Another Covid winter is coming. In many ways, we’re on our own

Heading into our third Covid winter, many people may have moved on from the last two-plus years' fears and precautions. But whichever side you take on the broader debate about whether, as President Biden said in September, the pandemic is “over,” we won’t have all the same tools to get through the pandemic. No more free at-home tests. Fewer updates on outbreak data. Less support for vaccination campaigns.

Some high-risk people may no longer benefit from two remaining antibody therapies, not because of a policy change but because virus variants have undercut them. Future variants are the huge unknown here: Curtailed testing and surveillance programs may mean it takes longer to spot them. “The lesson from that, and from Delta, is that it is very hard to judge too far into the future,” said Tom Inglesby of Johns Hopkins. STAT’s Andrew Joseph and Jason Mast have more.

At a 'tipping point': Flight of young life scientists shakes up academia

(Thumy Phan for STAT)

Does this sound familiar? Students and postdocs in the life sciences are pushing back against a system they say exploits their long hours at the lab bench to advance the careers and renown of professors. In return, they’re left powerless, overworked, and so underpaid that eking out a living is difficult if not outright impossible. Those critiques go back decades, STAT’s Jonathan Wosen points out. What has changed is there’s now a booming biotech industry and private sector with a seemingly insatiable need for life science talent — and the willingness to offer six-figure salaries and benefits. For many young researchers, the allure is irresistible.

Meanwhile, faculty are reporting that they’re struggling to hire postdocs, delaying research projects and pressuring universities to consider improving salaries and benefits as endowments are shrinking. “The tipping point is coming,” Dawn Eastmond of Scripps Research told Jonathan. Read his special report.

‘Expanding the repertoire of fetal therapy,’ a child's fatal disease is treated in the womb

Her family had already lost two children to Pompe disease, a rare genetic illness that even when discovered at birth might be too late to prevent heart damage. So her doctors turned back the therapeutic clock, delivering a medication to replace a missing enzyme before she was born. Now 16 months old, Ayla’s heart is strong and, with weekly infusions, she has no symptoms of the most serious form of the inherited disease.

Her case, reported yesterday in NEJM, was the first to provide enzyme replacement therapy in utero. It suggests treating genetic diseases in fetuses staves off damage before birth and raises the possibility of one day trying gene therapy or even genome editing in utero. The case is “expanding the repertoire of fetal therapy,” Tippi MacKenzie, a pediatric and fetal surgeon at UCSF involved in Ayla’s care, told STAT’s Andrew Joseph. Read more.

Closer look: Abortion laws depend on gestational age, an estimate defined by uncertainty

(Illustration: STAT; Photo: Courtesy Stephanie Dworak)

Gestational age is a measure we’re all used to hearing. How many weeks pregnant are you, someone might ask. But now that laws in many U.S. states restrict abortion, that metric is forcing decisions based on an estimate that grows more uncertain over time. Stephanie Dworak, who was 20 weeks and five days pregnant in September 2021 — too late for the procedure in her home state of Nebraska — traveled to Iowa (and its different rules) for an abortion that was denied when an ultrasound assigned a different gestational age.

She and her husband had already lived through six weeks of uncertainty after they’d found out their fetus’ organs were growing in a sac outside of its body but before enough anatomy was visible to know the severity of the diagnosis. STAT’s Eric Boodman has more of their story.

Improvements in addiction care disproportionately benefit white patients

Even though U.S. drug overdose deaths are hovering around an all-time high of 107,000 per year, there's a glimmer of hope in addiction medicine: Patients using buprenorphine, a common medication used to treat opioid use disorder, are staying in treatment longer. Those gains, however, are heavily concentrated among white patients, STAT's Lev Facher notes.

According to a research letter published yesterday in JAMA Psychiatry, white patients consistently continue buprenorphine treatment longer than non-white patients. In recent years, the disparity has also grown worse: On average, white patients have stayed in treatment for longer stretches since 2017, even as Black and Hispanic patients' treatment durations have trended downward. The disparity in treatment outcomes coincides with stark increases in overdose death rates among people of color — in Black and Native American communities in particular.

Response to Ebola in Uganda 'needs to be further optimized,' WHO official says

There has been grumbling for several weeks now about the way Uganda is running the response to its ongoing Ebola Sudan outbreak. Britain’s Daily Telegraph reported earlier this week about tensions between Kampala and the outside agencies there to assist in the containment effort. (It also reported modeling done for planning purposes suggests this outbreak could become very large.) Yesterday, the head of the WHO’s health emergencies team tacitly acknowledged the problem, STAT's Helen Branswell tells us.

While stressing that international organizations have to respect a country’s sovereignty when they respond to a disease outbreak, Mike Ryan said countries in Uganda’s situation need to recognize the international community has a stake in what’s going on. Ryan said he has “huge faith” in Uganda’s capacity to end this outbreak but noted “the response needs to be further optimized” on all sides. To date there have been 156 confirmed and probable cases and 74 confirmed and probable deaths.

What we're reading

FDA panel votes against Veru’s drug for severe Covid, STAT
She was convicted of killing her four children. Could a gene mutation set her free? Nature
Scientists say concussions can cause a brain disease. These doctors disagree, New York Times
A tiny lab finds danger on drugstore shelves while the FDA lags behind, Bloomberg
Meditation works as well as a popular drug to reduce anxiety, study finds, NPR
Opinion: Health workers’ mental health: Addressing the invisible global pandemic, STAT