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Morning Rounds Shraddha Chakradhar

Good morning. Andrew Joseph here, filling in.

A quick note: The newsletter is taking a break for a few days, but will be back in your inboxes Monday morning. 

Thanksgiving and a perilous point in the pandemic


Tomorrow’s Thanksgiving celebration is likely to add fuel to an already uncontrolled Covid-19 situation in the U.S., experts warn. The CDC had asked Americans to avoid traveling for Thanksgiving, a message echoed by many governors and mayors, not to mention epidemiologists and providers. Many people are complying and sticking with their households for the meal, perhaps accompanied by family Zoom sessions and outdoor visits. But certainly, some people are still going all in on a big Thanksgiving. Experts say how badly Thanksgiving sets the U.S. back depends on what people do. It’s why even if people have traveled or are getting together with others outside their household, experts are still urging precautions: wear a mask, keep your distance, and wash your hands.
New cases yesterday: 172,935
Deaths yesterday: 2,146

How many Americans have had Covid-19?

Testing people’s blood for antibodies to the coronavirus can signal a past infection, even if there was no diagnosis, so CDC scientists have been conducting regular serosurveys as a way to get a better estimate of the country’s true Covid-19 infection rate. In their latest update, which looked at more than 177,000 people from July to September, researchers found that the prevalence of antibodies ranged from just 1% to 23% depending on the time frame and jurisdiction. The survey only went through late September, so hundreds of thousands of people have since been infected. The study design also meant the findings may be an underestimate. But the broader takeaway still stands: Most Americans have not had Covid-19, and thus remain susceptible to the infection. “Our results reinforce the need for continued public health preventive measures, including the use of face masks and social distancing,” the researchers wrote.

Purdue Pharma pleads guilty to criminal charges

The OxyContin maker Purdue Pharma pleaded guilty yesterday to a trio of criminal charges, admitting to contributing to an addiction crisis that has taken hundreds of thousands of lives. The plea came after Purdue struck a deal with federal prosecutors, with the company conceding that it paid doctors to get them to write more prescriptions for its pain medications and that it lied to the DEA about a program to monitor diversion. As part of the settlements, members of the Sackler family, which built and have run Purdue, agreed to pay $225 million to resolve civil claims, and so far no criminal charges have been filed against family members. Purdue, which is in separate bankruptcy proceedings, has proposed becoming a public benefit corporation.

Inside STAT: How New Jersey clinicians are preparing for a second Covid-19 wave

Nurse Victorine Long Njaka stands outside Trinitas Regional Medical Center in Elizabeth, N.J. (ALICE PROUJANSKY for STAT)

New Jersey was one of the states hardest hit by the first Covid-19 wave in the U.S., putting doctors and nurses in the difficult spot of trying to treat a disease then that was so poorly understood. Some eight months later, clinicians say they feel better prepared to treat patients with the infection, but that they are discouraged by what might be headed their way. Cases and hospitalizations are both increasing in the state, which has the highest per capita death rate in the country. “I have a bad case of déjà vu,” one doctor said. STAT contributor Gabrielle Glaser has the story here.

How federal regulation influenced magnet ingestions among children

Toys made with small, high-powered magnets — certain spinning toys, building sets, and jewelry kits — started appearing on the market in 2009, and quickly, magnet ingestion became a health risk for children. These strong magnets are particularly dangerous because if someone swallows more than one, or a magnet and another metal object, they can obstruct or tear the bowels. Regulators intervened, pushing to limit sales and eventually, in 2014, prohibiting these high-powered magnet sets. And according to a new study that looked at more than 1,400 emergency department visits for kids who swallowed the magnets over a decade, the policies led to a decline in magnet ingestions. But after a court tossed the rule in 2016 and the magnets reentered the market, ED visits for magnet ingestion started increasing again.

The (gastric) rhythm is going to get you

This is maybe not an item you’ll want to read with your breakfast, but in a new study, researchers have found a link between the rhythm of the electrical signals our stomach muscles produce and having a repulsed reaction to something. Scientists have known those rhythms get out of sorts when we’re nauseous or sick to our stomachs, and for the study, researchers showed volunteers a mix of normal and disgusting images. Some participants were given a placebo, while some were given an anti-nausea medication called domperidone, which helps stabilize those gastric rhythms. The researchers found that volunteers on the drug were able to look at the nasty images for longer, showing how the stomach rhythms influence our repulsion. Overall, being repulsed — think rotting food — helps us avoid things that could make us sick.

What to read around the web today

  • Can you repeat that? Hearing trouble more obvious with masks. AP
  • ‘The trend is irreversible’: How Covid-19 could drive a shift toward decentralized trials. STAT+
  • A North Texas superintendent is openly defying the state mask mandate in schools. No one is stopping him. Texas Tribune
  • Opinion: Beyond burnout: For health care workers, this surge of Covid-19 is bringing burnover. STAT
  • Two school districts had different mask policies. Only one had a teacher on a ventilator. ProPublica

Thanks for reading, and wishing you and yours a happy and safe Thanksgiving!

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Wednesday, November 25, 2020


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