Yes, it’s been a challenging and often tragic year when it comes to health. But our hardest times often push us to our greatest achievements, and there’s a lot of progress to be excited about in 2021—like these seven advances.
Gene therapy for repairing sickle cell disease
The idea is simple: Take a defective gene, fix it, and cure a devastating genetic disease. Getting that to work has been tougher, but this year scientists at several research centers made remarkable progress with sickle cell disease. The condition—caused by an inherited defect in the gene producing hemoglobin in the red blood cells that leads to deformed, crescent-shaped cells that cause pain, anemia, and organ damage—affects some 100,000 Americans, mostly Black and Hispanic.
Researchers at Boston Children’s Hospital are testing a gene therapy treatment that tricks the gene into reverting to a healthier version called fetal hemoglobin. In eight patients treated so far, they are seeing the fetal hemoglobin increase and hoping the change will last a lifetime, says Erica Esrick, M.D., a pediatric hematologist there. Several other research groups have reported similarly promising results using gene therapy and gene-editing techniques for patients with sickle cell disease. Experts believe these techniques may one day cure many genetic diseases, such as hemophilia and genetic immune deficiencies, as well as some cancers.
The first new birth control in decades
Women looking for a nonhormonal birth control option finally got a new one this fall. Phexxi is a prescription gel that makes the vagina more acidic so it’s less welcoming to sperm. Using it is simple: You squirt it from a prefilled applicator up to an hour before sex. Phexxi is not the most effective birth control method (it’s 86% effective, the manufacturer says, compared with 91% for the Pill and 99% for an IUD), and it doesn’t protect against STDs, so you still need to use a condom, but it’s something to celebrate. The last time new options for women came on the market—the patch, vaginal ring, and hormonal IUD—was two decades ago, says Elizabeth Watkins, Ph.D., a professor of the history of health sciences at the University of California, San Francisco. The more ways women have to take control of their reproductive futures, the better.
Telemedicine comes of age
Who would have thought so many of us would comfortably visit a doc in our PJ’s from home? But because of COVID-19, by summer nearly a quarter of us had used a computer, app, or phone for a telemedicine appointment (before the pandemic, only 14% of women said their doctors even offered this option, according to a federal survey). We’re now virtually showing a rash to a dermatologist, demonstrating joint pain to a rheumatologist, and getting an antibiotic Rx for a nasty UTI.
Even more significantly, we’re treating our anxiety via online psychotherapy—hugely helpful, especially in areas where therapists are in short supply. Will this tele-trend last? Experts say it won’t continue to the same extent, as uneven insurance reimbursements, laws about practicing across state lines, and the belief that docs need to see us in the flesh have physicians eager for patients to return to their offices. But the shift toward at least a few appointments each year that don’t require driving, taking a half day off from work, or even changing out of your sweats may be here to stay.
Finally, a focus on Black women’s health
It’s sad and horrifying that it took publicized deaths at the hands of police and disproportionate suffering from COVID-19 to bring this about, but Black women’s health is finally getting the attention it deserves. In 2020, there was increased awareness of the impact of structural racism on health care: Black women suffer pregnancy-related death four times as often as white women, and their mortality rate is higher for everything from heart disease and cancer to asthma and flu.
A true fix will require hard actions that have yet to materialize, but people of all races are taking the crucial first step in asking how we can fix this, says health disparities researcher Courtney Denise Townsel, M.D., a maternal-fetal medicine physician at Michigan Medicine in Ann Arbor. An editorial in the prestigious medical journal The Lancet this summer finally termed racism “a public health emergency of global concern.” And Congress introduced the Black Maternal Health Momnibus Act to address the health disparities in pregnancy and birth and to inspire innovative solutions with a series of grants.
Super-convenient breast pumps
For decades, breast pumps were stuck in the Dark Ages, with bottles, tubes, and wiring requiring you to sit in one spot for up to half an hour, says Tanya Powell, a board-certified lactation consultant at Sutter California Pacific Medical Center in San Francisco. Thankfully, the past few years have seen miraculous advances, and even more improved in 2020. Today the most convenient pumps, such as Willow’s Generation 3, slip right into your bra, allowing you to pump as you move around or even as you sleep. The Elvie Pump is silent enough to let you stealthily pump during an online business meeting. Powell cautions, however, that this generation of pumps might not be optimal for establishing or building a milk supply. Consult a lactation consultant to help choose the pump that’s best for you.
Disposable medical scopes
Scopes let doctors peer inside your body, but if these flexible lighted tubes with cameras aren’t thoroughly disinfected between patients, their use can lead to rare but serious bacterial infections. The duodenoscope, a device snaked down the throat to the top of the small intestine to diagnose and treat pancreas and bile duct diseases, has proven especially tough to clean. Now the first fully disposable duodenoscope has been approved by the FDA, which experts expect may finally end the recent spate of infections blamed on dirty scopes. Other similar tossable devices, including one for colonoscopies, are expected in the next few years, making potentially lifesaving exploratory procedures safer.
A novel way to detect Alzheimer’s
If a loved one’s memory is fading, it’s important to know whether they’re suffering from Alzheimer’s or another type of dementia, since early detection means better treatment (even if there is as of yet no cure) and perhaps the chance to take part in a clinical trial. But today, a definitive diagnosis requires a clinical evaluation as well as brain imaging or a spinal tap.
So it’s huge news that scientists have discovered a simple blood test that has accurately diagnosed Alzheimer’s in early studies. If the test, which hunts for proteins indicative of the disease, performs well in additional studies, it will offer the first easy, early screen for this debilitating disease. “For some people, knowing leads to better health behaviors,” says Mary Sano, Ph.D., director of the Alzheimer’s Disease Research Center at Mount Sinai, in New York City. Some may find the knowledge anxiety-producing, but for those who want to get a jump on treatment, the new blood test could be a game changer.
Plus, the biggest health story of 2020
In 2019, no one knew anything about the virus that would later be linked to COVID-19. But in one year, remarkable progress has been made. Several vaccines are showing promise. Doctors are using steroids and high-flow oxygen to keep people alive. New diagnostic tests have emerged, including one using lines like on a pregnancy test. And a powerful way to reduce the spread has been found: wearing a simple cloth mask.
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