The world’s response to Covid-19 deemed a ‘massive global failure’

“Damning” may be too weak a word to describe a new report from the Lancet Commission on the massive global failures in response to Covid-19. Lapses in prevention, transparency, “rationality,” basic public health practice, and operational cooperation and international solidarity led to 17.7 million deaths, the authors estimate. Governments were unprepared, slow, and inattentive to vulnerable populations while an “epidemic of misinformation” further hampered their response. WHO was also called slow in declaring a public health emergency and recognizing airborne transmission of the coronavirus while countries failed to cooperate on travel, testing, supplies, and data reporting.

Regions previously rated high on pandemic preparedness didn’t measure up, with the U.S. and Europe trailing the Western Pacific. A bright spot: public-private partnerships that rapidly developed effective vaccines. Those vaccines are key to next steps, the authors say, as they envision a “vaccination-plus” strategy combining vaccination with public health measures and financial support.

Covid deaths at lowest point since March 2020

Could the world have reached a turning point in the pandemic? That’s what WHO Director-General Tedros Adhanom Ghebreyesus suggested in remarks yesterday, as Covid-19 deaths recorded last week were the lowest since March 2020. “We are not there yet, but the end is in sight,” he said in a virtual press conference, invoking the metaphor of a marathon runner closing in on the finish line. “Now is the worst time to stop running.”

Deaths reported worldwide fell by 22% in the past week, to just over 11,000. There were 3.1 million new cases, down 28%, continuing a weeks-long global trend. But case numbers come with an asterisk: They're harder to come by with less public health reporting and more home testing. In response, Johns Hopkins University will report data less frequently on its dashboard, the Wall Street Journal reports.

Medicare is not helping enough older people find opioid addiction treatment, report says

Older Americans are not immune to opioid overdoses, although their overdose death rates are lower than in younger Americans. A new inspector general’s report is a startling look at missed opportunities for treatment. Medicare is underserving the 1.1 million older Americans diagnosed with opioid use disorder, the report says, because only 18% of those enrollees get recommended medication treatment. More than 50,000 Part D beneficiaries overdosed on opioids in 2021, a number that reflects only people who died from overdoses and had medical care billed to Medicare.

There are barriers to obtaining medication treatment that aren’t solved by Medicare coverage, the report notes. Methadone is not dispensed by pharmacies, so it is not covered by Medicare Part D. Naltrexone and buprenorphine are covered by Part D, but prescribing buprenorphine requires providers to get a special waiver from the government. STAT’s Andrew Joseph has more on the problem.

Closer look: 3 tech startups are trying to improve diversity in clinical trials

(adobe)

Here’s the challenge: U.S. clinical trials rarely study people who are non-white, non-male, non-English-speaking, older, poorer, pregnant or lactating — which not only widens existing health disparities, but can also stall trials, costing billions and delaying research. Enter health tech startups and companies, many marketing their apps and platforms as solutions to improve outreach, enrollment, and retention. And while experts in health equity agree tech has a place in tackling the representation issue, they also told STAT’s Ambar Castillo there’s no single tech intervention that will solve the issue. Here are three startups trying:

The app Power focuses on breaking down medical jargon and helping users connect with trial sponsors nearby.
Acclinate touts a trust-building platform just for people of color and a cadre of specialists focused on outreach.
Trial Library, among other tactics, pays clinicians to pre-screen patients for trials, whether or not they get referred.

Post-Roe, weighing 'professional civil disobedience'

As new abortion bans are enacted around the U.S., physicians working with pregnant patients are facing potential ethical and legal dilemmas. STAT’s Theresa Gaffney asked physician Matthew Wynia about his NEJM commentary on what doctors should do when following the law could harm, or kill, their patients.

Has “professional civil disobedience” from mainstream organizations happened before in the U.S.?
At the time of the Iraq War, there were known examples of clinicians who were involved in the so-called enhanced interrogation program — torture. And the AMA publicly said, “You can disobey that and we will support you.”

Why do you think this is rare?
There may be something about people who go into medical school and succeed. We don’t break the rules. And it’s only when that guidance really puts our patients at risk that we’re liable to see ourselves as having this social, political role of trying to change the world so that it is better protective of our patients and their health care rights.

Read the full interview here.

Raising hopes and eyebrows, multivitamins improved seniors’ memory

If you dumped your daily multivitamin as just “very expensive urine,” you may want to reconsider — or wait for even more evidence. Researchers now report in Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, that adults 65 and older who took Centrum Silver showed more improvement over three years on tests of overall cognition and memory than participants who took a placebo, with the most benefits among people with cardiovascular disease. In contrast, daily consumption of cocoa extract didn’t help, despite hints from previous studies.

As STAT’s Jonathan Wosen writes, “It’s the kind of result that is bound to raise both hopes and eyebrows,” even though the trial was large, placebo-controlled, and randomized. Still, as Jeff Kaye of Oregon Health & Science University and not involved in the study pointed out, doing well on a memory test might not matter in a person’s life. Read more.

What to read around the web today

What a high-risk pregnancy looks like after Dobbs, New York Times
Inside the U.S. Supreme Court’s war on science, Nature
U.S. to spend more than $2 billion to launch Biden’s biomanufacturing initiative, STAT
Sexual-assault survivors pay average $3,551 for emergency care, study says, Bloomberg
Medical pioneers team up to launch new cell therapy biotech, STAT