The health and science races we'll be watching

(CHRISTINE KAO/STAT)

Tomorrow’s momentous midterm elections will reflect concerns about the economy and fears for the fate of democracy. They will also record voter priorities for health care access and affordability, as well as the future of public health. Just two years ago President Biden and Democrats spent that election cycle promising to trust science, but this year the script has switched to Republicans villainizing Anthony Fauci and criticizing such public health measures as mask mandates and economic lockdowns to contain the Covid-19 pandemic.

Here’s what STAT will be watching:

Abortion: There are abortion-related measures on state ballots in California, Michigan, Vermont, Kentucky, and Missouri. Candidates’ views are on the line, too.
Drug pricing: Amid the relative silence, it may crop up in Florida, New York, Georgia, and Vermont.
Vaping: Voters in California will decide whether to ban all flavored products in the state.

Read more on fentanyl, Medicaid expansion, and other issues.

A new notes tool offers doctors a deal: share patient data to end ceaseless documentation

HYACINTH EMPINADO/STAT

When patients see doctors now, there’s usually a third party in the exam room: the electronic health record the doctor is viewing during the visit and updating later with notes to document what’s just transpired. That record-keeping can be the bane of clinicians’ existence, adding hours to already long days. The promise of a system to record and transcribe the encounter seems almost too good to be true, but it’s here already in a product made by Nuance Communications and its parent company, Microsoft.

Here’s the catch: To improve its accuracy, health systems share patients’ most sensitive data with companies trying to develop their next blockbuster product. STAT’s Casey Ross has found that health systems interested in the AI tool are reaching different conclusions about whether that data-sharing violates federal privacy rules, or whether it’s possible — and adequate — to inform patients and get their consent. Read Casey's special report.

Flu cases are off to an early start but vaccination rates aren't keeping up

This year, flu activity has taken off earlier than any year in the past decade, with some parts of the country already experiencing widespread transmission. Despite that, vaccination rates are currently lagging, STAT’s Helen Branswell tells us. Five million more adults were vaccinated against flu at this point in the autumn of 2021, Lynnette Brammer, head of domestic influenza surveillance at the CDC, told a press conference on Friday.

The flu vaccination rate for pregnant people is down 5% from last year at this point. In children, the vaccination rate looks similar to last year’s — but last year’s rate was down 6% from before the Covid-19 pandemic. The southeast and south-central parts of the country are seeing influenza A H3N2 viruses, while in the mid-Atlantic and midwest states, H1N1 is the dominant circulating virus. The CDC estimates 13,000 people have been hospitalized with flu and 730 have died from it so far this season.

Closer look: How trying to quit ER medicine gave him reasons to stay

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Emergency physician Jay Baruch sat in his car in the hospital lot, summoning the will to open the door and leave for his emergency department shift. It was early 2021, when providers were pancaked by two Covid surges, he writes in a STAT First Opinion, but he got out of the car to relieve the overnight staff and meet the patients waiting for help. That night, after 30 years, he wrote a letter of resignation. It’s still unsent, even as ER conditions have gotten even worse.

“For all the burnout studies and headlines about physicians leaving the field, there’s less attention on those of us searching for reasons to stay,” he writes. “To say goodbye is to shake hands with loss, and I recognized while writing the resignation letter the cherished parts of working in medicine that I’d leave behind.” Read more on why he still gets out of the car.

Uganda continues measures to control Ebola outbreak

Uganda announced Saturday that it is extending for another 21 days a basket of measures aimed at bringing the country’s Ebola Sudan outbreak under control, STAT's Helen Branswell tells us. First announced in mid-October, the measures block movement in and out of Mubende and Kassanda, the two worst-hit districts. Both have 7 p.m. curfews, and churches, bars, gyms, and other places where people gather have been closed.

Health Minister Jane Ruth Aceng Ocero said the exhumation of bodies to perform cultural rituals is contributing to the spread of Ebola, saying that one such event led to 43 people becoming infected, six of whom died. There have been reports that the man whose body was exhumed was cared for through most of his illness by his family, suggesting some of the transmission likely occurred before his death. To date there have been 153 confirmed and probable cases and 74 confirmed and probable deaths.

Families report bias in care for their kids, with insurance status leading the list

How families are treated when they're seeking health care can undermine or build trust in the medical system, a qualitative study out today in Pediatrics says about discrimination and disrespect based on race, ethnicity, or socioeconomic status. Researchers who interviewed 80 families found that having public insurance was the strongest indicator of the worst care encounters in hospital outpatient clinics while positive interactions with providers made for better experiences. Black and Hispanic parents had more negative comments overall, followed by Asian parents. Two examples from Black parents with public insurance:

“My daughter was crying and [the nurse] came in [and stated:] 'It’s tough being a single mom. Huh?'... I am not a single mom. Why would you assume that I’m a single mom? My husband is on his way to pick me up.”
“She definitely answered everything and wanted to make sure that I was comfortable with what was being prescribed for him before we left with it.”

What we're reading

Why aren’t there more ways to treat alcoholism? Washington Post
Big Tobacco heralds a healthier world while fighting its arrival, New York Times
Eight-hour waiting times. Patients leaving before being seen. Mass. hospital emergency departments are beyond the brink, Boston Globe
A SCOTUS nursing home case could limit the rights of millions of patients, Side Effects Public Media
Stranded without care, Minnesota man loses limbs because of severe staffing shortage, Star Tribune
The worst pediatric-care crisis in decades, The Atlantic