Breaking News

Will emergency medicine soon face a worker surplus? 

October 27, 2023
Annalisa-Merelli-avatar-teal
General Assignment Reporter

Buongiorno a tutti, this is Nalis writing to you on the last day of my 40th year! Society makes such a big deal about women entering their 40s, so I am pleased to report, one year in, that it's actually quite A-OK. Seems pretty appropriate that the news I have for you today includes the discovery of menopause in chimpanzees — shall we?

science

The curious case of the menopausal chimps

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GUERCHOM NDEBO/AFP via Getty Images

The club of animals that experience menopause is a very small one, comprising humans and a few types of whales. An article published in Science reports a new member: Ngogo chimpanzees, who live in Kibale National Park in Uganda. Though their reproductive phase ends around age 50, much as it does for humans, female Ngogo chimps live till their 60s, spending about a fifth of their lives after the end of their fertility. 

What's dissimilar from many humans is that older female chimps don't spend time being grandmothers: Their daughters leave the group as they become adults. This challenges one of the common hypotheses to explain menopause — that older females help procreation in their later years by supporting their offspring's offspring. For chimps, it is more likely that their fertility may end so that older females don't compete for a small pool of mates, or that they help their group in other ways, such as by using their experience to hunt (as whales do). Or perhaps it's just that Ngogo chimps have it so good that their lifespans have gotten longer, even while their fertility window has not. Read more.


HEALTH CARE

How do we end health care worker burnout?

Health care workers are still feeling the toll of the "superhuman work" they were asked to do during the pandemic, with almost half considering changing jobs, according to a new research published by the CDC. The issue of burnout in the profession has been clear for years, but as my colleague Anika Nayak reports, there's little in the way of systemic interventions. Often, it's the individual health care worker who is in charge of identifying their stress and finding support. 

Experts tell STAT the ways to help health care workers are clear, chief among them increasing staffing to reduce unsustainable workloads and normalizing seeking help for burnout, while offering easy access to psychological support. Read more.


health

Covid booster rates among kids "abysmal": CDC advisory panel member

An estimated 7% of Americans aged 18 and older and 2.1% of children received one of the updated Covid-19 vaccines in the first month of the rollout, the Centers for Disease Control and Prevention reported on Thursday. Survey data presented to the Advisory Committee on Immunization Practices — the expert panel that helps CDC formulate vaccine guidance — showed that among people over age 75, 20.5% said they'd received a Covid shot by Oct. 14. In adults aged 64 to 75, the rate fell to 15.4%. Last year 17% of people 18 and older got a Covid booster; in people aged 65 and older, the rate was 43%.

STAT's Helen Branswell explains that in this, the first year of the commercialization of Covid vaccines, finding available doses has been a struggle, especially for parents trying to vaccinate children. Among parents, 26% said they intend to get their child vaccinated. But more — 38% — said they would not. The low numbers left some members of the committee aghast. "I don't even really have words for this," said David Kimberlin, a liaison for the American Academy of Pediatrics' Red Book — its infectious diseases reference guide. Camille Kotton, an expert in transplant medicine at Harvard Medical School and a voting member of the ACIP, called the uptake rates "abysmal." The CDC estimated that about 1,200 people a week are dying at this point from Covid.



 

Closer look

Emergency medicine grapples with potential surplus

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Gerald Herbert/AP

The health care workforce is in a tenuous state, facing staff shortages and discontent that fuels strikes. There's a different problem in emergency medicine, one that sheds light on the complicated residency system that trains hospital doctors. While the American College of Emergency Physicians predicted in 2021 that there would be a surplus of nearly 8,000 emergency physicians by 2030, the pandemic — not to mention the prediction itself — has since dissuaded medical students from pursuing the field. Where once there were almost no vacancies in emergency medicine residency programs, now there are hundreds of unmatched seats.

Amid this confusing picture, Christus Spohn Hospital in Corpus Christi, Texas, said it would shut down its emergency medicine residency program, alarming doctors and patients across the region. Experts told STAT's Brittany Trang the Corpus Christi case shows how complex it will be to fix the country's inefficient medical residency system, which is ruled by outdated government stipulations regarding how many slots the government will fund and how much it will pay per resident. Read more.


First opinion

The end of the "excited delirium" diagnosis

The police killings of George Floyd, Angelo Quinto, and Elijah McClain, among others, initially revolved around the diagnosis of "excited delirium." Now the American College of Emergency Physicians has officially repealed the diagnosis, admitting it was wrong to ever introduce it. 

The supposed condition was endorsed by the ACEP in a 2009 white paper that described it as "a unique syndrome" presenting characteristics including "pain tolerance," "agitation," "police noncompliance," and "unusual strength." The white paper was not based on previous literature, nor was it peer reviewed, and other prominent doctor organizations have long rejected the existence of such a condition, noting the racist connotations of its description. 

Yet for many years, the ACEP's endorsement of "excited delirium" gave the concept credibility, promoting fears in the police and leading to violence, writes Utsha G. Khatri in First Opinion. The withdrawal of that endorsement is important, Khatri writes, but the damage won't be easy to undo. 


biotech

How ARPA-H head Renee Wegrzyn plans to tackle Biden's Cancer Moonshot goals

Renee Wegrzyn, director of ARPA-H, visited Cambridge yesterday for the official launch of the agency's new 'investor catalst' hub. She spoke with STAT's Theresa Gaffney about the agency's plans for the future, including how it will navigate the cancer goals handed to it by President Biden without conflicting with the efforts of the National Cancer Institute.

"We have a very different model for the research that we do," Wegrzyn said. "Not a single dollar at ARPA-H is dedicated or pre-determined for a specific disease or a specific technology. Rather, we look for the areas that we see our asymmetrical investment can really advance on state of the art and nobody else is funding it." Read more


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What we're reading

  • America's pharmacy system in revolt over burnout and errors, USA Today 
  • ALS patients support bill that could help patients with other rare diseases, STAT

  • The cannabis that people are using for anxiety is probably making it worse, The Wall Street Journal
  • Dobbs's confounding effect on abortion rates, The Atlantic
  • FDA warns about giving probiotics to preterm babies after infant death, other injuries, AP
  • Doubts abound about a new Alzheimer's blood test, KFF Health News

Thanks for reading! See you Monday — Annalisa


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