Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of Feb. 24, 2020 – Feb. 28, 2020.

U.S. confirms 35 cases of coronavirus, including 21 among repatriated people

CNN (2/21, Nedelman, Tinker) reported there are 35 confirmed cases of coronavirus in the U.S., including 21 “among repatriated individuals,” 18 of which were passengers on the Diamond Princess cruise ship. Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said, “We are keeping track of cases resulting from repatriation efforts separately because we don’t believe those numbers accurately represent the picture of what is happening in the community in the United States at this time.”

Meanwhile, Reuters (2/21, Steenhuysen, Hay) reported the CDC “said they are preparing for the possibility of the spread of the new coronavirus through U.S. communities that would force closures of schools and businesses.” Dr. Nancy Messonnier, a CDC official, said, “We’re not seeing community spread here in the United States yet, but it’s very possible, even likely, that it may eventually happen.”

U.S. appeals court upholds Administration rules that gag physicians

The AP (2/24, Johnson) reports “a U.S. appeals court on Monday upheld...administration rules that bar health care providers in the federal family planning program for low-income women from” presenting patients with all their care options. In a “7-4 ruling by the 9th U.S. Circuit Court of Appeals,” decisions issued by judges in California, Washington and Oregon were overturned, but “the court had already allowed the administration’s changes to begin taking effect while the government appealed those rulings.” The American Medical Association said, “It is unconscionable that the government is telling physicians that they can treat this underserved population only if they promise not to discuss or make referrals for all treatment options.”

Modern Healthcare (2/24, Subscription Publication) reports “the 9th Circuit’s majority opinion, by Judge Sandra Ikuta, found that the U.S. Supreme Court had already approved nearly identical regulations in a 1991 decision.” However, “the dissent, by Judge Richard Paez, found that since the high court’s decision, Congress had barred the Department of Health and Human Services from imposing rules ‘that frustrate patients’ ability to access health care.’” The American Medical Association criticized the ruling, saying, “This government overreach and interference demands that physicians violate their ethical obligations – prohibiting open, frank conversations with patients about all their health care options – if they want to continue treating patients under the Title X program.”

Editor’s Note: Read a statement on the decision from AMA President Patrice A. Harris MD, MA.

Health officials warn that novel coronavirus will likely spread within the U.S. and say Americans should take steps to prepare

The New York Times (2/25, Belluck, Weiland) reports Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said that the novel coronavirus will most likely spread in the U.S. and Americans should take steps to prepare for such outbreaks now. Dr. Messonnier, said, “It’s not so much of a question of if this will happen anymore but rather more of a question of exactly when this will happen.” Meanwhile, HHS Secretary Alex Azar “told a Senate panel that federal and local health departments will need as many as 300 million masks for health care workers and additional ventilators for hospitals to prepare for an outbreak of coronavirus in the U.S.” Azar also said, “This is an unprecedented potentially severe health challenge globally.”

The Washington Post (2/25, A1, Werner, Abutaleb, Bernstein, Sun) reports officials from the CDC, NIH, and other health agencies spoke about the virus in “a closed-door meeting with senators as well as a separate briefing with reporters by phone.” Speaking with reporters, Dr. Messonnier, said, “Ultimately we expect we will see community spread in the United States. It’s not a question of if this will happen, but when this will happen, and how many people in this country will have severe illnesses.”

NPR (2/25, Stein) reports Dr. Messonnier warned that Americans should be prepared for the possibility of workplace and schools being closed and public events being canceled.

Meanwhile, Newsweek (2/25, Rodriguez) reports a survey conducted by the California Nurses Association and National Nurses United found that the majority of nurses in the U.S. have not “been provided with the information necessary to respond to the coronavirus.” According to the survey, around 13% “of nurses said they have a plan in place to isolate patients,” while 31% “of their employers have personal protective equipment available to them.”

Study: Cognitive decline may happen faster in widowed adults than in married ones

CNN (2/26, LaMotte) reports researchers found that over a period of three years that “cognitive abilities declined three times faster in widowed adults with high levels of beta-amyloid – a key marker for Alzheimer’s – than in married people with equally high levels,” suggesting that losing a spouse may accelerate cognitive decline. The researchers also found that “even for those without beta-amyloid accumulation and no signs of cognitive decline, the risk for dementia was greater for men and women who were widowed.” The findings were published in JAMA Network Open.

About four in ten U.S. adults have obesity, report finds

The AP (2/26) reports, “About four in 10 American adults” has obesity, “and nearly one in 10” has severe obesity, investigators from the CDC concluded after examining data “from a 2017-18 health survey that measures height and weight” in which “more than 5,000 U.S. adults took part.” Specifically, that “survey found that the obesity rate was 42%,” while “the severe obesity rate was more than 9%.” This report did not disclose “new obesity numbers for kids and teens.” The findings were published in a National Center for Health Statistics Data Brief report, Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018.

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