Brainstorm Health: After the Flood

Good morning, readers. This is Laura (filling in for Cliff).

Hope you had a great holiday weekend. Unfortunately, with the return of the work week comes news of another hurricane: Irma, which has strengthened into a Category 5 storm, appears to be headed for the Caribbean and Florida.

In the meantime, Houston is starting the long recovery process in the wake of Hurricane Harvey, which has claimed the lives of dozens. In the short-term, this includes assessing and clearing the damage.

In the longer-term, it means much more: rebuilding, yes, but also addressing the physical and psychological wounds that can fester long after the water recedes.

Here’s what past storms have taught us. Houston residents can expect an increase in infections (exacerbated by flood waters that merged with sewage and dredged up other toxic debris), and the spread of contagious diseases (aided by crowded conditions in shelters) in the coming weeks. After Katrina, the CDC reported a host of infectious outbreaks among evacuees, including 30 documented cases of MRSA, an infection caused by a type of antibiotic-resistant staph bacteria. As a precautionary measure, Houston residents are advised to stay out of the water get tetanus booster shots.

Complications from chronic conditions including cardiovascular disease, respiratory illness, and diabetes are also expected to increase post-flood, a danger compounded by the fact that access to medication remains an issue. Past floods indicate that the overall mortality rates will remain elevated for months to come.

And then there’s the emotional toil. Research involving Katrina victims suggests that in the wake of the storm, the city will see a rise in mental health diagnosis. Unlike a surface wound that, when properly cared for, heals within a set time period, emotional scars don’t come with a contained path to recovery. They can linger for months, even years, and flare up again long after the initial, triggering episode.

Studies on residents in regions affected by Katrina, for example, found that the prevalence of PTSD was up 21% a year after the hurricane, while the percentage of those who said they experienced suicidal thoughts climbed from 2.8% to 6.4%. These numbers provide a glimpse at the long road ahead for Harvey victims, many of whom have lost their homes, some of whom have lost loved ones.

As the flood waters recede and the world moves on to the track the next hurricane, Houston (as is true for New Orleans, New York, Hawaii, and so many other cities and regions) will feel the effects of Harvey for years to come.

DIGITAL HEALTH

The robots are coming. We know automation will eventually render many jobs obsolete. That said, some professions are safer than others (those in manufacturing should be worried, while hair stylists can breathe a sigh of relief). This dichotomy extends to the medical industry, where “high touch” jobs (such as physicians, nurses, and physical therapists) are relatively safe from being replaced by a machine. Radiologists, who enjoy a cushy, average annual salary of $400,000, don’t fit inside this category -- and that has them worried. (NPR)

INDICATIONS

FDA shuts down CAR-T clinical trials. A mere days after the FDA approved CAR T-cell immunotherapy, which targets cancer cells by harnessing the body’s own immune system, it shut down two clinical trials involving the treatment following the death of a patient. Both trials were being conducted by Cellectis for its off-the-shelf version of CAR-T therapy. (Endpoints)

THE BIG PICTURE

Getting specific about cancer treatment. Writing for The New Yorker, Siddhartha Mukherjee takes an in-depth look at why it’s still so hard to predict whether a patient’s cancer will become metastatic or not (and, as a result, to determine the best method of treatment). The way forward could involve a radically different approach to cancer treatment, one based on the host’s peculiarities as well as characteristics of the cancer itself. (The New Yorker)

Trump to nominate a ‘drug czar’. His choice to head the Office of National Drug Control Policy? Long-time supporter Rep. Tom Marino, who originally withdrew his name for consideration citing his mother’s critical illness. Now Marino, who sits on a bipartisan congressional committee focused on creating laws to fight the opioid crisis, has apparently withdrawn his withdrawal. (STAT News)

Birth control belly. I’ve heard it repeated countless times, from friends and doctors alike: the pill causes weight gain. Except it’s not true. Or, at the very least, it’s complicated. While taking the pill can, in specific instances, lead to weight gain, the relationship is thornier than a simple cause-and-effect. (New York Magazine)