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How a new discovery is making scientists rethink ventilation and viruses

June 4, 2024
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Morning Rounds Writer and Podcast Producer
Good morning! Nobody has offered me the Sally Rooney yet. That's fine, I forgive you.

h5n1 bird flu

A big jump in dairy cows infected with H5N1 bird flu

STAT's Helen Branswell brings us this bird flu update: The USDA reported a big jump in the number of dairy cattle herds with confirmed H5N1 bird flu infections Monday, with the cumulative number of affected herds reaching 80 in nine states. That is up from 69 as of Friday. Idaho was responsible for most of the increase, with eight new affected herds reported there; Idaho overtook Texas as the state with the second highest number of confirmed herds, after Michigan. Keep up with all our bird flu coverage here.


infectious disease

We need to rethink what we know about ventilation and viruses

When a disease is airborne, there's no sensor that can track how many infectious aerosols are floating around us in real time. But the amount of carbon dioxide in the air can act as a proxy. We exhale it when we breathe, so in spaces that aren't well-ventilated, it accumulates. This made carbon dioxide monitors a hot commodity in 2020 as people navigated indoor spaces during the pandemic. 

But over the past three years, researchers in the U.K. have learned that CO2 isn't just a proxy for how much virus there is. The more CO2 in the air, the more virus-friendly that air becomes. It's a revelation that is already transforming the way scientists study airborne pathogens. Read more from STAT's Megan Molteni on the science, how the research played into the messy, contentious debates about the virus that causes Covid-19, and what it means going forward.


washington

Fauci says the Covid origins debate has been 'seriously distorted'

Anthony Fauci, the former top U.S. infectious disease official and a longtime foil for congressional Republicans, came out forcefully against GOP accusations on a host of Covid-related issues while testifying before a congressional committee yesterday. He called the allegations that he sought to influence scientists' research about Covid's origins — so that they would not conclude the virus was the result of a lab leak — "simply preposterous."

"I don't think the concept of there being a lab leak is inherently a conspiracy theory. What is conspiracy is the kind of distortion of that particular subject," Fauci said at one point. "Like it was a lab leak and I was parachuted into the CIA like Jason Bourne." Read more about the hearing from STAT's Sarah Owermohle. 


maternal mortality

Pregnancy and childbirth are more dangerous in the U.S. than any other high-income nation

The U.S. still has the highest maternal death rate of any high-income nation, even after seeing a decline since the pandemic, according to a report from the Commonwealth Fund published today. I planned to share just "One Big Number" from this report with you, but there are too many numbers that are too stark, so here are a few takeaways:

  • The U.S. maternal mortality rate is 22 deaths per 100,000 live births. This is already triple what some other high-income countries see. But for Black women in the U.S., the rate is 49.5 per 100,000.
  • Nearly two-thirds of these deaths occur after the baby is born, up to 42 days later. One in five deaths occur during pregnancy, most often caused by heart conditions like stroke.
  • In most high-income countries, midwives greatly outnumber ob-gyns. Only in the U.S, Canada, and Korea do these physicians outnumber midwives. Overall, the U.S. and Canada have the lowest total supply of providers (midwives and ob-gyns), with 16 and 13 per thousand live births, respectively.


medical devices

Imagine a $1,000 bill for batteries you didn't need in the first place

Kayana Szymczak for STAT 

When Michelle Bean bought a basic pain management device in 2020, the company, Zynex Medical, assured her that the supplies would be covered by her insurance company. Batteries and electrode pads arrived at her home every month for two years, taking up more and more space in her closet, unused. Until one day, Zynex informed her that the insurer had never paid. Those batteries were going to cost her almost $1,000.

It's a maneuver reminiscent of the classic "razor blade" business model, with a company deriving most of its revenue from a product's supplies as opposed to the product itself. The batteries ostensibly keep the device running, but the regular shipments also allowed Zynex to bill insurers for thousands of dollars more than it otherwise could. The practice is rampant in health care, STAT's Lizzy Lawrence writes, but rarely impacts insurers' bottom lines enough to put companies under regulatory or legal scrutiny. As a result, patients like Bean are left to fend for themselves. Read more.


another infectious disease

MMR vaccine misinformation persists as measles cases rise

A quarter of U.S. adults may not know that claims about the MMR vaccine (measles, mumps, rubella!) causing autism are false, according to a report published yesterday by the Annenberg Public Policy Center. The CDC has said there is no evidence linking the vaccine to the disorder. But 24% of respondents said that statement — that the CDC has said there is no evidence — is "somewhat" or "very inaccurate." The results, collected from 1,500 people in April, come as measles cases in the U.S. are rising, but vaccinations against the disease are falling. 

It reminds me of a First Opinion that STAT published this year by physician Paul Law, who lives and works in the Democratic Republic of the Congo. Only about 20% of children there are vaccinated for measles, due to a lack of funding and infrastructure. Last year, there were more than 500 measles deaths. "I've never met a mom there who turned down the shots for her kids," he wrote.


first opinion

An outdated Medicare rule could be harming some dementia patients 

If you don't know anybody with Alzheimer's disease or dementia, you would be forgiven for assuming that memory loss is the main symptom. In reality, people with dementia often experience mood and behavior symptoms ranging from anxiety and depression to violent outbursts and psychosis. While changes like establishing a predictable daily schedule and engaging the person in meaningful activity can help with symptoms for some people, others will need medication.

But it's not that simple. Outdated regulations often prevent these medications from reaching the people who need them, writes gerontological nurse practitioner Carolyn Clevenger. The Centers for Medicare and Medicaid Services, which determines coverage for its beneficiaries and influences other insurance plans, has established policies that make it more difficult for providers to prescribe antipsychotic drugs when appropriate. Read more on how both patients and their families are affected.


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What we're reading

  • 'So much death': Lawmakers weigh stricter speed limits, safer roads for pedestrians, KFF Health News

  • Leading CRO to pay record fine for badly neglecting hundreds of beagles in breeding facility, STAT
  • Don't just blame rat fleas. Lice may have helped spread 'black death' plague, NPR
  • ASCO Daily Recap: A CAR-T advance, money talk, and tossing the cancer treatment 'sandwich,' STAT

Thanks for reading! More tomorrow,


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