, the Coalition for Epidemic Preparedness Innovations, and Gavi, the Vaccine Alliance announced a plan to buy 2 billion doses of Covid-19 vaccine for high-risk populations, including those over the age of 65 and those with conditions such as diabetes. 
  • Brazil, which currently has the second-highest number of Covid-19 cases, is the latest to sign a deal with AstraZeneca and the University of Oxford for a Covid-19 vaccine. According to the agreement, Brazil will produce more than 30 million doses of Oxford's experimental Covid-19 vaccine, although the total deal will eventually be for 100 million doses. 

New journal will vet Covid-19 preprints

Scientists, public health experts, and reporters may soon have an easier time parsing through the many preprints that have emerged on Covid-19 in the wake of the pandemic. MIT Press is launching today a new open access journal — called Rapid Reviews: Covid-19 — with the specific aim of vetting non-peer-reviewed papers that appear on servers such bioRxiv and medRxiv for credibility and possible instances of misinformation. “Preprints have been a tremendous boon for scientific communication, but they come with some dangers, as we’ve seen with some that have been based on faulty methods,” Nick Lindsay, director of journals at the MIT Press, tells STAT's Sharon Begley. One such preprint, which was later withdrawn, suggested that the coronavirus had somehow been engineered from HIV. “We want to debunk research that’s poor and elevate research that’s good,” Lindsay says.  

The U.S. could fall short of physician demand by more than 133,000 doctors

A report from the Association of American Medical Colleges further underscores the projected physician shortage in the U.S. There could be anywhere from 54,000-139,000 fewer doctors in the U.S. by 2033, according to the report, which also predicts a primary care physician shortage of up to 55,200. Medical specialties, including surgical specialties, could also experience a deficit of more than 86,000 physicians in the next 13 years. If communities that currently have trouble accessing medical care are able to gain access at equal rates as more privileged communities, physician demand could increase by an additional 145,500. An aging workforce continues to be the primary driver for the shortfall, the report suggests, as more than 40% of current physicians will be 65 or older within the next decade. 

Inside STAT: U.S. withdrawal from WHO threatens to leave it 'flying blind' on flu vaccines


WHO Director-General Tedros Adhanom Ghebreyesus at the agency's headquarters in Geneva. (FABRICE COFFRINI/AFP VIA GETTY IMAGES)

The pending withdrawal of the U.S. from the WHO doesn't just carry serious consequences for the current pandemic, but also for the management of other diseases, including the flu. The U.S. holds three seats in the group that meets every year to decide which flu variants ought to be included in the annual influenza vaccine, and pulling out of the global health agency throws the status of those seats in jeopardy. Without a presence at that table, the U.S. would be flying blind when it comes to making its own decisions about a yearly flu shot, since most flu variants don't emerge in the U.S. and intelligence from others would help the country make informed decisions. Not having a seat at the table and being part of the analysis "would be a blow," infectious disease specialist Richard Webby tells STAT's Helen Branswell. Read more here

E-cigarette advertising restrictions could reduce teen vaping

Laws restricting advertisements of e-cigarettes to youth could help prevent teens from vaping, according to a new survey of around 12,000 teens (ages 16-19) in Canada. In 2018, Canada prohibited e-cigarettes ads from being specifically marketed to teens, but some provinces such as Quebec and Manitoba also banned retail displays and e-cigarette ads in general. The proportion of teens who reported seeing marketing for e-cigarettes often or very often doubled from 2017-2019, and these teens were around 40% more likely to also report vaping in the month or week prior to being surveyed. Teens living in Canadian provinces with fewer restrictions on e-cigarette marketing were not only more likely to say they saw ads for the products, but were also more likely to report having vaped in the previous month, and 65% more likely to say they vaped in the week before the survey. 

The rising global burden of thyroid cancer

Thyroid cancer cases have risen around the world in the past two decades, according to a new study. Researchers examined global health data between 1990-2017, and found that the number of cases of thyroid cancer worldwide increased by nearly 170%, from around 95,000 in 1990 to more than 255,000 in 2017. Deaths from the disease increased 87%. Almost half the cases were in South and East Asia, the analysis found, and more than 70% of cases and 58% of deaths were in women. Women were also more likely to get thyroid cancer at a younger age than men, although most deaths from the disease across both groups occurred among those aged 70 years and older. 

What to read around the web today

  • China forces birth control on Uighurs to suppress population. Associated Press
  • Houston hospitals hit 100% base ICU capacity. Then they stopped reporting data. Houston Chronicle
  • In its first tough test, CRISPR base editing slashes cholesterol levels in monkeys. STAT
  • Vaccine makers turn to microchip tech to beat glass shortages. Wired
  • Two patients die in Audentes gene therapy study, heightening concerns over high-dose treatments. STAT Plus

Thanks for reading! More tomorrow,

Shraddha

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Monday, June 29, 2020

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