Why this year’s flu season could be hitting teens and young adults hard

Get your daily dose of health and medicine every weekday with STAT’s free newsletter Morning Rounds. Sign up here. Good morning! One of our items today concerns this year’s flu. In the course of my research, I learned that the virus is hitting teenagers and young adults especially hard. I offer one possible explanation for what’s going on below, but welcome your theories and other ideas. We’ve also got a round-up on a lot of cardiology research testing ideas that didn’t work, and why at least one doctor is excited about that. 1,000,000+ That’s the number of people who could get access to Medicaid, thanks to last week’s blue wave. STAT’s John Wilkerson reports that three of the 10 states that haven’t expanded Medicaid could reconsider their holdouts now that Democrats have more power in state government: Texas, Georgia, and Wisconsin. The Democratic governors-elect in all three made Medicaid expansion a part of their campaigns. But the GOP still holds majorities in the Texas and Georgia state senates, which could complicate the path forward. Read more from John. We learned a lot about what might not work at the American Heart Association conference After last weekend’s American Heart Association meeting, we know a lot about what may not work. Experts presented research showing that targeting inflammation didn’t limit serious cardiac events. Neither did reducing lipoprotein(a), a genetically-based risk factor for cardiovascular disease. Researchers also found that lowering blood pressure in people with diabetes didn’t help cut down on heart attacks, and educating emergency responders and bystanders to improve their responses to sudden cardiac arrest didn’t keep more people alive. Even yoga didn’t seem to move the needle on health improvements after heart failure. A slew of studies showing the kinds of interventions that don’t measurably change outcomes might seem a little disappointing. But one person STAT’s Liz Cooney spoke to offered a silver lining: “I always find that when a trial is neutral, I think it’s more exciting for scientists to find a way forward … I call it a really big, beautiful baby who shouldn’t be thrown out with the bathwater.” Read more about what doctors are taking away from the AHA conference here. This year’s flu is hitting teens and young adults hard The number of flu cases is climbing, according to data from the Centers for Disease Control and Prevention. At least 1.7 million cases have been reported and 1,400 Americans have died so far this year, with case clusters in southern states and the West Coast. That makes sense, pulmonologist Vin Gupta, affiliate professor at the University of Washington’s School of Medicine, told the radio station WBUR. This year’s dominant flu strain — a mutated h2N1 virus — surged earlier this year in Japan. “The West Coast has major travel gateways from Asia, and that’s what we likely think is driving this initial spike,” Gupta said. Case counts are higher than usual for early November, but that doesn’t mean the virus will be more severe, or that peaks will continue to be higher. Another element to watch: According to one preliminary study, teenagers and young adults seem more affected by this year’s strain than older people. This could be because our immune response is shaped in part by the flu strains we were exposed to as children. The strain of flu that’s spreading now is a mutated version of the strain that fueled the 2009 swine flu pandemic. People without additional h2N1 exposure before then may be especially vulnerable because of the particular mutations being spread, USA Today reports. AI doesn’t have to get things wrong to offer poor health advice Consider this — someone could ask AI about the risks of smoking, receive completely accurate information, and still come away with the impression that lighting up isn’t all that bad for you. How? As academics Jessica Fishman and John L. Jackson Jr. explain, a lot of health messaging comes down to emphasis. An AI-generated response could share, honestly, that most smokers never get lung cancer. It’s true, but it’s not nearly the whole story. And right now, we just don’t know exactly how LLMs are explaining health information, and how that’s impacting patients. That needs to change, they write. As Fishman and Jackson put it: “Medical ethics pairs the duty to do no harm with beneficence, which is an affirmative obligation to do good. Safety evaluations of AI have focused mainly on the first duty … Far less attention has gone to the second: whether AI can help people by communicating more effectively. Responsible engineering means honoring both duties.” Read more. Moral injury is a ‘significant threat’ to doctor well-being, AMA says Doctors are burnt out, exhausted, leaving the field. On Monday, the American Medical Association’s House of Delegates weighed in on a related phenomenon — moral injury. In a new policy, the AMA voted to recognize moral injury as a “distinct and significant threat” to the well-being of doctors. The AMA distinguishes moral injury from other challenges such as exhaustion or distress, arguing that it is brought on when systemic constraints make it impossible for doctors to deliver evidence-based, equitable care. “The practice of medicine is fundamentally a moral activity, yet physicians routinely face barriers that can prevent them from delivering the care they know their patients need,” said AMA Board Secretary Pauline P. Huynh in a press release. “When those barriers repeatedly conflict with physicians’ professional values, that harm can contribute to physicians reducing their hours, leaving positions or training programs, or exiting practice altogether.” STAT’s First Opinion published a column on this phenomenon in 2018, which helped bring this issue to light. Take a look here. What we’re reading Acorns—not deer—can predict a rise in Lyme-spreading ticks, Science In America’s measles epidemic, RFK Jr. is now on trial, Politico Your stroke risk is 72 percent higher during these 3 hours of the day, The Washington Post Her death from dengue may signal that the disease is here to stay, New York Times