Quantifying Alcohol’s Death Risk; NDAs Hide Docs’ Mistakes; H5N1 Pandemic Prep

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This past week in healthcare investigations

by
Sophie Putka,

Enterprise & Investigative Writer, MedPage Today

June 18, 2024

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Quantifying Alcohol’s Death Risk

Increasingly, research is coming out in favor of drinking as little as possible — but the exact level of risk hasn’t been made clear, according to the New York Times.

A recent meta-analysis of 107 studies found that no amount of alcohol consumption improved health. It had come after one scientist noticed that many alcohol studies had a fundamental flaw: they included ex-drinkers in their “abstainers” group, who may have stopped drinking because of illness.

By comparison, moderate drinkers looked healthier, according to the Times. The reevaluation found a statistically significant increase in all-cause mortality for women who drank under two drinks a day, and men who had more than three. Another study found that even one or two drinks daily can shrink the brain.

So how should people think about their risk? Someone who has two drinks a week could shave a week off their life, and seven drinks a week could shave off 2.5 months, a researcher told the Times. But consume five drinks a day, and it may cost 2 years.

Researchers are striving not to overcorrect past notions, but rather to emphasize that drinking is not beneficial. There’s also an added drawback: the risk of harming others while drinking, despite the connective role it can play in society.

NDAs Routinely Hide Doctors’ Mistakes

In medical malpractice cases, non-disclosure agreements (NDAs) are frequently used by public hospitals like the University of Washington Medical Center to keep injured patients and families silent after a settlement. As a result, physicians responsible for the harm may go on to practice unscathed, according to NBC News.

NDAs of this type normally stipulate that both the patient and the responsible entity will not discuss details of the case publicly. As a University of Washington spokesperson told NBC News, “UW asks for confidentiality in order to achieve finality and certainty when a claim concludes.” But as a public university, UW may still be compelled to release information related to the case by Freedom of Information Act requests from people like NBC reporters.

Lawyers typically support NDAs as a standard part of medical malpractice cases, but patients are often unaware that they are not mandatory — and some argue that NDAs can cover up patterns of harm, endangering future patients.

NBC uncovered a number of major settlements that used NDAs. In one, a surgeon operating on a young woman who needed a heart transplant allegedly caused a stroke that led her to lose her sight by using an unconventional technique, and tried to cover it up, even removing her from a heart transplant list. No enforcement actions were taken against the doctor, who is now the cardiac division director at a medical center, making $400,000 more than he did in his last year at the University of Washington, NBC News reported.

Is the U.S. Ready for a Human Bird Flu Pandemic?

H5N1 bird flu has yet to effectively spread from person to person, and symptoms among humans infected by cows have been mild. But scientists say it could only be a matter of time before the virus mutates enough to spread rapidly among people, according to the New York Times.

So far, the virus has been deadly to ferrets, cats, seal pups, and other mammals. The appearance of the virus in cows was unexpected — and, some experts say, a sign that the virus is changing quickly, according to the Times.

The U.S. has stockpiles with four types of flu antivirals, but they must be taken within 48 hours of symptoms. Their effectiveness against H5N1 in the future is unclear: some new versions of the virus have mutations that make it resistant to the antivirals.

Hundreds of thousands of vaccines could be rolled out, with company contractors ready to churn out 100 million doses in the first 130 days — but H5N1 could take many forms. Scientists have a library of 40 “candidate” vaccine viruses to match many of these, speeding the production of a new vaccine. But even in the quickest scenario, with a matching candidate, only 1 in 5 Americans would be protected, the Times reported.

So far, officials have hesitated to vaccinate cows because of concerns about vaccinated animal products being barred from trade. There’s been little push to vaccinate farm workers because of the relatively low risk. But one expert told the Times a co-infection with H5N1 and seasonal flu could create a gene-swapped version of bird flu more efficient than any version yet.