Addressing Covid missteps, CDC plans ‘ambitious’ agency revamp

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The nation’s premier health agency, the CDC, suffers from a reputation battered by flaws in its responses to Covid-19 and further tarnished by its slow reaction to the monkeypox outbreak. Now the agency will reform its culture to become nimble and responsive to needs that arise in health emergencies, its director said yesterday, focusing on gathering data to rapidly dispense public health guidance rather than crafting scientific papers.

“For 75 years, CDC and public health have been preparing for Covid-19, and in our big moment, our performance did not reliably meet expectations,” Director Rochelle Walensky (above) said in an email to the agency’s 11,000-person staff.  Although errors in the Covid-19 response predate her tenure, the agency has also struggled since Walensky’s arrival at the beginning of the Biden administration, notably with confusing messaging about how long people who have been infected need to isolate to prevent transmission of the virus that causes the disease. STAT’s Helen Branswell has more.

Bad and good news on risk of neuropsychiatric illnesses after Covid-19 infection

Two years ago, a trickle of patient stories about neurological and psychiatric problems following Covid-19 turned into a flood. Long Covid was relatively new then, but a year later Oxford researchers reported that 1 in 3 people experienced mood disorders, strokes, or dementia six months after having Covid-19. Now the same team is back with a longer-term analysis of 1.25 million records from Covid patients. Their news is both bad and good.

Up to two years after Covid-19 infection, the risk of developing psychosis, dementia, “brain fog,” and seizures is still higher than after other respiratory infections, they say in their Lancet Psychiatry study. But while anxiety and depression are more common soon after a Covid diagnosis, the mood disorders are transient, becoming no more likely after two months than after similar infections. You can read my story here.

Bluebird wins FDA approval for a gene therapy to correct a rare blood disorder

The FDA has approved a new one-time treatment that delivers a potentially permanent genetic fix for patients with the inherited blood disorder beta thalassemia. Called Zynteglo, Bluebird Bio’s gene therapy — just the third gene therapy approved by the FDA, and the first to target a chronic blood disease — replaces a defective gene with a normal one, allowing the body to produce healthy red blood cells. It’s an entirely new way of treating beta thalassemia, which in its most severe form tethers patients to chronic blood transfusions and other medical procedures, and shortens their lives.

“It’s going to be life-changing,” Farzana Sayani of the Penn Comprehensive Adult Thalassemia Program at Penn Medicine told STAT’s Adam Feuerstein. Bluebird has set the price of Zynteglo at $2.8 million per patient. But individuals with beta thalassemia incur costs that average $6.5 million over their lifetimes, the company says. Read more about yesterday’s approval.

Closer look: To cut overdose deaths, experts say expand methadone access

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You’re no doubt aware of the opioid epidemic raging in the background, and its annual toll of 100,000 lives lost to overdoses. Did you know there’s no tool more effective than methadone to fight opioid addiction, but it’s out of reach for countless Americans? For example:

Physicians aren’t allowed to prescribe the drug directly to patients.
Pharmacies aren’t allowed to dispense it.
Patients who want methadone are often required to show up at a designated facility every day — sometimes at the crack of dawn — just to receive a single dose.

“There’s a lot of interest in expanding access to methadone via responsible dispensing,” Regina LaBelle of Georgetown University told STAT’s Lev Facher. “Sometimes, it’s been so restricted it’s almost seen as a punishment.” Lev takes us through federal regulations making access to methadone and other treatments an uphill climb — and how that could change. Read more.

Opinion: History doesn’t have to repeat itself with monkeypox

“As a member of the gay community, I am heartbroken and angry to see history repeating itself.” So begins a First Opinion essay by Ofole Mgbako, a primary care HIV doctor at NYC Health + Hospitals/Bellevue. He is talking about monkeypox and how powerfully stigma has dictated patients’ experiences, just as it did in the 1980s, when HIV was first thought of mostly as a disease of white gay men. This time, the slow response of the U.S. public health system has galvanized a community that has always had to protect itself, Mgbako writes.

“Had this outbreak been among young children in classrooms and summer camps across the country, the public health response would almost certainly have been swift to protect them. But it happened among a community whose lives are undervalued,” he writes. “It feels like we haven’t learned at all from the past.” Read more.

Is your vaccination card full yet?

Do you carry your Covid vaccine card in your wallet or keep a photo of it on your phone? I remember a time before boosters, when people were warned not to laminate these official vaccination records. Now people over age 50 and immunocompromised people who’ve gotten two initial doses plus two boosters may have run out of room for the promised fall shots, tailored to Omicron variants.

The CDC has thought about this. In a message to state health departments anticipating questions, the agency has a simple, old-school solution: Complete a second vaccination card and staple it to the first one. Kits that come with vaccine orders include the cards, so public health departments should have a supply. And they should encourage people to photograph both cards and be ready to present both for travel, employment, or any future vaccine appointments — which seem pretty likely.

What to read around the web today

Judge rules CVS, Walgreens, and Walmart owe $650M in opioids suit, Associated Press
Tracking viruses can be tricky. Sewage provides a solution, New York Times
Right-wing groups hit Boston Children’s with barrage of threats over trans health program, Boston Globe
Pharma’s likely to sue over Medicare negotiation. Here are the arguments they might use, STAT
Darwin’s lost treasure, found, The New Yorker
'A blind eye': NIH fails to ensure clinical trial results are reported and funds researchers who don't file results, STAT