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The case for giving long covid a new name

September 14, 2023
September 14, 2023
Reporter, Morning Rounds Writer
Good morning. Dive deep with Usha Lee McFarling into the 40-year search to explain the "Hispanic paradox" of longer — if not healthier — lifespan.

politics

Cancer moonshot gets some more fuel

The next phase of President Biden's moonshot to end cancer unfolded yesterday with roughly 50 new programs and partnerships with multimillion-dollar pledges to advance testing, data pools, clinical trials, and outreach efforts. While some in the cancer community greeted the announcement with enthusiasm, others criticized the lack of new funding and an overall strategy. Oncologist Robert Winn of the VCU Massey Cancer Center hailed the emphasis on prevention, screening, data, and navigation: "This is a very exciting component of the moonshot that I hope will be game-changing."

Some advocates questioned why the moonshot is part of the new ARPA-H, not the National Cancer Institute, and why it has no metrics to measure success. "This is a compilation of what individual organizations are doing … but there isn't a cohesive moonshot strategy with focus and specific aims," like the first iteration, said an advocate who requested anonymity. STAT's Sarah Owermohle and Angus Chen explain.

drug pricing

Regeneron deal sets new precedent for price limits

This is a first: An agreement between the White House and drug maker Regeneron requires that the list price for a future Covid-19 drug be no higher in the U.S. than in other high-income countries. The deal, part of the Biden administration's $5 billion Project NextGen initiative, includes $326 million to help Regeneron develop a new, variant-proof monoclonal antibody to prevent Covid-19. The company is planning to start clinical trials later this year. Unlike existing antibody drugs that lose their power as the virus mutates, variant-proof versions would add protection beyond vaccination for immunocompromised individuals. 

HHS and Regeneron declined to comment further on the arrangement, but experts told STAT's Rachel Cohrs this is an important moment. "The U.S. government is essentially calling for a lower price from day one, which is different from the Inflation Reduction Act," said Reshma Ramachandran of Yale. Read more.

global health

Rising obesity and the crisis of poor child growth

There is such distance between the two conditions that four new studies explore I hesitate to combine them, but it's noteworthy that the globe faces both increased childhood obesity rates and a continuing catastrophe of poor child growth. So here goes:

  • To better understand obesity, a study of BMI in Danish schoolchildren and young military men looked at trends by birth year, starting in 1930. Their analysis in Science Advances found an overall upward trend in BMI (while noting BMI's limitations in assessing health) that got markedly steeper decades before the 1970s' "obesogenic transformation," marked by higher-calorie foods becoming more available and chances for daily physical activity becoming more scarce. Unknown factors (genetics? epigenetics? early childhood environments?) may be responsible, deepening the mystery of what causes obesity.
  • At the other end of the spectrum is the crisis of poor child growth under age 5 in low- and middle-income countries, which includes wasting — the loss of fat and muscle from malnutrition — and stunted growth, defined as when height falls below international standards. Both raise the risk of impaired cognitive development, illness, and death. Data covering more than 80,000 children in South Asia, sub-Saharan Africa, and Latin America found the window from birth to three months is critical for wasting, as is the time from birth to six months for stunted growth. Better maternal care and improved nutrition before and after birth are vital, authors of the three Nature studies say, urging more attention to a child's first 1,000 days.

Closer Look

'We live long and suffer': A new generation of researchers is unraveling the 'Hispanic paradox' 

STAT23_Paradox_Fin01Thumy Phan for STAT

First, there was disbelief. When the "Hispanic paradox" was first proposed in a 1986 paper showing Hispanics in the American Southwest lived as long or longer than whites, its findings were dismissed. After all, on average, Hispanic Americans have far less income and health care, and higher rates of diabetes and obesity, than white Americans. Over the intervening 40 years, acceptance of the paradox has increased, along with a recognition that longevity doesn't necessarily equal good health. "I always say, 'Hispanics, we live long and suffer,'" said Jane Delgado of the Alliance for Hispanic Health.  

A new generation of researchers are boring down on the paradox, looking at what the survival edge can teach us about further improving the health of Hispanics as well as the health of rest of the country. They don't have all the answers, STAT's Usha Lee McFarling reports, but they're getting closer. Read more.

first opinion

The case for giving long Covid a new name 

Long Covid is a story of frustration and pain as long as the pandemic. Its causes remain elusive, but its enormous health, social, and economic toll is indisputable, Steven Phillips of the COVID Collaborative and Michelle Williams, former dean of the Harvard T.H. Chan School of Public Health, write in a STAT First Opinion. What we call the condition affecting 6% of American adults infected with Covid may seem trivial, but hear them out.

"Long Covid is really not new," they say. "It is virtually indistinguishable from the condition long known in the medical lexicon as post-infectious syndrome or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)." The authors argue this is important because resources should be directed not at determining the cause of long Covid, but instead toward how best to deliver care. That's at odds with the much-criticized RECOVER initiative's focus on risk factors, demographics, and attributes of the clinical syndrome. Read more.

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What we're reading

  • Consumers can now buy a blood test to evaluate their Alzheimer disease risk, but should they? JAMA

  • FDA panel endorses Alnylam's heart drug — after picking apart its supporting data, STAT 
  • Akili abandons prescription business model, to lay off 40% of workers, STAT
  • The food industry pays 'influencer' dietitians to shape your eating habits, Washington Post
  • John Green launches attack on Cepheid over the price of its TB test, STAT 

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