About Covid-19
Laboratory-Confirmed COVID-19 Among Adults Hospitalized with COVID-19–Like Illness with Infection-Induced or mRNA Vaccine-Induced SARS-CoV-2 Immunity — Nine States, January–September 2021: From the CDC: “Among COVID-19–like illness hospitalizations among adults aged ≥18 years whose previous infection or vaccination occurred 90–179 days earlier, the adjusted odds of laboratory-confirmed COVID-19 among unvaccinated adults with previous SARS-CoV-2 infection were 5.49-fold higher than the odds among fully vaccinated recipients of an mRNA COVID-19 vaccine who had no previous documented infection (95% confidence interval = 2.75–10.99)…
All eligible persons should be vaccinated against COVID-19 as soon as possible, including unvaccinated persons previously infected with SARS-CoV-2.” [Emphasis added]
COVID-19′s global death toll tops 5 million in under 2 years: “Together, the United States, the European Union, Britain and Brazil — all upper-middle- or high-income countries — account for one-eighth of the world’s population but nearly half of all reported deaths. The U.S. alone has recorded over 745,000 lives lost, more than any other nation.”
Sanofi-GSK COVID-19 Shot Will Cost Around $11: “Sanofi is planning to price its recombinant protein-based COVID-19 vaccine developed with a GlaxoSmithKline (GSK) adjuvant at approximately $11 a dose.
Phase 3 trials on a reformulated version of the Sanofi-GSK vaccine candidate began in May and the companies are now also assessing booster jabs. Full trial results are expected by year’s end.”
About hospitals and health systems
How CHS, HCA, Tenet and UHS fared in Q3: A good summary of the reports from these four systems. Profitability is picking up even as hospitals repay Medicare advances.
Cost of Caring: From the AHA. A few highlights, though the entire monograph is worth reading:
“In recent years, health care spending growth has largely been driven by increased use and intensity of services.”
The highest cost for hospitals is still wages and benefits (at 56% of the total).
The AHA makes its case that insurance premiums are not rising because of hospital expenses: “Hospital price growth averaged 2.0% annually from 2010 until the beginning of the COVID-19 pandemic. Health insurance premiums, however, have increased 4.4% per year on average since 2010.”
About healthcare quality
Cardiovascular Safety Communications After US Food and Drug Administration Approval of Contemporary Cancer Therapies: “In this evaluation of contemporary FDA-approved cancer therapeutics, more than 1 in 4 required a cardiotoxic effects safety warning, including more than 40% targeted and immune-based drugs. In postmarketing, the median time to CVD warning issuance was nearly 5 years, a value 40% longer than noncardiac warnings. This pattern remained, even after accounting for the presence or absence of preceding safety reports.”
Watch Out for These Diagnostic Pitfalls: “…researchers looked both at where the diagnosis went wrong as well as the contributing factors that made the diagnosis harder than usual. They ended up analyzing 836 diagnostic cases…
The Top 10 missed diagnoses, in order of frequency from highest to lowest, were:
Colorectal cancer
Lung cancer
Breast cancer
Myocardial infarction
Prostate cancer
Stroke
Sepsis
Bladder cancer
Pulmonary embolism
Brain hemorrhage
In terms of where things went wrong in the process, failure to order a needed test was the most frequent issue, followed by failure to consider the correct diagnosis, failure to or delay in follow-up for an abnormal test result, failure to heavily weigh a critical piece of the patient's history, and failure or delay in ordering a referral.”
About health insurance
Tracking Health Insurance Coverage in 2020-2021: From HHS:
“Recent survey data suggest a stable uninsured rate in 2020 despite the pandemic and related recession, with estimates ranging from 8.6 percent to 9.7 percent of the population (28.0 million to 31.6 million people).
Examination of other available data sources provides insights about changes in coverage by source and the overall stability of insurance rates in 2020. Administrative data over the same period suggest that increases in Medicaid and Marketplace enrollment roughly offset decreases in employer coverage, potentially explaining the survey findings.
More recent administrative data in 2021 show ongoing gains in Medicaid (1.7 million between January and April 2021) and Marketplace coverage (1.6 million between August 2020 and August 2021), which suggest that the uninsured rate may be lower now than it was in early 2021.
Uninsured rates continue to be higher in certain populations, including Latinos (18.3 percent) and Blacks (10.4 percent), people with incomes below the poverty level (17.2 percent), and residents of states that have not expanded Medicaid (17.6 percent).”
ACA Marketplaces Became Less Affordable Over Time For Many Middle-Class Families, Especially The Near-Elderly: “In 2015 half of this middle-class population would have paid at least 7.7 percent of their income for the lowest-cost bronze plan; in 2019 they would have paid at least 11.3 percent of their income. By 2019 half of the near-elderly ages 55–64 would have paid at least 18.9 percent of their income for the lowest-cost bronze plan in their area. The American Rescue Plan Act temporarily expanded tax credit eligibility for 2021 and 2022, but our results suggest that families with incomes of 401–600 percent of poverty will again face substantial financial burdens after the temporary subsidies expire.”
About healthcare IT
Wearable device signals and home blood pressure data across age, sex, race, ethnicity, and clinical phenotypes in the Michigan Predictive Activity & Clinical Trajectories in Health (MIPACT) study: a prospective, community-based observational study: “Wearable technology has rapidly entered consumer markets and has health-care potential; however, wearable device data for diverse populations are scarce. We therefore aimed to describe and compare key wearable signals (ie, heart rate, step count, and home blood pressure measurements) across age, sex, race, ethnicity, and clinical phenotypes…”
Among the findings: “Blood pressure and resting heart rate varied by sex, age, race, and ethnicity, with higher blood pressures in males and lower heart rate in participants aged 65 years or older (p<0·0001). Participants took 7511 steps per day (SD 2805) and walked 6009 metres per day (SD 2608), varying across demographic and clinical subgroups.”
DATA PROTECTION REPORT 2021: Among the findings:
Average cost of a data breach has grown from $7.91m in 2018 to $9.05m so far in 2021.
More than 50% of business leaders said they do not have a response plan to a breach.
40% of breaches are caused by external partners and almost 25% by employee error.
About the public’s health
Fetal Mortality Drops to Historic Low of 5.70 Per 1,000 in 2019: “The fetal mortality rate at 20 or more weeks of gestation in the United States was 5.70 per 1,000 live births or fetal deaths in 2019, down 3 percent from 2018, according to the Oct. 26 National Vital Statistics Reports, a publication from the U.S. Centers for Disease Control and Prevention.”
About pharma
Merck Announces Withdrawal and Refiling under the Hart-Scott-Rodino Act and Extension of Tender Offer to Acquire Acceleron Pharma Inc.: “Merck has elected to withdraw its Premerger Notification and Report Form, which was initially filed on October 14, 2021, to provide the Federal Trade Commission (the "FTC") with additional time for review, and expects to refile such form on or about November 1, 2021. Following the refiling, the waiting period applicable to the pending acquisition will expire at 11:59 p.m., Eastern time, on or about November 16, 2021. The acquisition is expected to close in the fourth quarter of 2021.”