viernes, 15 de mayo de 2020

Concern over Covid-19 vaccine access, physician compensation, & a fair price for remdesivir

Morning Rounds
Shraddha Chakradhar

Under Trump, will the U.S. corner the market on Covid-19 vaccine?

Experts are worried that the Trump administration's "America First" agenda could spell devastation for the rest of the world for equitable access to a Covid-19 vaccine. The administration's "Operation Warp Speed" hopes to ready 300 million doses of a vaccine for U.S. use by January 2021, but the plan could prioritize low-risk individuals over health care workers and other vulnerable people elsewhere in the world. These concerns led more than 140 world leaders to sign an open letter asking governments to consider Covid-19 vaccines to be a "global good" and ensure equal access when the resource does become available. STAT's Helen Branswell has more here.

Here's what else you need to know about Covid-19 today: 
  • Much of yesterday's hearing with ousted BARDA chief Rick Bright centered on his accusations of the Trump administration's mismanagement of the Covid-19 response. His opening statement also included the ominous prediction that without proper steps to curb the virus in its tracks, "2020 will be the darkest winter in modern history." STAT's Nicholas Florko has more here
  • new modeling study estimates that nearly a quarter of a billion people in Africa could become infected with the coronavirus during this first year of the pandemic, and that up to 190,000 could die. Although the estimates represent a lower rate of spread than elsewhere in the world, the hospitalization and health needs of those who get infected could disproportionately put a strain on resources there, experts suggest. 
  • In this week's episode of "The Readout LOUD," the STAT podcast hosts are joined by STAT's Washington correspondent Lev Facher to talk about how Covid-19 has emerged within the White House.
  • Covid-19 has brought about a lot of disruptions, but the writer of a new STAT First Opinion — who has an autistic son — describes how the pandemic has upended life for individuals with autism and their families. "Autistic children thrive on routines and strongly dislike uncertainty and restrictions," writes Feda Almaliti, who calls for more accommodations for those with disabilities.



More people are unpaid caregivers and caring for multiple people than five years ago

new AARP report on the state of caregiving in the U.S. finds that nearly 1 in 5 adults is an unpaid caregiver for an adult with health or other functional problems, up from around 1 in 6 in 2015. Nearly a quarter of people now are caring for more than one person; say they're having difficulty coordinating care; that they're caring for someone with Alzheimer's disease or dementia; or that their health has gotten worse as a result of their caregiving duties. The latest figures represent an increase since 2015, when around 20% reported experiencing these trends. The report also breaks down caregiving by different groups: Asian caregivers reported having to take more time off, on average, than white caregivers. Caregivers who are in rural areas or are students are less likely to have health insurance than other types of caregivers. 


Physician salaries continue to increase — but Covid-19 could change that

Medscape's latest physician compensation report shows that the average U.S. physician's salary is around $243,000 for primary care physicians and $346,000 for specialists, an increase of around 2% from last year. Here's more from the report: 
  • Specialties: Orthopedists, plastic surgeons, and otolaryngologists topped the list of highest earners, with wages of more than $450,000 a year. Family medicine specialists and pediatricians were on the lower end of the spectrum, with salaries of around $230,000. 
  • Trends: Male physicians — both PCPs and specialties — continue to outearn their female colleagues. Self-employed doctors earned more than those employed by health networks. 
  • Caveat: The report was compiled early this year, before Covid-19 hit the U.S. in a major way. Many in the health industry have since reported losses, and so the report's authors estimate that the current figures based on Covid-19's impact are likely to be lower. 



Inside STAT: Experts name their price for remdesivir


(MIKE REDDY FOR STAT)
Now that Gilead Sciences' drug remdesivir has shown a moderate but much-needed benefit for Covid-19 patients and is being distributed to hospitals, the next question is: How much should it cost? STAT's Damian Garde and Ed Silverman asked several industry experts what they think a fair price would be, as well as how much company ought to be rewarded. The responses they received varied: Some suggested that the drug ought to cost less than a movie ticket because at least one estimate suggests it only costs 93 cents to make a day’s supply of remdesivir. On the other end of the spectrum, however, “It’s impossible to overpay for a truly effective drug,” one industry expert said. Read more here


Around 13% of women in the U.S. report experiencing postpartum depression symptoms

new CDC report finds that around 1 in 8 women report experiencing symptoms of postpartum depression. The analysis, which looked at 2018 data from 30 states and Puerto Rico, found that rates of postpartum depression symptoms ranged from a little under 10% in Illinois to almost 24% in Mississippi. An overwhelming majority of women reported making at least one visit to their physician after giving birth, and most reported being asked about their mental health during this visit. But this also varied by location: Women in Vermont were almost always asked about their mental health, while those in Puerto Rico were among the least likely to be asked. At the same time, women who were younger than 19, or white or Pacific Islander, or had a history of depression during prenatal visits were more likely to be asked about depression during a postpartum visit. 


Positive nursing facility reviews associated with lower rehospitalization rates

Nursing homes with positive Yelp reviews and high Medicare ratings also tend to have lower rates of hospital readmission, according to new research. Reshospitalization rates can be a measure of the quality of care provided as well as the quality of life experienced by patients. In the new study, researchers looked at Yelp reviews for around 1,500 nursing homes around the U.S., and found that nursing facilities with the highest rating from both Yelp and Medicare had a rehospitalization rate that was 2% lower than facilities with the lowest ratings on both sites (a figure the researchers found statistically significant). The analysis also found that facilities that scored well tended to receive comments praising the staff's attentiveness, a clean environment, and the ability to manage pain well. One caveat: The study was not able to distinguish between rehospitalizations that were necessary versus those that could have been avoided. 


What to read around the web today

  • These disinformation researchers saw the coronavirus 'infodemic' coming. NBC News
  • Building a mouse squad against Covid-19. Knowable Magazine
  • Coronavirus may pose a new risk to younger patients: strokes. The New York Times
  • Zoom fatigue is something the deaf community knows very well. Quartz
  • Iraqi doctor’s fight with virus lays bare a battered system. Associated Press

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