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Morning Rounds Shraddha Chakradhar

Covid-19: Doctors say ventilators are being overused

Even as hospitals scramble to get sufficient ventilators for the most serious Covid-19 patients, a group of critical care physicians is wondering whether the breathing machines are warranted for every case. The guidance for using ventilators is driven by low blood oxygen levels in the most critical patients, but these patients don't show any of the other signs associated with the low levels, such as gasping for air. Using sleep apnea masks instead might not only prevent invasive intubation, but also free up ventilators for those who absolutely need them. STAT's Sharon Begley has more here

Here's what else is new: 

  • At a White House press briefing last night, President Trump announced that the U.S. would be halting funding to the WHO, a decision that appears to be in response to the global agency's criticism of the way the U.S. has been handling the Covid-19 crisis.   
  • The DEA is increasing the production quotas of several drugs that are needed to create medicines that are now in short supply but necessary for Covid-19 patients who are placed on ventilators. 
  • The Covid-19 crisis is not sparing jobs in the tech industry, and especially not those in the digital health sector, where companies are being called to aid in the fight against the illness. STAT's Erin Brodwin and Rebecca Robbins have more here
  • In response to the ongoing outbreak and the financial hardships that many patients are facing, Eli Lilly announced that it would be cutting down the cost of most of its insulin products to $35 a month. STAT Plus subscribers can read more here
  • A new Kaiser Family Foundation analysis finds that up to 2 million uninsured individuals could end up needing hospitalization for Covid-19 infection, leading to hospital reimbursement costs of up to $42 billion. 

New research looks at wastewater to detect community spread of Covid-19

Sewage samples from a Massachusetts treatment plant are awaiting processing in Biobot’s lab. (Courtesy Katelyn Foppe)

With a shortage of large-scale clinical testing, some researchers are taking to testing wastewater samples for Covid-19. Recent research showed that particles of SARS-CoV-2, the virus that causes Covid-19, could be shed in fecal matter and other bodily fluids. In an analysis posted yesterday to the preprint server medRxiv, scientists at Biobot Analytics sampled sewage from a treatment facility that services a large metropolitan area in Massachusetts, and found enough virus particles in the samples to suggest that a far higher number of people in that community had been infected with Covid-19 than had been officially reported by public health authorities. Researchers in the Netherlands similarly detected Covid-19 particles in wastewater, and in at least one instance, before any cases of the disease had been reported in a city. Read more about these efforts in my story here

Even before Covid-19 restrictions, many in the U.S. had already begun altering their behavior

A new survey conducted before widespread lockdown measures were implemented in the U.S. asked nearly 9,000 adults about the coronavirus outbreak, and the majority said they had made lifestyle changes such as social distancing and increased hand-washing as a result. About two-thirds said they were very concerned about Covid-19 — with the most pressing worries being contracting the illness and accessing medical care.

At the same time, a small survey of 69 health care professionals in the U.S. reveals common sources of anxiety among these individuals, including access to appropriate protective equipment and infecting their family after being exposed to Covid-19 at work. These professionals also shared a wish list of supportive measures, including having political leaders visiting hospitals to better understand what they were experiencing, and temporary lodging and paid time off if they needed to be quarantined. 

Inside STAT: Will we give up privacy for security after Covid-19?

Almost as quickly as Covid-19 became a pandemic, privacy discussions on using consumer data and the invasion of autonomy have also turned murky. Researchers and public health officials are hoping to use data from phones and medical records to more quickly identify possible Covid-19 cases. HHS has also announced that it would back off from enforcing health privacy laws so that it's easier for hospitals and health care providers to share medical information with officials who want to track Covid-19 patients and their contacts. While easing up on privacy rules for the greater good makes sense in an emergency situation such as the current pandemic, what happens when Covid-19 is no longer a daily threat? STAT's Casey Ross has the story here

U.S. suicide rates have increased by 35% 

New data from the CDC reveal that between 1999-2018, the rate of suicides in the U.S. rose by 35%. Here's more from the report: 

  • Overall trends: The suicide rate in 1999 was 10.5 suicide deaths per 100,00 people in the U.S., but that increased by 35% for a rate of 14.2 suicide deaths per 100,000 people in 2018. 
  • Age and sex: Males had a suicide rate that was 3.5-4.5 times higher than females for the 20-year duration. Among males, the suicide rate was highest in those aged 75 and over, while among females, those ages 45-64 had the highest suicide rate. 
  • Geography: In 2018, suicides among both males and females were higher in rural rather than urban areas. In urban areas, however, males had suicide rates that were 3.5-3.9 times the rate among females. 

The earlier the first cigarette, the more likely smoking extends into adulthood

The younger you are when you first take up smoking, the more likely it is you'll be a daily smoker in adulthood, according to new research. Scientists analyzed data from a cohort of nearly 6,700 individuals who reported smoking as kids and teens in the 1970s and 1980s, and who shared information about their smoking habits as adults in their 20s and 40s. The data revealed that those children who started smoking at an early age were more likely to be daily smokers when in their 20s and less likely to have quit by their 40s. For instance, only around 8% of those who first tried smoking after turning 18 were daily smokers in their 20s, compared to 50% of those who tried cigarettes between the ages of 6-12. At the same time, more than 56% of those who were daily smokers in their 20s and had never smoked as children or teens reported quitting by their 40s, compared to 37% of those who had smoked as youth. 

If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

What to read around the web today

  • A rare investment mechanism is helping to fund some health tech companies’ coronavirus projects. STAT Plus
  • Italy, Spain ICU pressures decline, but emotional toll rises. Associated Press
  • For HIV survivors, a feeling of weary déjà vu. The New York Times
  • A nurse bought protective supplies for her colleagues using GoFundMe. The hospital suspended her. ProPublica
  • Former FDA leaders decry emergency authorization of malaria drugs for coronavirus. Science

Thanks for reading! More tomorrow,


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Wednesday, April 8, 2020


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