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Morning Rounds Elizabeth Cooney

Novavax says its Covid-19 vaccine is 90% effective, but less so for one variant

As countries around the world scramble to secure enough vaccine doses to protect their populations, Novavax reported its Covid-19 vaccine proved nearly 90% effective in preliminary results from a key clinical trial in the United Kingdom. But in a separate trial, the vaccine appeared far less effective against a new variant of the coronavirus first identified in South Africa. In a 15,000-volunteer U.K. trial, the vaccine prevented nine in 10 cases, including against a new strain of the virus circulating there. But in a 4,400-volunteer study in South Africa, the vaccine proved only 49% effective. 

Also yesterday, health authorities identified the first U.S. cases of Covid-19 caused by the variant first seen in South Africa. Neither of the two people in South Carolina has a history of travel to countries where the variant has been confirmed, and there is no connection between the two people, indicating local spread of the variant after it arrived in the United States.

Quarantine completed, WHO team seeks answers in China

After two weeks of quarantine, health experts from the WHO are ready to fan out from Wuhan, China, to learn about the coronavirus pandemic where it first began a year ago. Their targets include hospitals, markets like the Huanan Seafood Market linked to many of the first cases, the Wuhan Institute of Virology, and laboratories at facilities such as the Wuhan Center for Disease Control. They could also explore another potential source of the virus: bats in caves in rural Yunnan province, about 1,000 miles southwest of Wuhan. “All hypotheses are on the table,” the WHO tweeted, but it remains to be seen where China will allow the researchers to go and whom they will be able to question.

Cervical cancer screening rates plummeted during spring Covid surge

Cervical cancer screening is one of health care’s resounding success stories, dramatically reducing illness and deaths in women since the Pap test was introduced decades ago. But even the best test works only if patients get it. A new CDC study shows a drastic drop in cervical cancer screening rates during California’s Covid-19 stay-at-home order last spring. Among 1.5 million women in one health system, screening rates plunged 80%, consistent across racial and ethnic groups. After the stay-at-home order was lifted, screening rates crept back up, but were still 29% below 2019 levels for women in their 20s and down 24% for women 30 to 65 years old. The study ended before the most recent surge in Covid-19 cases.

Inside STAT: Pediatricians pivot to childhood vaccines on the go

Lake Country Pediatrics converted an old school bus into a mobile clinic to offer childhood immunizations during the Covid-19 pandemic.  (Courtesy Nathan Fleming)

At the beginning of the Covid-19 pandemic, Eileen Costello, chief of ambulatory pediatrics at Boston Medical Center, had to reduce patient visits by 90%. She tried to keep all appointments with kids to get their routine vaccinations for diseases such as measles, mumps, and whooping cough, but parents were too afraid to bring them in. So Costello got creative: With a donated van, she and her colleagues created a mobile vaccination vehicle to visit often underserved patient neighborhoods. “I just got really worried very early,” says Costello. “We’re going to have a huge cohort of undervaccinated kids.” As routine childhood vaccinations have plummeted during the pandemic, efforts like these have sprung up around the country. STAT’s Rebecca Sohn has more.

Organ transplants, after a spring decline, are trending upward

The coronavirus pandemic has made triage the go-to strategy throughout health care. Since March, hospitals have reordered their priorities to care for severely ill Covid-19 patients and protect others from the virus, sometimes asking transplant patients to wait if their disease wasn’t immediately life-threatening. Transplant operations fell markedly in the spring, but U.S. numbers have been ticking back upward, from a low of 405 transplants in early April to 731 last week. One health care system set a record. After a pause in living donor donations, Intermountain Healthcare performed 222 adult patient abdominal organ transplants in 2020, up from 186 in 2019. The system, with patients in Utah, Idaho, and Nevada, credits safety protocols and increased telemedicine to evaluate and treat potential transplant recipients.

New recommendations suggest when breast cancer survivors can stop mammograms

At what age do screening mammograms lose value for someone who has had breast cancer? An expert panel offers new guidelines to help doctors and patients answer that question. Right now, annual screening is recommended for all survivors, even though for those over age 75, the risk of developing cancer is low, the time needed to feel the benefit of mammography is long, and harms such as overdiagnosis can be high. Based on a review of the scientific literature, the new guidelines recommend discontinuing routine mammograms for breast cancer survivors when life expectancy is under five years. They also suggest considering stopping screening for survivors with a 5- to 10-year life expectancy and continuing mammography for those whose life expectancy is greater than 10 years.

Covid-19 in the U.S.

Cases yesterday: 171,534
Deaths yesterday
: 3,130

What to read around the web today

  • How the coronavirus turns the body against itself. New York Times
  • Germany recommends Oxford Covid vaccine not be used on over-65s. The Guardian
  • U.S. handling of American evacuees from Wuhan increased coronavirus risks, watchdog finds. Washington Post
  • New York undercounted nursing-home Covid-19 deaths, report says. Wall Street Journal
  • Racing the virus: Why tweaking vaccines to fight variants won't be simple. Reuters

Thanks for reading! More on Monday,

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Friday, January 29, 2021

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