January 17, 2025
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Morning Rounds Writer and Podcast Producer

Happy Friday! A couple days ago, I donated blood for the first time ever. I got so dizzy while laying down that they had to slap a cold compress on my forehead and hold a box of apple juice up to my lips. And is it TMI to tell you that when I got home, I puked? I'm fine now, and determined to try again someday. As of yesterday, 20% of community blood centers operated by America’s Blood Centers had one day's supply of blood or less. (I talked with Adm. Rachel Levine last fall about how climate change means more blood shortages.)

Anyway, have a nice long weekend! You'll hear from Liz Cooney on Tuesday, and I'll be back on Wednesday.

addiction

Safe consumption sites face an uncertain future under Trump

An over-the-shoulder close-up of a bearded man mixing cocaine and heroin in a small cup, with the back of a syringe, on a clean metal table.

Chantal Heijnen for STAT

When it comes to drug addiction, efforts focused on harm reduction have always been a little controversial. But Donald Trump’s imminent return to the White House has alarmed supporters of the approach, particularly when it comes to supervised consumption. The first Trump administration took a hard line on the tactic, and his pick for health secretary, Robert F. Kennedy Jr., has advocated a “tough love” approach.

“We’re operating an amazing service with an amazing staff providing services to beautiful human beings,” said Sam Rivera, the executive director of OnPoint, a harm reduction nonprofit.  “And if no one does anything for me to respond to, we keep doing it. If something happens where we’re being challenged, I’m ready.” Read more from STAT’s Lev Facher about what supervised consumption looks like at this East Harlem spot, and how the organization is preparing for the Trump presidency.

infectious disease

CDC says hospitals should rush to test all influenza A patients for bird flu

On Thursday, the CDC issued new guidance to health care workers, urging them to fast-track additional testing for H5N1 bird flu for all patients hospitalized with influenza A, ideally within 24 hours of admission. 

The move reflects growing concern about the widening bird flu outbreak, in particular an uptick in H5N1 infections among individuals with no known exposures to either poultry or dairy cattle. In the past two months, health officials in California have identified two children who tested positive for the virus. In both cases, it has not yet been determined how the infection occurred. 

This type of testing is usually done in public health laboratories. Samples are typically sent out in batches every few days. By the time results are returned, the patient may already have been discharged, making case investigations and contact tracing more difficult. “The system right now tells us what has already happened,” Nirav Shah, the CDC’s principal deputy director told reporters Thursday. “What we need is to shift to a system that tells us what’s happening in the moment.”

That extra vigilance is extra important now because the U.S. is in peak flu season, which complicates efforts to track H5N1. — Megan Molteni

science

A new way of looking at Huntington’s disease 

After decades focused on one idea of what causes Huntington’s disease, scientists are starting to look from a new perspective. The long-held notion is that the brain-ravaging disease is caused by the lifelong accumulation of toxic proteins produced by a mutant gene. But now, more and more researchers are investigating the dynamics of the mutant itself. The gene has this genetic stutter — repeats of a sequence of three letters. The more repeats there are, the more unstable the gene becomes.

Evidence to support this theory first emerged in the early 2000s, but was largely ignored. It’s been reinvigorated, in part, by the arrival of powerful new methods for peering more closely into the lives of individual cells. And a new study could help explain why so many recent drug development efforts have fallen short. Read more on the science from Megan.  

policy

Trans health care is back in court 

On Wednesday, a federal court heard oral arguments for another case focused on gender-affirming care, about six weeks after the Supreme Court heard arguments on Tennessee’s ban on that care for youth. This case, heard in the Ninth Circuit, focused on an attempt by Blue Cross Blue Shield of Illinois to apply a religious exemption to deny coverage of gender-affirming care. Lambda Legal initially filed a lawsuit against the company in 2020 on behalf of a trans teen on his mother’s employer-provided plan. 

Similar to the arguments over Tennessee’s ban, a key component of this case relies on whether or not the exemption is discrimination on the basis of sex. Judge Johnnie Rawlinson asked if the Ninth Circuit should wait to decide this case until the Supreme Court puts out its opinion. Rob Hochman, the lawyer representing BCBS, said they’d have no objection, while Lambda’s Omar Gonzalez-Pagan said it was not necessary or appropriate to wait. 

This is just one of the cases around gender-affirming care that were considered in state and federal courts this week. Another federal appeals court heard arguments over Florida’s ban on the care for youth, which was blocked by a lower court last year. In North Dakota, a judge denied the state’s motion to dismiss a lawsuit challenging its ban.

All of these cases will be decided under the incoming Trump administration. Trump himself has pledged to issue a first-day executive order “instructing every federal agency to cease all programs that promote the concept of sex and gender transition, at any age.” Monday is that first day.

cancer

Pros & cons of the latest cancer trends

The good news: Deaths from cancer continue to fall in the U.S., per a report from the American Cancer Society released yesterday. Overall, the cancer mortality rate fell by 34% from 1991 to 2022. The bad news: The cancer burden is shifting from older to younger adults, and from men to women. For example, incidence rates for women under 50 are now 82% higher than for men under 50, up from 51% in 2002.

And, sorry, more bad news: Cancer mortality rates among Native American people are two to three times higher than among white people for kidney, liver, stomach, and cervical cancers. Black people are twice as likely to die of prostate, stomach, and endometrial cancers compared to white people and 50% more likely to die from cervical cancer — a cancer type that is preventable with HPV vaccination, the report notes. Read more on the report and what it all means from STAT’s Liz Cooney.

food

How many of you have ever felt personally victimized by calorie counts on menus?

Since 2018, the FDA has required calorie counts to be displayed on the menus of chain restaurants. In 2022, a similar rule was introduced in the U.K. But does this practice actually make a difference? A new systematic review finds that it has a small but tangible impact, STAT’s Sarah Todd reports. 

Researchers found that the labels prompt people to pick foods with an average 1.8% fewer calories than they would without calorie labels. That’s the difference between a 600-calorie meal and a 589-calorie one. Read more from Sarah on the rule. 

And as her editor put it earlier this week, it’s hard to keep up with this new commercial determinants reporter! Both she and Biden’s FDA have been busy this week. Make sure you didn’t miss the other stories Sarah wrote this week on front-of-package nutrition labels, the FDA’s authorization of 20 Zyn products, and its ban on red dye No. 3 (that one written with STAT’s Lizzy Lawrence).

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Clarification: In Thursday's item on red meat and dementia risk, researchers were affiliated with Massachusetts General Brigham, the Harvard Chan School of Public Health and the Broad Institute. 

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