WHO urges antivirals for people with non-severe Covid-19 at risk of hospital admission

The WHO strongly recommends giving Paxlovid pills to people with mild and moderate Covid-19 who are at the greatest risk for hospitalization because they are unvaccinated, older, or immunocompromised. The global health agency’s guidance, published yesterday in BMJ, relies on new data from two randomized clinical trials including more than 3,000 patients. Those studies concluded Pfizer’s antiviral combination of nirmatrelvir and ritonavir led to 84 fewer hospitalizations per 1,000 high-risk people, but called benefits negligible in low-risk people. The advice comes with a warning: “WHO is extremely concerned that — as occurred with Covid-19 vaccines — low- and middle-income countries will again be pushed to the end of the queue when it comes to accessing this treatment.” WHO calls on Pfizer to make its pricing and deals more transparent and to take measures that allow more generic manufacturers to make the medicine.

A second U.S. state reports unusual cases of hepatitis in kids

Health authorities in North Carolina are investigating two cases of hepatitis in young children, making the state the second to report illnesses that appear to be linked to a mysterious outbreak seen in a growing number of countries. Bailey Pennington, a spokesperson for the state’s Department of Health and Human Services, told STAT’s Helen Branswell yesterday that both North Carolina cases were in school-aged children, neither required a transplant, and both have recovered. The leading hypothesis at present is that infection with an adenovirus, a virus normally associated with colds, may have triggered liver inflammation in affected children. The number of cases is small, but the outbreak is unusual. While most children have made full recoveries, some required liver transplants, including two in Alabama, eight in the United Kingdom, and one in Spain. To date, there have been no reports of deaths. Read more.

Searching for early signs of blood cancers

For all the therapeutic advances that researchers have made in multiple myeloma, scientists have only inched forward in finding ways to screen for the disease or intervene early. Unlike colon or breast cancer, where the discovery of a polyp or a lump might avert illness, clinicians have few ways to help patients on the cusp of developing a blood cancer. “We wait, wait, and wait until people get cancer,” Irene Ghobrial of the Dana-Farber Cancer Institute told STAT’s Angus Chen. “Then we treat.” That’s because it’s exceedingly difficult to detect blood cancers. Scientists don’t know what causes them, and they can remain in a silent, asymptomatic stage for years. Ghobrial and others are embarking on long and intensive trials to study a precursor condition to myeloma and non-Hodgkin’s lymphoma. Read more about their progress and challenges in STAT+.

Closer look: For kids with Down syndrome, hope for treating sleep problems

Elliot with his mom, Kate Dougherty, and sister, Ella, before receiving his implant at Massachusetts General Hospital. (COURTESY DOUGHERTY FAMILY)

Thirteen-year-old Elliot Dougherty, who has Down syndrome, has dealt with obstructive sleep apnea for his entire life. The condition — caused by not enough oxygen while sleeping — affects about 80% of people with Down syndrome and can lead to brain fog, ADHD-like symptoms, and a host of other issues. These problems can often be written off as “oh, that’s just Down syndrome,” his mother, Kate Dougherty, told STAT’s Theresa Gaffney. But in 2018, Elliot received an implant in his chest as part of a Phase 1 clinical trial to treat sleep apnea. The results were published yesterday in JAMA Otolaryngology – Head & Neck Surgery. The device is like a pacemaker, stimulating a nerve to move the tongue throughout the night and open the patient’s airway. It worked for Elliot, but more studies will be needed to see if other patients also benefit. Read more.

Childhood-vaccination rate slipped for kindergarteners last year

It doesn’t look like much of a slide, but health experts are concerned about a decline from 95% to below 94% in the proportion of kindergarteners who are up to date on their routine childhood immunizations. That nearly 2 percentage point difference represents an additional 35,000 kids entering kindergarten without documented protection against common diseases via shots for measles, mumps, and rubella; diphtheria, tetanus, and pertussis; and chicken pox. The overall percentage of children with an exemption remained low, at 2%. The CDC report says the data don’t capture kids who didn’t enroll in school for the 2020–2021 school year, when nearly 400,000 fewer children entered kindergarten than expected. Pandemic-related disruptions to schools and health care could have lasting implications for school-age children, the researchers say, but with most schools back to in-person learning, there’s an opportunity to catch up on missed vaccinations.

A new nonprofit wants to reboot how the U.S. government funds science

The Good Science Project is hoping to push government science agencies to be faster, bolder, and more efficient. The new nonprofit, launched this week and funded by tech billionaire Patrick Collison (founder of payment-processor Stripe), highlights simmering concerns among researchers and science policy experts that the U.S. isn’t getting its money’s worth from the billions of taxpayer dollars spent each year in pursuit of new knowledge. Stuart Buck, the new organization’s executive director, thinks agencies like NIH and NSF often incentivize scientists to pursue incremental research instead of transformative discoveries. Researchers, he argued, also spend far too much time on bureaucratic tasks and not enough time in the lab. “We’re trying to improve the funding and practice of science,” Buck told STAT’s Lev Facher. “The question is: What are we getting for $40 or $50 billion?” Read more.

What to read around the web today

Leaked reports allege that Penn officials led ‘shameless cover-up’ to protect Gene Therapy Program. The Daily Pennsylvanian
CDC, FDA, and NIH staffers aren’t reporting political interference, new watchdog report shows. STAT+
Waiting for a Covid vaccine for your under-five kid? It may take a bit longer. Politico
A puzzling phenomenon: Patients report a rebound of Covid-19 symptoms after taking the antiviral Paxlovid. Boston Globe
U.S. spending on pharmaceuticals jumped 12% in 2021, fueled by costs of Covid-19 vaccines and therapies. STAT+