Seven places you should avoid

Seven south Georgia counties — Bacon, Charlton, Heard, Jeff Davis, Lanier, Telfair, and Treutlen — are now in the CDC red zone for spread of the Delta variant. And Charlton, with its 14.5 percent vaccination rate, is highest in the country for new Covid cases.

Two steps back

By the time you read this, the CDC is expected to have updated its guidance and once again recommend that everyone wear a mask while indoors in areas (like a lot of Georgia) where the Delta variant is spreading fast.

The idea is that unvaccinated people will start to take the virus more seriously, while vaccinated people will mask up to protect their unvaccinated neighbors. (There are breakthrough infections, but for vaccinated people the risk is minor.)

Eleanor Rigby might be over-using

If you’ve got senior patients who seem to be taking more and more drugs, they may not actually be sick — they could be lonely. A study out of the UC San Francisco found that the lonelier older people are, the more likely they are to use opioids, sedatives, and anti-anxiety meds. Oh, and antidepressants and OTC painkillers, too.

Contraindications may not come to light until a patient is suddenly hospitalized. “It’s only then that we might find out that a patient’s prescriptions include Valium and he’s been taking it for more than 20 years.”

No, the monkeypox saga isn’t over

Now it’s 43 people in Georgia being monitored for the disease, up from 26 last week. Move along, citizen, nothing to see here.

Coupla Covid notes

As scientists try to figure out what the heck is going on with long Covid, a new detail: nerve damage in the cornea. That’s not only slightly terrifying, it’s a clue as to why symptoms persist — it could have done damage specifically to small nerve fibers. Besides carrying signals like pain and itchiness…

Small-fiber nerve cells also help control involuntary bodily functions, such as heart rate and bowel movements; therefore, damage to these cells can cause a wide array of symptoms.

=AND=

Yet another reason to avoid this thing like the plague it is: A third (!) of Covid patients are diagnosed with a neuropsychiatric condition within six months of recovery. An Oxford University study looked at the health records of 81 million people, and the conclusion is based not on what people reported, but what their actual diagnosis was.

Anxiety, mood, and substance use disorders were most common, but the researchers also found worrying, if lower, rates of serious neurological complications, especially in patients who had been severely ill with Covid-19. In all Covid-19 patients, 0.6% developed a brain hemorrhage, 2.1% an ischemic stroke, and 0.7% dementia.

Just a reminder

There is no cure for Covid-19. In fact, there’s no surefire treatment — just a bunch of ‘stuff that seems to work at least some of the time.’

The cost of business

With a $26 billion opioid settlement getting closer to reality, you might be tempted to send thoughts and prayers to the drug distributors (and Johnson & Johnson) that are doing the settling.

But don’t you worry — they’ll be OK if the deal goes through.

Since 2016, the four companies involved in the latest opioid settlement — Johnson & Johnson, McKesson, AmerisourceBergen, and Cardinal Health — have funneled a combined $100 billion to shareholders through stock buybacks and dividends.

At least one state attorney general — Washington’s Bob Ferguson — has done the same math and said he won’t support the deal because it doesn’t “provide a transformative amount of money for state and local governments to address the opioid epidemic.”

Yes, what we need is another PBM

Lucky for us, that’s just what’s Anthem and Humana are launching with their partner, software maker SS&C. The two insurers are investing about $140 million for their stake in the new PBM platform: DomaniRx. It will, they say…

…offer its payer and provider users with data analytics and end-to-end transparency around drug costs—features that will help them better comply with the changing PBM regulatory environment.

Anthem, as you may recall, is not at all friends with Express Scripts, and it tried to launch its own PBM once before (the ill-fated IngenioRx). Humana has its own PBM, but it will be DomaniRx’s first customer.

Correction: An earlier version of this story misspelled the name of the new company. There is no “T” in it.

Not surprising, but still good news

The 2020–21 flu season was the lightest since the CDC began tracking it* — we’re talking a 1 percent positive rate, compared to a typical 25 percent. Amazing what wearing masks and hunkering down will do.

* It sounds like a long time, but it’s only been since 1997.

(Another) breast cancer breakthrough

If you have a mouse with breast cancer, good news: University of Illinois biochemists have found a drug they call ErSo that “quickly shrinks even large tumors to undetectable levels.”

It takes advantage of the estrogen receptor on tumor cells and effectively revs up the cancer cells’ protection system until it kills them. Oh, and then it goes on to kill the cancer where it’s metastasized, too.

“The unique thing about this compound is that it doesn’t touch cells that lack the estrogen receptor, and it doesn’t affect healthy cells — whether or not they have an estrogen receptor. But it’s super-potent against estrogen-receptor-positive cancer cells.”

Next up, human trials.

ARBs eke out win over ACE inhibitors

Sure, ACE inhibitors are the popular kid who gets all the prescriptions, but ARBs have fewer side effects — so found Columbia University researchers who looked at data from 3 million patients from around the world.

Both did their job, but those newer ARBs seemed just a wee bit safer.

Patients taking ACE inhibitors had a higher risk of cough and angioedema, but the study also found they had a slightly higher risk of pancreatitis and gastrointestinal bleeding.

Bottom line: If an ACE inhibitor is working well, leave it be. But for first-time users, maybe give an ARB a shot instead.