Bird flu has a PPE problem, global gene therapy access, and the politics of alcohol guidelines

States have offered free protective equipment for affected farms' workers, with few takers

May 10, 2024 Check out STAT+

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By Annalisa Merelli General Assignment Reporter

Buongiorno! The little songbirds (house finches, sparrows, and cardinals mostly) outside my window have been extremely chatty as of late — it may be spring, it may be the new food I got for their feeder, or it may be that they are following the H5N1 developments on STAT! I bet the latter; read on to keep up with the birdie babble.

h5n1 bird flu Bird flu prevention efforts have a PPE problem  In an attempt to reduce the risk of bird flu transmission to humans, the Centers for Disease Control and Prevention have recommended that dairy farms with infected cows provide their workers with personal protective equipment such as gloves, masks, goggles, and gowns. But making it happen is far from straightforward, reports STAT's Sarah Owermohle.  The CDC has no way to enforce this recommendation, and health officials so far have not had much luck getting farms to give out free, state-supplied PPE to their workers, even as more affected herds are reported (the national total grew by six yesterday, to 42). Texas, where one worker exposed to sick cows was infected, has offered to ship gear to affected farms; only four took the state up on the offer.   Experts believe the bird flu isn't a high threat to the general population, but things could change. Workers in contact with infected animals are the most vulnerable, and experts say adopting protections after a herd has been identified as infected is a weak approach, because by that point the cows are likely on their way to no longer being contagious. Read more. access Why gene therapies should do better than other drugs on global access For certain rare diseases, including sickle cell disease, gene and cell therapies have been transformative — though only for a small part of the world. The countries that are most vulnerable to these diseases lag years behind, if not decades, when it comes to accessing treatments. Initiatives trying to expand access have had limited success, and a new paper in Science reviews those challenges while asking for more engagement with scientists worldwide.  Review author Jennifer Adair, who develops scalable, low-cost gene therapies at the Fred Hutchinson Cancer Center, shared her thoughts in a Q&A with my colleague Jason Mast. Gene therapy needs to focus on global access, she emphasized, because the entire field is based on the genetics of humans. "We are not the most ancestral population. That is Africans," she said. "And if you want to make a drug that works, that is based on genetics, it ought to be considering the most ancestral population." More here.  health No amount of alcohol is good for you. Why don't U.S. dietary guidelines say so? The misconception that some drinking may be beneficial, if not harmless, dates back to the U.S.'s 1995 dietary guidelines, which for the first time included the idea that a drink a day helps cardiac health. "The evidence seemed quite clear at the time," said nutrition researcher Marion Nestle, who was one of the guideline's authors. Things have changed since: No matter how much we may wish otherwise, alcohol has no health benefits. Quite the opposite, in fact: CDC research shows excessive alcohol use is the leading preventable cause of death in the U.S.  But translating this awareness to dietary guidelines for Americans is not straightforward, reports STAT's Isabella Cueto. This is due in no small part to the influence of the alcoholic beverage industry in politics, including a history of conflict of interest among the scientists tasked with providing independent advice on what's best for Americans to eat and drink. "It's not a question of what the science says. It's a question of what is politically acceptable science," said Nestle. Read more.

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first opinion A better way to measure how hot it feels out there FREDERIC J. BROWN/AFP VIA GETTY IMAGES The temperature a thermometer reports can sometimes matter less than how hot it feels to the human body. In many industries, the go-to measure of perceived temperature has been the heat index, which factors in humidity. But tragedies such as the heat-caused death of José Arturo González Mendoza, a 30-year-old potato farmer in Georgia, show the measure can grossly underestimate the lethal risk of heat.  A better metric, write heat policy experts Ashley Ward and Jordan Clark in a new First Opinion, is using the wet bulb globe temperature, which factors in wind speed and solar radiation along with temperature and humidity. Athletes and the military prefer this measure, and it should be used for farmers and other workers at risk of high heat exposure too, argue the authors. Read more about their thoughts on protective measures for people asked to work on extremely hot days. CANCER Racial and ethnic disparities in breast cancer treatment acceptance A large study published on Thursday in JAMA Network Open found that a significant percentage of 1.3 million breast cancer patients decided not to be treated. Chemotherapy was refused by close to 10% of patients, radiotherapy by 6%, and hormone therapy by 5% — and the study found meaningful variations in refusal depending on patients' ethnicity and race.  Hispanic people were less likely than white people to turn down any kind of treatment, while people of Black, Native, and Asian descent were all more likely than white patients to decline treatment. In a related commentary, researchers note how those patterns in treatment decisions reflect existing inequities in health care, such as lack of awareness, access, and trust in the medical establishment.  research Working nights may raise the risk of diabetes and obesity They don't call it the graveyard shift for nothing: Even a few days on a night shift can have an impact on blood glucose and metabolism, according to a small study published in the Journal of Proteome Research. The research was conducted on volunteers put on simulated night shifts for three days under constant lighting, posture, temperature, and food intake conditions.  By looking at blood drawn at regular intervals, the researchers found that night shift participants saw changes in protein expression compared to volunteers following a simulated day shift. This affected glucose regulation rhythm, resulting in what the researchers called "a tug of war" between central mechanisms controlling insulin secretion and peripheral mechanisms regulating insulin sensitivity. More research — including larger, real-life studies — would be required to understand the long term consequences of the shift, but researchers believe it may increase the risk of metabolic diseases.

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Thanks for reading! More next week, Nalis

annalisa.merelli@statnews.com

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