May 11, 2022
🐪 Good morning, Vitals readers. Today's newsletter is 799 words or a 3-minute read.
1 big thing: Medical education in abortion may disappear in red states
A key piece of OB-GYN training — how to perform an abortion — could soon be missing from the medical school curriculum if states make the practice illegal, Axios' Oriana Gonzalez and I report.
Why it matters: If the U.S. Supreme Court overturns Roe v. Wade, it could drastically impact the training of young doctors for a procedure sought by up to one in four women, experts say.
What they're saying: "The implications for our field are devastating," Kavita Vinekar, assistant clinical professor at the David Geffen School of Medicine at UCLA told Axios.
- "The politicization of our field has made the public think of abortion as a very separate thing from reproductive care when really it's very much intertwined in what we do," Vinekar said.
- "Abortion care is very much intertwined with miscarriage management, with pregnancy care, with overall reproductive care," she said.
By the numbers: 128 of the roughly 300 U.S. OB-GYN residency programs in the U.S. are in states that are certain or likely to ban abortion if the Supreme Court strikes down Roe and eliminates a federal right to the procedure, according to a recently published study in Obstetrics and Gynecology.
- Of the roughly 6,000 residents in accredited OB-GYN programs, more than 2,600 (44%) are in states that are likely to ban abortion.
Zoom in: "I'm one of the only physicians in the entire state of Indiana who performs [dilation and evacuation] procedures," a common second-trimester procedure, Caitlin Bernard, an OB-GYN in Indiana and a fellow with Physicians for Reproductive Health, told Axios.
- "I'm currently training residents on how to perform [D&E] because I'm able to perform abortions," Bernard said. "When I'm not able to perform abortions, I'm not going to be able to train those residents."
2. Pumping the brakes on the FDA fast track
A week after the maker of a controversial Alzheimer's drug announced it would largely stop marketing it, Congress is readying legislation that tinkers with the pathway used by the FDA to approve the drug.
But it avoids making large-scale changes, Axios' Adriel Bettelheim reports.
Why it matters: Aduhelm's approval created heightened scrutiny around whether the FDA's "accelerated approval" process is being used appropriately. But as the drug fades largely into the background, so are the calls for stringent reforms.
Be smart: Accelerated approval lets drugmakers sell their products based on preliminary evidence and finish clinical trials once they're already on the market.
- 14 of the 50 new drugs the FDA approved last year went through the accelerated pathway, including Takeda Pharmaceuticals' Livtencity for post-transplant infections and Regeneron's Evkeeza for a genetic form of high cholesterol.
- But the process has drawn concern because of the way it could put big-ticket drugs in the public's hands that may wind up being ineffective or unsafe.
What we're watching: House Energy and Commerce leaders are proposing fixes as part of a broader legislative package to renew FDA programs that will be marked up today.
3. Gun homicides jump 35% in 2020
The nation's firearm homicide rate hit its highest mark in more than a quarter-century during the first year of the pandemic, Axios' Ivana Saric writes about a newly released CDC report.
- Deaths jumped 35% from 2019 to 2020, with the largest increases occurring among Black men aged 10–44 years old and Native American or Alaska Native men aged 25–44 years old.
- Counties with the highest poverty levels in 2020 experienced firearm homicide and suicide rates that were 4.5 and 1.3 times as high, respectively, as counties with the lowest poverty levels.
4. 1 big number: Staffing shortage fallout
More than four in 10 hospitals have seen staffing shortages limit their ability to discharge patients because of a lack of post-acute care, according to a survey provided exclusively to Axios by CarePort Health, a care coordination software company.
- Among the hardest hit are the facilities that fall on the spectrum of post-acute care.
Zoom in: This National Hospital Week survey is limited — it captured the responses of care coordination leaders at 23 hospitals and post-acute care providers — but offers a glimpse at the potential real-world impacts of shortages on the health care system.
- For instance, 86% of hospitals said COVID-19 made it harder to secure placement for discharged patients.
- 70% of respondents said hospital length of stay is increasing due to challenges discharging patients.
5. Catch up quick
🌏 At least 3,000 Ukrainians have died due to lack of access to health treatments for chronic ailments such as cancer and diabetes, a World Health Organization official said Tuesday. (Axios)