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Morning Rounds Shraddha Chakradhar

Wastewater testing gains support as early warning for Covid-19

In the absence of rapid, accurate, and widely available swab tests, examining wastewater for the presence of the virus that causes Covid-19 is increasingly becoming a more plausible way to track community spread. As early as this fall, communities around the U.S. could be testing sewage samples for coronavirus particles, a method that was only recently shown to be a viable approach. Other countries, including Finland, the Netherlands, and Germany, have already instituted such programs and are monitoring sewage for Covid-19 in real time. “There is real hope that this can be a sensitive, early warning,” Water Research Foundation CEO Peter Grevatt tells STAT's Sharon Begley, especially if states start to see a resurgence of cases as social distancing measures ease. Read more here

Here's what else is new with the pandemic: 

  • The U.S. has now surpassed 100,000 deaths from Covid-19, with more than 1.6 million cases. Worldwide, there have been more than 340,000 deaths to date and 5.6 million cases. 
  • FDA regulators tell STAT's Erin Brodwin that the agency's decision to halt a high-profile study on the impact of SARS-CoV-2 in the Seattle area was because investigators involved with the study had failed to secure key approvals. Outside experts criticized the move, calling it unnecessary, confusing, and counterproductive.
  • A follow-up survey from the American Cancer Society finds that 87% of cancer patients say the pandemic has affected their ability to get care, up from 51% who said the same in April. Nearly 80% of those actively being treated reported delays, up from 27% last month. 
  • A new study comparing a small group of asymptomatic Covid-19 patients in China to those showing symptoms finds that the former group tended to be younger, female, and tended to show faster signs of lung recovery on CT scans. Asymptomatic patients were still found to be shedding virus particles — albeit for a shorter duration than those with symptoms — underscoring the need for testing even those without Covid-19 symptoms. 

Outspoken AIDS activist Larry Kramer dies at 84

Larry Kramer, the outspoken AIDS activist and noted writer, died yesterday at the age of 84 from pneumonia. In 1981, he helped start the Gay Men's Health Crisis, the first service organization dedicated to HIV-positive individuals — an organization he was kicked out of because of his brash and abrasive approach to activism. When asked about his aggressive personality, he told Newsday in 1992, "Sure, I have a temper, who doesn’t?" adding, "It happens when you’ve seen so many friends die." Kramer, who was himself HIV-positive, was also a founder of ACT UP, the AIDS advocacy organization whose strategy involved civil disobedience that often disrupted the work of government offices. His fiery streak never dulled, saying in an email to STAT earlier this month that HIV drug maker Gilead "has always been selfish, greedy, tricky pigs." As news of Kramer's death broke yesterday, NIH director Francis Collins — whom Kramer had been critical of — tweeted, "He was provocative, irascible, and frequently outrageous, but the scientific community owes him a debt of gratitude for never letting up on us." 

Kavli Prize winners for neuroscience are lauded for work on sensory receptors

The 2020 Kavli Prize laureates for three major areas of science were just announced, and the two neuroscience winners were recognized for their work discovering sensory receptors. David Julius, a physiologist at the University of California, San Francisco, discovered TRPV1, the first-known ion channel for sensing temperature differences, and how the body can distinguish between different temperatures by using different chemicals for varying heat levels. That work that is now being used to develop new pain relievers. Howard Hughes Medical Institute researcher Ardem Patapoutian, who works as a neuroscientist at Scripps Research in California, discovered a family of ion channels called Piezos, which help animals respond to pressure, but also play a role in a range of genetic disorders. The laureates will share a prize of $1 million.  

Inside STAT: Testing blitz in San Francisco shows Covid-19 struck mostly Latinx essential workers


Tents at the Garfield Square coronavirus-testing site in San Francisco's Mission District. (COURTESY BARBARA RIES)

While many reports have now shown that communities of color are being hit harder by Covid-19 than white communities, the numbers out of a testing blitz in San Francisco — one of the largest coronavirus testing studies in the nation — are especially sobering. Over four days at the end of April, a coalition called Unidos en Salud swabbed and tested more than 4,100 adults and children in heart of the the city's Mission District. Roughly 2% tested positive for the coronavirus, but nearly all of them — 95% — were Latinx individuals. The others were Asian or Pacific Islanders. And even though a third of that neighborhood is white, not a single positive case was in these individuals. “When we all saw these results most people were a little spellbound,” infectious disease specialist Diane Havlir tells STAT contributor Usha Lee McFarling. Read more here.  

Surgery residency programs are attracting few diverse applicants 

More women are applying for surgery residency programs now than a decade ago, but there hasn't been a similar increase in non-white doctors applying for surgery residencies, according to a new study that looked at applications between 2008-2018. Here's more: 

  • Trends by sex: More women applied for thoracic, vascular, and general surgery programs in 2018 than in 2008. For instance, only eight female medical school graduates applied to thoracic surgery programs in 2008, but that more than quadrupled to 50 a decade later. 
  • Trends by race: Applications from non-white students for general surgery programs decreased across the board over the past decade. Most surgical specialties saw a decrease in applications from non-white students since 2008. 
  • Future steps: "Addressing potential barriers and increasing mentorship of medical students may foster a more diverse interest in surgery," the authors write. 

Up to 80% of medical society leaders have industry ties

Up to 8 out of 10 doctors who lead professional medical societies have financial ties to pharmaceutical or device companies, according to new research. Scientists looked at 2017-2019 data in the U.S. government's Open Payments database, which tracks payments from industry groups. Among the 10 most common and costliest disease areas, researchers found that 80% of society leaders who were M.D.s or D.O.s had financial ties to industry. Leaders of 10 groups — including the Infectious Disease Society of America and the American Society of Clinical Oncology — received payments totaling nearly $130 million over a five-year period. The payments varied greatly, from a median of $212 to the American Psychiatric Association to more than $500,000 to ASCO's leaders. Future research ought to look more closely at whether these financial relationships influence the guidelines put out by professional societies, the authors write. 

What to read around the web today

  • The global pandemic through the eyes of the world’s children. Associated Press
  • Masks sold by former White House official to Navajo hospitals don’t meet FDA standards. ProPublica
  • The epic battle against coronavirus misinformation and conspiracy theories. Nature
  • Medical groups ask FDA to ease access to abortion pill during the pandemic. NPR
  • The end of handshakes—for humans and for robots. Wired

Thanks for reading! More tomorrow,

Shraddha

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Thursday, May 28, 2020

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