2022 Healthcare News Roundup Special
<p>Welcome to the special end-of-year healthcare news roundup, where we highlight 2022’s most relevant news health topics. In this article, we will explore COVID-19 vaccines, the impact of climate change on health, how misinformation affects people’s behaviors, and the rising post-pandemic mental health concerns, but also how artificial intelligence can help detect serious diseases and the healthcare fraud case of the year.</p> <h2>Misinformation Has Negative Impact on People’s Health</h2> <p id="E162">According to a <a is="qowt-hyperlink" href="https://www.who.int/europe/news/item/01-09-2022-infodemics-and-misinformation-negatively-affect-people-s-health-behaviours--new-who-review-finds" target="_blank" rel="noreferrer noopener">systematic review by the World Health Organization</a> (WHO), receiving misleading and incorrect health information can increase vaccine hesitancy and make people delay their care. Unfortunately, the amount of misinformation increases during disease outbreaks and disasters, posing a considerable threat to public health.</p> <p id="E167">In their <a is="qowt-hyperlink" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421549/" target="_blank" rel="noreferrer noopener">article</a>, the authors analyzed 31 scientific publications reporting on fake news, misinformation, disinformation, and infodemics related to health. The researchers made a distinction between <em>misinformation</em>, which was defined as false or inaccurate information deliberately intended to deceive, and <em>disinformation</em>, which also included misleading or biased information, manipulated narratives or facts, and propaganda.</p> <p id="E179">Social media was found to have a powerful role in spreading misinformation, due to its fast and far-reaching attributes, which are further accelerated by easy access to online content, especially on smartphones. Misinformation on social media reached up to 51% of posts related to vaccines, up to 28.8% in posts associated with COVID-19, and up to 60% in posts related to pandemics.</p> <p id="E182">The effects of fake news, misinformation, disinformation, and infodemics on people’s health went beyond the individual level. It reduced patients’ willingness to vaccinate and to seek appropriate care, but it also increased misallocation of resources, wasting taxpayers’ money on scientific research that had already been disproved, and promoted discord to enhance political crisis.</p> <p id="E184">To counteract these effects, “promoting and disseminating trustworthy health information is crucial for governments, health authorities, researchers, and clinicians,” the authors stated.</p> <h2>Climate Change: A Threat to Public Health Within a Growing World Population</h2> <p id="E209">According to a <a is="qowt-hyperlink" href="https://www.un.org/en/desa/world-population-reach-8-billion-15-november-2022" target="_blank" rel="noreferrer noopener">United Nations forecast</a>, global population reached 8 billion people on 15 November 2022, and although it is growing at its slowest rate since 1950, it is now double the population of just 48 years ago. Liu Zhenmin, United Nations Under-Secretary-General for Economic and Social Affairs, stated that “rapid population growth makes eradicating poverty, combatting hunger and malnutrition, and increasing the coverage of health and education systems more difficult.”</p> <p id="E217">Adding to these problems is climate change, a relentless challenge for the whole world, but especially for the most vulnerable ones. In <a is="qowt-hyperlink" href="https://theconversation.com/8-billion-people-four-ways-climate-change-and-population-growth-combine-to-threaten-public-health-with-global-consequences-193077" target="_blank" rel="noreferrer noopener">this article</a>, author Maureen Lichtveld examines four of the greatest public health concerns caused by climate change:</p> <ol> <li><strong>Infectious diseases:</strong> floodings are one of the hallmarks of a world with rising temperatures, affecting water quality and creating more habitats where dangerous bacteria and vectors like mosquitoes can breed and transmit infectious diseases to people. Droughts, on the other hand, can degrade drinking water quality, allowing for more rodents to enter human communities, spreading hantaviruses.</li> <li><strong>Extreme heat:</strong> excessive heat can magnify preexisting health problems, such as cardiovascular and respiratory diseases. Today, about 30% of the global population is exposed to potentially deadly heat stress each year, a number that can increase to at least 48% (and as high as 76%) by the end of this century.</li> <li><strong>Food and water security:</strong> the previous two concerns are tightly interconnected, since rising temperatures shorten agricultural growing season, threaten fisheries that coastal communities depend on, and affect fresh water supplies.</li> <li><strong>Poor air quality:</strong> hot weather and fossil fuel gases contribute to ground-level ozone, a key component of smog, which can exacerbate allergies, asthma, and other respiratory problems, as well as cardiovascular disease.</li> </ol> <p></p> <p>In sum, climate change is driving negative changes in global health, and more people will continue to suffer, since the global regions where there is more population growth are also the most affected by climate change.</p> <h2>Theranos Downfall and the Implications for in Vitro Diagnostic Tests in the United States</h2> <p id="E264">When she was 31 years, Elizabeth Holmes was the youngest self-made billionaire in the United States (US). The reason? <a is="qowt-hyperlink" href="https://www.medicaldevice-network.com/analysis/theranos-ldt-regulation/" target="_blank" rel="noreferrer noopener">Her company Theranos</a>, which was set out to revolutionize laboratory testing, using just a tiny drop of blood from a finger prick to measure everything from glucose levels to cancer markers and infectious diseases. Making use of her charismatic personality, by the end of 2004 (one year after founding Theranos), Holmes had secured 6 million dollars in capital from investors to continue developing her “Edison” machine and the blood “nanotainer.”</p> <p id="E274">However, her lab employees soon started to see problems with the “Edison” machine, which was incapable of performing even a fraction of the tests advertised by the company and was fraught with measurement errors. The company management ignored the employees’ error reports, and correct results from the machines were cherry-picked, while wrong results were ignored.</p> <p id="E277">Problems continued to pile up, and after an article published by the Wall Street Journal in 2015 and two Food and Drug Administration (FDA) reports, doubts about the company and the technology were now impossible to ignore. In March 2018, the US Securities and Exchange Commission charged Holmes and former Theranos president Ramesh ‘Sunny’ Balwani with “raising more than 700 million dollars from investors through an elaborate, years-long fraud in which they exaggerated or made false statements about the company’s technology, business, and financial performance.”</p> <p id="E290">In January 2022, Holmes was found guilty on four charges of defrauding investors and could now face up to 20 years in jail.</p> <p id="E293">The Theranos saga has been portrayed in countless articles, podcasts, and even TV shows, serving as a cautionary tale for investors, showing how volatile Silicon Valley start-ups can be, and also highlighting a 40-year-old legal loophole in the US. Theranos technology fell in a category called lab-developed tests, which mean that if the tests are designed and used in a single lab, that lab can market them without the US authority’s approval. Following this high-profile scandal, a new law proposal proposes the establishment of a new regulatory category called in vitro clinical tests, which would include these lab-developed tests and in vitro diagnostic tests in a single class that is distinct from other medical devices. This is expected to improve transparency in the development of such tests and ensure patient safety.</p> <h2 id="E293">Artificial Intelligence Tool Has the Potential to Prevent Thousands of Deaths</h2> <p id="E326">A new <a is="qowt-hyperlink" href="https://hub.jhu.edu/2022/07/21/artificial-intelligence-sepsis-detection/" target="_blank" rel="noreferrer noopener">artificial intelligence (AI) tool</a> developed by investigators at Johns Hopkins University can quickly scan the record and clinical notes of inpatients to identify those at risk of life-threatening complications from sepsis. After being used by 4,000 clinicians in five hospitals to treat 590,000 patients, the AI tool showed a 40% accuracy in detecting sepsis cases. For comparison, previous attempts to use electronic tools were only 2-5% accurate. Although all sepsis cases are eventually detected, time is of the essence. If a patient is already in septic shock, their survival chances are much lower, and with the standard of care, this condition kills about 30% of those who develop it.</p> <p id="E335">In the most severe cases, an hour can make the difference between survival and death, and the new AI tool was able to detect sepsis cases at an average of six hours earlier than traditional methods. Additionally, and unlike conventional approaches, the system allows doctors to see <em>why</em> the tool is making specific recommendations, so it is not just a black box spurting commands.</p> <p id="E342">According to Suchi Saria, founding research director of the Malone Center for Engineering in Healthcare at Johns Hopkins and lead author of the published studies on the AI tool, the approach is “adaptive and takes into consideration the diversity of the patient population, the unique ways in which doctors and nurses deliver care across different sites, and the unique characteristics of each health system, allowing it to be significantly more accurate and to gain provider trust and adoption.”</p> <h2>Yale Medicine Experts Compare the Available COVID-19 Vaccines</h2> <p id="E360">As the COVID-19 pandemic enters its third year, the available information about SARS-CoV-2, its variants, and the available vaccines continues to increase. Unfortunately, so does misinformation, which continues to spread despite our best efforts. To help you keep up with how well the vaccines are performing, specialists from Yale Medicine have mapped out a <a is="qowt-hyperlink" href="https://www.yalemedicine.org/news/covid-19-vaccine-comparison" target="_blank" rel="noreferrer noopener">comparison of the most prominent COVID-19 vaccines</a>.</p> <p id="E367">They explore and compare two mRNA vaccines (Pfizer-BioNTech and Moderna), one virus vector vaccine (Johnson &amp; Johnson, J&amp;J), and one protein adjuvant vaccine (Novavax), all of which are available in the US. Both mRNA vaccines had about 95% efficacy against the original SARS-CoV-2 strain and although immunity was shown to wane with time, additional vaccine doses (boosters) have been effective in preventing severe COVID-19, hospitalization, and deaths from the disease. J&amp;J vaccine showed 67% efficacy in preventing moderate to severe or critical disease when it was applied for authorization, but preliminary results from a study conducted in South Africa at a time when Omicron was prevalent showed that it was 85% effective against hospitalization. Novavax was the last vaccine to be approved in the US and showed 90% effective against lab-confirmed, symptomatic infection and 100% against moderate and severe disease, with the advantage of being simpler to manufacture and store.</p> <p id="E380">Although not available in the US, the experts also discuss the Oxford-AstraZeneca COVID-19 vaccine, which is, like J&amp;J, a virus vector vaccine, in which an adenovirus was engineered as a shell to carry the genetic code on the SARS-CoV-2 spike proteins to the cells. Once there, the cells use this genetic material to produce a spike protein and train the body’s immune system, protecting the body without an actual infection. As for its effectiveness, clinical trials showed that it was 76% effective at reducing the risk of symptomatic disease and 100% against severe disease.</p> <h2>The Future of Work and Mental Health in a Post-pandemic World</h2> <p id="E406">One of the biggest changes caused by the COVID-19 pandemic was the shift to remote working. At first, employers were concerned that productivity would decline, but soon it was discovered that</p> <p>productivity, engagement, and morale on the job skyrocketed during the pandemic, with 52% of employers reporting more engagement from their employees. However, the last few years have also shown a sharp increase in <a is="qowt-hyperlink" href="https://www.forbes.com/sites/forbesbooksauthors/2022/02/01/mental-health-in-a-post-pandemic-world/?sh=3120d703b7af" target="_blank" rel="noreferrer noopener">mental health concerns and burnout</a>.</p> <p id="E413">Despite having an engaged and productive workforce, the mental suffering of people is bound to bring a tsunamic change in the not-so-distant future, the experts say. However, this bleak vision of the future is not set in stone.</p> <p id="E418">Forced isolation and remote working helped workers to realize that a big part of their earnings and time was spent commuting, eating out, and in childcare. Recent surveys have shown that workers are now prioritizing their work-life balance and more flexible job requirements, including hybrid virtual models, allowing them to work from home at least part of the time. These arrangements do not work for all workers, though. Those who do not work in offices do not have the possibility to work from home, but are also increasingly vocal about their demands for a better life balance, with better pay and enough rest time.</p> <p id="E421">The pandemic has highlighted the importance of employee well-being and mental health, and employers that decide to make these issues a priority have a competitive advantage.</p> <h2>FDA Approves Most Expensive Drug in the World</h2> <p id="E427">On November 22, 2022, the <a is="qowt-hyperlink" href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-gene-therapy-treat-adults-hemophilia-b" target="_blank" rel="noreferrer noopener">US FDA approved</a> Hemgenix (etranacogene dezaparvovec), the first gene therapy for the genetic blood-clotting disorder hemophilia B. With a price tag of 3.5 million dollars, this one-time treatment is not the most expensive drug in the world, surpassing Novartis’ Zolgensma, which costs just over 2 million dollars and is used to treat spinal muscular atrophy in children under 2 years.</p> <p id="E454">According to the clinical trials conducted to get the drug approved, a single dose of Hemgenix can protect people with moderate to severe hemophilia from life-threatening uncontrolled bleeding for eight years, and potentially longer. The drug uses a modified virus to deliver a gene to the recipient’s cells, a technology that has been widely used for advanced treatments as well as vaccines, including some COVID-19 ones.</p> <p id="E465">Despite the hefty costs, CSL Behring, the company that developed Hemgenix, says that its use will result in savings for the US healthcare system, since it will eliminate the need for regular injections of Factor IX. Until now, the only available treatment for patients with hemophilia B consisted of routine intravenous infusions of Factor IX to keep an adequate level of this clotting factor and prevent bleeding episodes.</p> <p id="E475">Although encouraging, this approval also highlights the challenges in developing effective gene therapies for hemophilia. While Hemgenix gives a new hope for hemophilia B patients, these account for only about 15% of patients with the condition; the rest has hemophilia A. In Europe, the European Medicines Agency (EMA) <a is="qowt-hyperlink" href="https://www.ema.europa.eu/en/news/first-gene-therapy-treat-severe-haemophilia" target="_blank" rel="noreferrer noopener">approved a different gene therapy for hemophilia A</a> in August 2022, which was at the time rejected by the FDA, but it is now being re-evaluated.</p>