Assessing the latest Covid uptick

The ideas and innovators shaping health care
Aug 01, 2023 View in browser
 
Future Pulse

By Ben Leonard, Evan Peng and Erin Schumaker

CHECKUP

The East Bay Municipal Utility District wastewater treatment plant.

Wastewater testing may be the best way to predict Covid surges going forward. | Justin Sullivan/Getty Images

Covid is making a bit of a summer comeback, with hospitalizations rising in July — albeit from low levels.

Case counts are hard to gauge, with most people testing at home or not at all. That leaves wastewater surveillance as an early warning system, but a new study in JAMA Network Open from Stanford researchers found that even robust testing of sewage may not tell us as much about the virulence of the disease as it used to.

The researchers found that wastewater surveillance that had accurately predicted rising cases and hospitalizations early last year became less effective in doing so as the year wore on.

The researchers said that, so far as case counts went, it was likely the result of the decline in reporting on case counts from testing.

For hospitalizations, they suspect that rising virus levels in wastewater may not always predict increased hospitalizations, given changes in the virus’ virulence.

Even so: The researchers said that “wastewater surveillance is the most consistent measure of infection prevalence during this unstable time, especially given its sensitivity even in low-prevalence settings.”

Even if the virus remains less virulent, they argued that maintaining wastewater surveillance to gauge disease surges is a good idea.

That’s because it can detect new variants and alert people who are immunocompromised when they need to take extra precautions against infection.

 

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WELCOME TO FUTURE PULSE

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This is where we explore the ideas and innovators shaping health care.

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Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com.

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Today on our Pulse Check podcast, your host Ben talks with Daniel Payne, who explains why public health experts fear an uptick of opioid overdoses as temporary pandemic rules expire and state Medicaid programs check participant eligibility for the first time in years. That's leaving some with no health care coverage and potentially hobbling the nation's opioid response.

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WORLD VIEW

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Most nations are taking steps to dissuade people from using tobacco, the WHO says. | Getty

The world is making progress in combating tobacco use, according to a new report from the World Health Organization.

The positive developments:

— 74 countries have smoke-free policies in all indoor spaces, an increase of 64 since 2007.

— 151 countries, comprising 5.6 billion people, have implemented at least part of the WHO’s guidance on tobacco control, up from 44 in 2007.

— Two more countries, Mauritius and the Netherlands, have joined Brazil and Turkey in achieving best-practice level in all six sections of the guidance.

The guidance includes best practices for monitoring tobacco use, warning people of tobacco’s dangers, protecting people from tobacco smoke, helping people quit tobacco, raising taxes on tobacco and restricting tobacco advertising.

Even so: The pace of progress has slowed considerably since 2018.

Forty-four countries don’t follow best practices in any of the six areas as of 2022, the WHO estimates.

 

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THE REGULATORS

WASHINGTON, DC - JULY 13: Federal Trade Commission Chair Lina Khan prepares to testify before the House Judiciary Committee in the Rayburn House Office Building on Capitol Hill on July 13, 2023 in Washington, DC. The committee and its chairman, Rep. Jim Jordan (R-OH), have accused Khan and the commission of "mismanagement," "disregard for ethics and congressional   oversight" and  "politicized rulemakings." (Photo by Chip Somodevilla/Getty Images)

Khan is asking tough questions about health care mergers. | Getty Images

The Federal Trade Commission continues to view health care mergers skeptically.

The agency on Tuesday applauded medical device firm CooperCompanies’ decision to end its attempted $875 million acquisition of medical device company Cook Medical Holdings’ reproductive health care division.

Cooper had announced in February 2022 that it intended to acquire Cook Medical to boost its fertility footprint – Cook makes products used for in vitro fertilization – but the FTC quickly requested more information, signaling an antitrust inquiry.

“Following a full-phase investigation by FTC staff, CooperCompanies’ decision to abandon this proposed acquisition ensures that critical reproductive health markets remain competitive,” said FTC Competition Bureau Director Holly Vedova in a release.

Both CooperCompanies and Cook Medical declined to comment.

The backdrop: Under Chair Lina Khan, the FTC has withdrawn antitrust guidance documents for pharmacy benefit managers and health care more generally, toughening its stance, and has blocked several hospital mergers.

The agency has also sued to block health care data firm IQVIA’s deal for Propel Media.

 

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