NIH, at a crossroads, searches for a new leader

(mike reddy for stat)

Under the reign of Francis Collins, the NIH was untouchable. From virtually the moment President Obama appointed him in 2009, prominent figures in government and science have been enchanted by Collins, the Harley-riding, guitar-playing geneticist who brought newfound attention to the nation’s medical research agency. But his popularity obscured a debate raging in university laboratories and biotech boardrooms across the country: Is the biomedical sciences agency living up to its mission? Should its mission be basic science or ambitious, instant-impact projects like Operation Warp Speed? The Biden administration’s search for Collins’ replacement is not just a key personnel decision: According to many NIH critics, it’s a once-in-a-generation chance to tackle the agency’s shortcomings and turn the government’s science strategy upside down. STAT’s Lev Facher has more in this special report.

A month of war in Ukraine threatens health system

After 28 days of war in Ukraine, there have been 64 verified attacks on health care, causing 15 deaths and 37 injuries at a rate of two to three per day through Monday, WHO said yesterday in a report outlining its response with medical teams and supplies. Access to Ukraine’s health system has been severely restricted, intensifying the difficulty in treating both traumatic injuries and chronic conditions. The country’s health infrastructure has been destroyed and the medical supply chain has been disrupted, threatening the health of millions. Some details:

1 in 4 Ukrainians are displaced (1 in 3 with a chronic condition).
Nearly 1,000 health facilities are close to conflict lines.
Half of pharmacies are thought to be closed.
Covid-19 vaccination and routine immunization have halted.

Moderna asks FDA to authorize its Covid vaccine for the youngest kids

Moderna will ask the FDA to authorize its Covid-19 vaccine for emergency use in children aged 6 months to 6 years, a group currently with no authorized Covid vaccines. Yesterday’s announcement came with the company’s interim data from two clinical trials in children under 6 that showed similar immune responses to those in adults aged 18 to 25. But the kids’ two-dose vaccine was less effective at preventing symptomatic infection than vaccines in previous trials for older age groups. Moderna said the efficacy was on par with what would be expected after two doses in adults against Omicron, which predominated during the trial. Competitor Pfizer previously hit a snag in clinical trials testing its vaccine in children under the age of 5, when two doses of the vaccine did not generate immune responses similar to those seen in older teens and young adults. STAT's Helen Branswell and Matthew Herper have more on the questions involved.

Closer look: Scientists enlist a tetanus bacteria to target pancreatic tumors in mice

Part of a metastatic outgrowth of a pancreatic tumor In a mouse. The nuclei are blue, the cytoplasm is green, and the bacteria that deliver tetanus are red. (COURTESY CLAUDIA GRAVEKAMP)

Pancreatic cancer is among the deadliest forms of the disease, one that only about 10% of patients survive for more than five years. Often diagnosed at an advanced stage, its tumors shrug off immunotherapy and resist chemo drugs. Now, working in mice, scientists have tried an unconventional approach: using Listeria bacteria, best known for food poisoning, to create an immunotherapy that paints a bull's-eye on pancreatic tumors. It works by using Listeria to dot tumor cells’ surfaces with a tetanus protein fragment, which the immune system should recognize as an enemy flag and then attack, thanks to previous tetanus immunizations. A study published yesterday in Science Translational Medicine reports the therapy can extend survival in mice by 40% — a figure experts told STAT's Angus Chen was promising, though preliminary, warranting further research in humans. Read more in STAT+.

Patients of color less likely to have a provider who looks like them

Having a health care provider who is of the same race or speaks the same language can be good for your health, research tells us, improving the chances that patients will buy into preventive measures. A new study from the Urban Institute reports that fewer Black adults (22%) than white adults (74%) or adults of other races (34%) say they were of the same race as their usual care provider. Among Hispanic or Latinx adults, 23% were of the same race and ethnicity as their provider and spoke the language they preferred. A caveat: About 30% of all survey respondents and 45% of Hispanic ones did not have a usual provider. “Barriers to medical education for people of color and barriers to services in patients’ preferred languages will need to be addressed to improve access to concordant providers,” the study authors write.

Hospitalized Covid and heart attack patients face similar cognitive burden, study says

After-effects on the mind are among the more worrisome consequences of Covid-19. Researchers set out to more rigorously study the question among people whose infections sent them to a hospital than previous studies relying on electronic health records or answers to telephone or internet surveys based on what patients recalled about their illnesses. A new prospective case-control study in JAMA Psychiatry compared 85 patients at a Copenhagen hospital admitted for Covid to 61 patients admitted after a heart attack — also known for cognitive and neuropsychological damage. They found that Covid patients had more severe cognitive impairment but their overall burden of neuropsychiatric and neurologic symptoms and diagnosis six months after leaving the hospital seemed similar. Another difference: Covid patients were much more likely to say they’d lost the sense of smell or taste.

What to read around the web today

Trying to solve a Covid mystery: Africa’s low death rates. New York Times
Lessons from the COVID data wizards. Nature
America is about to test how long ‘normal’ can hold. The Atlantic
As states impose abortion bans, young doctors struggle — and travel far — to learn the procedure. Kaiser Health News
Opinion: Private equity, health care, and profits: It’s time to protect patients. STAT