GLOBAL HEALTH

How Moderna is Advancing Global Health

Moderna released its new global health strategy to accelerate its mRNA technology to prevent infectious diseases worldwide, not just Covid-19 (link).

The Deets
Moderna’s new global health initiative spans four areas:

1. Advance mRNA vaccines to target 15 pathogens that pose the biggest threats to global health, including HIV, Zika, TB and Malaria, by 2025.
2. Launch mRNA Access, allowing researchers worldwide to use Moderna’s mRNA technology to explore new vaccine designs in preparation for Disease X (whatever that may be).
3. Patent pledge to never enforce patent protections on the company’s mRNA technology for the 92 low- and middle-income countries identified by the COVAX initiative (link). Moderna will enforce patent protections for everyone else, citing that vaccine supply is no longer a barrier.
4. Establish an mRNA manufacturing facility in Kenya to produce 500 million doses of vaccines each year.

A Kick A$$ Year
Moderna saw $17.7B in vaccine sales after selling 807M vaccine doses in 2021. The company’s revenue at the end of the year totaled $18.5B. Even though Covid-19 prevalence is slowing down, turning more into an endemic vs. pandemic problem, Moderna expects $19B in vaccine sales in 2022. Moderna CEO Stephane Bancel says the vaccines will likely be a seasonal shot, just like the flu vaccine (link).

My Thoughts
I don’t think we’ll see any other Covid-19 vaccine company take this patent pledge to promote vaccine equity or build a worldwide collaboration to advance vaccines (link).

I do think it’s wise to expand access to Moderna’s mRNA technology, which will allow the greatest scientists in the world to work together to build the next vaccine against debilitating diseases. I wonder if Moderna will offer any (monetary) incentives for researchers to experiment with the company’s tech? Money is a powerful motivator. 

BUSINESS

Avengers, Assemble

Six of the nation’s top hospitals are assembling to form a “unique human resources alliance” called Evolve Health Alliance (link). This alliance is well-needed, considering high rates of healthcare worker burnout and labor shortages.

The Deets

These six health systems will share resources and information with each other to improve the diversity, well-being and engagement of their employees. Additionally, these hospitals will agree to reciprocate staffing arrangements if any of the hospitals need staff. For example, Intermountain Healthcare sent around 50 employees to Northwell Health during the pandemic’s peak, and Northwell later returned the favor (link). Heather Brace, co-chair of Evolve Health Alliance, said,

Collaboration is key for health care systems to successfully adapt to changing conditions and prepare for the future.

My Thoughts 
Healthcare worker burnout has been a significant problem that the pandemic only exacerbated. Around 55% of front-line healthcare workers reported burnout in a KFF/Washington Post poll last year (link). I also see burnout firsthand in the hospital: doctors (including trainees) and nurses try to keep their spirits high, but they’re just so evidently exhausted, mentally and physically.

Additionally, burnout has influenced nurses to ditch the employed-by-hospital life and join travel nursing agencies, which pay significantly more than before (see my recent article here). These travel nurses also have more flexibility in their schedules.

There are many different ways to address burnout and subsequent staffing shortages. Evolve Health Alliance is one way, while the University of Pittsburgh Medical Center’s in-house travel nursing agency is another way (here’s my article on it). Are these the best ways to solve burnout and staffing shortages? I don’t think so. The answers can be found in the hallways of the hospitals. Ask any physician or nurse what they want to better their well-being and I would bet they’d say:

• More genuine appreciation and recognition by administrators.
• Being heard.
• Higher wages or salary.
• Less bureaucratic tasks that waste time and energy.

What else should I add to this list?

BUSINESS

The Fate of Telehealth

Congress plans to extend telehealth flexibilities made during the pandemic for up to five months after the public health emergency ends. This is great news, and I wouldn’t be surprised if these flexibilities became permanent.

The Deets
The telehealth flexibilities extension is part of congress’s $1.5T omnibus bill. These flexibilities are centered around Medicare providers and beneficiaries, but private insurers will likely follow Medicare in providing these flexibilities:

• Coverage for telehealth visits, including some audio-only, regardless of the patient’s location relative to the healthcare provider. Before, coverage was limited only to beneficiaries in rural areas who were required to travel to a healthcare facility like an FQHC to have the virtual visit with a doctor who was in another location (seems pointless, I know).
• Provider reimbursement for virtual visits that take place from the patient’s home or medical facilities.
• Delay the requirement that Medicare beneficiaries who use virtual mental healthcare see their mental health provider within six months of the telehealth visit.

The Telehealth Boom

The share of telehealth outpatient visits ballooned during the pandemic. Before, telehealth visits made up 0% of outpatient visits, reaching 13% at the height of the pandemic (link). And, while we’re still waiting for official numbers, it seems telehealth visits spiked again during the omicron surge (link). Demand for telehealth services doesn’t seem to be going away anytime soon (link).

My Thoughts
Telehealth increases access to healthcare services, although there are still barriers for those who lack internet access. From a provider’s perspective, telehealth is a convenient, more efficient way to follow up on non-acute patients. There’s no need to travel room to room—providers can literally sit in the same chair to chart review and speak with patients. And, with the increased usage of remote patient monitoring (shout out Athelas), providers can still get the entire patient picture by reviewing their recent vitals, blood sugars and weight, for example.

I do have some concerns about telehealth, though:

• Telefraud (link).
• Over-utilization of telehealth services, consequently leading to low-value care and unnecessary spending.
• Little data on telehealth patient outcomes.

Overall, I’m a fan of telehealth as both a patient and (future) provider. I truly hope these flexibilities become permanent and my concerns are addressed. What do you think?

OUTSIDE THE HUDDLE

• Speaking of telehealth, LG is partnering with Amwell (one of the largest telemedicine businesses) to build devices for the hospital.
• About one in 10 adults have significant medical debt, a number that adds up to $195B nationwide.
• Overdoses involving Xylazine (a veterinary tranquilizer) are on the rise, accounting for up to 20% of overdose deaths in certain areas. Xylazine doesn’t respond to Naloxone (a.k.a. Narcan, which rapidly reverses opioid overdoses), making it harder to reverse.
• The role of pharmacists during the pandemic included vaccinating, testing and dispensing antivirals, and now it’s time to figure out what that role will look like post-pandemic.
• Just last week, Microsoft finalized its $20B acquisition of Nuance Communications, cementing its dive into the healthcare space. That’s a big deal.

HUDDLE HITS

• 🐶 Reduce the Carbon Pawprint: This company is keeping our dogs and environment happy. They make high-quality, nutritious and yummy food that reduces the carbon pawprint. Plus, they’re woman-owned and operated 💪🏼. Enjoy 25% off your order here.
• 👨‍⚕️Med School Adventures: Week 2 on my colorectal surgery rotation. Last week I scrubbed into a transanal total mesorectal excision (taTME) procedure to remove a tumor in a patient with rectal cancer! Check it out here.
• 📚What I’m Reading: What Can Hospitals Learn from The Coca-Cola Company? Health Care Sustainability Reporting from NEJM Catalyst.
• 📺 New Show: Our Flag Means Death. New comedy/thriller show on HBO Max based on a true story. Essentially, a real nice guy back in the 1700s leaves his family to become a pirate, even though he doesn’t have any of the characteristics of a pirate.
• 🐈 Pet of the Week: Meet fellow Huddler Corry’s kitty, Pepper!