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A scarcity of obesity specialists; the next phase of Covid products; and mistreatment in maternity care

August 23, 2023
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Reporter and Podcast Producer

Good morning! Reporter and podcast producer Theresa Gaffney here, subbing in for Liz. Since we're somehow already getting close to back to school season, it's a good time to read Helen Branswell's piece on when, if ever, Covid might become seasonal.

The obesity revolution

Obesity specialists are scarce — for now

A collage illustration with various elements. In the background is a map of the United States with doctors and pins on it. In the foreground is a hand hold a diploma tied with measuring tape and student holding a megaphone.Marian F. Moratinos for STAT

People are talking about obesity and new weight loss drugs like Ozempic and Mounjaro more than ever before. And yet, trained physicians who specialize in obesity are still few and far between. Across the U.S., fewer than 100 doctors have completed a fellowship in obesity medicine and are actively practicing. And more than half of these specialists are located across just four states, with the majority of states not having a single one.

Experts say it's essential to bolster education efforts for both general practitioners and specialists. And those efforts are underway, but it's complicated — Novo Nordisk, the company that makes Ozempic and Wegovy, provides funding for educational curricula and the majority of obesity medicine fellowship programs. "Obviously, the company has their own interests in doing it, and we have our interests in being able to train and getting more people to care for patients with obesity," Juliana Simonetti, an obesity medicine doctor at the University of Utah, told STAT's Simar Bajaj. Read more.


health care

1 in 5 mothers experience 'truly unacceptable' mistreatment in maternity care

About 1 in 5 mothers suffer mistreatment during maternity care, especially Black women and other women of color, according to a new CDC report. This includes experiences like having one's physical privacy violated, being ignored when requesting help, or being verbally abused and discriminated against. "Many women are having experiences that are truly unacceptable," Wanda Barfield, director of the CDC's Division of Reproductive Health, said in a media briefing. Mothers with public or no insurance were mistreated at higher rates than those with private insurance. Age, weight, and income were the most common reasons for the discrimination.

The report comes from the Porter Novelli View Moms survey, which was administered during one week in April 2023 to over 2,400 women concerning their most recent pregnancy. The study did not include any information about the characteristics of the providers who were mistreating patients.


covid

Feds lay groundwork for next phase of Covid products

The Biden administration is dispatching $1.4 billion for next-generation Covid-19 vaccines and treatments in the first round of funding from Project NextGen, a successor to Operation Warp Speed. STAT's Sarah Owermohle reports that the vast majority of the initial awards ($1 billion) will go to four contract research organizations in a bid to quickly pull together clinical trials for new vaccine candidates, though those haven't been determined yet.

Regeneron is also receiving $326 million to develop a new monoclonal antibody to treat the virus, while Johnson & Johnson Innovation will get $10 million for a new round of Blue Knight, a competition to bankroll startups targeting infectious disease treatment and prevention.

The government office running NextGen has $5 billion to spend, a budget Assistant Secretary for Preparedness and Response Dawn O'Connell said they are "extraordinarily comfortable with." Congress has regularly rebuffed efforts to allot more money to Covid relief and recently clawed back unused funds from various health departments.



Closer Look

Covid-19 still isn't seasonal yet, and experts can't agree why

Molly Ferguson for STAT

Culturally, many of us are living our lives like the pandemic is over. But scientists say that there's one final step that the virus that caused it hasn't fully taken yet: seasonality. There's no "Covid season" the way there is with other respiratory pathogens, like flu season. It's unclear to experts if and when it might happen. "If you kind of squint, you could see a little, you know, in different places," Maria Van Kerkhove, WHO's technical lead for Covid, told STAT's Helen Branswell. "But that isn't at a national level. … And it's not hemispheric."

It's an interesting academic question, but also a critical planning consideration for hospitals and other health care providers. My colleague Helen spoke to experts about whether we'll ever be able to more readily predict when Covid will spread. Read more.


HIV

U.S. task force adds long-acting PrEP to HIV prevention recommendations

The U.S. Preventive Services Task Force yesterday issued an updated recommendation on prescribing PrEP, or pre-exposure prophylaxis, for HIV prevention. PrEP reduces the risk of getting HIV through sexual activity by 99%, yet racial and income-based inequities remain in accessing the medication. HIV affects over a million people in the U.S., and is acquired most often through sexual activity or injection drug use. Black and Latino LGBTQ+ people in particular are at high risk, but aren't prescribed PrEP anywhere near the rates of their white counterparts.

The panel's recommendation is consistent with 2019's, with added evidence on a long-acting injectable form of PrEP, which experts note could be a "game changer" regarding these racial disparities, according to an editorial published in JAMA Internal Medicine about the recommendation. The injectable medication, cabotegravir, was approved by the FDA in 2021 and can be taken once every two months, which may lower barriers to uptake. But experts are also urging the federal government to work toward making all forms of PrEP more affordable and accessible to those both with and without insurance.


infectious disease

What a doctor who specializes in treating leprosy wants you to know

In recent weeks, you may have seen alarming headlines about how leprosy might become "endemic" in Florida. In a new STAT First Opinion, Florida physician Andrea Maderal, who specializes in treating leprosy, writes that the news didn't necessarily surprise her. She says that experts have long known about endemic cases of leprosy. Even though the disease is more common there than in other parts of the country, it's still incredibly rare.

Maderal also stressed several points the public should know about leprosy:

  • Over 95% of the world's population is immune to infection.
  • The exact mechanism for the transmission of leprosy is unknown. It is thought to spread through respiratory droplets after prolonged periods of exposure, such as a household contact. It is important to note that spread does not occur by incidental contact.
  • Leprosy is still a significant global health burden. The prevalence of leprosy is highest in resource-limited settings, such as India, Brazil, Indonesia, Nepal, and Bangladesh.

Correction: Yesterday's item on Intellia's CRISPR trial incorrectly stated that it had been halted. The trial is still ongoing.


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What we're reading

  • Federal study links testicular cancer to 'forever chemicals,' Undark
  • Opinion: A roadmap for making over-the-counter birth control affordable, STAT
  • Life in a rural 'ambulance desert' means sometimes help isn't on the way, KFF Health News
  • Former Pear Therapeutics executives start new VC firm, with biotech veteran Bob Langer as adviser, STAT
  • The unending indignities of 'vaginal atrophy,' New York Times

Thanks for reading, more tomorrow! — Theresa


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