Experts grapple with booster weariness and pandemic uncertainty

There was still plenty to debate at yesterday's meeting of outside experts advising the FDA on vaccine policy. Initially framed as a general discussion about a second set of Covid-19 boosters, it was scooped last week when the FDA authorized another round of boosters for people 50 and older and those with certain immunocompromising conditions. STAT’s Matthew Herper and Andrew Joseph followed the advisory committee all day, enduring technical difficulties and delays. Some take-homes:

‘What is enough?’ Amanda Cohn of the CDC asked about booster strategy going forward. Many panel members agreed boosting people every four months wasn’t a long-term plan.
What’s next? Most likely, new strains will emerge from the Omicron variants, Trevor Bedford of Fred Hutchinson Cancer Research Center answered. But he also said it’s possible that an out-of-nowhere strain will appear anywhere from every 1.5 years to every decade.

Read much more here.

After Covid, risk of dangerous blood clots lingers

Serious blood clots are among the known dangers that come with Covid-19 infection, but how long people remain vulnerable hasn’t been established. A new observational study in BMJ analyzing health records in Sweden confirms higher risk and charts this timeline: up to three months for blood clots in the leg, up to six months for blood clots in the lung, and up to two months for bleeding problems. People with underlying health problems were at greater risk, as were people who had more severe Covid illness. The risk was also higher during the pandemic’s first wave, possibly because treatment has improved, the researchers and the authors of a linked editorial suggest, including standard use of blood thinners and the uptake of vaccination, which has meant milder infections in later waves.

Medical faculty diversity falls behind U.S. population

The clinical faculties and academic leadership at American medical schools are not keeping up with the growing diversity of the U.S. population, a new analysis of 42 years of data concludes. While women have achieved marked progress, improvement has stagnated or worsened for groups underrepresented in medicine. Female clinical faculty levels rose from 15% in 1977 to 43% in 2019 and female deans rose from zero to 18%. But Black and Hispanic doctors still represent a small part of total clinical faculty and growth and representation of Black men in academic medicine has stayed the same or decreased. At all faculty levels, non-Hispanic Native Hawaiian/other Pacific Islander and non-Hispanic American Indian/Alaska Native accounted for less than 1%. "This increasingly diverse, complex population will benefit from a profession with expanded perspectives that can inform solutions to pervasive and persistent health inequities," the authors write.

Closer look: Inventing new ways to share patient data and protect privacy

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It is one of health care’s most vexing quandaries: Patient data must be shared to develop more effective medicines and artificial intelligence tools, but there’s no way to share it without violating privacy and basic data rights. Or is there? A fresh crop of companies is building a new data economy that enables the exchange of personal health information while enforcing ironclad privacy protections, STAT’s Casey Ross reports. Not a monolithic group, these companies use different methods and technologies, serve different customers, and are motivated by distinct problems and personal philosophies. But underlying their work is a shared belief that the nation’s system of exchanging health data is fundamentally broken because it relies on buying and selling personal information without patients’ knowledge or explicit consent. Read more in STAT+ about the entrepreneurs and technologies behind the effort.

Giving video tablets for mental health care to rural veterans linked to less suicidal behavior

The numbers are grim: Suicide rates in the U.S. are the highest they’ve been since World War II. Veterans are 1.5 times more likely to die by suicide than non-veterans. Suicide rates are higher for both groups living in rural than in urban areas, a gap widened by the pandemic's increased levels of social isolation, intimate partner violence, and access to guns. Against this backdrop, in 2016 the VA began giving video-enabled tablets to rural veterans who’d received mental health care, but increased these efforts during the pandemic. A new cohort study in JAMA Network Open of more than 471,000 rural veterans found having a tablet from March 2020 through April 2021 was associated with more mental health care via video; more video, phone, or in-person psychotherapy; less suicidal behavior; and fewer emergency department visits.

Access to lifelong care for congenital heart defects is unequal

It’s a call to action driven by a failure to build on success. As more children with congenital heart defects survive into adulthood, social determinants of health are narrowing their access to the lifelong specialty care they need, the American Heart Association asserts in a scientific statement published today. Those societal factors — which AHA tied to structural racism — include education, employment, housing, and income, and limit access to care and ability to pay for it. Improved surgical and medical care can repair defects that occur when the heart or blood vessels near the heart don’t develop normally before birth, but follow-up care is hard to find outside cities. And more people with private insurance are referred to hospitals with lower mortality than people who have public insurance, AHA said, citing previous research and urging measures to close the gap.

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

America’s pandemic orphans are slipping through the cracks. The Atlantic
Patients should know who's operating, surgeons say. MedPage Today
Opinion: Report: U.S. nursing home care is ineffective, inefficient, inequitable, fragmented, and unsustainable. STAT
Help wanted: Adjunct professor, must have doctorate. Salary: $0. New York Times
‘We are not casting a wide enough net’: Rob Perez on how biopharma companies can help out their neighbors. STAT