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SOTU watch, what digital scribes can't catch, & how many households got hit by viruses

February 7, 2023
Reporter, Morning Rounds Writer
Good morning. Today we bring you news from the doctor's office, where mumbling can defeat digital scribes.

politics

What we'll be watching in Biden's speech tonight

President Biden is expected to hammer home the successes of his first two years in tonight's State of the Union address, leading with good economic news. Health objectives may take a back seat to that and to foreign policy, with attention focused on the Chinese spy balloon shot down last weekend and the continuing conflict in Ukraine.

Biden is set to take a victory lap on the drug-pricing legislation Democrats passed last year, including its provisions to let Medicare negotiate drug prices and cap monthly insulin costs at $35. He's also set to highlight savings on hearing aids and the No Surprises Act on medical billing. We're guessing this might also get a callout: The Covid-19 pandemic, for which Biden officially gave an end date last week to the national emergencies. My D.C. colleagues will be covering the speech closely tonight, and we'll highlight their top takeaways in tomorrow's newsletter.


Health

Viruses hit 4 in 10 U.S. households in recent weeks, but most people aren't worried

It's been a rough spell for Americans laid low by respiratory bugs, with almost 4 in 10 households reporting someone fell ill with Covid, flu, or RSV from the December holidays through mid-January. The KFF Covid Vaccine Monitor out today found someone had the flu in 27% of households, 15% had Covid, and 10% had RSV. Nearly three years after Covid first hit, most people (69%) are "not too" or "not at all" worried about getting seriously ill from the coronavirus, although some (31%) still say they are concerned. By comparison, 26% worry about flu and 25% about RSV.

Just hearing about the three viruses spurred nearly a third of poll respondents to say they'd wear a mask in public (31%), avoid large gatherings (26%), postpone travel (20%), or skip indoor dining (18%). Nearly two-thirds of immunocompromised people said they'd take more of these precautions. Meanwhile, bivalent Covid booster uptake stayed low, ticking up to 30% of adults (from 22% in December), while 86% of those who've gotten them say it's important to get another (and they said they're watching the CDC).


chronic disease

Risk of infection varies with route of dialysis and race

Infection is a serious danger for patients undergoing dialysis, estimated to cause more than a third of deaths. A new CDC study based on data from 2017 to 2020 reports the risk of developing life-threatening bloodstream infections is higher for Hispanic, Latino, and Black Americans on dialysis for end-stage kidney disease. How patients received dialysis mattered: Going through a central venous catheter straight into major veins was linked to higher rates of infection than when delivered through less invasive routes. 

Even though a larger proportion of white patients had a central venous catheter (23%, versus 21% of Black people and 14% of Hispanic or Latino people), those from minority groups had higher rates of infection. About one-third of the infections came from Staphylococcus aureus, and 40% of those were from the methicillin-resistant S. aureus bacterium, also known as MRSA, that is more difficult to treat. STAT's Isabella Cueto has more.



Closer Look

Hmm. Digital scribes in the doctor's office can't catch everything we say

Illustration of a confused robot emerges from hole

Adobe

What would you say if someone asked whether medical providers should use tech tools to transcribe their conversations with patients? If you said "mm-hm" or "uh-huh," a digital scribe might not get it right. A recent study in the Journal of the American Medical Informatics Association found that speech-to-text engines don't accurately record these responses, potentially leaving out clinically relevant sounds. And they're not very good with speech from non-native English speakers, STAT's Brittany Trang found when she used a transcription service for her interview with study author Kai Zheng.

While the tools might seem like a good way to help ease clinical burnout, they have limits, meaning humans still need to check them, especially if there are too many speakers in the room and the sound quality is poor. Still, Zheng thinks, even if an automatically generated document falls short of 100% accuracy, a near-perfect transcription could make a big difference. Mm-hmm. Read more.


coronavirus

Lower long Covid risk linked to healthy lifestyle before infection

In the search for answers to long Covid — what causes it, how to treat it, how long it lasts — researchers have looked for who might be more likely to develop the persistent symptoms after infection, from fatigue to brain fog to shortness of breath. A new paper in JAMA Internal Medicine based on prospective data from the long-running Nurses' Health Study II found an association between embracing five of six lifestyle factors (led by healthy body weight and adequate sleep) and a 50% lower risk of long Covid compared to participants with none of those factors. 

The other behaviors were not smoking, getting regular exercise, eating a high-quality diet, and drinking moderate amounts of alcohol. The authors note each factor has also been linked to increased risk of chronic inflammation, which has been implicated in long Covid. Caveats: The associations can't prove cause and effect and most participants were white and middle-aged.


mental health

Primary care providers are treating more mental health concerns

At a time when mental health care is increasingly hard to find, a new study in Health Affairs tells us that even before the pandemic, primary care providers were treating more mental health concerns than before. For their analysis appearing in Health Affairs, the researchers compared the proportion of primary care visits dealing with a mental health concern in 2006 and 2007 to the share in 2016 and 2018. Those visits grew from 10.7% of the total to 15.9% in the later years.

Patients were more likely to ask for help with a problem like anxiety from their regular physician than a PCP they didn't know. The study also showed the patient's race and ethnicity mattered. Black patients were 40% less likely than white patients to have a mental health concern addressed during a primary care visit; a similar 40% difference divided Hispanic and non-Hispanic patients.


by the numbers

feb. 6 cases covid-chart-export - 2023-02-06T180035.093


feb. 6 deaths covid-chart-export - 2023-02-06T180101.547


More around STAT
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What we're reading

  • Exclusive: Senators probe telehealth companies for tracking and monetizing sensitive health data, STAT

  • Biden's top Covid adviser wishes he had tangled with Tucker Carlson, Politico

  • What doctors are learning about marijuana and surgery, Wall Street Journal

  • Death toll from mysterious meningitis outbreak in Mexico at 35, Reuters

  • Opinion: The tyranny of the inbox: What it's like to be a PCP with OCD, STAT

Thanks for reading! More tomorrow,


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