After the emergency, a huge health care headache

(MIKE REDDY FOR STAT)

Bringing down the curtain on the country’s “public health emergency” may sound like an idea whose time has come, but formally ending the pandemic is going to be a major headache, STAT’s Rachel Cohrs writes in a special report. The next chapter of the U.S. Covid-19 response will center on how the Biden administration chooses to unwind the tangle of temporary policies put in place to help the country address the virus — with millions of people’s insurance coverage and billions of dollars at stake. To name a few: There were protections to help people stay on Medicaid when they lost their jobs. Extra payments to help struggling hospitals address the crush of extra patients, and to make the regulatory environment flexible enough to accomodate telehealth and other remote care options. Even some vaccine authorizations are tied to the country’s formal emergency declaration. Read more in STAT+.

In the wake of Omicron, White House steers toward a more targeted Covid strategy

As the Omicron variant recedes and cities around the country lift their mask mandates, the Biden administration isn’t ready to declare an end to the Covid-19 pandemic. Its new strategy unveiled yesterday focuses on continued public health measures to expand access to coronavirus therapies and improve ventilation in indoor spaces. The plan represents a move toward a world in which the government allows life to proceed as normal, while keeping a watchful eye for new outbreaks or viral variants. Some new efforts:

initiating programs to help families deal with the costs of treating long Covid symptoms
paying for funerals and bereavement support
funding programs to help address the country’s ongoing mental health crisis

STAT’s Lev Facher has more.

Covid has amplified gender gaps

The pandemic’s toll on people around the world has been uneven, more deadly to men than women, disproportionately affecting people of color, and leaving behind low-income countries with less access to vaccines. A new Lancet study looks at Covid’s indirect effects, measuring gender gaps in employment, school dropout rates, and gender-based violence in 193 countries surveyed from March 2020 through September 2021. Compared to men and boys, women were more likely to lose their jobs and do unpaid caretaking; women and girls were more likely to drop out of school; and women were more likely to report domestic violence. “The further we progress in this pandemic, the more we feel that the inequities being exacerbated are only going to worsen, and that any pre-pandemic progress towards gender equality will be reversed,” Rosemary Morgan of Johns Hopkins says in a linked commentary.

Closer look: Organoids reveal tipping point in kidney damage

Kidney organoids with markers of nephrons (purple, light blue, green) and stroma (red and yellow). Researchers used the miniature models to study when kidney damage turns irreversible. (N. GUPTA, ET AL., SCIENCE TRANSLATIONAL MEDICINE )

Chronic kidney disease is a serious medical problem for about 13% of the world’s population. Some kidney damage is reversible, but the tipping point toward damage that’s beyond repair hasn’t been clear. Navin Gupta, a physician-scientist at Massachusetts General Hospital, led a team that used human kidney organoids to identify that juncture and discover a drug candidate that might prevent chronic disease. He told me more about the work behind a new Science Translational Medicine study.

What did you find?
We learned that the DNA damage response in the tubular cells of the kidney helps to determine whether there is going to be recovery versus irreversible damage.

Why organoids and not, say, lab mice?
Even though many compounds appear safe and effective in animal studies, they don’t translate well to clinical trials in humans. The whole point of kidney organoid work is for a translational medicine and to impact patient care. We imagine ourselves sort of on the cusp of the bench to bedside translation.

You can read our full interview here.

Drug overdose deaths rising more among some groups than others

Deaths from drug overdoses have surged along with Covid, increasing most sharply for Black and Hispanic people, according to a new study in JAMA Psychiatry that says more lethal drugs and lower tolerance after incarceration are behind the disparities. In 2020, the overdose mortality rate among Black people was 16% higher than in white people, for the first time since 1999. American Indian or Alaska Native people had the highest rate, 30.8% above white people. Although also growing, drug overdose rates among Hispanic people remained the lowest. “The increasing toxicity of the drug supply has been associated with the increased lethality of recent incarceration as a risk factor for overdose mortality, which may disproportionately affect American Indian or Alaska Native, Black, and Hispanic or Latino individuals as a result of structural racism in the criminal justice system,” the authors write.

Suicide rates have dipped after peaking in 2018

For both males and females, suicide rates were lower in 2020 than in 2018 and 2019. (CDC National Center for Health Statistics)

See those lines sloping gently downward? They represent a 5% decline in suicide rates starting in 2018 and continuing through 2020. Suicide dropped from the 10th to the 12th leading cause of death in 2020, but that was driven by soaring Covid-19 deaths as well as increases in deaths from chronic liver disease and cirrhosis, a new CDC report notes. The lower rates dating to 2018’s peak follow steady increases from 2000 through 2017, so the overall increase adds up to 30% over 20 years. Some gender differences:

Suicide rates were 3 to 4 times higher for males compared with females from 2000 through 2020.
For females, firearm-related suicide recently replaced poisoning as the leading means of suicide.

If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.

What to read around the web today

'We are not politicians': WHO avoids naming Russia as it condemns attacks on civilians and hospitals in Ukraine. CNBC
Awaiting 'definitive' Alzheimer's drug data, Roche and Genentech launch ambitious new study. STAT+
The Biden administration killed America’s collective pandemic approach. The Atlantic
Desperate for cash: Programs for people with disabilities still not seeing federal funds. Kaiser Health News
Aurinia Pharma’s takeout hopes dim with new legal challenge to key drug patent. STAT+