How the next cyberattack can be averted, why we need to look at indoor air, & what human milk might mean for treating disease

Americans are an indoorsy bunch.

March 29, 2024 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. As we approach the end of March, you know what that means? We're getting down to the wire on STAT Madness, our college basketball-inspired contest to find the best innovation in science and medicine. You can vote here.

health tech Eyes are on Washington to fend off another Change Healthcare cyberattack Adobe The recent ransomware attack on a billing company called Change Healthcare brought pharmacy and hospital payments across the country to a halt. Policy makers and industry lobbyists are demanding tougher strategies to prevent future attacks, but what that picture will look like is still murky. Some early ideas:  A White House budget request would set aside $800 million to help financially struggling hospitals cover the cost of meeting minimum federal cybersecurity standards. The Homeland Security Department's Cybersecurity and Infrastructure Security Agency proposed a rule setting a deadline for reporting cyber attacks and payments. Sen. Mark Warner (D-Va.) introduced a bill that would allow advance Medicare payments to providers who suffer a cybersecurity incident as long as they and their vendors meet minimum security requirements.  STAT's Mohana Ravindranath gets reaction to these trial balloons. environmental health We need to improve the air we breathe indoors, too, scientists warn Americans are an indoorsy bunch. We spend more than 90% of our time inside— a statistic the rest of the world is trending toward as more people live and work in cities. That's a growing public health problem, scientists say, because unlike water, food, and outdoor pollution, there are no indoor air quality standards that are monitored and enforced around the globe. And the air we breathe indoors is making people sick. Poorly ventilated buildings were a major driver of disease transmission during the Covid-19 pandemic. But improving indoor air quality isn't just about fighting infectious diseases: Unhealthy indoor air can damage the heart, lungs, and brain. It has also been shown to lower cognition and shorten life spans.  Addressing these mounting concerns will require establishing long-overdue national air quality standards and laws for public buildings, an international group of air pollution experts argued yesterday in Science, STAT's Megan Molteni tells us. To deal with the challenges of a complex indoor environment, the group recommended a number of high-priority pollutants and parameters that regulators could adopt as proxies for overall air quality. These changes will be expensive in the short term, the researchers noted. "However, if some countries lead by example, we anticipate that IAQ standards will increasingly become normalized." addiction Help for substance use disorders is all over the map KFF As Lev Facher reported in his investigative series The War on Recovery, we have medications for opioid use disorder — methadone and buprenorphine —  but they are not reaching all the people who need them. A new KFF analysis that broke down diagnosis and treatment rates for opioid use disorder and  alcohol use disorder by race and ethnicity in 2020 found that Black, Hispanic, and Asian people insured by Medicaid had lower rates of both diagnosis and treatment, which includes counseling or therapy as well as medications.  Black people with Medicaid were far less likely than white people with Medicaid to be given recommended medication treatment for diagnosed opioid use disorder — 42% versus 68%, respectively. This comes at a time when drug overdose death rates have been rising faster for Black people. Treatment rates also varied by state, ranging from above 80% in Connecticut and Delaware to below 60% in Arkansas and Mississippi.

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closer look Researchers hope human milk can repair the gut microbiome and reduce infections Diana Bagnoli / Getty Images  The remarkable qualities of human breast milk can defy overstatement  — and duplication. Breast milk not only supplies nourishment, it also lowers the risk of asthma, diabetes, and allergies while helping prevent the intestinal disorder necrotizing enterocolitis. That's why researchers hope to mine molecules in the milk to treat arthritis, atherosclerosis, Parkinson's disease, and irritable bowel syndrome as well as fortify people who are immunocompromised. There are a host of academic and industry efforts focused on taking one particular element further: complex sugars called human milk oligosaccharides (HMOs), the third-most abundant component of human milk. They're attractive because they support the infant microbiome, but the path to treatment in adults is not yet clear. STAT's Deborah Balthazar explores how long the effects of milk-based treatments might last and what safety concerns may be. Read more. business Payments to physicians from drug and device makers continue their uneven spread by specialty Just over half of U.S. physicians got a payment from drug and device makers over a recent 10-year span analyzed for a new study in JAMA. These payments added up to $12.1 billion for approximately 826,300 physicians, the lion's share (94%) connected to at least one marketed medical product. On average, each physician pocketed $48, but that amount varied widely by specialty, with orthopedic surgeons, neurologists, psychiatrists, and cardiologists leading the list while pediatric surgeons held down the bottom. At the very top (0.1%) of the pyramid were physicians in each specialty who received payments that ranged from nearly $195,000 for hospital physicians to more than $4.8 million for orthopedic surgeons. All the data came from openpayments.com, a resource launched in 2014 as part of the Affordable Care Act and intended to shine a light on conflicts of interest. STAT's Ed Silverman has more. public health 2 out of 3 babies with sickle cell disease are born in socially vulnerable areas We've been hearing for months about historic advances in gene therapies for sickle cell disease since the first approval in December, along with questions about fertility and who will have access to the costly treatments. A new CDC report out yesterday reminds us of the heavy toll the inherited blood disorder takes on communities already facing challenges. The analysis of newborn screening data from 2016 through 2020 in 11 states found that 2 out of 3 infants with sickle cell disease were born to families living in socially vulnerable counties, as defined by socioeconomic status, housing, and transportation.   This is not a new development for people facing complex health needs, lower life expectancy, and high health care costs, but the report highlights sickle cell disease prevalence and specific community needs. "Implementation of tailored interventions, such as increasing access to transportation, improving housing, and advancing equity in high vulnerability areas, could improve health outcomes" for children with sickle cell disease, the article says.

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What we're reading 'Everyone will die in prison': How Louisiana's plan to lock people up longer imperils its sickest inmates, ProPublica U.S. changes how it categorizes people by race and ethnicity. It's the first revision in 27 years, Associated Press Adam's Biotech Scorecard: A contrarian view on Viking Therapeutics, biotech's hottest obesity stock, STAT 'A chance to live': How 2 families faced a catastrophic birth defect, New York Times U.K. becomes the first country to release detailed data on sponsors that fail to register clinical trials, STAT

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Thanks for reading! More Monday,

elizabeth.cooney@statnews.com

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