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How to start a fight among virus researchers

January 9, 2025
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Morning Rounds Writer and Podcast Producer

Good morning! It has been so cold all week in Boston, and it's cold again today. I would like it to be less cold.

Anyway, we've got some great stories up on the site today. I highly recommend you spend some time with both Drew's and Jason's in particular.

science

How CAR-T could help vanquish some autoimmune diseases

Ksenia Kuleshova for STAT

CAR-T therapy, in which a patient's own T cells are engineered to recognize and wipe out disease-causing cells, has completely changed how some cancers are treated in recent years. But in 2021, German researcher Georg Schett and his team were able to use CAR-T therapy to seemingly eradicate a young woman's lupus. The resulting case report didn't receive much attention, but the next year, they achieved similar results with five more people. That's when things began to change.

Today, more than three dozen people with lupus and other intractable autoimmune diseases have been treated by the German team. It's still unclear exactly how long the remission that patients experience will last. Are they really cured, or could their disease resurge?  "Sometimes I even forget I had lupus," said Janina Paech, one of the first lupus patients to receive the treatment, pictured above. 

STAT's Drew Joseph wrote about Schett (who doesn't care if you pronounce his first name "George or Gay-org"), the patients whose lives have been changed, and the gold rush among drugmakers to turn the science into approved medicines.


politics

Who you gonna call? Mandy Cohen says call the CDC

The outgoing director of the CDC had a message she gave to health ministers when she traveled abroad during her tenure. "What I said is: We want to be your first phone call," Cohen said Wednesday in a discussion at the Washington-based Center for Strategic and International Studies. The agency has for years worked in multiple countries around the globe building up the skills of laboratory workers and epidemiologists, work that paid off last fall when a CDC-trained epidemiologist in Rwanda figured out that country was experiencing its first outbreak of Marburg fever. Rwanda's health ministry called the CDC looking for help and "within hours" the head of the agency's viral pathogens lab was en route to Kigali to help set up the testing apparatus needed to confirm the outbreak and bring it under control.

Cohen said it takes time to build the types of relationships that the CDC has around the world, but that investment is critical to keeping Americans safe. Helping countries contain such health threats keeps them from spreading internationally, she said. "You can't just show up at the moment of crisis. No one's going to call you to tell you about the crisis unless you are doing the work to build relationships, to build the infrastructure alongside them." — Helen Branswell 


evolution

How to survive the most despised job in virology

Researchers who have heard of the International Committee on Taxonomy of Viruses tend to think of the group's work as a form of biological stamp collecting. But recently, its members did something that caught everyone's attention, and even fueled outrage: They renamed all the viruses.

The new names sound, as STAT's Jason Mast puts it, like they were cooked up by a medieval monk. HIV-1 is now Lentivirus humimdef1. SARs-CoV-2, the virus that causes Covid, is now Betacoronavirus pandemicum. Ebola is Orthoebolavirus zairense.

Why did this happen? Swaths of new research have upended scientists' understanding of just how big the viral world is. There are likely billions of viruses teeming around the globe. Some experts have argued that this greater understanding means that a new taxonomy is needed, for organizational purposes. Others say the attempt is a clumsy imposition of human categories on a completely different world. 

Read more in Jason's great story. It charts the current debate around virus taxonomy, and why the science of classifying and naming organisms is so controversial to begin with.



global health

U.S. overdose rates are worst in the world

mr-data-jan9

Commonwealth Fund 

After years of a building crisis, overdose deaths dropped substantially in the U.S. last year. In November, the country was on pace for its first year with fewer than 100,000 overdose deaths since 2020. STAT's Lev Facher described it as a "powerful, if bleak, symbolic milestone." 

A new report from the Commonwealth Fund shows just how much work is left to do. In 2022, about 108,000 people in the U.S. died from an overdose. At 324 deaths per million people in the population, that's more than 1.5 times the rate of deaths in Scotland. 

One of the biggest problems in the U.S. is a lack of access to effective and affordable medications like methadone and buprenorphine. Previous research from the Commonwealth Fund found that only 11% of Americans with opioid use disorder receive these medications, compared to 87% in France, 86% in Norway, and 51% in Scotland. (If you haven't read Lev's War on Recovery series, about America's systemic failures to support people with addictions, I highly recommend it.)


public health

Food waste is increasing — and so is food insecurity

Here in the U.S., we generate more food waste than virtually any other country on earth. (Anyone sensing a pattern?) Ten years ago, the USDA and EPA set a goal to reduce this waste 50% by the year 2030. But food waste has actually increased since then. And a study analyzing existing state policies published today in Nature Food shows that it's likely no state can meet that goal without further interventions at state and federal levels.

Food waste occurs at stores, restaurants, and in homes. It's bad for the environment, but there are also more immediate stakes. In 2023, 13.5% of U.S. households faced food insecurity — a significant increase from 12.8% in 2022, according to recent USDA data. Redirecting food that's wasted toward people who aren't getting the food they need to be healthy and maintain well-being should be a key strategy to reduce waste, say researchers at UC Davis — ahead of composting, recycling, and directing waste toward animal feed.

Companies have argued that food processing reduces waste, but it also creates it. President-elect Donald Trump will lead the country for most of the remaining years between now and 2030. Robert F. Kennedy Jr., his presumptive nominee to lead HHS and champion of the "Make America Healthy Again" movement, has a lot to say about food companies, ultra-processed food, and public health. While running for president himself early last year, he pledged broadly to address food insecurity. But he hasn't spoken on food waste.  


first opinion

Doctors don't know how to address eating disorders

Can you identify what the following patients might have in common? A young woman whose partner found her unresponsive after vomiting, an adolescent boy training for his school's track team and not meeting growth targets, a man prescribed a weight loss medication who now isolates himself due to strict food rules.

Experts know that these people are all showing signs of a potential eating disorder. But most medical professionals get little or no training in these conditions. They might not consider the diagnosis or be unsure of how to ask about certain behaviors or patterns. In many fields of medicine including eating disorder treatment, fatphobia and weight stigma are still a big problem. 

In a new First Opinion essay, two Columbia University physicians focused on eating disorders argue that creativity, humility, and fortitude are necessary to fix this life-threatening knowledge gap. Read more.


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What we're reading

  • China is having standard flu season despite widespread HMPV fears, Ars Technica

  • Investors call on UnitedHealth to disclose human and economic costs of policies that limit care, STAT
  • Being in shape is better for longevity than being thin, new study shows, Washington Post
  • Q&A: How electrical stimulation can improve rehabilitation after spinal cord injury, STAT

Thanks for reading! More tomorrow,


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