FDA authorizes outpatient remdesivir

There aren’t a lot of drugs available to treat Covid-19 outside the hospital, and only one works against Omicron (and it’s in short supply).

So the FDA has given its approval for administering intravenous remdesivir, previously limited to hospital use, to outpatients. The goal: Keep them out of the overcrowded hospitals. (It had been used this way off-label, but that could prevent insurance reimbursement. Now it’s covered.)

The FDA action Friday followed recent publication of a study in the New England Journal of Medicine that showed remdesivir can be beneficial when given on an outpatient basis. The study found that the drug reduced hospitalization and death by 87 percent when given soon after a coronavirus diagnosis.

Southern healthcare crisis

Nurses in rural hospitals in the South are quitting, getting sick, and fed up. That doesn’t bode well for patients. Even with the latest Covid wave receding, hospitals are filled to bursting, and the staff is D-O-N-E done.

Successive waves of illness and death have left them exhausted and numb; nearly one in five have left the profession over the past two years. And they are angry — at the patients who refuse to get vaccinated, at the hospital executives who won’t spend the money needed to maintain safe nurse-to-patient ratios, and at the political leaders who call them “health care heroes” while opposing mask and vaccine mandates that might blunt the tsunami of new infections.

This isn’t helping

Meanwhile, while hospitals fill and nurses stress, a crowd of anti-vaccine demonstrators rallied at the National Mall in D.C., claiming, among other things, that vaccines are bio weapons, masks infringe on freedom, vaccination causes autism, and that the entire pandemic is a lie*. (The rally was ostensibly about the Covid-19 vaccines, attendees are presumably also against vaccines for polio, measles, rubella, smallpox, and the like.)

* 860,000 dead Americans might beg to differ.

You say ‘iron deficiency,’ I say ‘iron deficiency’

There’s a connection between iron deficiency and heart failure, but Italian researchers found a bit of a problem: There’s no single definition of “iron deficiency.”

So while everyone might agree that a patient has it, doctors can’t make a prognosis without knowing which definition was being used — ferritin level? Transferrin saturation? Serum iron? A combination?

“Many patients fulfilled one definition of iron deficiency but not others,” the researchers wrote.

Disarming listeria

One of the nasty tricks listeria bacteria has infecting and eventually killing immune cells … after using them to multiply. (You can supply your own metaphor here.) But now researchers at the University of Queensland have found a way — a “drug-like inhibitor” — that regulates the listeria so it can’t grow inside the immune cells.

That’s half the trick. The other is that it also helps the immune cells realize they’ve been invaded so they can destroy the bacteria. (“The bacteria is inside the house!)

It’s not the years, it’s the mileage

What’s your actual biological age? It may not be based on your birthday— but your retina knows. And like a friend who blurts out, “She just turned 30!” it’s willing to give up that info.

A group of Chinese, German, and Australian researchers found that a quick scan of an eyeball — run through the right algorithm — can identify people who are older than the number of candles on their cake. (Without knowing someone’s age, it could guess it plus or minus 3.5 years.)

And if your retina says you’re older … be careful:

For instance, if the algorithm predicted a person’s retina was a year older than their actual age, their risk of death from any cause in the next 11 years went up by 2 percent. At the same time, their risk of death from a cause other than cardiovascular disease or cancer went up by 3 percent.

Smoking through the generations

Here’s a weird one: Men who start smoking before puberty will have granddaughters and great-granddaughters with more body fat.

So found a study out of the University of Bristol, based on data of more than 14,000 people enrolled in Britain’s Children of the 90s study. But here’s a crazy twist: A previous study had found that …

…if a father started smoking regularly before reaching puberty (before 11 years of age), then his sons, but not his daughters, had more body fat than expected.

It apparently took an extra generation for granddad’s habit to reach the girls.

The Long Read: Future of Vaccines edition

Gene-based (or “nucleic acid”) vaccines, whether mRNA or DNA, are ready to take on a lot of conditions — and not just infectious diseases.

University of Washington biotechnologist Deborah Fuller explains their history, how they work, and what’s coming next.