Racism stalling pandemic science, external advisory boards, and broadband as a social determinant of health
|Katherine Ellen Foley||Mar 28||1|
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March 28, 2021
Racism is getting in the way of answering questions critical for preventing future pandemics.
Found while reporting: Where Covid-19 came from is as much a political question as a scientific one.
At the beginning of the pandemic, scientists were more preoccupied with the explosive spread of Covid-19 than they were with the origin of the SARS-CoV-2 virus. Four out of the last five respiratory pandemics were viruses that evolved from infecting animals to infecting people—that was likely the story for this virus, too.
Except the evidence confirming it never emerged. It still hasn’t, which is why the World Health Organization sent over a delegation of 10 scientists to Wuhan, China, earlier this year. They were looking for evidence that the virus either came from an animal, or that it may have escaped from a lab, like the Wuhan Institute of Virology, while it was being studied.
Most of the evidence points to the fact that it was zoonotic (science speak for “from animals”)—but it’s suspicious that scientists haven’t been able to find actual animals hosting the virus nearby. If that were the case, we’d want to double down on finding and studying viruses that could evolve to infect humans, which scientists have already been doing. But if it did escape from a lab—even if it were originally a zoonotic virus that had been brought back to be studied—scientists would want to know, because it’d have huge implications for how they’d approach security in these spaces. The WHO delegation’s final report is expected any day this week.
But scientists haven’t been enable to properly conduct this work. Part of it is because the Chinese government hasn’t been particularly forthcoming with information about the virus in the early days of the pandemic. But a much larger part has to do with politics.
When former US president Trump started blaming Chinese scientists for the pandemic (a flimsy accusation; there are so many other reasons this virus has killed nearly 3 million people, including a general lack of pandemic preparedness overall), he immediately associated anyone exploring the lab-release theory with his anti-Asian racism. As a result, scientists didn’t want to even explore the question, for fear of perpetuating hate. Arguably, the murder of eight women, six of whom were Asian, two weeks ago, were motivated by this racist sentiment.
I’ve donated to the Asian American Journalists Association in the wake of the horrific rise in racist violence. If you can, consider doing the same to support Asian voices in the media.
The US Food and Drug Administration has dozens of external advisory panels to keep them in check.
Found while reporting: AstraZeneca’s data missteps shows that drug regulation actually works.
The bad news is that the US Food and Drug Administration is understaffed. They’ve got way too many medical products and therapies to clear and authorize or approve than they’ve got people power.
But fortunately, they’ve got a workaround to make sure they’re holding drug companies accountable—external advisory boards.
If you’ve been hearing talk about the safety and efficacy of AstraZeneca’s Covid-19 vaccine this week, it’s because an external data and safety monitoring board flagged some discrepancies in the data AstraZeneca submitted. It could have been an honest mistake, and the Anglo-Swedish drug company has since rectified the error to show that their vaccine is actually around 69 to 75 percent effective.
While it’s been an unfortunate PR moment for AstraZeneca, the fact that this external board acted so promptly showed that the FDA’s current system works, even in a dire situation like a pandemic—which is a great thing!
Although I’d argue that ideally the US government would fund the FDA enough to have all of these boards internally reviewing data, Jordan Paradise, a professor of law at Loyola University in Chicago, pointed out that really, you probably don’t want the same group of people making the final decision to authorize drugs to do all the data review. There’s can be a surprising (or, maybe not so surprising, depending on how cyclical you are) amount of funding from pharma companies to the FDA per the 1992 US Prescription Drug User Fee act, which can allow drug companies to finance the FDA to expedite its review of the product in question.
Groups of physicians are banding together to argue that access to broadband gets the status of a “social determinant of health.”
Found while reporting: Access to broadband could affect your healthcare.
There are a lot of factors medical professionals wish they could control for their patients. Racism is one of the biggest, but there’s also socioeconomic status, geographic location, and many more. They label these factors “social determinants of health.”
Now that we’ve seen how telehealth can be a complement in-person health care, we’ve also seen where it doesn’t work—which includes people with inadequate internet access. Those individuals are disproportionately likely to fall though the cracks of regular, in-person health care, too.
Independent physicians, as well as professional groups like the American Medical Informatics Association have noticed this, and are petitioning to get broadband access labeled as another social determinant of health, which could allow it additional funding from groups like the Department of Health and Human Services. Right now, independent groups and the Federal Communication Commission are trying their best to rectify these discrepancies, but they could use the extra help.
Other stuff you may have missed:
The speed with which Covid-19 vaccines came to market is the speed of science—sans red-tape/cost prohibitions. I spoke with Panagis Galiatsatos, a pulmonologist at Johns Hopkins University, for a Quartz event answering EVEN MORE of your. Covid-19 vaccine questions. You can watch the recap here.
Bonus shot: My face when Galiarsatos said an exceedingly rare side effect of Tylenol is your skin melting off. (He said you should still take Tylenol if you need it—its effects are exceedingly more beneficial than it is risky.)
There are some “low hangover” boozy drinks out there, but weirdly that’s not science’s top priority right now. We’re gonna have to wait for those clinical trials for a hot minute. Don’t hold your breath, though—booze still isn’t ever gonna be great for anyone.
Want to hang out with your vaccinated friends? According to the US Centers for Disease Control and Prevention, your household can—but it’s probably unwise to go beyond that for now, until more studies on whether vaccines can stop transmission have occurred…
…But luckily, they’re already underway! The CDC is keeping track of several observational studies that should give public health experts information on how well vaccines stop against transmission.
The Biden administration has orchestrated cooperation in the drug industry. Even more former competitors are working together to make Covid-19 vaccines, thanks to to the Defense Production Act. His team’s got a lot of work ahead of it if they want us to be able to celebrate America’s birthday in July—but it’s doable.
Nine of the 10 happiest countries are in Europe. Even with those harsh winters. Woof. Europe is also home to some of the largest populations of vaccine hesitant people 🤔 despite their enormous trust in government. That’s a public health conundrum!
That’s all for now—stay curious, friend ❤️
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Top image by E. Y. Smith; headshot by Matt Anzur.