Health & Veritas

Howie and Harlan are joined by infectious disease specialist Michael Dunne to discuss the growing problem of antimicrobial resistance and what’s needed to incentivize the development of new antibiotics. Harlan reflects on the controversy sparked by the release of his study on post-vaccination syndrome; Howie provides an update on the measles outbreak in Texas.  Links: Post-Vaccine Syndrome Harlan Krumholz: “Immunological and Antigenic Signatures Associated with Chronic Illnesses after COVID-19 Vaccination” “A small study on Covid vaccine safety sparks an online tempest” “Scientists Describe Rare Syndrome Following Covid Vaccinations” Antimicrobial Resistance and New Antibiotics "New bill would create a subscription payment model to jumpstart antibiotic development" Antimicrobials Working Group H.R.4127—DISARM Act of 2021 S.1355—PASTEUR Act of 2023 CDC: Antimicrobial Resistance Facts and Stats Michael Dunne: “Impact of Empirical Antibiotic Therapy on Outcomes of Outpatient Urinary Tract Infection Due to Nonsusceptible Enterobacterales” Michael Dunne: “A multicenter analysis of trends in resistance in urinary Enterobacterales isolates from ambulatory patients in the United States: 2011-2020" CDC: Core Elements of Antibiotic Stewardship "Crisis Looms in Antibiotics as Drug Makers Go Bankrupt" "Bill & Melinda Gates Medical Research Institute Initiates Phase 3 Clinical Trial of Tuberculosis Vaccine Candidate" Michael Dunne: “Replacing serum with dried blood microsampling for pharmacokinetics, viral neutralisation and immunogenicity bioanalysis supporting future paediatric development of RSM01, a candidate respiratory syncytial virus neutralising monoclonal antibody” The Measles Outbreak “An unvaccinated child has died in the Texas measles outbreak” CDC: Measles, Mumps, Rubella (MMR) Vaccine Safety WHO: Measles "Consequences of Undervaccination—Measles Outbreak, New York City, 2018-2019" Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by legal historian Paul Lombardo to discuss his work exploring the role of the legal and medical establishments in eugenics and sterilization in the United States. Harlan reports on his new research on post-vaccination syndrome, a constellation of chronic symptoms experienced by some people after getting the COVID-19 vaccine; Howie discusses the science behind a measles outbreak in Texas. Links: Anxiety in Academia Yale Office of the President: Our commitment to our research mission Post-Vaccination Syndrome Harlan Krumholz: “Immunological and Antigenic Signatures Associated with Chronic Illnesses after COVID-19 Vaccination” “Immune markers of post vaccination syndrome indicate future research directions” Eugenics in America U.S. Supreme Court: Buck v. Bell, 274 U.S. 200 (1927) Paul Lombardo, New England Journal of Medicine: “‘Ridding the Race of His Defective Blood’—Eugenics in the Journal, 1906–1948” “Clarence Thomas tried to link abortion to eugenics. Seven historians told The Post he’s wrong.” Paul Lombardo: Three Generations, No Imbeciles In the Name of Eugenics Paul Lombardo: “Republicans, Democrats, & Doctors: The Lawmakers Who Wrote Sterilization Laws” Measles and Herd Immunity “West Texas measles outbreak grows to 58 cases, including some people who said they were vaccinated” “Supreme Court rejects challenge to Connecticut law that eliminated religious vaccination exemption” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Deborah Rhodes, a Yale internist and the chief quality officer for Yale Medicine and Yale New Haven Health System. They discuss how she helped develop a better approach to scanning for breast cancer in women with dense breast tissue, and the obstacles to wide adoption. Harlan reports on the Trump administration’s plan to slash indirect support for research; Howie explains the potential consequences of cuts to Medicaid. Links: Flu and Research Cuts “Weekly US Influenza Surveillance Report: Key Updates for Week 5, ending February 1, 2025” “This Is One of the Worst Flu Seasons in Decades” “Court Pause on Trump Cuts to Medical Research Funds Is Expanded Nationwide” “What National Institutes of Health funding cuts could mean for U.S. universities” Harlan Krumholz: “The NIH’s drastic cut to indirect cost rates is a critical threat to U.S. research infrastructure" Breast-Cancer Screening TED Talk by Deborah Rhodes: “A test that finds 3x more breast tumors, and why it's not available to you” Deborah Rhodes: “A Survey of Patient Experience During Molecular Breast Imaging” Mayo Clinic Breast Clinic: “How To Decide What To Do If You Have Dense Breasts On Mammogram” Deborah Rhodes: “Dedicated dual-head gamma imaging for breast cancer screening in women with mammographically dense breasts” Cleveland Clinic: Fibroglandular Density Are You Dense? “Evaluation of a Clinical Decision Support System for Imaging Requests” Medicaid “House Republicans release budget plan, with trillions in tax and spending cuts” “Trump's return puts Medicaid on the chopping block”  “Red states likely to feel the pain of Medicaid cuts” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan discuss a breakthrough pain medication, studies on AI-assisted medicine, the explosion of sports gambling, and the health consequences of the shutdown of USAID.  Links: A First-in-Class Painkiller “F.D.A. Approves Drug to Treat Pain Without Opioid Effects” “FDA Approves Novel Non-Opioid Treatment for Moderate to Severe Acute Pain” “Peripheral Sodium Channel Blocker Could Revolutionize Treatment for Nerve Pain” “Alabama to Beijing… and Back: The Search for a Pain Gene” AI Screening “Screening performance and characteristics of breast cancer detected in the Mammography Screening with Artificial Intelligence trial (MASAI): a randomised, controlled, parallel-group, non-inferiority, single-blinded, screening accuracy study” “3D mammograms show benefits over 2D imaging, especially for dense breasts”. “The Robot Doctor Will See You Now” USAID and Foreign Aid “Trump and Musk move to dismantle USAID, igniting battle with Democratic lawmakers” “What USAID does, and why Trump and Musk want to get rid of it” “The Status of President Trump’s Pause of Foreign Aid and Implications for PEPFAR and other Global Health Programs” “The Case For Global Health Diplomacy” The Super Bowl and Legalized Sports Gambling “Super Bowl LIX: Betting By The Numbers” “Americans expected to bet $1.39B legally on Super Bowl 2025” “Record 68 million people plan on making Super Bowl bets” “Gambling problems are mushrooming. Panel says we need to act now.” COVID and Flu “The U.S. Is Having Its Mildest Covid Winter Yet” “Estimated Vaccine Effectiveness for Pediatric Patients With Severe Influenza, 2015-2020” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Lisa Rosenbaum, a cardiologist and the national correspondent for the New England Journal of Medicine, to discuss her writing illuminating critical topics in medicine. Harlan reports on the companies claiming to prevent illness through a non-invasive full-body scan; Howie explains the healthcare impact of the Trump administration’s freeze of federal aid.  Links: Body Scanning “Neko Health raises $260M to expand body scan service, fund R&D” Neko Health “Kim Kardashian Promotes $2,500 Body Scan—Here’s What To Know And Why Some Experts Warn Against It”“ “Daniel Ek’s body scanning startup hits £1.4 billion valuation with 100,000 people lining up to pay £299 for a health check” “The rise and fall of Theranos: A timeline” Lisa Rosenbaum Lisa Rosenbaum: “Gray Matters: Analysis and Ambiguity” Lisa Rosenbaum: Not Otherwise Specified podcast Lisa Rosenbaum: “Beyond Moral Injury—Can We Reclaim Agency, Belief, and Joy in Medicine?” Lisa Rosenbaum: “Being Well while Doing Well—Distinguishing Necessary from Unnecessary Discomfort in Training” “The Case Against the Trauma Plot” “The Rise of Therapy-Speak” Lisa Rosenbaum: “On Calling—From Privileged Professionals to Cogs of Capitalism?” “The Moral Crisis of America’s Doctors” The Ezra Klein Show: “Democrats are Losing the War for Attention. Badly.” IMDB: The Doctor The New Administration “Kennedy, Polarizing Pick for Health Secretary, Makes His Senate Debut” “WATCH: Sen. Elizabeth Warren questions RFK Jr. in confirmation hearing” “Trump aid freeze stirs chaos before it is blocked in court” “Trump administration rescinds order attempting to freeze federal aid spending” “Uncertainty Causes Chaos as Trump Threatens Funding Pause for Schools” “Read the Memo Pausing Federal Grants and Loans” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Susan Mayne, a Yale epidemiologist and the former director of the FDA’s Center for Food Safety and Applied Nutrition, to discuss what the agency can and can’t do to keep contaminants out of food and promote healthier eating habits. Harlan reports on the Trump administration’s cancellation of multiple scientific meetings; Howie explains the administration’s health-related executive orders.  Links: Changes at the NIH “Trump administration’s abrupt cancellation of scientific meetings prompts confusion, concern” “The Trump NIH Pick Who Wants to Take On ‘Cancel Culture’ Colleges” Food Safety and the FDA “Beyond Red Dye No. 3: Here’s what parents should know about food colorings” “FDA to Revoke Authorization for the Use of Red No. 3 in Food and Ingested Drugs” U.S. Government Accountability Office: Regulation of Cancer-Causing Food Additives—Time for a Change Nutrition Labeling and Education Act of 1990 FDA: Front-of-Package Nutrition Labeling “Court ruling curbs unfounded claims for memory supplement” FDA: Questions and Answers on Health Claims in Food Labeling FDA Budget Summary FDA: Closer to Zero: Reducing Childhood Exposure to Contaminants from Foods FDA: Food Safety Modernization Act (FSMA) Executive Orders “Breaking Down All of Trump’s Day 1 Presidential Actions” KFF Morning Briefing “Trump orders reflect his promises to roll back transgender protections and end DEI programs” “Trump wants to pull the US out of the World Health Organization again. Here’s what may happen next” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Sachin Jain, CEO of Scan Health Plan and advocate for patient-centered care, discusses the urgent need for managed care to prioritize patients over profit. He highlights the troubling state of the industry, marked by high deductibles and diminished trust in healthcare providers. The conversation also touches on the health impacts of wildfire smoke and a shift in obesity classification, advocating for broader health metrics. Jain emphasizes the importance of trust in healthcare, especially in combating vaccine hesitancy.

Howie and Harlan discuss health and healthcare headlines, including misaligned incentives keeping medicine from its mission, burdensome out-of-pockets costs, ultraprocessed foods, and serving the growing population of cancer survivors effectively. Links: Vivek Murthy’s parting letter to America “Surgeon General Urges Americans to 'Rethink How We're Living Our Lives' in Closing Letter to the Country (Exclusive)” Discontent with the Health System in the United States “View of U.S. Healthcare Quality Declines to 24-Year Low” “What We Know About the UnitedHealthcare C.E.O.’s Killing and the Suspect” “Killing of UnitedHealthcare CEO brings resentment of the health care system to the fore” “Out‐of‐Pocket Annual Health Expenditures and Financial Toxicity From Healthcare Costs in Patients With Heart Failure in the United States” Bird Flu “First Bird Flu Death in U.S. Reported in Louisiana” “First H5 Bird Flu Death Reported in United States” “H5N1 Bird Flu” “Eyeing Potential Bird Flu Outbreak, Biden Administration Ramps Up Preparedness” “What is the HMPV virus in China? The human metapneumovirus and its symptoms, explained.” “Respiratory Virus Activity Levels” Alcohol and Cancer “Alcohol and Cancer Risk” “The cardioprotective association of average alcohol consumption and ischaemic heart disease: a systematic review and meta-analysis” “Alcohol Exposure and Disease Associations: A Mendelian Randomization and Meta-Analysis on Weekly Consumption and Problematic Drinking” “No level of alcohol consumption is safe for our health” Cancer Survivorship “Prevalence of cancer survivors in the United States” Cancer Survivorship: Cancer.Gov Ultra-Processed Foods “Trans fat” “Low-Grade Inflammation and Ultra-Processed Foods Consumption: A Review” “The Power RFK Jr. Would Have Over Food” Lawsuits: "Bad Behavior" on the Physician side “Sixteen Cardiology Practices to Pay a Total of $17.7M to Resolve False Claims Act Allegations Concerning Inflated Medicare Reimbursements” “CVS-owned insurer Aetna sues Radiology Partners alleging multiphase ‘fraud scheme’” Jimmy Carter  “Jimmy Carter, Peacemaking President Amid Crises, Is Dead at 100” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Yale physician Dana Dunne, who leads a new coaching program designed to help medical students develop a lifelong orientation toward growth and building knowledge. Harlan reports on a new generation of AI that can diagnose patients more consistently than human doctors; Howie explains how the state of Connecticut wiped out medical debt for thousands of low-income residents.  Links: AI Diagnosis “Superhuman performance of a large language model on the reasoning tasks of a physician” “Reasoning Foundations of Medical Diagnosis: Symbolic logic, probability, and value theory aid our understanding of how physicians reason” (1959) Coaching Medical Students Yale School of Medicine: The Yale System Yale School of Medicine: Longitudinal Coaching Program “Developing Master Adaptive Learners: Implementation of a Coaching Program in Graduate Medical Education” “Risky Business: Psychological Safety and the Risks of Learning Medicine” Amy C. Edmondson: Psychological Safety Review: The Fearless Organization Medical Debt “Governor Lamont Announces Nearly 23,000 Connecticut Residents Will Have $30 Million in Medical Debt Erased Under First Round of State’s Newly Launched Partnership With Nonprofit” “CT cancels $30M in medical debt for thousands of residents” “Disparities in Medical Debt Among U.S. Adults with Serious Psychological Distress” “63% of workers unable to pay a $500 emergency expense, survey finds. How employers may help change that” White House Fact Sheet: Biden-⁠Harris Administration Announces New Actions to Reduce Medical Debt and Address Illegal Medical Debt Collection Practices Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.

Howie and Harlan are joined by Jaewon Ryu, CEO of Risant Health, a nonprofit company that brings together integrated health systems with the goal of spreading the adoption of value-based care. Harlan reports from the annual Cardiovascular Clinical Trialists Forum on progress toward faster and more effective clinical trials; Howie reflects on the murder of UnitedHealthcare CEO Brian Thompson.  Links: Clinical Trials “Artificial Intelligence in Cardiovascular Clinical Trials” Jaewon Ryu Wikipedia: Integrated Delivery System Geisinger: Fresh Food Farmacy “Geisinger opens a new $5.8 million senior-focused primary care center in Pottsville” “Kaiser Permanente Unit to Acquire North Carolina Hospital System” “Value-Based Care: What It Is, and Why It’s Needed” The Killing of Brian Thompson “What We Know About the UnitedHealthcare C.E.O.’s Killing and the Suspect” “A Very Un-American Response to the Murder of Brian Thompson” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.