Roughly 8.8 million people signed up for health care coverage through Healthcare.gov this enrollment season, HHS reports, down from the 9.2 million signups in 2016. Many experts actually expected that number to drop much more, given the Trump administration’s decision to cut funding for enrollment advertising and for “navigators” to assist consumers in signing up for plans. Several states extended the open enrollment period past the standard Dec. 15 deadline, so more signups will still trickle in.

The House and Senate have both passed a resolution to fund the government through Jan. 19 — and to extend funding for the Children’s Health Insurance Program and community health centers through March. Congress let federal funding for both lapse in September. Lawmakers are going to wait until next year to deal with an effort to stabilize Obamacare's struggling markets with extra funding for insurers. 

Dicer, this big l-shaped blob, chops up the double-stranded rna of a virus. (janet iwasa)

Researchers have pinpointed how a microscopic machine attacks certain viruses — those with two strands of RNA, instead of just one — when they invade a cell. Here’s what biochemist Brenda Bass of the University of Utah told me about the work in fruit flies, published in Science.

What did you study?

We previously discovered that this molecule called Dicer can tell the difference between the ends of double-stranded RNA, which is made by both cells and viruses, so it can recognize what's a virus. The good and the bad look very similar, but you can tell the difference... by their ends. When viruses evade recognition and get inside our cells, they go into the cytoplasm and start replicating and making double-stranded RNA. In fruit flies, that gets recognized by Dicer. We wanted to understand how this happens. 

What did you discover Dicer doing?

We discovered Dicer reacts differently when it sees those two ends. If it sees the bad end, it dices up the double-stranded RNA by threading through [it], which is much more efficient than what it does if it saw a good end. It’s like going from chopping with an axe to a woodchipper.

As Purdue Pharma faces a barrage of lawsuits for its alleged role in seeding the opioid epidemic, the OxyContin maker is countering with a public outreach campaign. “We manufacture prescription opioids,” reads one of the ads, a full-page spread in the Wall Street Journal. “How could we not help fight the prescription and illicit opioid abuse crisis?” Similar messages have appeared in the past week in other national and D.C. publications, as well as in local papers in Purdue's home state of Connecticut. STAT’s Andrew Joseph has more on the ad push — read here.

The WHO has delivered more than 70 tons of medicines and surgical supplies to Yemen, where an ongoing conflict has damaged the bulk of the country's health facilities and left many people without access to clean water, food, or sanitation. And a cholera outbreak that began more than a year ago has now killed 2,000 and infected 1 million people, officials estimate. A blockade has exacerbated the problem; labs have had trouble getting the materials they need to diagnose cholera and other infectious diseases. The blockade has been partially lifted, but global leaders say more needs to be done to open the country to aid. 

There’s been significant progress in cutting tobacco use nationwide, but it’s still far more common among American Indians and Alaska Natives than any other racial or ethnic group in the U.S., according to new numbers just released by the CDC. More than 43 percent of American Indians and Alaskan Natives have used some type of tobacco in the past month, compared to 27 percent of people who aren’t part of those groups. Those disparities were even wider in certain subgroups — for instance, more than half of American Indian and Alaskan Natives who live below the poverty level, and 55 percent of those ages 18 to 25, use tobacco products.

Part of the problem: Tobacco products are often cheaper on tribal land, and the tobacco industry has specifically targeted this group with its marketing efforts. 

Morning Rounds is taking a short break for the holidays — your next newsletter will be on Tuesday, Jan. 2. Until then, STAT has you covered with all sorts of holiday health care stories: advice for staying healthy during holiday travel, a Gut Check on whether exercise in cold weather actually burns more calories, and a guide to medical billing codes for odd holiday injuries. Also look for our upcoming "3 to watch" series, in which our beat reporters share the trends, people, and news they'll be keeping tabs on in the new year.

 Don't forget to send me your predictions for what 2018 will mean for health and medicine — you can just reply right to this email. I hope you all have a lovely, restful holiday season!