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Morning Rounds Shraddha Chakradhar

FDA advisory panel endorses Pfizer/BioNTech Covid-19 vaccine

A panel of outside experts recommended yesterday that the FDA grant emergency use authorization to the Covid-19 vaccine from Pfizer and BioNTech. The 17-4 vote (with 1 abstention) came after a nearly nine-hour meeting of the FDA's Vaccines and Related Biological Products Advisory Committee. They discussed a wide range of issues, including how those with severe allergies would tolerate it and how well the vaccine would fare in those who are pregnant or lactating. The FDA does not have to grant an EUA based on the committee's recommendation, but it is widely expected to do so within days, which would launch a massive vaccine rollout.

Fewer than 40% are enthusiastic about taking a Covid-19 vaccine

As the U.S. prepares to roll out a Covid-19 vaccine, a new McKinsey & Company survey of nearly 2,500 adults finds that more than a third are willing to take a vaccine after an EUA is issued, participate in a trial, or take a vaccine after trials are completed. People in this group were likely to have had Covid-19 or have at least one chronic condition. At the same time, 45% want to wait to get the vaccine until it has been on the market for between three months and a year, or until they hear from trusted sources such as physicians about its safety in terms of side effects and other health consequences. Finally, 18% of respondents said they are unlikely to receive a vaccine, regardless of timing. People in this last group also had low flu vaccination rates, of less than 10% this season.

New cancer patients — especially Black people — are more susceptible to severe Covid-19 infections

A new analysis of 73 million people's electronic health records in the U.S. revealed that newly diagnosed cancer patients have a higher risk of severe Covid-19 infection than people without the disease. And this risk is even higher for Black cancer patients than those who are white. Specifically, researchers found that those who had learned of a leukemia, non-Hodgkin lymphoma, or lung cancer diagnosis in the past year had a higher risk of severe Covid-19 than people without cancer. Among Black patients, the risk was highest for those with a recent breast, prostate, colorectal, or lung cancer diagnosis. Black people were also more likely to be hospitalized for their cancer, for Covid-19, or both, although there wasn't a statistically significant difference in death rate between Black and white patients.

Inside STAT: Covid-19 vaccine-distribution timeline will keep slipping, experts say


Capped vials shown during filling and packaging tests. (VINCENZO PINTO/AFP VIA GETTY IMAGES)

If there's one thing that experts know about vaccine distribution, it's to expect that any timeline will continuously change. This has already happened several times with a Covid-19 vaccine: In May, the Trump administration said that 300 million doses of a vaccine would be available by January 2021, with the first of those distributed in October this year. When October came around, that target was revised to 100 million doses by the end of the year. And now, that looks more like 40 million, though some in health care doubt that will come to fruition. There are any moving parts involved with getting a vaccine to people — manufacturing, storage, regulatory review — and each part could face delays. As one expert tells STAT's Olivia Goldhill, “If you try and do something quickly in your kitchen, even if you have a recipe, sometimes things go wrong.” Read more.

How a surgeon's birthday could be deadly, and other research from the BMJ Christmas issue

The BMJ's Christmas issue is out, and as usual, the journal has a mix of quirky and interesting research, including how (sadly) patient death rates are higher on surgeon's birthdays. Here's more:

  • Deadly birthdays: Older patients who underwent a surgical procedure on a surgeon's birthday were more likely to die within a month of the procedure than those who were operated on on any other day. One possible reason: Surgeons may feel more rushed to complete surgeries on their birthdays to make post-work plans. 
  • A diabetes twofer: Owners of a dog with type 2 diabetes are likelier to also be diagnosed with the condition. The same was not true for cat owners, however, according to a study of more than 330,000 pet-owner pairs. Dogs and their owners could share similar health behaviors, such as physical activity level, which could explain the findings. 
  • Music therapy: In a small trial, patients who were played soothing background music and positive messages for 20 minute periods under general anesthesia had lower pain scores and lower opioid prescription levels in the 24 hours after surgery than those who were just played a blank tape. The findings ought to inspire surgeons and staff to be more careful about background noise during surgery, the authors suggest. 

Emergency visits for child abuse and neglect have decreased during the pandemic

There was a 53% decrease in emergency department visits for child abuse and neglect during the first six months of the Covid-19 pandemic in the U.S. compared to the same period last year. New CDC data show that this decrease mirrors a drop in ED visits for other causes as well. At the same time, the report finds that while the actual number of abuse and neglect-related visits decreased, the proportion of these visits per 100,000 ED visits increased, possibly because visits for so many other health causes decreased through September 2020. The report also found that the rate of hospitalizations — albeit low — didn't fall this year, suggesting that the severity of neglect and abuse isn't decreasing.

Covid-19 in the U.S.

Cases yesterday: 224,452
Deaths yesterday: 2,768

One final note: Thanks to those of you who caught my inadvertent transposing of the number of cases and the deaths from Covid-19 in yesterday's newsletter. My apologies for the error. 

What to read around the web today

  • Sanofi suffers major setback in development of a Covid-19 vaccine. STAT
  • CDC’s Redfield told staff to delete email, official tells House watchdog. Politico
  • The future of the U.S. national stockpile isn’t a bigger stockpile. Bloomberg Businessweek
  • A hospital’s secret coronavirus policy separated Native American mothers from their newborns. Native News Online
  • Biogen conference in Boston likely linked to 330,000 COVID-19 cases worldwide, researchers say. The Boston Globe

Thanks for reading! And happy Hanukkah to those celebrating the festival. More on Monday,

Shraddha

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Friday, December 11, 2020

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