Why aren't there new drugs to protect people most vulnerable to Covid?

It’s a familiar — and sad — story. Immunocompromised people hoped first Covid vaccination and then antibody treatments would allow them to leave the lockdown they’ve been living under while the coronavirus cooks up new variants. This deep into the pandemic, they ask, why are there so few treatments in biopharma’s pipeline to thwart the virus? Several companies have announced plans for new Covid-19 antibodies, but they are all either still in animal studies or are being developed as therapeutics, despite the 7 million to 10 million immunocompromised Americans who might benefit.

It’s not difficult to isolate new antibodies that powerfully neutralize Omicron and its various children, James Crowe, the Vanderbilt immunologist who in 2020 first isolated the antibodies in Evusheld, told STAT’s Jason Mast. “It becomes more of a business question than a medical question.” Read more on the challenges.

Lack of Covid vaccines, not mistrust, explains low uptake in vulnerable communities, study finds

“Vaccine deserts” in Black neighborhoods and in rural and low-income areas — not mistrust of the medical establishment — were more to blame for low rates of vaccine uptake among populations hit hardest by Covid-19, according to a study published Thursday in PLOS Medicine. Examining more than 50,000 community pharmacies across the nation, the authors found health care facilities in counties that were rural and counties that had high Black populations and high Covid mortality were less likely to administer Covid vaccines in May of 2021, during the early vaccine rollout.

The study found that racial and ethnic disparities in vaccine availability differed by location: Black people had less access to vaccines in urban counties while Hispanic people did not, and Hispanic people had less access to vaccines in rural areas while Black people did not. While most of the discussion of low vaccine uptake among Black and Hispanic and other medically underserved populations has focused on the role of mistrust and misinformation, the study authors said, “systemic barriers play an important role … often omitted in conversations around mistrust.”

Delays in cancer care for patients with Covid linked to disparities

Many cancer patients faced disruptions in their care during the coronavirus pandemic, particularly in its earliest days. A new study in JAMA Network Open that looked at delays in cancer care for patients who also developed Covid-19 infections found that some disparities in care may have worsened during the pandemic. Different factors, both medical and demographic, were linked to more delays of at least two weeks among just over 3,000 patients at 60 medical practices through July 2021. Delays were higher among:

Black patients compared with white patients
Hispanic or Latino patients compared with non-Hispanic or Latino patients
Patients with two or more comorbidities
Patients with metastatic disease
Patients who had Covid-19 complications

“Our findings suggest that individual patient factors, social determinants of health, and Covid-19 severity and diagnosis date were associated with exacerbated health disparities during the pandemic in regards to cancer treatment delay,” the authors write.

Closer look: Telehealth companies are facing headwinds

(COURTESY TELADOC)

After the U.S. House overwhelmingly passed a bill on Wednesday to extend telehealth policies first introduced during the Covid-19 pandemic, the future looks bright for companies in this space, right? Not necessarily. Telehealth giant Teladoc is bracing for disappointing earnings this year, STAT’s Mohana Ravindranath reports, and it’s not alone. Others in the virtual care space are struggling to turn a profit as they face increasingly frugal employers delaying or dropping contracts for virtual care.

“The challenge that we’re seeing is, in these times of economic uncertainty, all purchases are just getting a significantly higher level of scrutiny,” Teladoc CEO Jason Gorevic said in an earnings call Wednesday. Outside workplace plans, individual patients may start spending less on direct-to-consumer services like BetterHelp, Gorevic said about the company’s mental health care offering. Its competitors, including Amwell and Talkspace, could also have to grapple with cutbacks. Read more.

For high-schoolers, carrying guns carries risks

It’s a toxic mix for young people. A new CDC study ties high-schoolers experiencing violence, suicidal thoughts or actions, and substance use to a greater likelihood of carrying a gun. Overall, the pre-pandemic Youth Risk Behavior Survey reports that 1 in 15 males and 1 in 50 females said they’d carried a gun in the past 12 months for other than recreational purposes such as hunting or target shooting, a new measure for data gathered from 2107 through 2019. Gun carrying was significantly more prevalent among young people who reported these serious problems.

For this age group, suicide and homicide are the second and third leading causes of death, behind motor vehicle injury. Most of those homicides (93%) come from firearm injuries, and firearms are the most common method (46%) 14- to 17-year-olds use in suicide. "Taken together, the results underscore the importance of comprehensive approaches to preventing multiple forms of violence affecting youths and associated behaviors such as substance use and gun carrying," the report says.

Rapid loss of smell predicts dementia and brain changes, study says

While Covid-related loss of taste and smell may be new to us, a deteriorating sense of smell has long been connected to cognitive decline and Alzheimer’s disease. (And no, the research does not link the two diseases.) A new study in Alzheimer’s & Dementia lends strength to that association, showing that a rapidly declining sense of smell predicted a greater likelihood of diminished cognitive function and structural changes in the brain tied to Alzheimer’s. The researchers said smell loss compares to carrying the APOE-e4 gene in terms of risk for Alzheimer’s.

To reach this conclusion, the researchers followed 515 people with normal cognition for up to 18 years, giving them annual smell and cognitive tests, neurological exams, and for some, brain MRIs. One hundred people were later diagnosed with Alzheimer’s. Caveats: 94% of the participants were white so research in other populations is needed. Still, the researchers suggest smell tests for early detection of Alzheimer’s.

What to read around the web today

Biden administration plans to offer updated booster shots in September, New York Times
Testing the limits: How a Covid-19 testing company accused of sloppiness, fraud, and profiteering kept expanding, APM Reports
‘The entire protein universe’: AI predicts shape of nearly every known protein, Nature
A ViiV deal to license its HIV prevention shot to poor countries runs into criticism, STAT
Report recommends blood tests, medical monitoring for people exposed to toxic PFAS chemicals, WBUR
Typhoid mutated to beat antibiotics. Science is learning how to beat those strains, NPR