Get your daily dose of health and medicine every weekday with STAT’s free newsletter Morning Rounds. Sign up here.

“Put THIS in the STAT newsletter,” a friend prompted me yesterday. “WHERE are the sour cream and onion chips?” The flavor used to be everywhere, she says, but now every little aluminum bag seems to be labeled cheddar and onion instead.

Perhaps we should put commercial determinants of health reporter Sarah Todd on the case. For now, I’d suggest re-visiting her explainer, written with Lizzy Lawrence, about the FDA’s “generally recognizable as safe” exemption. Yesterday, health secretary Robert F. Kennedy Jr. directed the agency to study eliminating that loophole.

Francis Collins doesn’t want security — but he got it

Back in 2016, as his first term began, President Trump asked then-NIH director Francis Collins to stay on in the role. Collins, known as a legendary geneticist, was beloved by lawmakers on both sides of the aisle. Almost a decade later, Collins has retired from the agency, but he’s still deeply concerned about his safety as a public figure. He’s hired security at his home, he told STAT, “but I don’t have anything more — it’s way more expensive than I could ever afford.’’ 

It’s just one sign of his new public image as a common target of President Trump’s followers. “You’re going to prison,” an agitated protestor said, confronting Collins on Friday at a Stand Up for Science rally. “He’s an indicted felon, he lied before Congress,’’ the protestor, who only identified himself as Jeff, later baselessly told STAT. Read more from Anil Oza and Katherine MacPhail about Collins’ experience as the subject of intense criticism and scrutiny.

How did kindergarteners fare in the pandemic?

Five years ago today, the WHO declared Covid-19 a pandemic. Today, JAMA Pediatrics published a study on how kindergarteners fared during that time. The study found that young children suffered when it came to language and cognitive development, social competence, communication skills, and general knowledge. 

Using data on more than 548,000 kindergarteners in 19 states from 2010 to 2023, the researchers found that assessment scores were already decreasing across all categories before the pandemic. But compared to the three years immediately beforehand, scores from 2021 to 2023 were significantly worse in the categories above. Interestingly, scores for emotional maturity were higher during the pandemic. Scores for physical health and well-being were unchanged.

Telehealth companies say goodbye to weight loss, hello to hormones

In the two years since blockbuster weight loss drugs like Ozempic and Wegovy came on the scene, hundreds of businesses have cropped up to meet the surge in demand for these medications, known as GLP-1s. The majority prescribe compounded copies of the drugs — a tenuous business strategy, now that shortages of the branded versions of the medications have come to an end. 

But STAT’s Katie Palmer reports that, in their place, some businesses are setting their sights on another opportunity in compounding: hormones. Dozens of wellness and direct-to-consumer telehealth companies that offer GLP-1s have started marketing hormone replacement therapy to women in perimenopause and menopause, and testosterone replacement therapy to men.

Health experts warn that profits may drive prescription behavior more than medical need. Read more from Katie on the latest trend.

This century’s other, larger, public health crisis

In dominating the early 2020s, the Covid-19 pandemic distracted from what could arguably be a more significant public health emergency: Even at the height of the pandemic, more young Americans were dying of drug overdoses than the infectious disease. 

More than 1.25 million people in the U.S. died from a non-alcohol drug overdose between 1999 — about when the crisis began — and 2024. That puts overdose deaths a tick ahead of overall U.S. deaths from Covid-19, and the gap will surely grow. But the country’s drastically different responses to these two crises shows how relatively little attention people pay to the addiction crisis, STAT’s Lev Facher writes. 

“When you look at the adoption and spread of vaccination versus the adoption and spread of medications for opioid use disorder, they’re light years apart,” physician Brian Hurley told Lev. Read more from Lev about the contrast between the responses to these two deadly crises.

Water, the environment, and health

Two recently published studies looked at the connection between health and water — one on PFAS in drinking water, and another on flooding. Authors of both studies used administrative health care data to find links between the environment we live in and our health:

• In 2014, PFAS (“forever chemicals”) were found in five drinking water wells in one Delaware county. A study, published last week in Environmental Epidemiology, found that people living in the ZIP codes served by these wells were at higher risk for type 2 diabetes, hypertension, hypertensive diseases, coronary artery disease, and hyperthyroidism based on new health insurance claims, compared to people living in other places. 
• In a study published yesterday in JAMA Network Open, researchers looked at Medicare beneficiary data from 2008 to 2017 for more than 11 million people over 65. Those who lived in ZIP codes that were exposed to large-scale floods in that time were more likely to visit the emergency department and be hospitalized, especially for infectious diseases, metabolic and kidney disorders, and injuries. 

And in even more water news, it looks like Utah will become the first state to ban fluoride in public water. To learn about the science behind fluoride, read Anil’s story from last fall.

Yes, and 

We’ve all experienced the awkward, painful moment when a loved one with dementia calls us by the wrong name. And then there’s the deliberation — to correct them, or let it be? In a new First Opinion essay, geriatric physician Ted Johnson offers a strategy with a surprising origin: Improv comedy. 

Improvisers talk about the idea of “yes, and”-ing your scene partner. It’s a core tenet of improv, to accept the thing (a joke, a premise, an accent) that’s been offered and build on it. It’s not just a way to meaningfully engage with someone who has dementia, but it has also been shown to ease the deep emotional toll the disease takes on family and caregivers. Read more on how to incorporate improv into dementia care. 

What we’re reading

• The next five years of Covid, C&EN

• Zyn and the new nicotine gold rush, New Yorker

• For Google, health equity becomes ‘health optimization’ as Trump targets DEI, STAT
• Supreme Court to hear challenge to law banning conversion therapy, New York Times
• NIH to terminate or limit grants related to vaccine hesitancy and uptake, Washington Post