Two sides to the nursing shortage, violence against health care in Gaza, & what's new in Medicare open enrollment

"Outrage at Hamas' atrocities ...  has led to a declining commitment to conduct combat operations in accordance with the law." 

October 16, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Today we have a commentary on the toll the Gaza conflict has taken on health care, a story on two sides to the nursing shortage, and a warning on digital health tools.

hospitals Is there a nursing shortage?  Justin Sullivan/Getty Images Hospitals have been bemoaning the nursing shortage even as we've come out of the pandemic, insistent that because they've had to hire so many travel nurses, there must be a shortage of nurses. On the other hand, nurses say that there are plenty of nurses — they just don't want to work in an understaffed work environment where they don't have time to do everything, much less do it well. So who's right? Linda Aiken, the founding director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania, said that the problem is a shortage of nursing care."These two things can exist at one time," she said. "You can have a lot of nurses, but really at the intersection of care that's delivered to the public, you could have a shortage because those institutions are not hiring enough of them." Read more from my colleague Brittany Trang. insurance It's Medicare enrollment season again, with some new wrinkles It's that time of year again. Medicare's annual enrollment period, which opened yesterday and runs through Dec. 7, brings a surge of marketing to get eligible older adults and people with disabilities to pick either Medicare coverage or Medicare Advantage, an alternative run by health insurance companies. This year isn't the same-old, same-old: The federal government is cracking down on deceptive TV ads and other messaging that exaggerate the benefits of, or hide the potential flaws of, Medicare Advantage plans. Medicare Advantage comes with higher costs for taxpayers and widespread care denials for the 32 million people in those plans, but extra perks — such as $0 premiums, out-of-pocket caps, vision and dental coverage, and newer additions like grocery stipends — have proven enticing, especially for people who don't have a lot of money. STAT's Bob Herman has more, including a look at fluctuating prescription drug plan premiums. Health tech FDA warns Abiomed, signaling a crackdown on digital health tools A year after the FDA made it clear it would regulate more health software tools, sending the industry into an uproar, the agency has made good on its promise. Last week it reprimanded Johnson & Johnson's heart pump company, Abiomed, in a warning letter saying it should have submitted its software for approval before putting it on the market. It also noted Abiomed's failure to report various problems with its heart pumps. The software in question provides clinical decision support, often powered by artificial intelligence, to help doctors understand treatment options or predict patient risk. The FDA has not regulated them, historically. But when the tools don't work properly, patients are harmed, as shown in STAT's investigation into a malfunctioning sepsis algorithm developed by Epic. An Abiomed spokesperson told STAT the company is working closely with the FDA to resolve the concerns as quickly as possible. STAT's Lizzy Lawrence has more.

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Closer Look Opinion: Why violence has hurt Gaza heath care so much Ali Mahmoud/AP In a little more than a week since the Hamas terror attack on Israel, thousands have been killed and wounded, a toll made worse by 30 incidents of violence against health facilities, ambulances, and health workers in Gaza (a figure not yet verified) in the first five days of war. Violence against health care is hardly unique to this conflict, Leonard Rubenstein of the Johns Hopkins Bloomberg School of Public Health reminds us in a STAT First Opinion, but why has there been so much damage, death, and injury to health care in Gaza? The author of "Perilous Medicine: The Struggle to Protect Health Care From the Violence of War," he suggests that procedures agreed upon during previous conflicts to keep medical care safe have been abandoned. "Now, visceral and justified outrage at Hamas' atrocities and taking of hostages has led to a declining commitment to conduct combat operations in accordance with the law," he writes. Read more. cancer People are confused about detecting breast cancer There's some confusion among Americans about breast cancer, whether it's what the warning signs might be or when mammograms are a good idea, a new poll from The Ohio State University Comprehensive Cancer Center suggests. While most people (93%) know a lump is a symptom of breast cancer, they were less familiar with other indicators: a retracted, inverted or downward-pointing nipple (31%), breast puckering (39%), loss of sensation in part of the breast (41%), pitting/thickening of the skin on the breast (45%), or nipple discharge (51%). Screening mammography is a better tool to detect breast cancer, but the survey found one-third of women are confused about recommendations for when breast cancer screenings should start, and even more under age 30 (44%). While about 1 in 8 women will be diagnosed with the disease, 75% of women and 91% of men polled don't believe they will get breast cancer. About 1% of breast cancers are found in men. climate health Wiping away (if not out) pollutants from wildfires We all remember the summer's eerie skies tinged orange by wildfires burning in the western U.S. and across Canada. The skies faded, but what about the residues left behind? New research in Science Advances compared methods to get rid of the indoor air pollution that might remain from trace gases in wildfire smoke, volatile compounds that can settle on indoor surfaces and pollute the air inside for days or weeks. Researchers injected smoke into a test house for two weeks and then ran HEPA air purifiers, opened windows and doors, and cleaned surfaces. These pollutants persisted on indoor surfaces, emitting them back into the inside air for days after the smoke injections ended. Continued ventilation and air purifiers were ineffective, but vacuuming, mopping, and dusting surfaces worked better, reducing pollutants in the air ranging from 19% for furan and 50% for formic acid.

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Thanks for reading! More tomorrow,

elizabeth.cooney@statnews.com

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