Good morning. Today we learn who's making money on the travel nurse workforce and what's next for the FDA commissioner vote.

Private equity firms cash in on travel nursing

A travel nurse walks down the hallways during a night shift at a field hospital set up to handle a surge of Covid-19 patients in Cranston, R.I. (David Goldman/AP)

As the U.S. health system buckles under the weight of the Covid-19 pandemic, private equity firms are cashing in. Some of their investments center on nurse staffing agencies, which send free-floating nurses help to hospitals when they need extra help. Hospitals rely on these agencies as wave after wave of hospitalizations have strained nurses who face a crushing burden of sick patients and the possibility that they will fall ill themselves. The demand for nurses has made travel nursing a lucrative business — and private equity firms have taken notice. Since the beginning of 2021, at least 10 private equity firms have bought at least seven staffing agencies, according to a new STAT analysis. Now 200 members of Congress, concerned that travel nursing agencies might be “taking advantage” of the pandemic-induced staffing crisis, have asked for an investigation. STAT’s Rachel Cohrs has more.

It was tight, but Senate moves Califf’s FDA nomination near final vote

In a dramatically close procedural vote last night, the Senate voted 49-45 to advance Robert Califf’s nomination to lead the FDA, virtually guaranteeing he will soon be confirmed as its commissioner. The Senate vote technically only limits debate on Califf’s confirmation; lawmakers will have to hold another formal floor vote on Califf’s confirmation before he assumes the agency’s top job. That vote is expected later this week. But the procedural vote, known as a cloture vote, generally signals how lawmakers will vote on the nomination itself. Califf’s confirmation has been stalled in the Senate since November after some Democrats, as well as anti-abortion groups, publicly pledged their opposition to his nomination. “He’s as good as we could hope for out of the administration with this majority in the Senate,” Roy Blunt (R-Mo.) said regarding his vote to advance Califf’s confirmation.

Remote Covid-19 trials upped diversity, study finds

Racial and ethic diversity among clinical trial participants is urgently needed to improve equitable access to health care, particularly during the Covid-19 pandemic. A new study in JAMA Network Open examines whether pursuing trials online might help expand racial, ethnic, and geographic demographics beyond the physical location of the clinic-based study. Researchers drilled down in three studies conducted early in the pandemic: two remote studies that looked at hydroxychloroquine (using couriers to deliver nasal swabs and medication) and one in-clinic study of convalescent plasma. Without going into those studies' conclusions, the researchers did find that among the 1,410 participants, those recruited online represented more racial, ethnic, and geographic diversity than the single-site study. For example, 11% of remote vs. 2% of clinic participants identified as Black. “Our findings suggest that remote trial participation and online recruitment may be associated with improved research equity and inclusion,” the authors write.

Closer look: What Akili’s regulatory filing can tell us about digital therapeutics

Akili Interactive, the maker of an FDA-cleared video game to treat ADHD, is one of the pioneers pushing the idea that software can be prescribed by a doctor to treat medical conditions. Its EndeavorRx is among the very first products to test the market on prescription software. Akili has long been bullish on the potential of its technology to reach wide swaths of the population, but the difficulty of realizing that dream is laid bare in the company’s freshly filed regulatory paperwork as it looks to go public via merger with a special purpose acquisition company. Despite clinical evidence of efficacy and clear investor enthusiasm, the S-4 reveals the many challenges Akili must navigate before its novel approach is widely accepted by the health care system. STATs Mario Aguilar has more for STAT+ subscribers.

Declining teen pregnancy rates tied to sex education program, study finds

It works. Comprehensive sex education that does not rely solely on abstinence was linked to lower teen pregnancy rates, according to a new study in the Proceedings of the National Academy of Sciences that examined birth rates in 55 U.S. counties before and after the federally funded Teen Pregnancy Program began in 2010. The researchers also compared birth rates to counties that didn’t activate the program, which provides more complete information on sex, contraception, and reproductive health than abstinence-only programs. The researchers found that teen pregnancy fell by 1.5% the first year the program went into effect, then 7% at year five for an overall decline of 3%. Their results — which they call "quasi-experimental" — fit with other correlative studies on sex education, an issue they emphasize is important in a country where women are much more likely to become teen mothers than in other wealthy countries.

Opinion: ‘I trust my drug dealer more than I trust this vaccine’

That provocative statement floored Nicholaus Christian, an internal medicine physician and addiction fellow in the Yale Program in Addiction Medicine. Because he had already learned much from the patient who said this, he asked her to explain, stunned that someone would more readily put something from the current fentanyl-contaminated heroin supply in her arm than a highly vetted vaccine. The gist, Christian relates in a STAT First Opinion, is that when she speaks to her dealer, they listen to her concerns without judgment and accept her for who she is. “Contrast this with how the health care system treats people who use drugs,” he writes. “Perhaps providers and public health experts can learn from my patient’s drug dealer.” Read more.

What to read around the web today

Pedestrian deaths spike in U.S. as reckless driving surges. New York Times
The next pandemic could start with a terrorist attack. The Atlantic
Sewage sampling already tracks Covid. What else can it catch? Wired
As state medical boards try to stamp out Covid misinformation, some in GOP push back. NPR and Kaiser Health News
Belgium discloses penalties for failing to report clinical trial results. STAT+