US COVID-19 hospitalizations hit record high | More midwife care could reduce maternal, newborn deaths | Paternal early life stress tied to pediatric brain development
States are now testing their vaccine data systems in preparation for the expected rollout of two COVID-19 vaccines in a few weeks amid a continued spike in COVID-19 cases and hospitalizations. The number of people hospitalized with COVID-19 across the US reached 98,691 Tuesday, the highest figure yet, while 157,900 new cases and nearly 2,200 deaths were reported, bringing the nationwide tally to 13.5 million cases and 268,200 fatalities.
Researchers examined health care interventions by midwives in 88 countries and estimated that 41% of maternal deaths, 39% of neonatal deaths and 26% of stillbirths could be averted by a 25% increase in coverage of midwife-delivered interventions every five years. The findings in The Lancet Global Health also showed that providing midwife-delivered care to up to 95% of mothers and newborns in the 88 countries could result in a 67% decrease in maternal deaths, a 65% decrease in stillbirths and a 64% decrease in deaths of newborn babies.
A study in JAMA Network Open found a statistically significant link between paternal cumulative early life stress and child brain development, with the link persisting after controlling for maternal variables such as maternal depressive symptoms during pregnancy, maternal body mass index and maternal socioeconomic status. The findings were based on data involving 72 trios of infant, mother and father in Finland.
A study in the Journal of Pediatric Surgery found that laparoscopic percutaneous extraperitoneal closure for hernia repair in youths was safe, efficient, reduced operative time, provided improved cosmetic outcomes and hastened recovery, compared with laparoscopic intracorporeal suture. The findings were based on data involving 474 youths.
A study in JAMA Pediatrics found that cannulas with long and narrow tubing were noninferior to short binasal prongs and masks for giving nasal intermittent positive pressure ventilation to infants who were born preterm. The findings, based on data involving 166 infants who were born preterm, also showed that moderate to severe nasal trauma caused by ventilation was significantly less common in those who used cannula tubing, compared with infants in the short binasal prongs and masks group.
Health care workers will likely be the top priority for receiving a COVID-19 vaccine as soon as one is approved, but some are expressing concerns about the speed of vaccine development and potential political interference. The CDC, which says addressing hesitancy in this group is key, shared that recent polling found 63% of health care workers said they would get the vaccine.
Research suggests that the COVID-19 pandemic is causing primary care physicians to leave medicine and indicators suggest more women than men clinicians are being affected. "It's really important for society to recognize the extraordinary impact this pandemic is having on physician mothers, as there will be profound ripple effects on the ability of this key segment of the health care workforce to serve others if we do not address this problem urgently," said Reshma Jagsi, MD, a radiation oncologist at the University of Michigan.
Physicians are the basis of the US health care system, but the fee-for-service model of medicine has led to financial repercussions for independent providers as "elective" care is delayed or denied due to the pandemic. These physicians could pave the way for lasting market-based changes to the health care system, including improved cost and quality transparency, tying payment to outcomes and engaging in value-based competition.
Open enrollment on HealthCare.gov ends Dec. 15, but President-elect Joe Biden could reopen the exchange if the COVID-19 emergency continues into the new year, and his administration can choose to have a longer open enrollment period for the 2022 plan year, says Karen Pollitz, a senior fellow with the Kaiser Family Foundation. Other steps the Biden administration could take to bolster insurance coverage include boosting funds for marketing and navigators and easing special enrollment period criteria, Pollitz says.
Senate Majority Leader Mitch McConnell, R-Ky., on Tuesday rejected a $908 billion COVID-19 relief package introduced by a bipartisan group of lawmakers, noting that he prefers to advance a "targeted relief bill" this year. During a GOP caucus call the same day, McConnell reportedly offered new COVID-19 relief legislation that could receive support from the White House, and it includes protections against COVID-19 lawsuits, extension of unemployment insurance, another round of Paycheck Protection Program small business assistance, and additional funding for vaccine distribution, testing, schools and the Postal Service.
