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Morning Rounds Elizabeth Cooney

Biden will push states to make vaccines available for all adults by May 1

The White House will compel state, local, and tribal governments to make Covid-19 vaccines available to all adults no later than May 1, Biden administration officials said yesterday. The White House has previously issued nonbinding recommendations on mask use and school reopenings, but the aides stressed that its vaccine order will be binding and states’ compliance will be mandatory, STAT's Lev Facher reports. The goal, Biden aides said on a conference call, is to allow Americans to gather in relative normalcy by July 4. The announcement came just hours before Biden's speech marking one year since the pandemic was declared. More than 530,000 have died in U.S. to date, and 1 in 5 say they've lost someone close to them, according to a new Associated Press poll.

‘I have nowhere I can go’: Latinx voices on the impact of Covid

Latinx people have been hit harder by Covid-19 than other populatioms, especially if they are immigrants. Because they are more likely to be essential workers and live with more than four people, existing inequities in health have deepened. A small survey of Latinx people hospitalized for Covid-19 in San Francisco and Denver tells what the pandemic means:

  • Fear of unemployment: “After getting sick, my main concern still was being fired.” 
  • Living undocumented: “We are just surviving ... in this country, I have nowhere I can go for help.” 
  • Crowded houses: “I would arrive home from work and hope I was not sick. I didn’t want to spread it to my whole family.”  

The researchers urge economic and housing policies to support Latinx individuals and the broader community.

Measles outbreak in 2019 had a high price tag

Remember measles? Before Covid-19 emerged, there was a 2019 outbreak in Washington state that infected 72 people over four months and cost society $3.4 million. Put another way, that’s $47,479 per case, a new study concludes, updating previous estimates to include not just medical costs and the cost to public health agencies tracking and tracing cases and contacts, but also productivity lost to quarantine by people who were exposed. For strapped county agencies, that toll is high, if small by comparison to today’s pandemic numbers. But for a preventable disease, the tally becomes a bit more sobering. Measles was declared eliminated in the U.S. in 2000, but 2019 saw the most cases since 1992.

Inside STAT: How will doctors talk to patients about contraception apps?

(adobe)

Last week, the fertility awareness market got a little more crowded when the FDA cleared Clue, an existing menstrual tracking app, to market a birth control feature that will be available this year. It joins Natural Cycles, an app the FDA cleared in 2018 to be marketed as birth control, that uses daily basal body temperature readings to identify the roughly six-day period leading up to ovulation when having sex can lead to a pregnancy. With the  growing visibility of fertility-awareness-based birth control, more patients will likely have questions about whether the approach — and either of these apps — is right for them. But the medical system isn’t always well-positioned to answer them. STAT’s Katie Palmer has more.

Yeast blocks healing in inflammatory bowel disease, early research suggests 

Debaryomyces hansenii is a yeast found in foods like cheese and processed meats. The fungus also shows up in our guts, where it impairs wound healing, especially after antibiotics open niches for it in the intestinal walls. New research in mice and in cells from people with Crohn’s disease warns that this fungus may be especially bad for people with Crohn’s and other inflammatory bowel diseases defined by chronic intestinal tissue damage. Bacteria outnumber fungi in our microbiomes, but antibiotics upset that balance, allowing the fungus to colonize inflamed tissue and block molecular signals that promote healing. Debaryomyces hansenii is not common in people, but a commentary suggests people with Crohn’s might want to avoid foods containing the yeast.

Twin births may be peaking in wealthy countries

Since the 1980s, the number of twin births around the world has jumped by one-third, a new analysis comparing two time periods says. The increase from 9 out of 100,000 births from 1980-1985 to 12 out of 100,00 births from 2010-2015 has been driven by medically assisted reproduction techniques and the older age of mothers giving birth, when twins are more likely. The growth has been concentrated in high-income countries in Europe, North America, and Asia. Twin births are linked to higher infant and child mortality as well as complications during pregnancy and delivery. Efforts to limit births via IVF to singletons, particularly in Europe and North America, will likely lead to an eventual leveling off in twin birth rates.

Covid-19 cases in the U.S.

Cases yesterday: 49,356
Deaths yesterday: 1,557

What to read around the web today

  • CDC’s ‘huge mistake’: Did misguided mask advice drive up Covid death toll for health workers? KHN
  • A year after the first widespread outbreak in the U.S., the Seattle area's success shows what could have been. New York Times
  • Biden faces pressure to distribute vaccine worldwide, while Americans still need the mat home. Washington Post
  • People are keeping their vaccines secret. The Atlantic
  • Modern life is messing with our microbiomes, but science is fighting back. Wall Street Journal

Thanks for reading! More Monday,

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