The nose won’t know

Hopes for a nasal Covid vaccine were set back as Oxford/AstraZeneca has reported that its candidate failed in its first trial.

The underwhelming results have led scientists to abandon plans to develop the spray in its current form, with hopes now resting on different formulations of the vaccine and more complex delivery devices, such as nebulisers that can deliver medicines deep into the lungs.

Congrats to Jim Martin!

A huge GPhA Buzz congratulations to GPhA Past President (1989–1990) Jim Martin, who was honored with the Calvin J. Anthony Lifetime Achievement Award from NCPA.

Although he now lives in Texas, we’ll forgive him that little transgression, as Jim has a huge list of accomplishments that make him a more than worthy recipient. Not only was he GPhA’s president, he owned several independent pharmacies in Georgia over more than two decades; served as a member of the Georgia General Assembly; and was president, chairman of the board, and executive vice president of NCPA.

Jim remains licensed in Georgia, and he owns four independent pharmacies in the Austin area.

What to worry about: “Rainbow fentanyl”?

The DEA is warning that drug dealers are targeting kids with “rainbow fentanyl” — pills in various colors designed, they claim, to attract kids. And, you know, Halloween is coming.

But drug experts say no, no they aren’t. Dealers, like anyone selling a product, do marketing. No one is targeting kids. (Seriously, how would giving a 10-year-old fentanyl drive up business?)

[T]raffickers have long used bright colors in their products for reasons that have nothing to do with children. […] dealers use colors, stamps and other markers “to distinguish their product from other products on the street.”

What CE do you want to see?

Your call: Same old, same old? Or something new and better?

GPhA’s CPE advisory committee needs to hear from you! They want to schedule the CPE you’re looking for, but you have to tell them what that is.

And the clock is ticking.

You can influence GPhA’s education for 2023 — but only if you respond quickly to the GPhA CPE survey!

We’re counting on you to help us help you. Take a few minutes to tell us the topics vital to your practice. But hurry: The survey closes October 21!

What to worry about: War games (the video kind)

“Video games may trigger lethal heart rhythm problems in children.” according to a report published in Heart Rhythm. How big is the problem? After reviewing literature from around the world and conducting “a multisite international outreach effort,” the researchers found … 22 cases.

They provided a helpful image of a potential victim:

But seriously, folks, if a kid has a heart issue, be aware.

“Children who suddenly lose consciousness while electronic gaming should be assessed by a heart specialist as this could be the first sign of a serious heart problem.”

(The biggest problem, they say, is war games, which they called “a potent arrhythmic trigger.”)

Covid origins settled?

The origin of the SARS-CoV-2 virus has finally been established … at least for now. An international task force, with members from the US, Africa, Asia, and Europe has published a detailed, peer-reviewed analysis that concluded, “SARS-CoV-2 likely spread naturally in a zoonotic jump from an animal to humans—without help from a lab.”

The PNAS [Proceedings of the National Academy of Sciences] authors say their literature search revealed “considerable scientific peer-reviewed evidence” that SARS-CoV-2 moved from bats to other wildlife, then to people in the wildlife trade, finally causing an outbreak at the Huanan Seafood Market in Wuhan. In contrast, they say, relatively few peer-reviewed studies back the lab-leak idea.

In fact, most of the argument for a lab leak, they said, “has been advanced through opinion pieces” and “relatively few peer-reviewed studies back the lab-leak idea.” But they acknowledge that even their detailed report can’t be definitive — it’s just by far the most likely.

What to worry about: Being stuck in the middle

Covid is bad, agrees The Atlantic (“World’s Most Depressing Magazine™”), and long Covid is also bad. But you know what we aren’t worried enough about? Medium Covid.

For the majority of vaccinated people, however, the worst complications will not surface in the early phase of disease […] Rather, they emerge during the middle phase of post-infection, a stretch that lasts for about 12 weeks after you get sick. This period of time is so menacing, in fact, that it really ought to have its own, familiar name: medium Covid.

Medicare at a disadvantage

Congress created Medicare Advantage to bring the private sector into Medicare. Private industry, after all, must be better than the government at running programs like that.

So what do you think happened?

A) Giant private insurers like UnitedHealth, Humana, and CVS brought cost savings and efficiencies to the market as only private corporations can do.

B) The private companies defrauded Medicare (and thus taxpayers) for billions, and are now settling one Federal lawsuit after another.

Yeah, it’s B.

Each of the strategies — which were described by the Justice Department in lawsuits against the companies — led to diagnoses of serious diseases that might have never existed. But the diagnoses had a lucrative side effect: They let the insurers collect more money from the federal government’s Medicare Advantage program.

Two medical oddities

Delta blues, but Omicron’s OK

Apparently, infection with Covid’s delta variant was causing a spike in maternal deaths and stillbirths due to a combination of preeclampsia and plancental ‘hardening.’

Chalk that up to Yet Another Covid Effect, but here’s the weird part: Once Omicron took over as the dominant strain, those problems dropped to close to pre-pandemic levels. Health experts still don’t know why (“Further studies are needed”), but it’s another example of just how weird this virus is.

Kids are having breathing trouble

The CDC is monitoring a significant rise in the number of kids with acute respiratory illnesses caused by rhinoviruses and enteroviruses.

Enterovirus outbreaks aren’t news; they happen every couple of years. But starting in August, the number of cases has gone much higher than usual, thanks to enterovirus D68 (EV-D68^*).

In August 2022, clinicians in several geographic areas notified CDC of an increase in hospitalizations of pediatric patients with severe respiratory illness and positive rhinovirus/enterovirus (RV/EV) test results.

The biggest danger is that some of these cases can lead to acute flaccid myelitis (AFM), so the CDC is advising medical folks to test for EV-D68 if a kid has breathing issues, and if it gets to the point of limb weakness, they should consider AFM as a possible cause. Oh, and because this is 1952 in some parts of the country (looking at you, New York), the CDC also suggests testing for poliovirus.

Hang this story up by your toothpaste section

“Microbes that cause cavities can form superorganisms able to ‘crawl’ and spread on teeth” — UPenn

… and just put a newspaper by the sleep aids

“Politics are keeping Americans up at night: Nearly 60% of adults struggle to fall asleep due to political worries” — American Academy of Sleep Medicine