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How would a government shutdown impact health services? 

September 25, 2023
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Reporter & Podcast Producer

Good morning, Theresa here! It's the first full week of fall, which means we all deserve lots of fall treats, and we all get lots of news. Don't miss a new video from my multimedia colleague Hyacinth on rural health.

CANCER

Big cancer centers have an edge in drug shortages

InvisiblePharmacyTeams_Illustration_MollyFerguson_090623Molly Ferguson for STAT

While a months-long shortage of key chemotherapies has been a strain on practically all oncology practices, some clinics were able to secure supplies for their patients — while others struggled more. The difference was often in the size of the clinic, STAT's Angus Chen reports, as larger clinics have key advantages — chief among them pharmacy teams that dedicated time to managing shortages and had access to more distributors.

In some cases, smaller community practices that struggled to maintain a chemotherapy supply during the shortage have had to send patients to larger systems for infusions. That translates to lost income for these practices, a problem some oncologists could become more common as drug shortages persist.

"Small practices are already struggling. In rural areas where access is a huge problem, the closest center may be hundreds of miles away," said Kristin Rice, an oncologist at Medical Oncology Associates of San Diego. "We cannot afford to lose those small practices." Read more.


Washington

A government shutdown looms. What's that mean for health services? 

The federal government runs out of money Oct. 1, and Congress still hasn't clinched a deal — which means Washington is on shutdown watch this week. That's bad news for staff at the various health care agencies, who might have to stop working temporarily or work without pay.

There are also questions about whether Congress will use the government funding moment to extend crucial federal money for community health centers and other health programs. Programs to fight AIDS globally and prepare for pandemics are set to expire at the end of the month.

However, my colleague John Wilkerson reports that HHS will continue providing many critical services. Nearly 60% of HHS workers would work through a shutdown, either because they're deemed essential or because their operating divisions are already funded. For example, 81% of FDA staff would stay on, due in large part to user fees that companies pay for medical product reviews. 


RURAL HEALTH

Watch: The last doctor in town 

0448_Bloomberg-Rural-01-YT-Thumb
Hyacinth Empinado for STAT

Physician Jennifer McKenney never knows what she might see in her rural emergency room in Fredonia, Kansas, where she is 80 miles from the nearest city. Rattlesnake bites, car accidents, toothaches — anything is possible, and sometimes she's the only one there to deal with it.

For decades, rural areas like Fredonia have been facing a physician shortage. More than 46 million Americans, or 15% of the U.S. population, live in rural areas, but only 10% of doctors serve in these communities. In the first video of a special series focused on rural health, special projects editor Hyacinth Empinado explores how we got here — hint: it might have something to do with the Flexner Report, which Hyacinth and I first learned about while working on Color Code — and how the deficit might be addressed. Watch the video.



VACCINES

CDC backs maternal RSV vaccine for seasonal use

Pfizer's new shot to protect infants against RSV by vaccinating their mothers late in pregnancy won a limited recommendation Friday from an expert panel that advises the Centers for Disease Control and Prevention, STAT's Helen Branswell reports. The panel said the vaccine should be given to pregnant women between September and January in order to protect babies born between October and March, when RSV traditionally peaks.

"This is another new tool we can use this fall and winter to help protect lives," CDC Director Mandy Cohen said in a statement. 

A monoclonal antibody to protect newborns from RSV was also recently approved — but experts told Branswell earlier this year they were worried the U.S. may not put this new arsenal of tools to good use. Read more about Pfizer's new vaccine.


In the lab

New clues on long Covid

Patients who were hospitalized with severe Covid-19 symptoms were four times more likely to have abnormalities in multiple organs after an MRI scan than people who hadn't contracted the virus, according to a study published Friday in The Lancet Respiratory Medicine. The research is part of a multi-center MRI follow-up study of 500 Covid-19 patients who had been hospitalized with the virus. Over half of those patients received MRI scans of their heart, brain, lungs, liver, and kidneys an average of five months after being discharged for inclusion in the analysis. One-third showed abnormalities in multiple organs. 

Patients who had been sick were on average older and more often had obesity, hypertension, or diabetes than patients in the control group. Still, researchers found a clear connection between Covid-19 hospitalization and later organ damage. Patients who had had Covid were particularly more likely to have abnormalities in the lungs, brain and kidneys, but saw similar risk in the heart and liver as the control group. In a comment published simultaneously with the study, Columbia University physician and researcher Matthew Baldwin wrote that the results may have implications for our understanding of how long Covid forms — suggesting that it can't be explained by a problem in one singular organ, but rather the cumulative effect of multiple damaged organs.


BIOTECH

The biotech comeback that wasn't

After a couple bruising years on Wall Street, 2023 was supposed to bring about a recovery for the biotech industry. Instead, a closely watched biotech stock index has fallen about 10% for the year, dramatically underperforming the broader market and making it that much more difficult for cash-strapped companies to finance their science.

But there's reason to believe the worst is over, STAT's Allison DeAngelis and Damian Garde report. In just the last two weeks, two biotech companies successfully went public, and on Wednesday, the Federal Reserve projected that interest rates will drop next year, welcome news for a sector that had fallen out of favor with risk-averse investors. Venture capitalists are increasingly confident the market will support initial public offerings for biotech companies, and executives are dusting off their long-shelved IPO paperwork. Read more.


More around STAT
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Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

  • The calendar of human fertility is changing, The Atlantic

  • As Biden plans to ban medical debt from credit scores, advocates press for more change, STAT

  • Some providers are dropping gender-affirming care for kids even in cases where it's legal, Associated Press
  • Genetically altered pig heart transplanted into a human for the second time, STAT
  • How research in space helps doctors treat people on Earth, Wall Street Journal

Thanks for reading! More tomorrow — Theresa


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