All Sauce from Weekly Gravy:

Nearly half of U.S. states are seeing upticks in new coronavirus cases, leading some state officials to order the reimposition of mask wearing for citizens. In California on Thursday, Gov. Gavin Newsom announced that people will be required to wear masks in any indoor space, while Oregon Gov. Kate Brown issued a similar order for people living in seven counties there, CNN reported. North Carolina and Arizona are considering similar measures. Those four states — along with Alabama, Florida, Nevada, Oklahoma, South Carolina and Texas — are experiencing the highest week-long average rise in new daily cases seen in their states since the pandemic began, according to a CNN analysis of Johns Hopkins University data. Floridians, in particular, could be in peril, with experts warning it could become the next U.S. epicenter as citizens flock back to beaches, restaurants and bars. In Oklahoma — where President Donald Trump plans to hold a large rally on Saturday — cases are up 110% from last week, CNN said. In New York, the former epicenter of the U.S. pandemic, Governor Andrew Cuomo on Sunday warned that a return to lockdown for his state was possible. “If we have a high number of violations of the [reopening] policy, which is tantamount to a high likelihood of the spread of the virus, and the local governments are not monitoring policing,…  read on >

A person’s genes and blood type may help determine their odds for a nastier form of COVID-19, should they get infected with the new coronavirus, a new genetics study finds. Published online June 17 in the New England Journal of Medicine, the research helps confirm earlier, more anecdotal evidence that blood type was tied to better or worse illness. Now a team of European researchers have found that people with blood type A had a 45% higher risk of catching coronavirus and developing “COVID-19 with respiratory failure,” compared to people with other blood types. On the other hand, people with type O blood had a 35% lower risk for this more serious form of COVID-19. There are four main blood types: A, B, AB and O. It’s not clear why blood type might influence susceptibility to severe disease. Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, noted that genes that control blood type also play a role in the makeup of the surface of cells. Changes in cell-surface structure might influence the vulnerability of the cell to be infected by the new coronavirus, he said. “We also know from previous research that blood type affects clotting risk,” he said, “and it’s now quite evident that critically ill patients with coronavirus demonstrate significant clotting.” The new study was conducted…  read on >

Stroke patients in rural areas of the United States are less likely to get cutting-edge treatments and more likely to die than those in cities. That’s the takeaway from a new analysis of nationwide data on more than 790,000 adults who were hospitalized with stroke between 2012 and 2017. Most were 64 or older. Compared to patients in cities, those treated at rural hospitals were: about half as likely to receive clot-busting medication for strokes caused by blood clots; about one-third less likely to undergo a procedure to remove a stroke-causing clot; and more likely to die before leaving the hospital (6.8% versus 5.8%). The study was published June 18 in the journal Stroke. “There are so many challenges facing rural America right now — higher rates of chronic disease, poverty and joblessness — and cardiovascular and other health outcomes are much worse in rural areas,” said senior author Dr. Karen Joynt Maddox. She’s an assistant professor of medicine at Washington University School of Medicine in St. Louis. “This study shines light on one area where changes in care, such as the introduction of telehealth or other programs, could really make a difference,” she added in a journal news release. Joynt Maddox said the disparities were striking. “One would think that recent improvements in technology and in telehealth would mean that we could, as a…  read on >

If you’re thinking about traveling this summer, you need to consider the risks posed by the coronavirus pandemic, an expert says. Factors to think about include your age, your health and other people in your household. “The first question you should answer is whether you or a member of your household have a condition that increases the risk for developing COVID-19,” said Dr. Michael Chang, an assistant professor of pediatrics at University of Texas Health Science Center at Houston and pediatric disease specialist at UT Physicians. People at increased risk for severe COVID-19 illness include those 65 and older and those with underlying health conditions. These folks might be safer if they avoid traveling. If you’re at higher risk and must travel, take extra precautions to minimize the risk of coronavirus transmission, Chang advised. “Another thing to consider is the prevalence of the virus at your destination and how strictly you will be able to adhere to precautions such as social distancing during planned activities or excursions,” Chang said in a UT news release. You can check the spread of COVID-19 at your destination by using a U.S. Centers for Disease Control and Prevention data tracker. It’s also important to find out about pandemic guidelines at your destination, because many areas have restrictions on activities or have particular rules. “Before you travel, you should also…  read on >

“I live in Washington state,” said the caller, “but my husband is on a plane to New York City, and I just got a call from my doctor telling me that he’s positive for COVID! What should I do?” “I take care of my grandmother,” said another, “and she goes to this temple whose Rabbi was recently diagnosed with COVID. And she was recently sitting right next to him! What should I do?” Those were two of the more than 90,000 calls, many anxious and tearful, that have flooded one New York City health care system’s COVID-19 hotline since the crisis first emerged in mid-March. The NYC Health + Hospitals (NYC H+H) COVID-19 hotline has been a lifeline for New Yorkers faced by tough decisions with little expert advice on hand. It’s been a tough and evolving process running the hotline, said Dr. Ross Kristal. He’s co-medical director of the NYC H+H Contact Center at NYC Health + Hospital’s Office of Ambulatory Care. When the first New York City case was diagnosed back on March 2, “COVID was new and scary,” he said. But no one could foresee just how bad things would get. But NYC H+H is one of the largest public health care systems in the United States, with over 70 inpatient and outpatient locations across the five boroughs of New York City.…  read on >

Anesthesiologists can help save the planet, a new study suggests. Increased use of regional anesthesia instead of general anesthesia may help reduce greenhouse gas emissions that contribute to climate change, according to researchers at the Hospital for Special Surgery in New York City. Unlike general anesthesia, regional anesthesia doesn’t use volatile halogenated agents, such as desflurane, or nitrous oxide. These are greenhouse gases that can remain in the atmosphere for up to 114 years, the researchers noted. Instead of those gases, regional anesthesia uses a local nerve block along with intravenous sedatives. “Increasing the use of regional anesthesia is potentially good for the climate, improves the quality of care (at least for hip and knee replacements), and may allow individual practitioners to take personal responsibility in the fight against global warming,” said Dr. Christopher Wu, an anesthesiologist at the hospital, and colleagues. In 2019, the hospital decided to use regional anesthesia in as many hip and knee replacements as possible. Of the 10,485 such procedures performed that year, only 4% used general anesthesia. The hospital’s increased use of regional anesthesia saved the equivalent of nearly 27,000 pounds of coal burned, 2,750 gallons of gas, 60,500 car miles, or 3.1 million smartphones charged, according to the study authors. In 2009, there were more than one million hip and knee replacement procedures in the United States. The…  read on >

With U.S. fatalities from COVID-19 now past 115,000, British scientists delivered some welcome news on Tuesday: A drug that appears to cut the odds of death in ventilated patients by one-third. The drug is a low-cost steroid called dexamethasone, which has been in use for decades, noted a team at the University of Oxford. In a trial of more than 6,000 patients, use of dexamethasone was also found to lower the death rate for slightly less-sick patients — those receiving oxygen but not on a ventilator — by about one-fifth. Dexamethasone was of no benefit to patients with milder cases of COVID-19. However, it “is the first drug to be shown to improve survival in COVID-19,” study co-lead investigator Peter Horby, professor of emerging infectious diseases at the University of Oxford, said in a statement, The New York Times reported. “The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment,” he added. According to Horby, given its cheap price tag and wide availability, there’s no reason why dexamethasone shouldn’t become the standard of care for severe cases of COVID-19. “Bottom line is, good news,” Dr. Anthony Fauci, who directs the U.S. National Institute of Allergy and Infectious Diseases, told the Associated Press. “This is a significant improvement in the available therapeutic options that we have.” One doctor’s…  read on >

After reopening, states such as Arizona, Florida and Texas are all seeing record-high one-day increases in new coronavirus cases. According to The New York Times, on Tuesday, Florida reported 2,783 new cases, Texas 2,622 and Arizona 2,392. The trio of Sun Belt states are among 20 that have seen upticks in cases over the past two weeks. Why numbers are rising has become a point of argument between politicians and scientists: Florida Governor Ron DeSantis said in a news conference that the rise in cases in his state is largely due to more widespread testing. But epidemiologists have suggested that increased transmission, due to businesses such as restaurants and bars reopening, is the true cause. Backing up their claim, epidemiologists point to a concurrent rise in many states of increased coronavirus hospitalizations, as well as a rise in the percentage of positive results from tests. In the meantime, concerns are mounting over hospital bed capacity in states seeing a rise in COVID-19 cases. According to the Times, Texas Governor Greg Abbott believes his state’s hospitals still have lots of capacity, even with 2,519 people hospitalized with the illness. In New York, the former epicenter of the U.S. pandemic, Governor Andrew Cuomo on Sunday warned that a return to lockdown for his state was possible. “If we have a high number of violations of the [reopening]…  read on >

Back off, Mom and Dad: Teens who feel their parents are overly controlling may have more difficulty with romantic relationships as adults, a new study suggests. The study, which followed 184 teens, found that those with domineering parents had a future that was different from their peers: On average, they did not go as far in their education, and they were less likely to be in a romantic relationship by age 32. The researchers said the study cannot prove cause and effect. But it does add to evidence that “helicopter” parenting may end up doing kids more harm than good. “Most parents have the best intentions,” said lead author Emily Loeb, a postdoctoral researcher at the University of Virginia in Charlottesville. And certainly, she added, “setting rules and structure for kids is a good thing.” The problem seems to come when parents try to dictate what their children do, not only through rules, but also manipulation. Loeb said they may attempt to “control through guilt,” for example by giving the silent treatment until their child does what they want. And there are reasons to believe that could affect children’s relationships later in life, according to Loeb. Research shows that kids with controlling parents can have difficulty developing autonomy — the ability to think for themselves and act independently. And young people with a healthy sense…  read on >

With U.S. coronavirus cases now past 2 million, a new report finds that COVID-19 is much more lethal for Americans with underlying health issues — illnesses such as heart disease, diabetes or lung ailments. In fact, “deaths were 12 times higher among patients with reported underlying conditions,” compared to healthy individuals, according to an analysis of more than 1.3 million cases of COVID-19 reported to the U.S. Centers for Disease Control and Prevention by May 30. People with chronic health issues were also six times more likely to require hospital care if they got COVID-19 compared to people without such conditions, said a team led by Erin Stokes of the CDC’s COVID-19 Emergency Response Team. Age, gender and race all seemed to matter, too. Although the average age of COVID-19 patients was 48, the odds for intensive care unit admissions and death rose with age, and deaths were most common for people 80 years of age or older “regardless of the presence of underlying conditions,” the CDC team said. As seen in other studies, men were more prone to severe, life-threatening illness than women. And the illness hits minorities hardest: Even though blacks and Hispanics make up 13% and 18% of the U.S. population, they comprised 22% and 33% of COVID-19 cases, respectively, the report found. This news comes against the backdrop of most states…  read on >