viernes, 5 de junio de 2020

Hydroxychloroquine doesn't seem to protect against Covid-19, racial disparities in NIH grants, & handgun ownership and suicide risk

Morning Rounds
Shraddha Chakradhar

Hydroxychloroquine does not prevent Covid-19 infection if exposed, study says

A much-anticipated study published yesterday found hydroxychloroquine didn't protect those those who took the malaria drug from developing Covid-19 after they were exposed to others with the infection. Around 12% of those in an 821-person, double-blind randomized trial who took the drug developed Covid-19, compared to 14% of those who were given a placebo. The findings come as many, including President Trump, have reportedly taken hydroxychloroquine as a prophylactic against Covid-19 infection. Still, “this is not the end of the story with hydroxychloroquine,” public health expert Ashish Jha tells STAT's Matthew Herper. Read more here.

Here's more of the latest with the pandemic: 
  • In more hydroxychloroquine news, the WHO yesterday announced that it was resuming a study testing whether the drug could be effective in treating Covid-19, after conducting a safety review. The agency had paused the trial last week after a study in the Lancet raised questions about the drug's safety.
  • A House subcommittee tasked with overseeing aspects of the federal coronavirus response is holding a briefing today with public health experts and doctors to examine the pandemic's impact on existing racial disparities, including the disproportionate number of Covid-19 deaths among Black and Hispanic people. 
  • As workers slowly head back into offices, health tech companies are rolling out new tools to help employers keep tabs on their workers' health, including Covid-19 symptom-checker and contact tracing apps. But these tools are raising thorny questions about how far employers can go in surveilling their workers and whether companies will actually want to use them. 
  • In a new First Opinion, health law expert A. Kayum Ahmed calls attention to the recent exclusive deal struck up between the University of Oxford and AstraZeneca to develop a Covid-19 vaccine. This kind of  "vaccine sovereignty," Ahmed writes, "symbolizes the vaccine as an instrument of power deployed to exercise control over life and death," and may influence how other players in the Covid-19 vaccine landscape also decide how accessible to make their products. 



Racial disparities in NIH grant funding emerge at the earliest review stages

New research finds that racial disparities in how NIH grants are evaluated persist despite a 2009 change to the review process designed to alleviate these differences. When scoring RO1 applications — the oldest NIH funding mechanism for principal investigators — reviewers first grade projects for five specific categories, including innovation, and also assign a separate overall score to the application, which is done at the reviewer's discretion, explains Elena Erosheva, a statistician at the University of Washington and lead author of the study. She and her colleagues found that Black scientists tended to receive worse scores on each of the five specific criteria categories. Overall, these early disparities meant that between 2014-2016, only 10% of Black investigators got NIH funding, compared to around 19% of white applicants. "The findings show that racial disparities are present at the earliest stages of review at NIH," Erosheva tells me, even though the criteria are supposed to be merit-based. 


Daily low-dose of aspirin doesn't seem to prevent depression in older adults

Depression is associated with increased inflammation in the body, and scientists have looked to see if taking aspirin could reduce inflammation, and, in turn, depressive symptoms. Now, a new study of more than 19,000 older adults — about half of whom received a daily low dose of aspirin — finds no benefit in taking the anti-inflammatory drug to stave off late-life depression. Study participants, who were on average 75 years old, were followed for about four years. When tested on a 10-item scale that measures the presence of depression, there wasn't a significant difference between those in the placebo group and those who received 100 milligrams of daily aspirin. Rates of new depression diagnoses were also nearly identical between the groups. 


Inside STAT: MIT engineers develop a system to help physicians get the most out of ventilators


A VENTILATOR MONITOR ATTACHED TO THE ISAVE SYSTEM. (HYACINTH EMPINADO/STAT)
Hospitals around the country have experienced ventilator shortages in the wake of Covid-19, and scientists have been brainstorming ways to help alleviate that. Although ventilators can be shared by more than one patient, that can come with complications — there isn't a good way to adjust the machine for each patient's individual needs, for example. Now, a team of engineers has devised a new system that can more safely support two people on one ventilator. The system — called iSAVE — allows physicians to make adjustments to air pressure and volume for each patient, and is made of affordable, medical-grade equipment while also being quick to set up. Learn more about the device in a new video from STAT's Hyacinth Empinado here

Handgun ownership vastly increases suicide risk, large study confirms


new study that drew from a cohort of more than 26 million people in California reinforces what mental health experts have known for some time: Owning a gun vastly increases suicide risk. Researchers followed people who hadn’t owned a gun before October 2004 for 12 years and found that gun owners had a risk of suicide that was nine times higher than non-owners. This risk increased in the weeks immediately after buying a gun — more than 1 in 7 suicides by firearm occurred in the first month after purchase. However, the majority of firearm suicide deaths among owners happened a year or more after the purchase, a finding that experts say reinforces the need for "red flag" laws in which an at-risk person's guns can be temporarily taken away by a judge until they no longer pose a threat to themselves or others. 


Racial disparities in cancer deaths come at a steep economic cost, study finds

Racial disparities in cancer mortality rates have led to a loss of at least $3 billion due to premature deaths among Black patients, according to new research. Black cancer patients die from their disease at greater rates than white patients, and this disparity grows among younger populations. In the study, scientists looked at 2015 data on average life expectancy, cancer deaths, and earnings data to calculate life years and earnings lost due to premature cancer deaths. The lost earnings rate for white cancer patients was almost $35 million per 100,000 people followed during 2015. That rate for Black cancer patients who died was more than $43 million per 100,000 people in 2015. However, if there were no disparities between the two groups, $3.2 billion in lost earnings could have been avoided, the authors conclude, and they suggest improving access to cancer prevention, screening, and treatment for these vulnerable populations. 


If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.


What to read around the web today

  • How U.S. cities lost precious time to protect black residents from the coronavirus. The Washington Post
  • Amid virus, those in India’s largest slum help one another. Associated Press
  • The only hospital in town was failing. They promised to help but only made it worse. ProPublica/The Frontier
  • Trump administration selects five coronavirus vaccine candidates as finalists. The New York Times
  • Allergan is trying to track down women with breast implants it recalled nearly a year ago. Fortune

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