Longer Looks: Interesting Reads You Might Have Missed

Each week, KHN finds longer stories for you to enjoy. This week’s selections include stories on covid, aspirin, the health care supply chain, home DNA tests and more.

CBS News:
Inside The Life Of A COVID Long-Hauler Who “Fought Like An Animal” To Make It Out Of The Hospital After 299 Days 

The past year has seen some dramatic swings in America’s fight against COVID-19. But while the number of COVID cases are trending downward, some long-haulers are having a hard time recovering from the disease. Alex Castro of Sandy, Oregon, used to be able to swim, cook and hike, but now it takes every breath he has and baby steps, to just walk across his living room. At 44 years old, Castro is just a shell of the man he used to be. COVID caused him heart failure and ravaged his kidneys and lungs. (10/27)

The Wall Street Journal:
A 12-Year-Old Girl Sparks Debate On Covid-19 Vaccines For Kids In Mexico 

In early September, 12-year-old Zulma Gonzalez grew exasperated. Zulma, who suffers from Type 1 diabetes and is at risk of having a serious illness with Covid-19, had been trying to get vaccinated for months to feel safe enough to return to school and have a normal life again. But government policy didn’t allow minors like Zulma to get vaccinated because officials said that anyone under 18 was unlikely to get gravely ill with Covid-19. The policy has been criticized by some epidemiologists, who cite the arrival in recent months of the Delta variant and another big wave of deaths in Mexico, the world’s fourth hardest hit country in pandemic deaths. So Zulma, with help from her lawyer mother, filed a lawsuit, and won a court order to get vaccinated. (Luhnow, 10/23)

The New York Times:
Do I Have Plans This Saturday? I’ve, Uh, Been Exposed To Covid

Last winter Trysta Barwig was burned out. She was overwhelmed by her job as a program manager and she was traveling too often for work from her home in Atlanta. She needed a break. So when Ms. Barwig’s boss asked her to pack her bags again, she used what had become her go-to excuse: a Covid exposure. “I figured this would be easier to tell my boss than having to answer a million follow-up questions of why I couldn’t go,” said Ms. Barwig, 31, who is also the founder of a travel blog, This Travel Dream. “He was very supportive and excused me from traveling for work.” Problem solved. (Braff, 10/28)

Covid Vaccination Rates: How Black Doctors Increased Shots In Philadelphia 

Earlier this year, Philadelphia’s partnership with the student-led group Philly Fighting Covid Inc. abandoned testing sites in Black neighborhoods. It seemed like the latest affront in a long legacy of racism that has fueled distrust in the medical system, dating back to the infamous Tuskegee experiments in the 1930s. But Philadelphia, after a slow start, is closing out the year with one of the highest Black vaccination rates in a major U.S. city. In Philadelphia, 54% of Black citizens are now vaccinated. That puts it at the top of a group of the country’s 10 most Black cities, with populations of 500,000 or more and with Black people making up anywhere from 77% to 28% of the population. (The country’s second-largest city, Los Angeles, has vaccinated 55% of its Black residents, but they’re just 8% of the population.) (Poon and Green, 10/28)

The Atlantic:
Is Moderna Really Better Than Pfizer—Or Is It Just a Higher Dose?

“More vaccine” is not a simple proposition. For one thing, doses of Pfizer and Moderna are measured in mass of mRNA lipid nanoparticles; J&J doses are measured by counting the number of harmless adenovirus particles that each one contains (about 50 billion). You can’t really compare lipid nanoparticles with viral particles, several experts told me. According to Michael Arand of the University of Zurich’s Institute of Pharmacology and Toxicology, you shouldn’t even assume that each 50-billion-particle dose of J&J will be equivalent in size to the next one, since, depending on the details of production, some particles can be more infectious than others. A better dosage measure for adenovirus-based vaccines, he argued in a recent opinion paper, would be “infectious units.” When I asked him via email whether developing a standard measure that works across different vaccine platforms might be possible, he said, “I do not think so.” (Gutman, 10/28)

Also —

The New York Times:
Why Does Medical Advice Often Change? Doctors Explain 

When it comes to preventive health, few tenets are as entrenched as daily aspirin. For more than 30 years, many people have relied on the pain reliever for added protection against a first heart attack or stroke. So it came as a shock to many this month when an influential expert panel, the U.S. Preventive Services Task Force, seemed to reverse decades of medical practice, announcing that daily low-dose aspirin should no longer be automatically recommended in middle age to prevent heart attack. (Parker-Pope, 10/22)

The Atlantic:
How Public Health Took Part In Its Own Downfall

By one telling, public health was a victim of its own success, its value shrouded by the complacency of good health. By a different account, the competing field of medicine actively suppressed public health, which threatened the financial model of treating illness in (insured) individuals. But these underdog narratives don’t capture the full story of how public health’s strength faded. In fact, “public health has actively participated in its own marginalization,” Daniel Goldberg, a historian of medicine at the University of Colorado, told me. As the 20th century progressed, the field moved away from the idea that social reforms were a necessary part of preventing disease and willingly silenced its own political voice. By swimming along with the changing currents of American ideology, it drowned many of the qualities that made it most effective. (Yong, 10/23)

Modern Healthcare:
Healthcare’s Supply Chain Poses The Next Big Environmental Challenge

Healthcare companies in recent years have largely focused on reducing greenhouse gas emissions as they strive to become more environmentally sustainable. While that focus has produced several innovations in conservation and alternative energy use, critics argue those actions have only scratched the surface of reducing healthcare’s climate footprint. Hospitals have remained one of the world’s largest polluters despite increased calls to address climate change. Healthcare greenhouse emissions rose 6% from 2012 to 2018, according to a December 2020 Health Affairs study. As a whole, the industry now makes up more than 8% of all U.S. emissions. (Ross Johnson, 10/22)

The Wall Street Journal:
Hospital Prices Are Arbitrary. Just Look At The Kingsburys’ $100,000 Bill. 

Barbara Kingsbury was diagnosed with cervical cancer two years ago and embarked on an aggressive course of treatment. The bills piled up on the kitchen counter of her home in Volin, S.D., at one point hitting $94,000 in unpaid fees and interest. With debt collectors threatening a lawsuit, her husband, Dennis Kingsbury, emptied her retirement savings in early May to pay most of the amount due. Bill collectors continued calling Ms. Kingsbury when she entered hospice care in early June, her husband said. She died on June 10, at age 62. In July, Mr. Kinsgbury received another hospital bill for $10,000. (Evans and McGinty, 10/28)

Philadelphia Inquirer:
Home DNA Tests Can Lead To Shock And Trauma, But Mental Health Resources Are Scarce

Advances in genomic technology have allowed DNA testing to break free of academic and forensic labs and enter the home. As costs have dropped from triple-digits to $99 over the past five years, direct-to-consumer DNA tests have risen in popularity, becoming common holiday gifts and impulse purchases. One in five Americans has spit in a tube and learned that their ancestors hailed from Greece, they have a second cousin in Texas, or that they have high risk for breast cancer. But DNA tests can also dig up closely guarded family secrets, such as an affair or an artificial insemination. And sudden discovery of a health condition can require new medical care — or the realization that there may not be a cure. Receiving unexpected DNA test results can lead to a mental health crisis for many people, yet resources to help process these unique changes are scarce. (Nathan, 10/28)

5-Day Brain Stimulation Treatment Highly Effective Against Depression, Stanford Researchers Find

Stanford researchers think they’ve devised an effective and quick-acting way to treat difficult cases of depression, by improving on an already approved form of brain stimulation. In a new trial published this week, the researchers found that almost 80% of patients improved after going through treatment—a far higher rate than those who were given a sham placebo. Brain stimulation has emerged as a promising avenue for depression, particularly depression that hasn’t responded to other treatments. The basic concept behind it is to use electrical impulses to balance out the erratic brain activity associated with neurological or psychiatric disorders. There are different forms of stimulation, which vary in intensity and how they interact with the body. Some require permanent implants in the brain, while others can be used noninvasively, like repetitive transcranial magnetic stimulation (rTMS). As the name suggests, rTMS relies on magnetic fields that are temporarily applied to the head. (Cara, 10/29)

The New York Times:
Japan Stays Tough On Marijuana As Other Nations Loosen Up 

From an early age, Japanese society had conditioned Takayuki Miyabe to fear marijuana. But that was before his infant daughter was diagnosed with a rare form of epilepsy. Desperately scouring the internet for a cure, he came upon an unexpected savior: a derivative of cannabis called CBD. During a business trip to California, he bought a tiny amber bottle of the elixir, hoping for a miracle. (Dooley and Hida, 10/27)

Friday, October 29, 2021