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Brainstorm Health: Hurricane Florence, The Apple Watch Debate, Rivals Hit Roche

September 13, 2018, 8:10 PM UTC

Good afternoon, readers. This is Sy.

With recent official reports finding that last year’s Hurricane Maria claimed nearly 3,000 lives in Puerto Rico—an assertion that re-emerged onto the national spotlight Thursday after President Donald Trump, without providing evidence, alleged that those estimates were artificially inflated and politically motivated—it’s worth exploring what it is that ultimately kills people, including the most vulnerable, when a hurricane strikes.

It’s incredibly hard to pin down a storm’s precise death toll because of the myriad, chaotic factors that accompany a natural disaster. On an island like Puerto Rico, which has limited health care and other types of infrastructure, a hurricane’s downstream effects can prove even more devastating than the initial surge. Low-income residents and the elderly face disproportionate consequences from lack of food and water, loss of electricity, and other elements indirectly and directly attributable to a hurricane. That’s on top of the flooding, flying debris, and the other immediate storm-related events that can claim countless lives.

But, more generally, the proximate causes of hurricane-related injury and death may be surprising, according to the National Hurricane Center. Whenever a hurricane tumbles toward landfall, the emphasis tends to be on wind forces. That makes sense since the category of a storm is generally determined by its maximum sustained winds; but, researchers have found, the vast majority of deaths (nearly 90%) from hurricanes, tropical storms, or tropical depressions between 1963 and 2012 were attributable to “storm surge, rainfall flooding, high surf, and deaths just offshore.” This implies that water, even more so than wind, is the most dangerous element of a major storm.

Of course, these various components blend together to cause maximum, and long-standing, devastation—which is what makes prudent pre-storm measures, and sustained post-storm aid, so critical to preserving human life.

Read on for the day’s news.

Sy Mukherjee


The Apple Watch ECG discussion heats up. Since yesterday's announcement that the new Apple Watch will have an integrated heart sensor and ECG—cleared by the Food and Drug Administration (FDA)—there's been a flurry of speculation about whether or not the advance will prove a boon to patients, or just another tool for overdiagnosis in an unproven device. (Speaking of that... A mea culpa to AliveCor, whose KardiaBand was the actual, first direct-to-consumer ECG device available on the market, despite Apple's PR framing on Wednesday). To the latter point, FDA Commissioner Scott Gottlieb issued some clarifications on Twitter that I'll leave you with: "#FDA’s approval of 2 medical apps for Apple’s iWatch is a significant step forward in FDA policy because we decoupled review of the app from review of the watch itself. The watch isn’t a medical device, just the apps that help consumers detect serious medical conditions... By focusing our review on the functionality of the software, irrespective of the hardware it’s deployed on, we hope to encourage greater innovation in digital health, including the use of AI and clinical decision support software." Much more on this in the coming weeks.


Rivals hit Roche. Swiss drug giant Roche is feeling the pinch of biosimilars—products that mimic pricey, lucrative biologic drugs—and consequently ramping up a cost-cutting drive to counteract the competition. CEO Severin Schwan told Reuters that the company expects a slowdown in sales growth before a "re-acceleration" in about three years as it grapples with generic rivals to U.S. biotech arm Genentech's flagship cancer drug portfolio. (Reuters)


Planned Parenthood names a new—physician—president. Reproductive rights and family planning group Planned Parenthood has appointed a new president. And she's drawing some attention for her unique background. Dr. Leana Wen is the first doctor to be named the head of Planned Parenthood (which has faced consistent attacks from state legislatures and the federal government in recent years) in 50 years; she also Chinese immigrant who has served as Baltimore's health commissioner since 2015. (USA Today)


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Produced by Sy Mukherjee

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