Today's News and Commentary

About the public’s health

Moderna: Early coronavirus vaccine results are encouraging: “The vaccine by Cambridge, Massachusetts-based Moderna Inc., generated antibodies similar to those seen in people who have recovered from COVID-19 in study volunteers who were given either a low or medium dose.
In the next phase of the study, led by the U.S. National Institutes of Health, researchers will try to determine which dose is best for a definitive experiment that they aim to start in July.”

Targets of T cell responses to SARS-CoV-2 coronavirus in humans with COVID-19 disease and unexposed individuals: In order to be able to develop an effective vaccine, the body must be able to respond to an infection. This research confirms that, indeed, the body’s immune system is able to recognize SARS-CoV-2 and respond.

China has been trying to avoid fallout from coronavirus. Now 100 countries are pushing for an investigation: Today is the start of the annual World Health Assembly and it is expected that the WHO (which convenes the conference) will call for a summary of COVID-19 pandemic activities. Included is an investigation into whether China withheld early information. Also, see: Unprecedented World Health Assembly Convenes Online As Pandemic Rages

State and Federal Data on COVID-19 Testing Don’t Match Up: “ The CDC has quietly started releasing nationwide numbers. But they contradict what states themselves are reporting…
[D]ata sets have one known major difference: Some states report the total number of people tested, while the CDC reports every test, even if a single person is tested more than once. A spokesperson for Indiana’s public health department pointed to this difference to explain the state’s test gap. But our analysis suggests this—or any other methodological factor—does not fully explain the widespread discrepancies.”

As coronavirus testing expands, a new problem arises: Not enough people to test: “A Washington Post survey of governors’ offices and state health departments found at least a dozen states where testing capacity outstrips the supply of patients. Many have scrambled to make testing more convenient, especially for vulnerable communities, by setting up pop-up sites and developing apps that help assess symptoms, find free test sites and deliver quick results.
But the numbers, while rising, are well short of capacity — and far short of targets set by independent experts.”

Serological testing for SARS-CoV-2 antibodies: This article from the AMA is an excellent update on the types of tests, their drawbacks and recommendations for use and interpretation.

 HHS announces leadership team for Operation Warp Speed: The headline is self-explanatory.

Strong Social Distancing Measures In The United States Reduced The COVID-19 Growth Rate: Shelter-in-place orders (SIPOs) do work to reduce spread of SARS-CoV-2.
“Adoption of government-imposed social distancing measures reduced the daily growth rate by 5.4 percentage points after 1–5 days, 6.8 after 6–10 days, 8.2 after 11–15 days, and 9.1 after 16–20 days. Holding the amount of voluntary social distancing constant, these results imply 10 times greater spread by April 27 without SIPOs (10 million cases) and more than 35 times greater spread without any of the four measures (35 million).”

Fitbit plans to make emergency ventilators for Covid-19: The news is not that another company is making a ventilator. The CEO of Fitbit says that he “intends for the devices to be the ‘most advanced’ emergency user ventilator that’s still available at a ‘lower’ price point.” This product would be a true disruptive innovation- high quality, lower price and widely available. Shows that the market can rapidly change for the better.

Effect of Patient Portal Reminders Sent by a Health Care System on Influenza Vaccination Rates: Patient reminders are often cited as a means to increase recommended care. In this study, however, using reminders via patient portals were only “slightly effective in increasing influenza vaccination rates.” More intensive and targeted methods are recommended.

The online competition between pro- and anti-vaccination views:  This fascinating study from Nature performs opinion mapping regarding vaccine use employing a “global pool of around three billion Facebook users. Its core reveals a multi-sided landscape… that involves nearly 100 million individuals partitioned into highly dynamic, interconnected clusters across cities, countries, continents and languages. Although smaller in overall size, anti-vaccination clusters manage to become highly entangled with undecided clusters in the main online network, whereas pro-vaccination clusters are more peripheral. Our theoretical framework reproduces the recent explosive growth in anti-vaccination views, and predicts that these views will dominate in a decade. Insights provided by this framework can inform new policies and approaches to interrupt this shift to negative views.” Look at Figure 1 and notice how the antivax messages are right in the middle of the undecideds, while provax messages are at the periphery.

Fear Of Contracting Coronavirus Propels Some Smokers To Quit: The article is just a few anecdotes with no system-wide data. But it would be great if fear does motivate quitting.

About pharma

COVID-19-Related Medication Errors: This article highlights common, but easily fixed errors. The types of errors are not new- for example, getting the patient’s correct weight.

New Study Finds Hydroxychloroquine Provides No Benefit for COVID-19: Yet another study with this finding. This one is from France, from where the original treatment suggestion originated.

About healthcare IT

Most promising healthcare tech in 2020: 15 execs from CommonSpirit, Kaiser Permanente, UPMC & more: An interesting read with opinions from leading experts.

Apple, Google team up for COVID-19 tracing app & 16 other key notes: A really good summary of “who is doing what.”

CO Health Information Exchange Incorporates Medical Image Exchange: The COVID-19 pandemic has accelerated activities like this one. “CORHIO, a top health information exchange (HIE) in Colorado, has unveiled a partnership with a medical image exchange company to power the transfer of medical images between healthcare providers in the state.
Regardless of the health system or EHR system, the HIE can now facilitate images between its 19,000-plus users in Colorado.
Using this partnership, providers will be able to exchange MRIs, CT scans, ultrasounds, mammograms, and x-rays.”

About emerging science

Reprogramming a patient’s own skin cells to replace cells in the brain that are progressively lost during Parkinson’s disease has been shown to be technically feasible: ”The McLean-MGH team reprogrammed a 69-year-old patient’s skin cells to embryo-like pluripotent stem cells (called induced pluripotent stem cells) and then differentiated them to take on the characteristics of dopaminergic neurons, which are lost in Parkinson’s…In a series of two separate surgeries in 2017 and 2018 at Weill Cornell Medical Center and MGH, the patient underwent transplantation of the replacement dopamine neurons…As for how the patient feels, in the time that has passed since surgery, the patient has enjoyed improvements in his day-to-day activities and reports an improvement in his quality of life. Routine activities, such as tying his shoes, walking with an improved stride, and speaking with a clearer voice, have become possible again.”

Designing vaccines from artificial proteins: Ecole Polytechnique Fédérale de Lausanne scientists “developed a new computational approach to create artificial proteins, which showed promising results in vivo as functional vaccines. This approach opens the possibility to engineer safer and more effective vaccines.”

About health insurance

States face looming crisis over Medicaid growth, which could trigger changes for providers and payers: “States are about to face a major budget crisis due to exponential growth in Medicaid enrollment and a decline in tax revenue, which experts say could lead to provider payment cuts or other measures to contain costs.”

About hospitals

Hospitals Knew How to Make Money. Then Coronavirus Happened: A really good article with examples of how hospitals may have to shift from their money-making elective procedures to stay in business.

About healthcare professionals

Medscape Physician Compensation Report 2020: Lots of information in this study, including figures on decreased volume and revenue during the COVID-19 pandemic, specialty salary rankings (as usual, orthopedics is at the top and primary care/public health is at the bottom), as well as persistent sex differences in income.