'Lives could be at stake,' CDC director says of potential change in abortion laws

A lack of access to legal abortion services could lead to American deaths, CDC Director Rochelle Walensky argued yesterday. “Women who are interested in accessing care, termination of their pregnancies, may not have resources to cross state lines,” she said, in light of a leaked Supreme Court draft opinion on overturning Roe v. Wade. “Those who don’t may take matters in their own hands, and may not get exactly the care they need … I do think lives could be at stake in that situation.” Other highlights from her interview with STAT's Rick Berke at the Milken Institute conference in LA:

On who is in charge of Covid communications: “We don’t vet each other’s ‘what are you going to say on this next TV hit.’ I’ll let Dr. Fauci speak for Dr. Fauci.”
On how CDC directors are selected, floating a shift to six-year terms: “I do think that had this been [a Senate-confirmed position] in January 2021, I don’t know that they would have a director."
On Covid and masks: “We are not where we were last summer or last spring. We have vaccination, we have boosting, we have many tests, we have many therapeutics available.”

Telemedicine abortion providers prepare for surges where it's still legal

Federal protections around abortion will leap back half a century if the Supreme Court repeals Roe v. Wade, as a leaked draft opinion suggests. How people access abortions, though, has evolved in those 50 years. Most U.S. abortions are now induced with medication instead of done surgically, and telemedicine providers of these pills will play a crucial role. It was only in December that the FDA made permanent a rule change allowing patients to receive abortion pills by mail instead of in person from certified providers. Now telemedicine abortion providers will grapple with how to serve patients across the country as more states are expected to restrict and criminalize abortions. Telehealth services are expected to ease the likely surge in demand in states where abortion remains legal, but many people are unaware that telemedicine abortion is possible. STAT’s Olivia Goldhill explains.

A new 'master regulator' could call the tune for cells essential to hearing

Cochlear cells perform a courtly dance during hearing. Outer hair cells (dressed in blue) jump and crouch while inner hair cells (in fucshia) swing in response. (Ignacio García-Gómez and Jaime García-Añovero)

Hearing is like a dance, scientist Jaime García-Añoveros says. Tiny hair cells in the outer ear leap and sway, transmitting sound’s vibrations to other hair cells in the inner ear that then carry information via nerves to the brain. But the music stops when these cells are damaged. García-Añoveros has identified a master gene regulator that controls whether these cells become inner or outer hair cells. We chatted about his team’s new paper in Nature.

How did you pinpoint the gene controlling these cells?
In our prior Nature paper, we found a mutant in which there were outer hair cells converting into inner hair cells. We identified the genes that were misregulated and we found that if we put one of them into an outer hair cell, it becomes an inner hair cell.

What does this mean for potential treatment?
It will become a very useful tool. I don't know when regeneration will be practical in terms of treating patients, but at least in animal models, we're moving forward in the right direction.

You can read our full interview here.

Closer look: FDA is hampering a highly effective schizophrenia treatment, psychiatrist argues

(Alex Hogan/STAT)

To protect people from serious side effects of otherwise effective drugs, the FDA sets stipulations for the use of medications with serious safety concerns. But for many people, this all too often delays access to treatment or prevents it altogether, psychiatrist Brian Barnett writes in a STAT First Opinion. He and his patients most often encounter roadblocks for clozapine, the only drug the FDA has approved for treatment-resistant schizophrenia. Despite having impressive efficacy, the relatively inexpensive generic drug is rarely prescribed because of a rare but potentially life-threatening side effect called agranulocytosis, which can harm infection-fighting blood cells. Barnett calls a new system that requires multiple blood tests and keeps prescribers on the phone for hours “the biggest barrier to starting patients on this potentially life-saving drug, indirectly causing more harm than good for people with schizophrenia.”

Covid risk tied to when cancer patients were diagnosed or got treatment

For patients with cancer and Covid, timing can be critical. Cancer has been considered a risk factor for worse outcomes because certain cancers and their treatments lower immune response. A new study in PLOS One reports that people diagnosed with cancer more than a year before their Covid infection and patients not currently receiving treatment weren’t more vulnerable to worse Covid-19 outcomes than other Covid patients without cancer. A recent cancer diagnosis was linked to a 17% higher risk of death and a 10% higher risk of hospitalization among more than 18,000 patients whose electronic health records were analyzed from June through December 2020. Their risks rose with chemotherapy or radiation treatments three months before Covid infection. Cancer patients who were older, Black, on Medicare, and/or lived in the Southern U.S. were more likely to die after Covid.

Deaths related to alcohol use disorder surged during the pandemic, study says

Alcohol sales and consumption have gone up during the pandemic, and so have complications of alcohol use, research over the past two years has shown. A new study in JAMA Network Open looks specifically at deaths related to alcohol use disorder, using data from 2012 through 2019 to project mortality rates for 2020 and 2021. Its conclusion: Death rates linked to alcohol use disorder rose by 25% in 2020 and 22% in 2021 compared to projected rates. Younger people from 25 to 44 years old showed the steepest upward climb. “The small proportion of Covid-19-related deaths suggests that excess deaths were more likely attributable to indirect effects of the pandemic, such as stay-at-home policies and reduced medical and social resources for patients” with alcohol use disorder,” the authors write.

What to read around the web today

Abortion providers expected that Roe v. Wade could be overturned. But the leaked draft made it real. The 19th
The gene-edited pig heart given to a dying patient was infected with a pig virus. MIT Technology Review
Researchers describe the human element in the alchemy behind the Moderna vaccine and other new medicines. STAT+
Medical parole got them out of state prison. Now they're in a decertified nursing home. LAList
How an AMA secret society sets physician prices. GoozNews
Race is often overlooked in key clinical trial data used to win new drug approvals in Europe. STAT+