Staying Home At All Costs: The Case of Dropping Emergency Department Visits

As the COVID-19 pandemic spread and cases climbed, authorities and public health officials encouraged people to stay home to avoid spreading COVID-19. While this type of message was an essential part of the public health campaign, one of the results was an apparent drop in routine visits to the emergency department for serious health conditions, such as heart attacks, appendicitis, broken bones, and strokes. A study conducted by Yale University and the Mayo Clinic and published in JAMA confirmed that a sample of emergency departments in states with spiking COVID-19 cases did experience a significant drop in emergency room visits.

This study was conducted in Colorado, Connecticut, Massachusetts, New York, and North Carolina during the spring (March and April), when COVID-19 cases were rising rapidly in these states. All five states experienced at least a 40% drop in emergency department visits and hospital admissions, with a full 63.5% drop in New York’s emergency department visits. This drop mirrors the increase in COVID-19 cases and government orders to stay at home.

While staying home can save lives during COVID-19, avoiding the emergency department for true health emergencies most certainly does not save lives. This analysis proves that public health messaging needs to specify that emergency medical care is an essential reason to leave home. Further research is needed to determine the true toll on human health and suffering of medical care avoidance during the COVID-19 pandemic.

CAR T-cell Therapy Receives FDA approval for MCL

As immunotherapy has become the standard of care for a variety of cancers, one powerful type of immunotherapy has emerged for the treatment of blood cancers: CAR T-cell therapy. CAR T-cell therapy involves the removal and alteration of a patient’s own T-cells (immune system cells) to attack cancer cells in the blood. Once altered in a lab to recognize the cancer cells, the CAR T-cells are infused back into the patient’s bloodstream. While CAR T-cell therapy is approved for several forms of lymphoma, a study by Dana-Farber Cancer Institute led to the first FDA approval of CAR T-cell therapy for mantle cell lymphoma.

Mantle cell lymphoma (MCL) is a rare and aggressive form of non-Hodgkin’s lymphoma that is often not caught and diagnosed until the blood cancer has advanced to later stages. Curing MCL has historically been difficult or impossible with traditional cancer therapies. For this reason, the disease can be life-threatening, especially if the disease is resistant to chemotherapy, and the approval of CAR T-cell therapy is a major step forward for the treatment of MCL.

In the study conducted by Dana-Farber, the results showed CAR T-cell therapy to be a highly effective treatment for resistant forms of MCL. Of the 74 patients treated with the CAR T-cell therapy, 93% responded to the first infusion, and all signs of cancer disappeared in 67% of patients. Since these patients had exhausted other therapies, these results showed promise for patients with an otherwise poor prognosis.

The CAR T-cell treatment, called KTE-X19, can now be used to treat patients who have treatment-resistant or relapsed forms of MCL. Dana-Farber, which conducted the clinical trial used for FDA-approval, will now administer the treatment to MCL patients.