Viruses are back — and acting in unexpected ways

(Alex Hogan/STAT)

The return of the viruses sounds ominous — and it could be. STAT’s Helen Branswell reminds us that the Covid pandemic’s disruptions shut the doors on other infectious diseases, but now that measures to slow Covid transmission are melting away, those viral and bacterial bugs are back. And they look strange. The past two flu seasons have been the mildest winters ever, but hospitalizations have picked up — in late spring. The worrying and unusual hepatitis cases in young kids have been linked to adenovirus 41, previously known for only mild GI illness. RSV, another childhood affliction that usually hits in winter, caused illness last summer and fall. And then there’s monkeypox, a virus usually found only in Central and West Africa but now is in a dozen countries outside Africa. “These viruses are not different than they were before, but we are,” Helen writes.

Long Covid numbers are growing, CDC says

(CDC)

More than one-third of adults recovering from Covid-19 still had problems one month to a year after they were infected, a new CDC report says about the rising number of long Covid cases. Among that 38%, older people fared worse: While 1 in 5 Covid survivors under 65 had persistent symptoms, 1 in 4 over 65 still suffered from lingering conditions, including more neurological problems. Covid survivors had twice the rate of pulmonary embolism or respiratory issues compared to similar people without Covid, while other long Covid symptoms spanned cardiovascular, pulmonary, hematologic, renal, endocrine, gastrointestinal, musculoskeletal, neurologic, and psychiatric conditions. The study, based on electronic health records from January 2020 through November 2021, did not take Covid vaccination into account. “As the cumulative number of persons ever having been infected with SARS-CoV-2 increases, the number of survivors suffering post-Covid conditions is also likely to increase,” the authors write, calling for routine assessment for post-Covid conditions.

Where health tech is now — and needs to go

Access and inclusion were front and center at STAT’s Health Tech Summit in San Francisco yesterday. You can find our coverage here, but here are some quotes that struck me:

“I think of the medical system as one of the most ableist institutions we still have.” — Joshua Miele, principal accessibility researcher, Amazon
“She was just so manipulative. She was so good at it. ... I swear she could convince half of this room that she invented a revolutionary technology.” — Tyler Shultz, Theranos whistleblower, on Elizabeth Holmes
"We need representation in the datasets that are making decisions about us. ... Data can cure us, or it can kill us." — Andrea Downing, co-founder, The Light Collective
“It was only a few decades ago that women were allowed to participate in research. … There’s a lot of data that’s not been collected.” — Lauren Cheung, physician, Apple
"Information is a determinant of health.” — Karen DeSalvo, chief health officer, Google Health

Closer look: The overlooked link between domestic violence and traumatic brain injury

When we think about traumatic brain injury, chances are we focus on military service or sports. But there’s another, more insidious source: domestic violence, Cecille Joan Avila of the Boston University School of Public Health writes in a STAT First Opinion. These injuries may outnumber their combined incidence in athletes and military personnel, she points out, but data aren’t complete: Domestic violence research often centers on women, and traumatic brain injury research focuses on men, while it happens regardless of race, ethnicity, socioeconomic status, gender identity, sexual orientation, ability, or age. The connection between domestic violence and traumatic brain injury may be obvious in retrospect, she says, “but until these injuries are consistently screened for in domestic violence cases and also more regularly discussed, they cannot be addressed as they need to be.”

Adding common diabetes drug to early breast cancer treatment didn’t help

Megan Thielking, a senior news editor at STAT and the inaugural author of this newsletter, always has her eagle eyes on negative findings, many of which never see the light of day via publication in a scientific journal. Here’s one, just out in JAMA, on the common type 2 diabetes drug metformin not improving disease-free survival in early breast cancer. I recall a biochemist telling me several years ago that he’d give metformin to his mother if she developed breast cancer, based on observational studies and his conviction it would do no harm. But a new, more rigorous study found no evidence for any benefit. The researchers followed more than 3,600 patients without diabetes who were diagnosed with early-stage, high-risk breast cancer. After an average of eight years, participants who took metformin in addition to regular cancer treatment did no better than those who took a placebo.

Health and access to health care differ by sexual orientation, study says

Adults' inability to afford mental health counseling in the past 12 months and serious psychological distress in the past 30 days, by sexual identity and sex. (National Health Interview Survey, 2013-2018)

First you need the data, then you can address disparities. In that spirit, national health surveillance systems have begun including questions about sexual orientation in surveys and health exams to see if there are differences in health and access to care for lesbian, gay, or bisexual adults compared to heterosexual adults. A new report from the National Center for Health Statistics brings together data generated in an effort to improve care. Some examples of what they found since 2005, after adjusting for age and survey year:

Bisexual men and women, gay men, and lesbian women reported smoking and heavy drinking and using marijuana and illicit stimulants more often.
Lesbian and bisexual women reported arthritis, asthma, cancer, diabetes, heart disease, and hypertension more often.
Heterosexual men and women were less likely to say they had trouble affording mental health counseling.

On this week’s episode of the “First Opinion Podcast,” On this week's episode of the "First Opinion Podcast," First Opinion editor Patrick Skerrett talks with nurses and educators Michelle Collins and Cherie Burke about the RaDonda Vaught case and the double standard of discipline between nurses and physician. Listen here.

What to read around the web today

As monkeypox panic spreads, doctors in Africa see a double standard. Washington Post
WHO chief Tedros reappointed to second five-year term. Associated Press
'Almost like malpractice': To shed bias, doctors get schooled to look beyond obesity. Kaiser Health News
Employers sue Advocate Aurora Health over alleged anticompetitive hospital contracts. STAT+
U.S. states, manufacturers to decide if gov't benefits apply to imported baby formula. Reuters