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Brainstorm Health Daily: March 6, 2017

March 6, 2017, 7:38 PM UTC

We open on a small Chinese village. A child is sick. Mother cradling him in her arms. Then quick shots of other homes, where a middle-aged man, then a grandmother, then a young woman are clearly ailing. Feverish. Coughing. Cut to: a small chicken farm, a few dead birds lay on the ground. Close-up on the farmer who can barely stand. He, too, collapses.

Cut to a rural hospital. Superimpose the following on-screen, typed out in quick fashion as in a Jason Bourne flick:



RATE OF PNEUMONIA (tick, tick, tick)…88%



Pause for a long second on-screen. Surgeons in scrubs burst in frame, rushing a gurney into the intensive care unit. Another gurney is right behind it. And there are patients in wheelchairs behind that. Too many to treat. The panic is palpable.

Superimpose title: THE FIFTH WAVE.

Good afternoon, Daily readers! Welcome to real-life screenwriting 101—the class where the moviemaking is hokey, but the underlying facts are as true as they come.

In the fictitious scene above, indeed, the stats—cases, ICU hospitalizations, deaths—are actual figures. (They’re drawn from the Chinese Center for Disease Control and Prevention and the World Health Organization.) And the term “the fifth wave” (or “the fifth epidemic,” as it’s often called) is the one scientists use to describe the outbreak of avian flu that began in China on October 1, 2016. So far, in this fifth wave, there are 460 confirmed human infections with this H7N9 strain—a total that, in just five months, already outnumbers those in waves 3 and 4 combined. This year’s outbreak, moreover, has spread farther geographically than the earlier ones.

While Chinese authorities have found no evidence of “sustained” person-to-person transmission, such a “spill-over” strain would truly make this horror film frightening—resulting, perhaps, in a devastating pandemic akin to what the world saw in 1918.

That scenario, unfortunately, is not as improbable as many might hope. Nor is this a “far-away” problem for Americans. We’ve had outbreaks of human infections from avian flu, in recent years, in Virginia, Canada, and last year in New York, when a strain of H7N2 avian flu virus passed from a cat in an animal shelter to a human. And there’s at least some research (sorry—this one’s behind a paywall) to suggest that certain unique attributes of H7 viruses make them more amenable to jumping species than other strains.

Bringing all of this closer to home, of course, is the news from yesterday, when the USDA announced that a strain of bird flu had been found in a Tennessee chicken firm. No humans are sick, but more than 73,000 breeder chickens will have to be culled to prevent further spread, authorities said.

So why would I use this space to scare all of my new good friends on a mopey Monday? (Shame on me!)

Well, there is method to my meanness. As frightening as this all is, it reinforces (I hope) what I said in last Tuesday’s newsletter: The spread of infection is a global problem and it demands a concerted, vigilant, global response. We can’t turn our backs on this.

On the hopeful front, it’s also an opportunity to showcase some potentially revolutionary applications of digital health and surveillance. And I’ll have more on that part of the story tomorrow.

Until then, here’s Sy with the day’s news.

Clifton Leaf


The future of data storage could be DNA. There's a fascinating piece out in Science about the potential of storing massive quantities of digital data within DNA. This approach, which scientists say they have now successfully performed, would allow the storage of 215 petabytes of information within a single gram of DNA. That's 215 million gigs of data. Theoretically, that means you could store all of the information created in human history within a single room. DNA carries several advantages, according to researchers, for data storage. “DNA won’t degrade over time like cassette tapes and CDs, and it won’t become obsolete,” Columbia University computer scientist Yaniv Erlich told the publication. The question is whether the process can be made cheap enough in order to justify its widespread use. (Science)

CVS expands use of Epic EHR systems. CVS will extend use of Epic's EHR technology to its specialty care programs for managing complex and chronic medical conditions and rare diseases, the company announced on Friday. "As the specialty pharmacy of choice for many payers and patients, we are focused on creating the most clinically advanced specialty pharmacy experience to help improve care and outcomes for our patients," said CVS Specialty EVP Dr. Alan Lotvin in a statement. "We are pleased to transition our care management programs onto the Epic platform, which will enable immediate information sharing with other health care providers across the patient's entire care team." (Healthcare IT News)


The EpiPen's market share is plunging. There's some bad news out there for Mylan's EpiPen - it's starting to hemorrhage market share to competitors in the wake of its price-gouging controversy. The EpiPen used to control more than 90% of the epinephrine prescription market. But as of the last week of February, that number has fallen to 71.1%, according to a new analysis by athenaInsight. "Patients and providers might be reaching for the alternatives and generics that have recently hit the shelves, as the industry responds to widespread demand," wrote the analytics firm. Now, it should be noted that the potential generics options include Mylan's own "authorized generic" of the EpiPen, which is essentially the same device and medication minus the brand name (and available at half the price of the EpiPen). But Kaleo's Auvi-Q, which was re-introduced into the U.S. market last month, has steadily been picking up steam, growing to 12.7% market share by the end of February. (Fortune)

Soon-Shiong companies' stocks plummet on reports of alleged money laundering. Los Angeles billionaire doctor-turned-biotech executive Patrick Soon-Shiong has had a spotty record when it comes to the companies he's launched. This morning, two of his companies, NantHealth and NantKwest, plunged to an all-time low on the market (the stock has fallen 67% since its IPO last year). The reason? An explosive report alleging that Soon-Shiong structured a $12 million donation to the University of Utah so that $10 million of it would be funneled back into one of his own companies. "I think that this transaction was deliberately structured to attempt to disguise self-dealing," tax lawyer Marc Owens told STAT News. "They’re laundering the funds through the University of Utah." While $2 million out of the donation were set aside for research and administrative costs, the remaining funds were required to be spent on a very, very specific type of genomic analysis that, as luck would have it, could only be fulfilled by a Soon-Shiong company product. (STAT News)

European, U.S. drug regulators strike agreement on plant inspections. Drug plant inspections can be a contentious issue thanks to differing regulations across countries and the biopharma industry's global nature. But the two main regulatory bodies in the U.S. and the E.U. (the FDA and the European Medicines Agency) have struck a pact to make them a little bit easier. The FDA and EMA will now trust each other's inspections of plants conducted in their respective nations so that more resources can be deployed to other countries with more checkered records on good manufacturing practices, such as India. (PharmaTimes)


GOP expected to unveil Obamacare replacement plan this week. After a topsy-turvy few weeks that saw deep divisions among Republican lawmakers on how to repeal and replace the Affordable Care Act, draft legislation is finally expected to be released in the coming days. "We are in a very good place right now, and while drafting continues, we anticipate the release of final bill text early this week," a senior Congressional aide told Reuters. Previously leaked drafts of the Obamacare legislation have indicated significant rollbacks, if not a full-fledged dismantling, of the health law. For instance, the Medicaid expansion would be significantly curtailed and Health Savings Accounts would be expanded. But other issues, such as providing tax credits to encourage people to buy insurance (while not outright mandating coverage), have proved controversial to conservative lawmakers who have described the plan as "Obamacare Lite." (Fortune)

Too much time on social media may be making you feel lonely. A new study published in the American Journal of Preventive Medicine suggests that heavy use of social connectivity platforms like Facebook, Instagram, and Snapchat may, ironically, leave people feeling more socially isolated. Researchers found that more than two hours of non-work-related social media use per day was correlated with double the chance of feeling social isolation compared with those who spent a half hour or less per day on such platforms. Face-to-face contact, however, has shown to be strongly correlated with well-being in numerous other studies. Of course, it's possible that the cause-and-effect is actually the other way around - people who feel lonely may purposefully use more social media in an attempt to feel less isolated. (NPR)


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Produced by Sy Mukherjee

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