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Morning Rounds Shraddha Chakradhar

How a Los Angeles doctor got swept up in the White House's Covid-19 response

David Agus, an accomplished cancer physician who has treated many famous patients including Steve Jobs and Lance Armstrong, has been advising the Trump administration behind the scenes on the best ways to collect data on treatments for Covid-19. Now that he's come on the radar in Washington circles, Agus is now finding himself the subject of a lot of backlash and ire, from people who believe he's an evangelist for the antimalarial drug hydroxychloroquine to the very White House he's advising. Read the full story on Agus from STAT's Rebecca Robbins and Nicholas Florko here

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

  • The Covid-19 case count in the U.S. has officially crossed the 1 million mark. And as of this morning, nearly 60,000 people have died. See the latest figures from the U.S. and the rest of the world in our Covid-19 Tracker
  • The new funding proposal announced yesterday by big health care names such as former FDA chief Scott Gottlieb and former CMS administrator Andy Slavitt is bipartisan in a way that much of the Trump administration's response to Covid-19 hasn't been. But it's unclear whether the group's plan, which is asking Congress to allocate $46.5 billion to expand testing and tracing efforts, will get support from either the White House or lawmakers. STAT's Lev Facher has more here
  • Hospitals' demand for the antimalarial drug hydroxychloroquine has seemed to have reduced in recent weeks due to ongoing uncertainty over whether the drug works against Covid-19. At the same time, anecdotal evidence suggests that patients with lupus, who do benefit from the drug, are having an easier time filling out their prescriptions.
  • The CDC has largely been silent in the fight against Covid-19, and in a new STAT First Opinion, public health expert Ashish Jha writes that with a reputation as the world's greatest public health agency, "we need that CDC back, and we need it now."
  • Wyss Institute researchers announced that they had designed a new kind of nasal swab that can be manufactured quickly and inexpensively to help with the ongoing shortage across the U.S.  The new swab is being tested in two human trials, and the California-based company producing the swabs hopes to be able to make 200,000 per day by May 15. 

New Chan Zuckerberg Initiative effort to assess coronavirus’ impacts on the Bay Area

The Chan Zuckerberg Initiative just announced a new research initiative aimed at better understanding how Covid-19 is impacting the Bay Area. Priscilla Chan and Mark Zuckerberg are donating $13.6 million to a pair of studies that are launching next month at Stanford, the University of California, San Francisco, and CZI's research center known as the Chan Zuckerberg Biohub. The research effort will aim to track hot spots of Covid-19 as restrictions are slowly relaxed over the coming weeks, and will enroll 4,000 Bay Area residents to be tested for the infection every month through December 2020. As soon as researchers involved with the effort identify patterns in infections, they plan to share the information with public health departments so that they can take any necessary steps to curb the spread of disease. STAT's Erin Brodwin has more here

Majority of people report struggling with mental health due to Covid-19, survey finds

A small, new survey from finance research and analysis website ValuePenguin finds that more than half of respondents are struggling with their mental health. Here's more from the nearly 1,200-person survey: 

  • Overall trends: 55% of those surveyed said their mental health is suffering due to the Covid-19 outbreak. This was especially the case with millennial respondents, nearly two-thirds of whom reported struggling with their mental health. 
  • Loneliness: 47% of respondents said they're feeling more lonely than usual. Although half said they spoke to loved ones daily, around 10% of respondents said that video or phone chats exacerbated their feelings of isolation. 
  • Resources: Nearly 60% said they don't know how to access mental health resources from home. More than 20% want to access a virtual therapist, but are unsure if insurance will cover the service. 

Inside STAT: In fading steel towns, chronically ill patients hope video visits stay


Truemann Mills, 86, now has checkups with his cardiologist via Zoom from his home in Clarion, Pa. (JEFF SWENSEN FOR STAT)

The Covid-19 pandemic may have ushered in a rapid increase in the use of telehealth, and for many people — especially those in rural America — it's been a welcome change and one they hope may outlast the crisis. Take the case of 86-year-old Trueman Mills, who lives 90 miles away from his doctor in Pittsburgh and usually has to make the trek to see his cardiologist for congestive heart failure. That changed in late March when Mills' legs ballooned up from fluid buildup as a result of his heart condition. His doctor then offered to examine him via video conference and was able to adjust Mills' medications accordingly. "If we get out of this, we might find that a lot more medicine gets done this way, for good or for bad,” Mills tells STAT's Casey Ross. Read more here

In a first, blood test can help find and treat cancer early in otherwise healthy people

Doctors for the first time have used a liquid biopsy test to detect and treat cancer in people who were otherwise healthy. The test, made by biotech company Thrive and called Thrive Earlier Detection, was used by doctors in the Geisinger Health System to detect uterine, thyroid, and other cancers in people before they were symptomatic. Normal cancer screening detected about a quarter of the cancer cases in the study group, but more than half the cases were detected with Thrive's test incorporated, too. These results, which were presented at the virtual meeting of the American Association of Cancer Research and published in Science, represent a win for proponents of liquid biopsy technology. But experts caution that the tests are still in their infancy and need further development before they can become routinely used. STAT Plus subscribers can read more from STAT's Kate Sheridan here

USPSTF asks physicians to also talk to kids about vaping

The U.S. Preventive Services Task Force has updated its recommendations for physicians talking to kids about tobacco use to also mention e-cigarettes. Although rates of cigarette smoking have declined in recent years, youth are using e-cigarettes in record numbers: In 2019, for instance, almost a third of high school students reported using some kind of tobacco product, with e-cigarettes being the most popular among them. The USPSTF's recommendation also comes after reviewing evidence to support the growing popularity of flavored e-cigarettes and that e-cigarette companies have used social media to market to youth. One limitation to this updated guidance, an accompanying editorial says, is that the long-term effects of vaping on health are still unknown. Still, it asks physicians to explain to youth that vaping products have potentially dangerous chemicals and could cause an addiction to nicotine. 

What to read around the web today

  • Patients, drug makers grapple with how to continue cancer trials during the coronavirus. STAT Plus
  • Could the handshake really disappear? The Boston Globe
  • Black activists and officials see a major threat in South’s plans to reopen. The Washington Post/The 19th
  • One thing the pandemic hasn’t stopped: Aggressive medical-debt collection. ProPublica
  • Groups sow doubt about Covid-19 vaccine before one even exists. Associated Press

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, April 29, 2020

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