Former CDC head blames predecessors for ‘all the shrapnel that’s in my back’

A defiant Robert Redfield teed off on other former CDC directors yesterday, lambasting them for publicly criticizing his and the Trump administration’s response to the Covid-19 pandemic. “The one thing I’ve gained from three years in the Trump administration is every time that I go through an airport now, I trigger the metal detector because of all the shrapnel that’s in my back,” Redfield said yesterday at an event hosted by Harvard’s T.H. Chan School of Public Health and moderated by STAT Executive Editor Rick Berke.“It was disappointing that some of my CDC director colleagues felt the necessity to publicly criticize me in the news.” His blast came a day after the Washington Post reported that CDC’s current director, Rochelle Walensky, has begun a formal review of the agency’s strengths and weaknesses. Redfield also hinted at his frustration with another major player: Anthony Fauci. “The CDC director ought to be driving the train,” Redfield said. STAT’s Lev Facher has more.

Most Americans would get a Covid-19 booster shot, if recommended, STAT-Harris Poll finds

As an FDA panel gathers today to sort out second booster shots for Covid-19, 60% of Americans have already decided they will get a booster — if it is recommended, a new survey by STAT and The Harris Poll tells us. But convincing others to get a booster may prove difficult. Just 22% say they will receive a second booster shot only if a new variant arises or there is a surge in cases in their area, while 18% have no plans to get a booster, despite any recommendations. The survey queried 2,028 U.S. adults between March 25 and 27. Who’s willing to get another booster if recommended:

73% of baby boomers, 48% of Gen Zers
68% of Democrats, 54% of Republicans
54% of Black people, 43% of Hispanic people, 73% of Asian people, and 65% of white people

Ed Silverman has more in STAT+, including mask-wearing behavior.

White House will boost long Covid research

The Biden administration will ramp up research into long Covid, following scathing criticism from patients and experts, STAT's Rachel Cohrs reports. The plan, announced yesterday, includes efforts to improve sluggish enrollment in a major NIH study and to create a task force to coordinate long Covid research across federal agencies. Crucial questions about long Covid remain, including how it will be defined, how prevalent it is, and who is most at risk. Millions of people in the U.S. experience persistent symptoms after Covid-19 infection, and research could help determine the long-term burden on the health care system and economy. As STAT reported last week, the NIH study has enrolled only 3% of its recruitment goal more than a year after the agency received $1.2 billion for the effort. How it will accelerate enrollment was not specified.

Closer look: VR moves into health care

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Elaborate and immersive simulations may be mainstream in gaming, education, and entertainment, but the technology is just catching on in health care. Virtual reality companies, bolstered by preliminary data, are clearing early federal regulatory hurdles to use immersive technology to help patients manage conditions like chronic pain and mobility challenges. Patients typically navigate the virtual environment — which could present mobility exercises or a soothing visual backdrop like an ocean or a riverbank — with a headset and handheld motion controllers. Clinical champions, doctors, and physical behavioral therapists say the technology lets them gather data and lets patients complete exercises on their own. “You can figure out who is having cognitive decline, who’s having trouble with their range of motion,” said Susan Persky of the National Human Genome Research Institute. STAT’s Mohana Ravindranath has more in STAT+ on how this technology might fit into the broader health care ecosystem.

More than half of the data used in health care AI comes from two countries

Sources of patient data in clinical AI research. (Chart: J. Emory Parker/STAT | Source: Celi et al., PLOS Digital Health (2022)

As medicine continues to test automated machine learning tools, many hope low-cost support tools will help narrow care gaps in countries with constrained resources. But new research suggests it’s those countries that are least represented in the data being used to design and test most clinical AI — potentially widening those gaps. Patterns of global research investment mean that even if individual scientists try to represent a range of patients, the field as a whole skews significantly toward just a few nationalities. In a review of more than 7,000 clinical AI papers, all published in 2019, researchers revealed more than half of the databases used in the work came from the U.S. and China, and high-income countries represented the majority of the remaining patient datasets. STAT’s Katie Palmer has more on the problem and programs to combat it.

Clues to inflammation in Covid — and a surprise

Since the pandemic’s earliest days, doctors have struggled to dampen the overwhelming inflammation some Covid patients endure. A new paper in Nature examines certain immune cells whose inflammation torches the virus but also sets off a cytokine storm endangering organs throughout the body. The researchers discovered that Covid infects monocytes in the blood and macrophages in the lung, two immune sentinels that spark defense, activating molecules that release more inflammatory signals when they die a fiery death (poetically called pyroptosis). Comparing blood samples from Covid-infected people to people with other respiratory illnesses, as well as lung biopsy tissue from people who died of Covid, the researchers were surprised to see that the antibodies developed by Covid-infected people sometimes cause more inflammation but antibodies generated by mRNA Covid vaccines don’t. Understanding the entire process could predict who develops severe illness and how to treat it.

On this week's episode of the "First Opinion Podcast," First Opinion editor Patrick Skerrett speaks with Dallas Ducar, the founding CEO of Transhealth Northampton, about gender dysphoria and the need for trans-inclusive providers to take a holistic, person-based approach to care. Listen here.

What to read around the web today

America is staring down its first So what? wave. The Atlantic
U.S. pulls GSK's Covid drug as Omicron sibling dominates cases. Associated Press
Douglas Melton, noted stem cell researcher, leaves Harvard for Vertex to create diabetes treatments. STAT+
These doctors are treating Covid smell loss by sticking plasma-soaked sponges up people’s noses. Philadelphia Inquirer
Opinion: Reimagining R&D can cut drug development costs from billions to millions. STAT+