Is There a Mental Health Pandemic?
Every month, High Lantern Group shares a collection of the most interesting perspectives on the healthcare industry’s trends and developments. We are happy to share them with you — and hope you share your thoughts with us.
Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.
1. Volume Over Substance in the IP Debates
Politicians, pundits, pharma execs, and public health experts are all shouting about potential waivers for IP protections for COVID vaccines. Economist Alex Tabarrok argues they’re mostly missing the point:
The mRNA technology is new and has never before been used to produce at scale. Pfizer and Moderna had to build factories and distribution systems from scratch. There are no mRNA factories idling on the sidelines. If there were, Moderna or Pfizer would be happy to license since they are producing in their own factories 24 hours a day, seven days a week (monopolies restrict supply, remember?). Why do you think China hasn’t yet produced an mRNA vaccine? Hint: it isn’t fear about violating IP.
Moreover, even Moderna and Pfizer don’t yet fully understand their production technology, they are learning by doing every single day. Moderna has said that they won’t enforce their patents during the pandemic but no one has stepped up to produce because no one else can.
2. Is There a Mental Health Pandemic?
The mental health fallout from COVID has been labelled “the second pandemic.” The logic is hard to dispute. Yet two new pieces complicate the picture.
New U.S. data sets from Medicaid and CHIP find a severe drop in utilization of mental health services:
When compared to data from the same time period from 2019 (March through October 2019), preliminary data for 2020 show 12 million (22%) fewer mental health services for adults age 19 to 64 and 3.6 million (13%) fewer substance use disorders (SUD) services. For children, the decline was 14 million (34%). Although there is significant variance across states, service utilization rates [for adults] across both domains appear to be continuing to decline across the majority of states even though preliminary evidence suggests there has been an increase in the number of adults reporting adverse mental or behavioral health conditions during COVID-19.
Meanwhile, The Atlantic pokes holes in the narrative that COVID has prompted spikes in mental health emergencies:
What many news outlets called a rise in claims or an increase in emergency-room visits was actually a rise in the percentage of claims or visits. So, for instance, the number of insurance claims related to intentional self-harm among those ages 13 to 18 did almost double as a percentage of overall medical claims in March 2020 compared with March 2019. But the total number of medical claims dropped by about half that month, likely because people were postponing their less urgent trips to the doctor.
3. “We Will Condemn the World to Successive Catastrophes”
The Independent Panel for Pandemic Preparedness and Response, established by the WHO, has issued a massive assessment of the global response to COVID.
Spoiler alert: we screwed up.
But the Panel’s goal isn’t to complain, but to learn from our failures with COVID to create a future with “no more pandemics.” The introduction sets the tone and argument for the remainder of the long report:
Our careful scrutiny of the evidence has revealed failures and gaps in international and national responses that must be corrected. Current institutions, public and private, failed to protect people from a devastating pandemic. Without change, they will not prevent a future one. That is why the Panel is recommending a fundamental transformation designed to ensure commitment at the highest level to a new system that is coordinated, connected, fast-moving, accountable, just, and equitable—in other words, a complete pandemic preparedness and response system on which citizens can rely to keep them safe and healthy.
4. Love in the Time of COVID and Malaria
Only in 2021 would the remarkable clinical progress of a breakthrough malaria vaccine be relegated to the deep pages of National Geographic. Nevertheless, the news amounts to a potential public health triumph, as malaria still kills more than 400,000 people a year, two-thirds of whom are young children:
The R21 vaccine was 77 percent effective at stopping malaria, when compared against a control rabies vaccine, rather than a standard placebo. R21 is the first vaccine candidate for malaria to cross the 75 percent threshold, a goal the World Health Organization (WHO) first set in 2013.
Making a malaria vaccine is extremely difficult, in part because this disease is complex. Most cases of malaria are caused by the parasite Plasmodium falciparum, whose genome contains more than 5,000 genes—far more than the mere 12 rattling around inside the coronavirus that causes COVID-19.
5. A Dollar in Hand
Cash. Cold, hard cash. That’s what the Biden administration is betting its money on in its latest idea for expanding healthcare coverage. The New York Times takes a wonky dive into why cash payments could be more effective than health insurance for people living in poverty:
The evidence indicates that for the low-income recipients of these programs, cash transfers will provide a greater bang for the government’s buck. Two separate studies that my collaborators and I conducted found that, on average, low-income adults would benefit more from a dollar in cash than a dollar of government spending on health insurance.