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The U.S. response to bird flu is deeply flawed three months in

June 26, 2024
June 26, 2024
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Morning Rounds Writer and Podcast Producer
Good morning, it's Wednesday! Some STAT folks from out of town are at headquarters in Boston this week, which is so fun. All I want to do is chit chat with them, but I'm taking some breaks from talking to write this newsletter :)

special report

Three months in and the U.S. bird flu response is deeply flawed, experts say

Mike Reddy for STAT

The U.S. is still bungling its response to the bird flu virus that has been spreading among dairy cows for three months, according to more than a dozen experts and current and former government officials who spoke to STAT. What's going wrong? Testing infrastructure is insufficient. Our understanding of how the virus spreads within and between herds is incomplete. And the government can't get farmers and dairy workers to cooperate with tracking or mitigation efforts. (Just to name a few things.)

"If you still can't determine the scale of the outbreak, and which states, what farms, what herds, are actually being affected, I don't see how you can possibly think that it's containable," said virologist Angela Rasmussen. Read more from our team of STAT reporters on what's going wrong and what needs to happen next.

infectious disease

CDC issues warning on higher risk of dengue virus in the U.S.

There's an increased risk of contracting dengue virus in the U.S. this year, the CDC announced yesterday in a health advisory. Countries in North and South America have reported twice as many cases so far this year as in all of 2023. Puerto Rico has declared a public health emergency, with almost 1,500 cases as of Tuesday's alert. The agency recommends health care providers look out for dengue among people with a fever who have been in areas with high transmission and promote ways to prevent mosquito bites in those areas.

But dengue infections likely aren't going to be rampant across the continental U.S., STAT's Helen Branswell told me, though people who travel to places where dengue circulates could be infected. (So far, there have been 745 cases among U.S. travelers.)

Diseases like dengue that are transmitted to humans through vectors like mosquitoes have historically affected few people in the U.S. But as climate change accelerates, the range of these vectors can shift. West Nile, Lyme, and other diseases are also on the rise. So while continental U.S. dwellers probably don't need to worry right now about dengue-carrying mosquitoes in their backyards, it's worth thinking about climate change, infectious disease, and how prepared we are for the changes ahead.

LGBTQ health

A bevy of LGBTQ papers as Pride month comes to a close

It's the last week of the month, which means it's also the last chance for researchers to tie their publications or other initiatives on LGBTQ health to Pride month. One takeaway: Trans and gender diverse people, especially trans men, have a higher risk of experiencing physical, sexual, and intimate partner violence than cisgender women, according to a study published yesterday in JAMA Network Open. Another study, published Monday in JAMA Internal Medicine, found that depression more than doubled among trans and gender diverse people between 2014 and 2022, with mental health outcomes declining significantly more than among cisgender adults.

National health data on queer people in the U.S. is severely lacking. But smaller, observational, or survey-based studies continue to find that queer, and especially trans people face health disparities. With this in mind, the American College of Physicians published yesterday an updated position paper on LGBTQ health disparities. In its first update since 2015, the organization calls for more national data and comprehensive insurance coverage of gender-affirming care, while condemning restrictions on such care and the criminal persecution of clinicians who provide it. 

first opinion

AI creates a paradigm shift in America's heartland

Spencer Platt/Getty Images 

A recent working paper by the National Bureau of Economic Research noted that artificial intelligence is being used in some "unlikely places," including the Midwest. Who's calling who unlikely? Bill Gassen, president and CEO of the largest rural health system in the U.S., argues in a new First Opinion essay that health care providers in rural America are pioneering new uses of AI in their practices. While much of the nation is debating the future of AI, he predicts that its impact on rural health care will be consequential.

Recruiting and retaining clinicians to work in understaffed specialities across rural America is one of the greatest demographic challenges in the region. AI can not only help streamline administrative tasks, said Gassen, but soon clinical decision-support tools could help to identify serious health threats, improve diagnoses, and calibrate the precision of medical treatments. Read more from Gassen on what's really happening with AI in rural America.

one big number

1.8 billion people

That's how many people around the world did not get enough exercise in 2022, according to new estimates published yesterday evening in The Lancet Global Health. That comes out to about a third of adults worldwide. If you're wondering where you stack up, "enough" is considered either 2 and a half hours of moderate-intensity activity, an hour and 15 minutes of vigorous-intensity activity, or an equal combination each week. In light of the findings, WHO is calling on countries to strengthen their implementation of policies encouraging activity through both recreation and transportation.

social determinants of health

"I" for "Insufficient": Does it help when doctors screen for food insecurity?

The U.S. Preventive Services Task Force found no strong evidence that screening for food insecurity in primary care settings actually improves people's health outcomes, it wrote in a draft recommendation published yesterday. The team of experts labeled the statement with an "I," meaning there was insufficient evidence for the intervention. Instead, they suggested clinicians continue having discussions with patients about food insecurity and connecting them with resources available in their communities.

"Food insecurity is a complex social risk," Tumaini Coker, who served on the task force, told STAT's Alia Sajani. People who don't have access to nutritious food may also struggle to pay for transportation or housing, which complicates the task of figuring out the impact of food interventions on their own. Read more from Alia on how experts considered the sticky issue.

More around STAT
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What we're reading

  • In states that won't pay for obesity drugs, 'They may as well have never been created,' New York Times

  • Journals issue corrections noting vaping researchers' undisclosed ties to Juul, STAT
  • Therapists learn how to help farmers cope with stress before it's too late, KFF Health News
  • Standalone organ donor centers have sprouted all over the U.S. Do they work better than hospitals? STAT

Thanks for reading! More tomorrow,

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