| | | |   By Elizabeth Cooney | Good morning. Be sure to read Katie Palmer's closer look at the regulatory gray zone where the mashup of telehealth and DTC drug advertising reside. | | | On the campaign trail, GOP ramps up anti-science messaging 
(STEFANI REYNOLDS/AFP via Getty Images)
You might think Covid-19 was on the midterms ballot. Three years into the pandemic, it’s still a sure-fire rallying point for GOP political candidates who paint scientific institutions and the people who lead them as far too powerful. Campaign rallies routinely call for investigating or even jailing Anthony Fauci. Ads blame Democrats for school shutdowns, business closures, and mask mandates.
“It's whether or not the federal government can ever close your child's school down again, or business, and whether or not you allow big decisions to be made on what scientists believe,” Robert Blendon, a professor emeritus at Harvard T. Chan School of Public Health and a fellow at the Bipartisan Policy Center, told STAT’s Sarah Owermohle, even though many policies, such as remote schooling and mask guidance, were fleshed out at a state level. Read more. | Rates of dementia and cognitive decline are higher among Black and Hispanic Americans STAT’s Usha Lee McFarling brings us this report: Almost 10% of Americans over 65 have dementia and 22% have mild cognitive impairment, according to a national study of Alzheimer’s prevalence released yesterday in JAMA Neurology. The study showed risk of either one rose sharply with age: 3% of people between 65 and 69 had dementia, while the number was 95% for those 90 and over. The study, based on 3,500 people enrolled in the longitudinal Health and Retirement Study who received comprehensive neuropsychological tests, found that 9% of white people, 10% of Hispanic people, and 15% of Black people had dementia. Dementia affected 13% of those who had less than a high school degree, but just 9% of those with a college degree or more. The study found no differences in prevalence between males and females, consistent with other studies that account for longer longevity in females.
The new study confirms earlier national estimates of dementia prevalence but provides more information about Black and Hispanic groups that have been historically excluded from dementia research even though they are at higher risk, said the study’s lead author Jennifer Manley, a professor of neuropsychology at Columbia University. “If we’re interested in increasing brain health equity in later life,” Manley said, “we need to know where we stand now and where to direct our resources.” | Opinion: Better access to PET scan coverage could reduce Alzheimer's disparities As Usha notes in the item above, Black Americans are disproportionately affected by Alzheimer’s disease and underrepresented in clinical trials to learn more. Writing in a STAT First Opinion, Linda Goler Blount of the Black Women’s Health Imperative argues that better access to PET scans can help reduce racial inequities by removing an important barrier. Currently Medicare covers only one PET scan per lifetime for Alzheimer’s, and patients must be enrolled in a clinical trial to get it. That's out of step with medicine’s growing reliance on the imaging tests to not only confirm the disease but also adjust treatment, she says.
The Biden administration has initiated a review of Medicare coverage. “Limiting these scans to people participating in clinical trials blocks a crucial opportunity to diagnose and treat Alzheimer’s disease in Black Americans — and undermines the shared goal of achieving health equity.” Read more. | Report: Reinventing value for the biopharmaceutical industry With a notable rise in increasingly complex medicines for smaller and more specific audiences, biopharmaceutical companies need to rethink their approach to determining and communicating the value of their products and portfolios to more stakeholders than ever before. Get expert advice on maximizing value for regulators, payers, clinicians, and patients. Explore new ways to meet stakeholders’ needs from preclinical to launch, including ensuring your evidence-generation plans and real-world evidence uncover powerful benefits. Download the magazine. | Closer look: 'Who's minding the store' when telehealth visits start with a drug ad?  (adobe) Last month STAT’s Katie Palmer told us about a powerful mashup of telehealth and direct-to-consumer advertising that has inspired increasing investment from drugmakers. It works this way: People scrolling webpages run by pharmaceutical companies can connect directly with a virtual provider who can write a prescription. In today's story she tells us while pharma companies promise the new model will improve access for patients (and boost refill rates while revealing a wealth of patient data), health policy experts worry that gaps in regulatory oversight leave patients vulnerable to the unique risks of the approach.
The FDA regulates drugs but states oversee the actual prescribing: providers, pharmacies, and medical practice standards. “Telemedicine is kind of blurring the boundaries between manufacturer and prescriber,” Nathan Cortez of Southern Methodist University told Katie. “Like, who's minding the store here?” Read more about this gray zone. | All about timing those flu and Covid shots Flu. RSV. A third Covid winter. This is not a recipe for good news, as flu cases spike in the southeastern and south central U.S., children with RSV are filling hospital beds, and we know the drill on Covid surges. All these illnesses, rising as mask-wearing and social distancing are falling off the table, make flu and Covid shots our best defense. But when to get them is another question, so STAT’s Megan Molteni asked health experts for some answers: - Will getting the flu and Covid shots together make either of them less effective? Probably not.
- What about time of day? While it’s clear that the immune system responds to vaccines differently at different times of day, whether that translates to better protection against a viral threat remains unknown.
- Will we need Covid boosters every six months and annual flu shots forever? Maybe, maybe not.
Those are some "whens." Read much more on the whys. | Covid death rates varied by urban vs. rural counties in 2020, but it's not so simple  (CDC)
U.S. mortality rates from the 10 leading causes of death are typically higher in rural parts of the country compared to metropolitan areas, but like so much else in health, the coronavirus changed that metric in 2020, according to a refinement of what “urban” and “rural” include. A CDC analysis out today looking just at deaths from Covid-19 but in six categories — four for urban, two for rural — found that the age-adjusted death rate was highest in the most-urban areas of the country, followed by more-rural areas, and lowest in medium metropolitan areas.
When stratifying by gender and age, “both the highest and lowest death rates were experienced in areas classified as ‘urban’ in most instances, so combining multiple levels of urbanicity into one group can mask these differences,” the authors write. | | | | | What we're reading - At 10, she speaks out for Uvalde’s victims. But the girl she used to be is gone, Washington Post
- Why doctors are studying new drugs to treat women’s midlife mood swings, Wall Street Journal
- Uganda's Ebola outbreak sees a worrisome increase in infections after spike in cases over the weekend, NBC News
- Stress and uncertainty drag down graduate students’ satisfaction, Nature
- Opinion: International concussion guidelines must protect all athletes’ brains, not just professionals’, STAT
| Thanks for reading! More tomorrow,  P.S.: “You talkin’ to me?” That’s what I think cats might be silently saying (in French) to scientists wondering if the animals can discern not just their owner’s voice, but also whether they’re talking directly to them (in this case, asking “Tu veux manger?”). The study in Animal Cognition says yes. Despite their apparent indifference compared to dogs and infants, cats do form strong bonds with their humans, as measured by — get ready — ears moving, pupils dilating, and tails moving at the sound of their owner’s voice. | | | | Have a news tip or comment? Email Me | | | | | |
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