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The top health and science takeaways from Fauci’s memoir

June 17, 2024
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Morning Rounds Writer and Podcast Producer

Good morning! I want to flag two things for you today. One: Below, STAT's Helen Branswell brings us the first in a series of updates on H5N1 bird flu that we'll publish in this newsletter each Monday. 

And two: STAT obtained a copy of Anthony Fauci's forthcoming memoir, "On Call: A Doctor's Journey in Public Service." STAT's Jason Mast shares the top health & science takeaways from the 455-page tome.

h5n1 bird flu

Bird flu snapshot: Saying the quiet part out loud

BIRDFLU-JUNE17

Seth Berkley, the former head of Gavi, the Vaccine Alliance, gave voice last week to a point of view STAT has been hearing for a while about the U.S. response to the H5N1 bird flu outbreak in dairy cows. "It's been shocking to watch the ineptitude," Berkley, an American currently living in Switzerland, said at an event on the future of vaccines held in London.

Berkley was talking, among other things, about the surveillance being done to try to get a handle on how widespread the outbreak has actually become. It has been nearly three months since the virus was first identified in cattle, and the country is no closer to an answer to that question. As of Friday, the U.S. Department of Agriculture had confirmed infections in 102 herds in 12 states; Iowa, one of the latest states to report infected herds, announced it had found two more that haven't yet made it to the USDA list. To date three people — all farmworkers — have contracted the virus from cows.

Have any of the affected herds cleared their infections? If so, how many? The USDA couldn't answer those questions on Thursday. And yet Agriculture Secretary Tom Vilsack confidently declared at a press conference earlier this month that his department feels it knows how the virus is moving between herds and how to stop it. "We are trying to essentially corner the virus," Vilsack said, despite the fact that operators of only 11 of the affected herds have applied for USDA help to improve biosecurity on their farms and defray testing costs. 

The government's seeming inability to get farmers to disclose that they have infected animals has many worried observers wishing more states were doing what Michigan's doing. True, it has more declared herds than any other state. But that's because its response is more robust, fans of the state's approach say. "One of our mantras is if you don't test for it you don't find it," the state's chief medical executive, Natasha Bagdasarian, told STAT in an interview.

- Helen Branswell


books

Inside Anthony Fauci's 'On Call'

To read the forthcoming memoir by the country's former top infectious disease expert, a copy of which was obtained by STAT, is to get a sense of Anthony Fauci's finesse while advising seven presidents, STAT's Jason Mast writes. Fauci strove to speak with complete candor and stay out of politics — something that wasn't always possible, particularly when he found himself being screamed at and taunted by former President Donald Trump.

But there's more to take home from the memoir than that anecdote. Fauci spent 40 years in the top echelons of government, and that was no accident. Jason shares the nine biggest takeaways from the book related to health and science. In the memoir, Fauci reflects on topics including Covid policies, HIV, and how he maneuvered within government to get as much done for public health as possible. Read more.


exclusive

Two Republican committee chairs say NIH needs reform and restructuring

The U.S. House Committee on Energy and Commerce unveiled a proposal to reform the National Institutes of Health for the first time in more than 20 years on Friday, announced in an exclusive First Opinion essay. The potential reforms include streamlining the 27 current NIH institutes and centers into 15 revised ones the committee says better align with overarching goals, missions, agendas, and constituencies. 

"We see the only way toward restoring trust in the NIH is through structural and policy reform that is thoughtful, strategic, and transformative," wrote two Republican House committee chairs, Cathy McMorris Rodgers and Robert B. Aderholt, in the essay. Read more about the proposal and keep an eye out this week for reporting from our team in D.C. on how policymakers are reacting.



infectious disease

Did you get salmonella from your pet bearded dragon?

An orange central bearded dragon rests on a piece of wood with its head held high

Joel Saget/AFP via Getty Images 

The CDC is investigating 15 cases of salmonella across nine states potentially linked to pet bearded dragons. More than half of the people who have gotten sick are under 5 years old. Four people have been hospitalized, and there have been no reported deaths. 

This isn't the first time that these apparently popular pet lizards have started a chain of salmonella cases. The "golden retriever of the reptile world" (as one expert described them to the New York Times) was responsible for a two-year-long outbreak between 2012-2014 that infected more than 130 people — again, most under age 5. And earlier this year, a rare strain of the infection was traced back to a breeder in Southeast Asia. If you've got one of these funny fellas, the CDC says wash your hands after touching them.


first opinion

How the health care system should deal with hypochondriacs, per a hypochondriac

In his own words, Hal Rosenbluth is a hypochondriac. "People like me are often dismissed by family, friends, and many doctors," he writes in a new First Opinion essay. But Rosenbluth is also a health care executive, a perspective that, combined with his hypochondria, provides him key insight into how the U.S. health care system works — and how it doesn't. 

People with hypochondria can put a significant burden on the health care system. But there are ways that system can change to better diagnose and support them, Rosenbluth argues. It starts with clinicians, who must strike a delicate balance: thoroughly vetting their patients' claims, while remaining cautious of not overselling or recommending a battery of tests. Read more on how the system can adapt.


pandemic

A new poll looks at the public's view on pandemic policies

In hindsight, most Americans agree that policies put in place during the height of the pandemic were "generally a good idea," according to new polling results from the Harvard T.H. Chan School of Public Health and the de Beaumont Foundation. The poll included over 1,000 U.S. adults, whose support for policies often fell along partisan lines. 

When considering four key policies — masking requirements in stores and businesses, mandatory vaccinations for health care workers, indoor dining closures, and school shutdowns — 42% of respondents said all were a good idea, while 20% said all were "generally a bad idea." The results are especially interesting in the context of a recent First Opinion essay: When two medical professors studied the effectiveness of Covid-19 policies, they found that government interventions were followed by better Covid-19 outcomes only about half the time.


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Correction: An item in the June 14 issue of Morning Rounds stated that Walmart has left the clinical trial business. The company has closed several of its medical clinics, but continues its clinical trials effort.


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