'Right to repair' revs up for medical devices

The “right to repair” movement has hit health care, accelerated by Covid. When Covid first surged in March 2020 and ventilators to help people in ICUs breathe were scarce, biomedical engineer Scot Mackeil, recruited by a Boston hospital to vet hundreds of ventilators from a federal stockpile, came across one with a crushed power cord. He thought he’d simply ring up its manufacturer to ask for a replacement.

“I never imagined that I would get the reaction that I got,” Mackeil told STAT’s Jayne Williamson-Lee. “‘Oh, absolutely no, we cannot send you a power plug,’” he recalled them telling him. “‘You’re not qualified to work on our pressure-driven transport ventilator. You haven’t attended our service school.’” The pandemic crystallized an old problem: You can’t maintain or repair their machines without the green light from medical device makers. But pushback is mounting from the “right to repair” movement. Read more.

Covid-inspired flexibility on addiction treatments may be here to stay

Addiction treatment got easier during the Covid-19 pandemic — and the Biden administration wants to keep it that way. Federal regulators want to make permanent the emergency policies enacted in 2020 in response to the emerging pandemic. That would preserve patients’ expanded access to two key medications used to treat opioid addiction: methadone and buprenorphine.

The changes underscore how sharply addiction treatment shifted during the pandemic. The emergency measures significantly increased the availability of methadone and buprenorphine. And, for the first time, doctors could initiate treatment with buprenorphine via telehealth instead of an in-person visit. “If it is easier to get illicit drugs in America than it is to get treatment, we will never bend the curve on overdoses,” Rahul Gupta, of the White House Office of National Drug Control Policy, said. STAT’s Lev Facher has more.

'Long Covid' is showing up on death certificates

Among pandemic challenges, long Covid looms large. Its name, description, and estimated prevalence have long been the subject of debate while there still are no proven tools to prevent, diagnose, or treat it. But a CDC report out today tells us "long Covid" and other names for symptoms that persist after acute infection are appearing on death certificates in a small percentage of people who have died during the pandemic.

Two experts told me that this tiny fraction — 3,544, or 0.3%, of 1,021,487 U.S. deaths from Covid through June 2022 — only hints at the whole story, while another has doubts about drawing any conclusions from death certificates on "a chronic condition that's got a lot of ambiguity." CDC pushed back at the criticism while acknowledging the difficulty of gathering such data. Here's what Harlan Krumholz, a Yale cardiologist who has been working with long Covid patients, makes of the analysis: "The quality of what they did is high; the challenge is that the data they have provides only a floor of an estimate of the mortality burden of long Covid," including suicide. Read more.

Closer look: Why some drugs trigger a rare and deadly brain disease

(nih)

We all walk around with dormant viruses hanging out inside our bodies. Many are harmless but some of us are unlucky enough to carry a particular virus that some medicines can awaken, triggering a deadly brain disease. A new study published today in the journal Frontiers in Neurology points to four gene variants connected with the immune system that significantly increase a person’s risk of developing the disease, known as progressive multifocal leukoencephalopathy or PML.

Two clues: The variants were far more common among those suffering from PML and they were conspicuously absent in multiple sclerosis patients who’d been receiving treatment for years from immunosuppressive therapies that rouse the virus from its slumber — without developing PML. Researchers have developed a simple genetic test using the four variants, which they hope could one day guide physicians to prescribe different drugs to such patients. STAT’s Jonathan Wosen has more.

WHO’s new chief scientist is worried

(Benedikt von Loebell/World Economic Forum)

This is big news, Helen Branswell flagged to me before the sun rose yesterday. Jeremy Farrar, director of the Wellcome Trust, the world’s second-largest private funder of biomedical research, has been named WHO’s new chief scientist. The global health agency also appointed Amelia Latu Afuhaamango Tuipulotu as WHO’s chief nursing officer.

Farrar takes the WHO job at a challenging time, when the world is trying to push past a pandemic that is still causing significant amounts of illness and deaths, but that many people wish to place firmly in the rearview mirror. “I think we’ve moved on too quickly,” Farrar told Helen on Sunday in an interview unrelated to his new appointment. He fears there’s a “non-zero” risk that Covid will mutate again to a form where it causes more severe disease. “I don’t think we would go back to March 2020.” Read more.

Exercise and mindfulness are great, but they didn't improve older people's cognitive health

Longtime readers of this newsletter know we have a soft spot for negative findings, which can get lost in the whirl of research news. If you believe assumptions must be tested, here’s one for you. A study in JAMA found that when older adults took up exercise, mindfulness training, or both under the supervision of coaches, there was no improvement in cognitive performance or brain volume after 18 months in 585 healthy people 65 to 84 years old.

The participants all worried about minor memory problems and other age-related cognitive declines, but none had been diagnosed with dementia. They were divided into groups that did exercise, mindfulness, both, or neither. The researchers tested their memory and did brain scans, but found no significant difference among the groups. Exercise and mindfulness have their own benefits, just not cognitive improvement, the authors say, although the study will continue to see if more time matters.

What we're reading

Huge U.S. study starts sharing gene findings with volunteers, Associated Press
Over half of car crash victims had drugs or alcohol in their systems, a study says, NPR
Nine in 10 health care companies with financial stress are owned by private equity, STAT
From heart disease to IUDs: How doctors dismiss women’s pain, Washington Post
Lawmakers tell Pfizer CEO to ‘back off’ on planned price hike for Covid-19 vaccine, STAT