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Morning Rounds Shraddha Chakradhar

Among people of color asked to join Covid-19 vaccine trials, worries about inequities run deep

Burned by the history of the medical establishment's mistreatment of Black and Latinx people, Covid-19 vaccine trial volunteers want to know: Will the same people of color being prioritized for participation also be a priority to get an approved vaccine? Would-be participants are concerned about getting treatment for vaccine side effects without insurance as well as government involvement in vaccine development and keeping data about citizenship status safe from immigration authorities. Vaccine makers are scrambling to find trial participants from historically underserved populations to ensure that a vaccine works across all populations, but they're quickly realizing that building trust has to outlast the current Covid-19 vaccine search. “We recognize that building trust is not something we’re going to do in a couple of weeks. This is going to take years,” one vaccine trial researcher tells STAT's Eric Boodman. More here.

Trump promises seniors $200 prescription drug gift certificates, but questions abound

In what's seen as a political ploy leading up to the election, President Trump yesterday announced that 33 million Medicare beneficiaries will get $200 prescription drug coupons "in the coming weeks." A White House spokesperson said the nearly $7 billion needed to implement this new program was coming from savings from the administration's "most favored nations" drug pricing proposal that promises the same low drug costs in other countries to people in the U.S. The catch: That policy hasn't been implemented, meaning the $6.6 billion in savings for these drug coupons don't actually exist. Trump also falsely claimed a provision to allow states and pharmacies to import drugs from Canada is effective today. In reality, an FDA policy on the subject did clear a White House review today, but the policy still has to be published and finalized, only after which states can apply to participate. 

Experts outline five strategies that helped some countries emerge safely from Covid-19 lockdowns

New research outlines five key strategies that have set apart countries that have successfully eased national lockdowns for Covid-19 from those that are still struggling to control the virus. The strategies were compiled based on the experiences of nine high-income countries including New Zealand and Japan. They range from seemingly obvious necessities like having a good surveillance system to gauge exactly how many people are infected to more challenging needs including a health system that can handle surges in infections. The other successful strategies include strict border control measures and quarantine requirements for any visitors; a robust public health system that has the capacity to do large-scale testing; and engagement from local communities to do their part to fend off the virus. 

Inside STAT: Pharmacies are bracing for a surge in demand for flu shots amid the Covid-19 pandemic


A nurse practitioner provides a flu vaccine to a patient in Florida. Health officials say widespread flu vaccine coverage will be crucial this year. (JOE RAEDLE/GETTY IMAGES)

Flu season is almost upon those of us in the Northern Hemisphere and experts are bracing themselves for the double impact of respiratory symptoms caused by the influenza and SARS-CoV-2 viruses. “This year is one of the most important — if not the most important — flu season in our generation,” Rite Aid's director of operations Christopher Savarese tells STAT's Priyanka Runwal. The pharmacy chain has purchased 40% more supplies of this year's flu vaccine than usual, in a trend observed across other hospitals and pharmacies across the U.S. It's not just about preventing the flu, experts say. "[T]he more we can reduce transmission of influenza in the country, the less stressed our health care systems will be as Covid and flu viruses start circulating together,” one expert shares. Read more here

Knowledge of common fungal infections is low among U.S. adults

A majority of people are unaware of common fungal diseases, according to a new CDC report, even though these diseases result in more than $7 billion in health costs annually. Experts analyzed survey responses from more than 3,600 people from across the U.S., and found that about a third of people had never heard of any of the diseases listed in the survey, including candidiasis (which can be a vaginal yeast infection or oral thrush) and aspergillosis (which can cause a clump of mold in the lungs). The fungal infection known as blastomycosis — which is often asymptomatic and caused by inhaling fungal spores — was the least well-known among the respondents, especially those in the Northeastern U.S., even though the disease is endemic to the eastern part of the country. Women were more likely to be aware of fungal infections — and more than three times as likely to know of candidiasis — than men.

ACA may have helped offer more financial protection against major medical expenses

More than 2 million fewer people had "catastrophic" medical expenditures yearly following the passage of the ACA in 2010, according to a new study. The WHO defines such medical expenditures as those where people are forced to spend more than 40% of their income on health costs after accounting for subsistence items like food and housing. Nearly 14 million people experienced catastrophic medical expenses yearly in 2010, but that figure was around 11 million in 2017. Those with the lowest incomes during this time period experienced a decrease in the likelihood of such expenses, while those with private insurance made up a slightly higher proportion of adults with catastrophic medical expenses in 2017 than in 2010. 

Clarification: Yesterday's item outlining the case of a man who died after consuming too much licorice is specific to black licorice. Red licorice doesn't usually contain the natural licorice extract that seemed to be the triggering factor in this case. 

What to read around the web today

  • Brainiacs, not birdbrains: Crows possess higher intelligence long thought a primarily human attribute. STAT
  • Heartbreaking bills, lawsuit and bankruptcy — even with insurance. Kaiser Health News
  • Blue Health insurers reach tentative antitrust settlement for $2.7 billion. The Wall Street Journal
  • Medical AI systems are disproportionately built with data from just three states, new research finds. STAT Plus
  • Neuroscience has a whiteness problem. This research project aims to fix it. NPR

Thanks for reading! I'll be back Monday, 

Shraddha

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Friday, September 25, 2020

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