Opinions are mixed on the U.S. response to Covid

Americans are less than thrilled with how their country has responded to the pandemic while fewer are concerned about catcthing Covid-19 (above), a new report from the Pew Research Center concludes. Asked about protecting public health, 43% say the country has given it about the right amount of priority, 34% say too little, and 21% say too much. More Democrats and Democratic-leaning independents said too little rather than too much (46% vs. 7%), while 46% say it’s gotten the right amount. More Republicans and Republican leaners say it got too much priority (40% vs. 20%) than too little (20%), while 38% say it’s about right.

More findings:

A narrow majority (55%) says vaccination has been effective.
About half say wearing masks around people indoors (48%) and limiting interactions (47%) have been effective.
A majority (59%) of adults ages 18 to 29 say they have tested positive, compared to 26% of adults ages 65 and older.

1 in 8 adults hospitalized for Covid have weakened immune systems

People with weakened immune systems caused by HIV, transplants, many cancers, or their treatments are more vulnerable to Covid-19 infection. A new CDC report estimates that 1 in 8 adults hospitalized for Covid from March 2020 through February 2022 were immunocompromised, and they had a higher risk of ICU admission and dying in the hospital compared to people with healthy immune systems. Being vaccinated helped keep immunocompromised people out of the hospital, but unlike people with healthy immune systems, once admitted, their vaccination status did not make a difference in ICU admission or death.

That seems puzzling, but the researchers say that patients with more medical conditions — and at higher risk for severe outcomes — likely had closer medical follow-up and were vaccinated, which would bias the numbers. The report strongly urges vaccination for patients and those around them, pre-exposure therapeutics such as Evusheld, early testing, and antivirals if they get sick.

Persistent spike protein could be a biomarker of long Covid, small study says

One of the main theories to explain what causes long Covid is viral persistence, or the continued presence of some part of the coronavirus in the body long after the acute infection ends. (Another, possibly overlapping hypothesis for lingering symptoms posits an overactive immune response that turns into an autoimmune attack on the body’s organs.) Now a new study reports the discovery of the SARS-CoV-2 spike protein circulating in the blood of more than half of long Covid patients up to 12 months after being diagnosed with an active infection.

That suggests the presence of an active persistent SARS-CoV-2 viral reservoir, the researchers conclude. There are caveats: The study was small, in 63 patients, and it’s a preprint, so it has not been peer-reviewed. But the researchers say this builds on their previous work on a rare Covid complication in children and could represent a biomarker to help diagnose and treat people with long Covid.

Closer look: Detecting ear problems via smartphone

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One of the most common reasons for a parent to bring a young child to the doctor’s office is worry about a middle-ear infection. Fluid in the ear from the infections can cause hearing loss and diminished hearing, so prompt diagnosis is important. Doctors use tympanometers to detect ear infections, but also punctured eardrums and abnormal bone growth, which all show up on graphs generated by tympanometers in response to vibrations from the eardrum and the sound it reflects. The devices aren’t cheap, typically running between $2,000 to $5,000.

Now researchers report in Communications Medicine that their smartphone-based device performed nearly as well as commercially available tympanometers, making them more accessible to health care providers worldwide. “This is the sort of product that's ideal for a resource-constrained setting where this information would just otherwise be unavailable,” otolaryngologist Michael Cohen told STAT’s Edward Chen. Read more.

Opinion: Real-world evidence must not become evidence for abortion-related prosecution

In the wake of the Supreme Court decision overturning Roe, alarm is growing over data being used to prosecute patients and doctors in states where abortion is illegal. FDA’s definition of real-word evidence as “data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources” makes it clear how having an abortion or providing one could be used.

Writing in a STAT First Opinion, Eric Perakslis of the Duke Clinical Research Institute urges hospitals to temporarily stop sharing data outside of the care continuum for aggregation or commercial research purposes until the risks of using real-world evidence — an imperfect tool with rapidly evolving science and errors in data collection — are better understood and mitigated. “It’s possible that the interconnectedness of health care may end up serving prosecutors better than patients or doctors.”

In mice, Covid antiviral reduced lung scarring one month after infection

Could Covid antivirals reduce the odds of patients developing long Covid? So far, little data are available to support the hypothesis. But a new study published in Science found that mice given an antiviral early in the course of coronavirus infection showed less lung scarring 30 days later — the point at which symptoms can begin to be categorized as long Covid — than control mice. An FDA-approved anti-fibrotic drug also reduced scarring. Lung scarring is but one possible sign of long Covid, and the study used a less effective antiviral developed by Merck, rather than Pfizer’s Paxlovid.

The authors say the research supports the need for human studies of antivirals and combination regimens for long Covid prevention. The first such data may come soon: Although neither Pfizer nor Merck have launched trials to look specifically at the question, both have said that long-term follow-ups from earlier trials may provide an early glimpse at whether their antivirals can actually curb long Covid.

What to read around the web today

Former Theranos exec Ramesh Balwani convicted of fraud, Associated Press
Ghana reports first-ever suspected cases of Marburg virus disease, WHO
When abortion clinics close, low-income people will also lose access to other reproductive care, The 19th
Drug companies will have to start refunding Medicare for certain drugs that get thrown out, STAT
A nasty disease is even nastier for patients with HIV. Now there's encouraging news, NPR
Opinion: Community-level risk: an 'uninformative' guide for Covid-19 prevention, STAT