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Morning Rounds Shraddha Chakradhar

Experts say Moderna didn’t produce data critical to assessing Covid-19 vaccine

Vaccine experts are cautioning against reading too much into Moderna's early trial results on its Covid-19 vaccine announced Monday. The company shared that in a small group, the vaccine seemed to generate an immune response similar to what has been observed in recovered Covid-19 patients — news that was followed by a surge in Moderna's stock valuation to $29 billion. But experts say large gaps of information are still missing. For instance, only eight participants saw the desired immune response, but 45 people were recruited to the Phase 1 trial — what happened to the others? And why hasn't NIAID, which is partnering with Moderna on this vaccine, commented on the results? STAT's Helen Branswell breaks down these and other concerns from skeptics here.  

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

  • Phlow, a company that has been awarded a $354 million federal grant to provide generics that are in short supply due to the pandemic, is led by an executive who has a dicey track record of helping the public, STAT's Ed Silverman writes. Phlow CEO Eric Edwards was previously at a company that jacked up the price of an opioid overdose antidote by more than 600% and received complaints from law enforcement officials for donating supplies of the drug that were nearing expiration. 
  • Lawmakers are once again scrutinizing issues related to health data privacy as tech companies roll out Covid-19 tools. But it remains to be seen whether Congress will be able to reach an agreement on how best to regulate data collected from digital contact tracing and other pandemic response efforts.
  • There are many lessons for health care workers fighting the current pandemic from the military, say the authors of a new STAT First Opinion, who are medical students who served in the armed forces. Along with leaving the safety of home and donning protective gear, those caring for Covid-19 patients are now facing a question "that has long bedeviled those in the military: How do I weigh the desire to serve against the risk of personal harm?" they write. 

Large study of Covid-19 patients in New York City shows trends among the seriously ill

A prospective study of 1,150 Covid-19 patients admitted to two New York City hospitals offers a glimpse into who experiences severe infection. More than 1 in 5 of these patients — who were followed for at least 28 days beginning in early March this year — became critically ill and nearly 80% of this group needed mechanical ventilation. Consistent with previous reporting, two-thirds of the critically ill patients were men, and the vast majority were older than 50 and had at least one chronic illness. Also consistent with data from other reports, those from non-white backgrounds were disproportionately affected: More than 60% of critically ill patients were Hispanic or Latino, while 19% were Black. As of April 28, 39% of the critically ill patients had died, while almost an equal amount still remained in hospital. Fewer than a quarter of these severely ill patients had been discharged.

Inside STAT: Halting progress and high turnover preceded Atul Gawande's exit


(ILLUSTRATION: ALEX HOGAN/STAT; PHOTO: ARAM BOGHOSIAN FOR THE BOSTON GLOBE)

When Atul Gawande announced last week he was stepping down as CEO of Haven, which had been billed as a pioneering health venture, the backstory of what happened was a mystery. For an enterprise that came on the scene with tremendous fanfare, Haven has been remarkably secretive. But in a special report, many new details have emerged: Haven, which was backed by Amazon, JPMorgan Chase, and Berkshire Hathaway, made a host of top hires, but struggled to retain that talent, losing many to the companies that launched Haven. Others also expressed concern about Gawande's ability to handle the gig — although a celebrated surgeon, health policy thinker and writer, Gawande didn't have much experience running a new business venture. STAT's Erin Brodwin and Casey Ross look at how these shakeups at Haven and overlap with work at Amazon may have disrupted efforts to set the startup apart. STAT Plus subscribers can read more here.

U.S. births decline for fifth consecutive year


The latest CDC birth statistics data show that for the fifth year in a row, the number of babies born in the U.S. is on the decline. Here's more from the report, which is based on 2019 data: 

  • Overall trends: There were more than 3.7 million births in the U.S. last year, which represents a 1% dip since 2018 and the lowest number of births since 1985.
  • Fertility rate: The general fertility rate for 2019, which represents the rate at which the majority of women of reproductive age (15-44) are presently having kids, was 58.2 births per 1,000 women, a 2% dip from 2018. 
  • Other characteristics: Birth rates among teenagers also reached a record low last year, down 5% since 2018. Delivery by C-sections continued to decline slightly last year, while pre-term births rose for a fifth year in a row and are at the highest rate in a decade. 

Medical workers caring for Covid-19 patients in China show elevated signs of mental distress

A small survey of medical workers caring for Covid-19 patients in China finds elevated signs of mental distress. Nearly 550 medical personnel who were caring for coronavirus patients in one of eight Chinese cities or provinces were asked to take a questionnaire asking them about various health behaviors — including anxiety, sleep, and diet. Compared to the national average, the health professionals in the survey scored higher on scales of somatization (which represented physical symptoms of underlying psychiatric conditions), anxiety, and obsessive-compulsive symptoms. At the same time, the medical workers also had lower scores of interpersonal sensitivity — or the ability to accurately guess others' feelings based on nonverbal cues — which could also be a result of the stress from the pandemic. Data from more people across more regions in China will be needed to better understand the mental impact of the pandemic.  

Women are prescribed common heart medications at lower rates than men

Women are prescribed common cardiovascular medications at rates lower than men, according to new research. The results of the new analysis — which reviewed data from 43 studies that included a total of more than 2.2 million participants — further show how sex-based disparities exist in how people receive common treatment. Across the studies, pooled rates of prescriptions for common medications including aspirin and statins was lower among women. For example, the prevalence of aspirin prescriptions among women was 41%, while it was 56% for men. There was more parity when it came to antihypertensive medications (68% for women, and 69% among men) overall, but differences existed with specific medications: Women were less likely to be prescribed ACE inhibitors for managing high blood pressure, but likelier to be prescribed diuretics. The authors suggest various possible reasons for these disparities, including the misperception that because heart disease is less common in women, it doesn't require intensive treatment. 

What to read around the web today

  • The woman behind ‘Roe vs. Wade’ didn’t change her mind on abortion. She was paid. Los Angeles Times
  • She was pregnant with twins and on a ventilator, and doctors faced a crucial decision. The Boston Globe
  • ‘They killed her’: Why are breast implants still putting millions of women at risk? Fortune
  • Trump allies lining up doctors to prescribe rapid reopening. Associated Press
  • Johnson & Johnson to end talc-based baby powder sales in North America. The New York Times

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, May 20, 2020

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