1 million deaths, and the story isn’t over

In September 2021, Suzanne Brennan Firstenberg's temporary art installation at the Washington Monument had more than 630,000 flags in remembrance of Americans who had died of Covid-19. (BRYNN ANDERSON/AP)

We did and we didn’t know this day was coming. One million deaths from Covid-19 have officially been recorded in the U.S. alone, the CDC said yesterday. The number is inconceivable, Eric Boodman wrote recently, as are the millions more gripped by grief.

It’s also somehow less than shocking, given the coronavirus’s protean nature and the stunning stumbles in our nation’s response to it. That’s a theme that still baffles Helen Branswell, as she says in this video about her race to keep up with Covid. As prescient as she was about the virus spreading from China in late 2019, she did not see the disorganization and disinformation coming.

There have really been five pandemics, J. Emory Parker shows us in grim data visualizations, and SARS-CoV-2 still leaves us with mysteries to be solved and promises to better prepare for the next pandemic. What was once a nagging suspicion has turned into solid certainty that it didn’t have to be this bad.

Remember the first waves? Our late colleague Sharon Begley, who could see around corners, charted a “seascape” in May 2020 that modelers told her could become recurring small outbreaks, a monster wave, or a persistent crisis. We know now it’s all three.

Eric brought us the life and death of Marie Deus, a hospital food worker who did not have the privilege of working from home. Lev Facher and Alex Hogan followed an emergency response team at a Louisiana hospital to document their “soul-draining work.” Andrew Joseph has tracked the twists and turns of coronavirus variants, and he also relayed a warning of the pandemic’s toll, from a traveling nurse who took his life.

Bethany Mollenkof’s photo essays and Olivia Goldhill’s words showed the stark rural and racial divides in health, from who gets vaccinated to who can find a hospital. After the “freaking miracle” of vaccines arrived, I listened to the pleas of patients with cancer who feel left behind by a mask-weary world that’s moving on, and I’ve heard how long Covid can make it hard to think — and to be believed. Their stories of lingering hardship are disheartening, made more so when they ask me if I’ve heard whether science has figured out how to help them and I have to say, not yet.

We’ve published more than 2,200 stories (and counting) on the coronavirus, many of which we told you about in Morning Rounds. More than two years ago, I remember working with Eric, guided by Helen, as we reported what was thought to be the first U.S. death, in a Kirkland, Wash., nursing home on Feb. 29, 2020. On that before-times day, Helen, Sharon, and a dozen other STAT women were at my home for a potluck brunch and Eric was the on-call reporter. Helen had been surprised we gathered despite my role as on-call editor that weekend. She was right, not for the last time.

We lost Sharon to lung cancer less than a year after that day. One million Covid deaths later, I remember her work among these other pandemic stories, heartbreaking and inspiring and, sadly, never-ending.

We may never bookend the first Covid death with the last, but I long for the day we no longer need to chart them daily.

After the U.S. stops paying for Covid medicines, then what?

The Covid-19 vaccines arming our immune systems, the treatments fighting infections, and the rapid testing kits in our mailboxes were all paid for by federal dollars. STAT’s Rachel Cohrs asks what happens when we stop getting vaccines or treatments for free. Before they can be bought and sold like other medical goods, regulatory planning and coordinating with pharmacies, providers, and companies that ship and buy these products have to happen first. With that transition, these pandemic shields might fall prey to problems in other diseases: potential price gaming by drugmakers or inequitable access to lifesaving treatments. “This isn’t business as usual,” Ingrid Katz of Harvard Medical School told Rachel. “We need to be sure we are removing as many barriers to vaccine access as possible, and putting equity at the forefront of any proposal on the table.” Read more.

Generic antidepressant earns FDA thumbs-down for Covid treatment

It’s overshadowed now by the impressive Covid antiviral Paxlovid, but earlier in the pandemic a cheap antidepressant had its moment in the sun after a clinical trial concluded patients who received it early in their disease were 32% less likely than patients who got placebo to need hospital admission or extensive emergency care. Yesterday the FDA rejected the 30-year-old generic drug called fluvoxamine as a treatment for Covid-19, saying in an unusual two-page summary that doctors advocating for its use failed to provide adequate evidence of effectiveness from the clinical trial in Brazil. In November 2020, Matt Herper and I wrote about pre-vaccine hopes for the $4 drug, which last summer also got positive attention after other clinical trials. STAT’s Jason Mast has more on the FDA’s move, including infectious disease physician and fluvoxamine proponent David Boulware calling FDA’s logic “inconsistent.”

Closer look: Tracking patients after they leave the ER is a matter of debate

(APU GOMES/AFP via Getty Images)

Electronic health records haven’t fulfilled dreams of improving our lives through seamless interconnections, but it’s still a shock to think emergency medicine physicians may not learn what happens to their patients after they leave the ER. “We only take care of patients for a few hours, yet the effects of what we do could have an impact way down the road,” Shamai Grossman, an emergency medicine physician, told STAT’s Tara Bannow. Grossman and other doctors think they should be able to track their patients even after treating them in the ER — but there are ethical and legal minefields to clear first. Citing patient privacy, some hospitals don’t allow the practice, but a new study adds to evidence that patient tracking is almost ubiquitous among doctors. Read more on the debate here (and on emergency medics who are also locked out).

More monkeypox cases detected in the U.K.

In what a British health official calls “rare and unusual,” seven monkeypox cases have been confirmed in the U.K. this month, with no known connection between the latest four cases and three earlier ones. The latest four people to be diagnosed appear to have been infected in London; they hadn’t traveled to a country where monkeypox is endemic, usually in West Africa. The first case was in a person who returned to the U.K. from Nigeria on May 4. The most recent cases are in four men who self-identify as gay, bisexual, or as men who have sex with men, so health experts advise people in those groups to watch for unusual rashes or lesions. Monkeypox, usually a mild illness, is spread by very close contact. Here’s some background from STAT’s Helen Branswell, who covered two U.S. cases last year.

As HPV vaccination rose, disease prevalence fell

In the first 12 years of an HPV vaccination program in the U.S., prevalence of the most common sexually transmitted infection fell among vaccinated and unvaccinated females as well as males, new research shows, hinting at herd immunity. Persistent HPV infection can cause six types of cancer, including cervical and oropharyngeal cancer. Efforts to vaccinate girls began in 2006, and boys in 2011, so yesterday’s study in Annals of Internal Medicine tracked sexually experienced females and males over different time spans. Compared to pre-vaccine years, HPV prevalence dropped by 90% among vaccinated females and by 75% among unvaccinated females. For males, there were no pre-vaccine data to compare but cases also declined. STAT’s Angus Chen previously covered U.S. vaccination rates, which lag behind the U.K’s. The current study’s authors fear that pandemic disruption to health care could dent protection and increase prevalence.

What to read around the web today

Pandemic’s pressures widen embrace of long-lasting drugs for addiction, mental illness. Wall Street Journal
Abbott says agreement reached to reopen baby formula plant. Associated Press
Google taps FDA’s former digital health chief for global strategy role. STAT+
A landmark study tracks the lasting effect of having an abortion — or being denied one. NPR
The state behind Roe’s likely demise also does the least for new parents in need. ProPublica
Seagen CEO resigns after arrest on domestic assault charges. STAT+