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U.S. Science Embrace of Wuhan “Gain-Of-Function” Viral Research Proved A Slippery Slope

By MIKE MAGEE

The truth hurts.

Eighteen months into a disaster that has claimed 3.5 million lives around the globe, the truth is seeping out. Human error likely caused the Covid pandemic, and America’s Medical-Industrial Complex was right in the middle of it.

Signs of a “great awakening” have emerged from various corners in the month of May.

On May 14, UNC’s top virologist, Ralph Baric, who worked closely with Wuhan chief virologist and batwoman extraordinare, Shi Zhengli, signed on with 17 other scientists to a Science editorial that demanded a reexamination of Covid’s causality writing “theories of accidental release from a lab and zoonotic spillover both remain viable.”

On May 26, Francis Collins, head of the NIH, which funded in part Zhengli’s risky bat virus research (more on that in a moment), admitted to Congressional investigators that “we cannot exclude the possibility of some kind of a lab accident.”

And on June 3rd, on MSNBC’s Morning Joe, the ever-present Tony Fauci advised all who would listen “to keep an open mind.” What he would like us to open our minds to is not a Chinese run weaponized microbe conspiracy, but simply scientific recklessness and human error.

It’s now well established that three Wuhan virology scientists were hospitalized in the Fall of 2019 with Covid. But the initial report from the Wuhan Municipal Health Commission, China, of this cluster of cases of pneumonia was only released on the last day of 2019.

It took only 50 more days for the tight knit group of global research virologists to get their act together and pen a Lancet editorial in which they stated “We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin,” and that they  “overwhelmingly conclude that this coronavirus originated in wildlife.”

Their coordinator-in-chief was one Peter Daszak, chartered power broker within the U.S. Medical Industrial Complex and president of New York based EcoHealth Alliance which was a major funder of Shi Zhengli’s work in Wuhan.

Daszak is known for adopting militarized terms in the battle against global infectious diseases. In 2020 he wrote in the New York Times, “Pandemics are like terrorist attacks: We know roughly where they originate and what’s responsible for them, but we don’t know exactly when the next one will happen. They need to be handled the same way — by identifying all possible sources and dismantling those before the next pandemic strikes.”

Daszak’s argument that risks involved in Shi Zhengli’s Wuhan bat viruses were justified as defensive and preventive was convincing enough to the NIH and the Department of Defense that his EcoHealth Alliance was funded from 2013 to 2020 (contracts, grants, subgrants) to the tune of well over $100 million – $39 million from Pentagon /DOD funds, $65 million from USAID/State Dept., and  $20 million from HHS/NIH/CDC.

As veteran Science reporter Nicholas Wade deciphered in a classic article in Science – The Wire, “For 20 years, mostly beneath the public’s attention, they had been playing a dangerous game. In their laboratories they routinely created viruses more dangerous than those that exist in nature. They argued they could do so safely, and that by getting ahead of nature they could predict and prevent natural “spillovers,” the cross-over of viruses from an animal host to people. If SARS2 had indeed escaped from such a laboratory experiment, a savage blowback could be expected, and the storm of public indignation would affect virologists everywhere, not just in China.”

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#Healthin2Point00, Episode 213 | Babylon’s SPAC IPO, plus big raises for Thirty Madison & Intrinsic

Today on Health in 2 Point 00, we’re talking about our new conference in September: Policies, Techies, & VCs: What’s Next for Health Care. On Episode 213, Jess ask me about some massive deals. Thirty Madison gets $140 million – they are now a unicorn. Babylon Health is going public via a SPAC – $575 million expected to be raised during this with a $3.6 billion valuation. Coming out of stealth, Intrinsic raises $113 million in the eCommerce space — and Dr. Oz is in this one. —Matthew Holt

THCB Gang Episode 56 – Thurs June 3

Episode 56 of “The THCB Gang” was recorded live on Thursday, June 3. Matthew Holt (@boltyboy) was joined by regulars: medical historian Mike Magee (@drmikemagee), THCB regular writer Kim Bellard (@kimbbellard) and health futurist Jeff Goldsmith; WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa) snuck in later after she finished up at the Going Digital: Behavioral Health Conference across the virtual street.

We really got into it on two issues — the Wuhan lab “leak” issue and Babylon Health’s IPO — lots of fun and no little disagreement!

Then video is below. If you’d rather listen, the audio is preserved as a weekly podcast available on Fridays on our iTunes  & Spotify channels.

#Healthin2Point00, Episode 212 | DayTwo, Hello Heart, Pack4U, and Curebase

Today at Health in 2 Point 00, Jess and I are presenting at the Going Digital: Behavioral Health conference today — tune in later for that. On Episode 212, our buddies at DayTwo get $37 million for the gut microbiome. Hello Heart raises $45 million, bringing their total to $68.2 million – this is for high blood pressure management. Pack4U, which is like the knockoff version of Pill Pack, raises $20 million. Swedish telemedicine company Doktor.se raises $50 million, and Curebase raises $15 million for decentralized clinical trials. —Matthew Holt

Voicemail, Repeat Requests and Multitasking: Inefficiencies in Today’s Healthcare

By HANS DUVEFELT

My nurse regularly gets at least 50 voicemails every day, many saying “please call me back”.

I have one patient who frequently tests the patience of our clinic staff by calling multiple times for the same thing. He is the most dramatic example of what seems to be a widely held belief that physicians, nurses and medical assistants sit at their desks and answer phone calls all or most of their time. But when we do, we are often hampered by busy signals, phone tag or “voice mail not set up”. Electronic messaging isn’t a panacea, because patients don’t necessarily know what we need to know in order to answer their questions correctly and efficiently at first contact.

Pharmacies, too, create duplicate requests that bog down our workdays. In my EMR, if an electronic refill request doesn’t get a response the day it comes in, the “system” sends a repeat request every day until it gets done. This is one reason I look like I am further behind on “tasks” than I really am. To top it off, every single refill request generated by the “system” comes with a red exclamation point next to it. This happens even when a patient has just picked up their last 90 day refill – a case where I theoretically should have 89 days to respond. Meanwhile, my system has no way of flagging truly urgent refill requests. This “alarm fatigue” is common in EMRs today.

The business model in today’s healthcare is that reimbursable activities (seeing patients in person or via telemedicine) are scheduled back to back, all day long. There is a universal assumption that this will still provide enough slack to deal with prescription refills, phone calls, incoming reports and the further ordering and feedback to patients prompted by them. And did I mention EMR documentation? Multitasking, or rather, constantly switching between different kinds of tasks, is not a sane or efficient way to work.

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Bias, Before First Breath

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How structural racism and implicit bias impact America’s babies, even prior to birth

By ELLIE STANG

Becoming a new mother in America is more dangerous for some mothers than it should be. Each year, 700 women die in childbirth or from pregnancy-related causes in the United States, the highest number of any developed nation. 

Health inequities in America mean that overwhelmingly, Black women and their infants are the ones impacted: Black mothers are 243% more likely to die from pregnancy than white ones. These discrepancies are wide ranging: American Indian and Alaska Native women are also 2x more likely to experience an adverse outcome as compared to  their white counterparts. Too many of our mothers are dying of preventable causes. The CDC estimates that 70% of maternal deaths are avoidable – which helps underscore the urgent need to create tangible change. 

Recent forces have helped shine a long overdue spotlight on the Black maternal mortality crisis in America. In April, the Biden Administration released a proclamation during Black Maternal Health Week, and planned legislative changes to address implicit bias in healthcare and apply funding where it is truly needed. Congress is fielding the “Momnibus” bill, which would fund grassroots organizations at the community level, actively establish bias training programs, and fill gaps created by social determinants of health (SDOH). Late last year, the HHS released an action plan to reduce maternal mortality and adverse outcomes by 50% in five years.

It is heartening to see action finally being taken: our mothers deserve more. At the same time, while we champion standardized and equal access to care for all of our mothers, we cannot overlook the newest cry in the room: the infant’s. Even before drawing her first breath, a baby girl’s future will be irrevocably shaped by structural racism and socioeconomic factors way beyond her control. 

That’s why, to address health inequities, we must begin with our babies. Despite great advances in NICU technology and managed healthcare, infant mortality is on the rise – and it disproportionately affects Black babies. Today, black infants are twice as likely to die as their white counterparts. 

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Make Some Microbe Friends

By KIM BELLARD

It’s the coolest story I’ve seen in the past few days: The New York Times reported how an Italian  museum cleaned its priceless Michelangelo sculptures with an army of bacteria.  As Jason Horowitz wrote, “restorers and scientists quietly unleashed microbes with good taste and an enormous appetite on the marbles, intentionally turning the chapel into a bacterial smorgasbord.”

And you just want to kill them all with your hand sanitizers and anti-bacterial soaps. 

The Medici Chapel in Florence had the good fortune to be blessed with an abundance of works by Michelangelo, but the bad fortune to have had centuries of various kinds of grime building up on them.  In particular, over time the corpse of one Medici “…seeped into Michelangelo’s marble, the chapel’s experts said, creating deep stains, button-shaped deformations…”

This is, I assume, why they tell you not to touch the art.

Scientists picked a bacteria — Serratia ficaria SH7, in case you’re taking notes – that ate the undesired grime without also eating the underlying marble.   It wasn’t hazardous to humans either and didn’t create spores that might go elsewhere.  “It’s better for our health,” one of the art restorers told NYT.  “For the environment, and the works of art.”

The technique was a success, allowing the sculptures to look like they did centuries ago. 

Using such bacteria to clean art has been around for at a decade, and not just for sculptures.  Perhaps more surprising is bacteria isn’t just cleaning art, it’s also creating it; the American Society for Microbiology hosts an annual Agar Art Contest. 

If you’re impressed by that, researchers are teaching bacteria to read, or at least to recognize letters.  That’s not all they might learn to do.  “For example, the framework and algorithm in our study can be used to facilitate the design of living therapeutics, such as targeted drug release systems based on engineered probiotic bacteria systems,” the researchers say.   

The thing is, we not only don’t know what microbes do, or could do, but we have only a vague understanding how they surround us.  That’s starting to change.  We’ve known for some time that each of us has a unique microbiome (including mycobiome!).  What we didn’t realize until recently was that each urban area has its own microbiome as well. 

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Matthew’s health care tidbits

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet!–Matthew Holt

In this week’s health care tidbits, we’re discussing hedge funds. Not those small private equity funds that are defunding small safety net hospitals and being exposed by Propublica & PBS Frontline. (Did you catch #TCHBGangster Jeff Goldsmith on the latter?). No, I’m talking about big non-profit hedge funds that also provide some health care services. This week two of them reported results.

Famed regional hedge fund Mayo Clinic’s health services business reported $243m profit on $3.7bn revenue for Q1 2021. Not exactly Apple margins, but a respectable 6.5%. While catholic national hedge fund Ascension eeked a $700m profit on $20bn of revenue in the nine months June 2020 to March 2021. The good news is that Mayo has $15bn in its main trading account while in those nine months Ascension made $4.3 Billion on Wall Street bringing its balance to a healthy $25.6 Bn.

And if you were concerned that these hedge funds were in trouble because of the pandemic, well not only do they avoid property, income tax and more they also got plenty of help from the taxpayer. CMS prepaid $2billion of Medicare payments to Ascension; presumably they made a tad more playing the markets with that. Then there’s the non-refundable CARES Act grants. Yes Ascension has been paid $900m since June 2020 ($1.1billion in all) and Mayo received $356m, although they were nice enough to pay $138m back.

I’m sure those Americans who lost their jobs, their houses and waited for months for government help are glad that–despite the pandemic–these hedge funds weren’t having to dip into their main reserves to keep their health services subsidiaries going…..

Public Health Nurses Once Again Asking, “What Are They Thinking?”

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Whitney Thurman
Karen Johnson

By KAREN JOHNSON and WHITNEY THURMAN

One recent Friday night, we huddled with our colleagues in the pouring rain at a movie theater parking lot– our cars packed with supplies for our mobile vaccine clinic— trying to find someone who wanted an extra dose of Pfizer’s COVID-19 vaccine before it expired. Five months ago, we would have been inundated with people desperate for that extra dose. But that has changed now that the most willing and able segments of the population have largely been vaccinated.

Amidst this backdrop of slowing vaccination rates in the U.S. and many miles to go before reaching all of those willing to be vaccinated, the CDC has released updated recommendations for mask wearing that we believe to be premature and contrary to the ethic and mindset of public health. Buoyed by mounting evidence supporting the effectiveness of vaccines, the CDC—  cheered by the Biden administration— gave fully vaccinated Americans the green light to ditch their masks. As fully vaccinated public health nurses who are as excited as anyone about the vaccines’ real-world effectiveness, we nonetheless find ourselves again asking: what are they thinking?

To be clear, we do not question the evidence showing that all COVID-19 vaccines currently approved in the U.S. are safe and effective. We also crave good news, hope, and allowing the bottom half of our faces to see the light of day. We have also appreciated the Biden administration’s commitment to “following the [biomedical] science” in pandemic policymaking. Our concerns lie with the timing of the recommendation; the lack of regard for social science demonstrating the importance of public policy in influencing community norms and human behavior; and the blatant disregard for health equity. That the nation’s preeminent public health institution has fallen prey to the individualistic mindset that typifies American society, as CDC director Dr. Rochelle Walensky stated herself on Sunday regarding this “science-driven individual assessment” of risk, is frustrating, to say the least.

Currently, only one-third of the U.S. has been fully vaccinated. The news media has been full of accounts of many sub-groups who stubbornly defend their right to refuse a COVID vaccine, but the majority of those in the U.S. who remain unvaccinated belong to communities that have been unable to access a vaccine due to difficulty navigating online appointment scheduling, inability to take time off of work, poorly translated informational resources, or being ineligible due to age restrictions or other medical contraindications. Universal mask-wearing has been a critical stopgap measure to protect these at-risk populations until the majority of Americans are vaccinated. The CDC’s recommendation is therefore not only premature: it sends the message to individuals and other governmental entities alike that we don’t need to care about our neighbors.

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#Healthin2Point00, Episode 211 | Noom, Akili, Unmind, Eleanor Health & Clearing

Today on Health in 2 Point 00, Jess gives us a little tour of Chicago before we dive into some deals. Noom raises $540 million, bringing their total to $657 million with a $4 billion valuation. What are they going to do now with all this money? Digital therapeutics company Akili raises $160 million – maybe this will bring them out of ADHD. Unmind, a mental health company out of the UK, raises $47 million, Eleanor Health raises $20 million for their addiction-focused mental health clinic, and finally Clearing raises $20 million in a Series A tackling chronic pain. —Matthew Holt

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