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Good morning. I’m Liz Cooney, sitting in on Morning Rounds for Theresa today.
The last time I subbed, exactly six weeks ago, I told you, “The next four years have just begun. STAT’s reporters and editors have teamed up to keep us on top of the health policy news from D.C. from Day One.”
Still true. Same for science news, too.
Trump’s pick to lead NIH brings contradictions to Senate hearing room
NIH nominee Jay Bhattacharya does not fit easily into one box. The Stanford academic and Covid contrarian has sparked condemnation along with grudging encouragement. With what seem like as many credentials as contradictions, he inspired a Tennessee judge to write this about his expert testimony in 2021: “… the Court is simply unwilling to trust Dr. Bhattacharya.” A colleague recently delivered this damning-with-faint-praise assessment: “I would rather see him appointed than not, because I think if he is not appointed, then whoever else is appointed will probably be worse.”
Bhattacharya will face a Senate confirmation hearing tomorrow, a long journey from early childhood in what he calls a slum near Kolkata, India. With dual degrees in medicine and economics, he has carved out a career parsing health statistics, rocketing into public awareness after the Great Barrington Declaration. Drafted by Bhattacharya and two other Covid-contrarian professors in October 2020, it suggested natural infection, not vaccination, would be a good thing for the healthy majority. He’s criticized Anthony Fauci, defended Joe Rogan, and won praise from RFK Jr. STAT’s Eric Boodman deciphers what the nominee might bring to the world’s biggest (for now) funder of biomedical research.
Makary vows to avoid conflicts if confirmed as FDA chief
Ahead of Thursday’s confirmation hearings, Marty Makary has pledged to leave his roles as adviser to health tech, medical device, and telehealth startups and to sell stock he owns in those companies if confirmed as FDA commissioner, his financial disclosures say. Makary doesn’t hold stock in large pharmaceutical companies, in contrast to outgoing commissioner Robert Califf and other former leaders of the regulatory agency who have been called out for close industry ties.
The filings say the value of Makary’s assets range from around $13 million to $54 million. That’s modest compared to the assets declared by Mehmet Oz, nominated to head the Centers for Medicare and Medicaid Services. His holdings come in somewhere between $95 million and $334 million. STAT’s Lizzy Lawrence has more financial details on Trump’s nominee, plus some opinions that have sparked controversy, although perhaps less fiery than reactions to other White House picks.
Improper Medicaid payments become target for GOP cost-cutters
If you’ve been following the debate in Washington over how to cut the federal budget without touching Medicaid, STAT’s John Wilkerson brings us a new wrinkle. Republicans trying to find billions of Medicaid dollars to pay for tax cuts now say that any reduction in Medicaid spending would derive from eliminating waste, fraud, and abuse and not from denying care to millions of children, low-income adults, and people with disabilities who rely on the program. This echoes President Trump’s press conference positions, saying “We’re not going to touch it” about Medicaid. “Now, we are going to look for fraud.”
Yesterday two think tanks issued a report suggesting Medicaid pulled in about $1.1 trillion in improper payments over the past decade, arguing that policies to lower that figure could save hundreds of billions of dollars. That estimate is on the high side of other analyses, but the devil is in the details. What is fraud, anyway? Missing documentation? Inappropriate payments? STAT’s John Wilkerson dives in.
1 in 6 young people will have obesity by 2050, analysis predicts
360 million. That’s the number of children and adolescents around the world forecast to be living with obesity by 2050. Taken together, 1 in 3 young people age 5 to 24 will be considered overweight or obese by then, a new analysis published last night in the Lancet estimates. There’s wide variation around the globe, including some countries battling both undernutrition and obesity. Half of the world’s young people with obesity will be living in two regions: North Africa and the Middle East and Latin America and the Caribbean.
The authors urge collective action to prevent the transition from overweight (a reversible risk exposure) to obesity (a complex chronic disease difficult to turn around). “While families and individuals can work to balance their physical activity, dietary intake, and sleep to uphold a healthy lifestyle, this lifestyle is difficult to maintain while living in obesogenic environments,” the report says. “It is governments rather than individuals that are required to address population-level drivers of obesity, such as its commercial determinants (e.g., marketing, pricing, and food industry lobbying).”
Cervical cancer diverges along rural-urban divide
Here’s another example of your ZIP code bearing more significance than just about any other health metric. Take cervical cancer, a disease that a vaccine can prevent and screening tests can flag at a precancerous stage. Those two forms of prevention help people only if they can get them, a research letter published yesterday in JAMA Network Open reports. Incidence and mortality rates have been climbing in rural counties in the U.S. since 2012. Cases were 25% higher and deaths were 42% higher in rural counties compared to urban counties through 2019.
That’s sobering news after a CDC report last week that said among women 20 to 24 years old, the rates of precancerous lesions fell by 80%, a testament to a vaccine recommended before girls and boys enter their teens. But both HPV vaccination and screening are lower in rural countries compared to urban counties, study author Trisha Amboree told me. “If you do find a cancer case in a rural area, are they actually able to get into treatment in time to have effective treatment?” she asked. I have more here.
Now’s the time to track infectious diseases in pets, too
It’s not quite man bites dog, to quote an old newsroom saw, but it’s an echo. Four experts — veterinarians, flu scientists, and biosecurity experts — share their concerns about humans infecting cats with H5N1 avian influenza, instead of the reverse. Bird flu has killed more than 100 domesticated cats since 2022, from house cats to barn cats to feral cats. Even “great cats” like cougars and bobcats have fallen prey to the virus. Many likely were exposed to the virus in raw milk, raw meat pet foods, and wild birds. But a new report from the Centers for Disease Control and Prevention and Michigan health authorities tells us two indoor cats who lived with dairy workers died, despite no exposure to other infected animals.
It’s hard to know the extent of the problem without public health oversight of pets. “Given the pandemic risk from H5N1, active surveillance of companion animals is needed to recognize the full scope of the problem and identify critical control points for intervention,” STAT First Opinion authors Meghan Davis, Ellen Carlin, Erin Sorrell, and David Stiefel write. But here’s the problem: coordinating government agencies to achieve this is like, well, herding cats. Read why.