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MorningMed is the best way to keep up with the world of health and medicine through curated round-ups, useful insights and other practical resources.

The World Health organization announces that Covid-19 is no longer a global public health emergency. The rescinded emergency declaration was initially issued over three years ago, on January 30th, 2020.

The US Centers for Disease Control and Prevention and Joe Biden have collectively announced that Dr. Rochelle Walensky, the agency’s director, is leaving her government post following June 30th. “Dr. Walensky leaves CDC a stronger institution, better positioned to confront health threats and protect Americans. We have all benefited from her service and dedication to public health, and I wish her the best in her next chapter,” President Biden said.

US Surgeon General Dr. Vivek Murthy has announced a framework for a “National Strategy to Advance Social Connection” in order to address the ongoing “epidemic of loneliness and isolation” impacting the nation. “Given the profound consequences of loneliness and isolation, we have an opportunity, and an obligation, to make the same investments in addressing social connection that we have made in addressing tobacco use, obesity, and the addiction crisis,” Murthy says in his advisory.

The Food and Drug Administration has approved the world’s first RSV vaccine, which comes in the form of a shot designed for adults ages 60 and up. Designed by pharmaceutical mainstay GSK, this single-dose shot was found to lower the risk of symptomatic illness by 83% and of severe illness by 94% in a recent late-stage clinical trial.

United States marshals have seized an estimated $3 million worth of kratom that was being sold as a supplement by an Oklahoma-based company. “There are no FDA-approved uses for kratom, nor have there ever been, and the agency has received concerning reports about the safety of kratom,” Lauren-Jei McCarthy, an FDA press officer, told NBC News in an emailed statement.

Biden admin says Alabama health officials didn’t address sewage system failures disproportionately affecting Black residents

In Lowndes County, Alabama, a U.S. departments of both Justice and Health and Human Services investigation has concluded that the Alabama Department of Public Health and the county Health Department are guilty of inaction and neglect towards a failing sewage system impacting the area. These horrific conditions disproportionately affected Black residents of the rural community by denying access to adequate sanitation systems and exposing residents to concerning health risks.

• As part of the findings, the federal departments have come to an “interim resolution agreement” under Title VI of the Civil Rights Act with the state and county agencies that, if followed, would substantially change the way local officials have been dealing with residents who have failing systems or no systems at all and have reported being forced to live amid raw human waste.
  
  
• The state agencies will also be required within one year to create a “plan to improve access to adequate sanitation systems and address public health risks associated with raw sewage exposure,” which many county residents have complained they have been dealing with for generations. And Alabama officials have also agreed to coordinate with the Centers for Disease Control and Prevention to measure the level of health risks different populations experience from raw sewage exposure and adopt any public health recommendations provided by the federal agency.

Kristen Clarke, the head of the Justice Department’s Civil Rights Division, states: “The fight for environmental justice is also a fight for racial justice,” Clarke said. “The sad reality is that too many communities of color are struggling for clean water, clean air and bear the consequences of pollution and under investment in wastewater infrastructure, transportation and health care.” She delivered a message for county residents. “We want this community to know that we have their back, and we will not stop until we provide the relief that is so long overdue to people disproportionately poor and Black here in Lowndes County,” she said.

National Provider Identifiers (NPIs) and Taxonomy Codes are essential components of the healthcare industry’s standardized system for identifying and categorizing healthcare providers and services. These codes provide a streamlined way of identifying and communicating important information about healthcare providers and services, enabling better communication and coordination among healthcare stakeholders.

Nursing survey results hint at an approaching widespread crisis

The 2023 Survey of Registered Nurses from AMN Healthcare has released its results, which point toward a perfect storm of problems across nursing that threaten the profession as well as the US health care industry. AMN Chief Clinical Officer Dr. Cole Edmonson stated, “a nursing crisis is upon us,” alongside the release of the biannual results.

Key takeaways

• The survey, which was conducted in January, shows a group of professionals who care very much about their work, but it also shows a significant decline in work satisfaction and a significant increase in stress levels. Many are thinking about leaving the profession.
  
  
• Coming out of the pandemic, far too many hospitals cut corners on staffing and allowed a higher nurse-to-patient ratio, said Kristine Kittelson, an RN in Austin, and a National Nurses United member. That has placed nurses in a moral dilemma, she said, where they cannot completely help their patients even if they want to.
  
  
• Nearly every nurse who participated in the new survey said they wanted increased staff support, a reduction in the number of patients per nurse, an increase in salary, a safer working environment, and more opportunities to share their input with decision-making.

By the digits

• Nearly 40% of nurses surveyed said they felt burnt out.
  
  
• 71% of nurses say they are satisfied with their work in 2023.
  
  
• Only 15% of hospital nurses say they will continue in the same job in one year.
  
  
• Nearly a third of all the nurses surveyed said they are likely to leave the profession.
  
  
• 4 out of 5 nurses said they experienced “a great deal” or “a lot of stress” in their work.

Is There a Doctor in the House?

A 48-year-old man comes to the clinic because of a 10-year history of recurrent, intrusive thoughts that his house will be broken into and damaged by criminals or accidentally destroyed by a fire when he is not home. These thoughts have worsened during the past 2 months. He reports now spending 4 hours daily checking that the doors and windows are closed and locked and that the stove and oven are turned off; he previously spent 2 hours daily doing these tasks. He says he cannot keep a job or leave the house very much because of the amount of time he spends checking these things. He has no other history of serious illness and takes no medications. Physical examination shows no abnormalities. On mental status examination, he has an anxious mood and a sad affect. He is fully oriented. He is not having hallucinations or delusions.

The most effective pharmacotherapy for this patient is an agent that targets which of the following neurotransmitters?

An overactive immune response to the mRNA Covid vaccines may be the culprit in rare cases of heart inflammation seen in some young men after they receive the shot, a small study published Friday in the journal Science Immunology suggests. An analysis of blood samples from nine of the twenty-three patients studied who developed myocarditis after their second dose of either the Pfizer-BioNTech or Moderna vaccine — all of whom had gotten Pfizer — found elevated cytokine levels.

Colon cancer demographics are trending toward young adults, and new research has identified the earliest symptoms to be aware of against this threat. Prolonged and unexplained bouts of diarrhea, stomachaches and spots of blood during bowel movements may be signs of early-onset colorectal cancer.

One dozen Covid-19 experts polled by the White House were tasked with answering the question: What did they think were the chances of the world seeing a highly mutated variant, akin to Omicron, within the next two years? The experts produced a surprisingly narrow range of probabilities, between 5% and 30%, according to Dr. Eric Topol, founder and director of the Scripps Research Translational Institute.

Adults in their 20s and 30s with mental disorders have a higher chance of having a heart attack or stroke, according to a new study. About 13% of participants had some type of mental disorder — which included insomnia, anxiety, depression, somatoform disorder, posttraumatic stress disorder, substance use disorder, eating disorders, bipolar disorder, schizophrenia, or a personality disorder, according to the study.

Thank you for reading! More next week,

My best wishes for a productive and idea-filled week ahead. Thanks for your ongoing efforts to improve the lives of the patients we all serve. Please send any news, comments, suggestions and ideas to hello@morningmed.email.

Quiz answer: The correct answer is D) "Serotonin"

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