Short Wave - The Biggest Health Stories of 2024

Episode Date: December 31, 2024

2024 was full of science news. There was a total solar eclipse, the Paris Olympics, elections in the United States and elsewhere, technological breakthroughs and many space launches. But perhaps above all, it was a huge year in health. So, today, we're talking through some of 2024's biggest health stories — from what's in our drinking water supply, to bird flu, obesity drugs and this year's record heat. They're also the stories we think will continue to be big in 2025. See you in the new year, Short Wavers!

You're listening to Shortwave from NPR. Hey, shortwavers, it has been a year. So many big events have happened. I mean, recently we went through a whole election. And back in April, there was a total solar eclipse over the United States for the first time in years. Then there was the Paris Olympics where athletes from around the world sought to get as close to define the laws of physics as possible. And then there was the continued memeification of life, like Mudang, the Pygmy Hippo. the internet is obsessed with, and honestly I'm obsessed with too. It was part of my Halloween costume this year. And still, we realize some of the biggest evolving stories of the year. They're all related to human health. So we're bringing some of our coolest science reporters around to talk about this year's biggest stories. One of those stories is what's in our drinking water supply, which we have ping Wong on deck to talk through. Yeah, I mean, there are so many buckets to look into from forever chemicals to lead, the fluoride. And we'll get to all of them.

Briefly, before turning to Will Stone, who we have here to talk about bird flu, which we might need to know a lot more about next year, right, Will? Hey there, yeah, unfortunately, it's looking like it. Third, we have Sidney Lubkin to talk all things of obesity drugs, which seemed to have gotten, like, more and more popular ever since we first heard the word, Ozimpec. Yeah, even though, as we'll get into later, Ozempic is a diabetes drug. And I'm happy to have Alejandro Burunda in the house to round out our squad and break down all things heat. Hey, Ollie. Hello, and yeah, the number two Google search of the year was excessive heat. And so it's great that people are aware, but it is less great that so many people have had to live through record-breaking heat.

Today on the show, with the help of my colleagues on the science and climate desks here at NPR, we're zooming in on some of the biggest science stories of the year and keeping an eye on the future, where all of these stories will go in 2025. I'm Regina Barber, and you're listening to Shortwave, the science podcast, from NPR. Hey, shortwivers, Emily Kwong here. Believe it or not, the year is almost over. And as we are reflecting on 2024,

we're thinking about the hundreds of podcast episodes we brought you this year. I mean, episodes about big things like climate change, nuclear energy, COVID, and episodes about weird and wonderful things like sea cucumbers, the biology of memory, the science of skin care trends you see on TikTok, and episodes about stuff we just can't stop obsessing over.

I'm looking at you, Naked Mole Rat Succession War. Now is the time of year when we reflect on all that work and ask you to support it. Maybe you are already an NPR Plus supporter, and if so, I'm sorry to bother you and thank you so much. But if you have never given to public media before or not in a while, please consider doing it right now. NPR Plus is a recurring donation that gets you special perks for more than 25 NPR podcasts, like sponsor-free listening, bonus episodes, behind-the-scenes content, and even exclusive and discounted items

from the NPR shop and the NPR Wine Club, it only takes a few minutes to sign up. You could do it right now at plus.npr.org because this year, shortwave turned five years old. Whether you've been with us from the very start or you're listening this week for the first time supporting public media means you're part of a community of people

who are curious about the world. We're honestly so proud to have served the public media community these past five years. Let's keep it going, but it can only be done with your help. So join NPR Plus today at plus.mpr.org. Thanks so much. Okay, short waivers, we have so much to get through, and I think it makes most sense to go kind of round-robin with this.

And I'm going to start with Ping Wong. Hey, Ping. Hey, Gina. Ping, and I wanted to start with you because part of your beat as a science correspondent is that your task is covering public health. And there's a public health angle to basically everything we're going to talk about today, but trust in public health is low, right? Yeah, I mean, it has gotten better since the pandemic.

So there was this nationally representative survey that the Pew Research Center did at the end of October. And it found that 76% of respondents were at least fairly confident in scientists. You know, they thought that they were intelligent, focused on solving real world problems. So like I said, that's up. But it's still lower than it was before the pandemic. And people in the U.S. are split about whether scientists should be actively focusing on policy or if they should be staying out of the fray. And now people in public health are quite worried that the nation could backslide on that hard-earned trust, you know, at least in federal agencies.

If some of President Trump's nominees get confirmed, Robert F. Kennedy Jr. for Health and Human Services lead, for instance, this is someone who rejects mainstream science, actively urges people to discount people with years of expertise in a topic and listen to him. Okay. And now that we have that, like, little preface of trust, I want to get into what I at least see as one of like the biggest most complex stories you've been monitoring. And that's like what's in our water supply and what's to be done about it. Yeah, absolutely. So this has been a big year for drinking water. There were two big new rules from the EPA in April. They passed a rule to limit the amount of six PFS chemicals. That stands

per polyfluoroalkal substances. We've talked about them here before. And these are manmade chemicals that have been used for many, many decades in waterproofing, stainproofing products that people can buy in the store or use in flame retardants. They're called forever chemicals because they have this really strong carbon fluorine bond that can stay bonded and intact for centuries. So they don't really fall apart in nature. They are in most human bodies. They've been linked to liver damage, high cholesterol, certain cancers, suppressed immune response in children. So the new PFS regulation requires water systems that find even low levels of PFS in the water to filter them out. Oh, wow. So that's PFS, and you said that there are two. What's the other one?

So the other one is lead, which we have known about for a really long time. You know that lead is a neurotoxin. It's especially dangerous for kids and they're developing brains, and it can leach out of lead pipes and into people's drinking water. So a little background here. Lead pipes and drinking water have been banned since the mid-1980s, but there are still more than nine million lead pipes that were installed before that that are still in use and in the ground. So the EPA also passed a new rule this year. that requires all of those 9 million lead pipes to be dug up, replaced with non-led pipes within the next 10 years. So all of that is really great, but there is work that remains. You know, there are other chemicals of concern in the water, some questions about what might happen to the work on PFS, on lead, when the New Trump administration takes effect. Some of these things are being challenged in court right now, so we will see if what has been passed this year is kept in whether that momentum keeps going. Right. One of the chemicals they're kind of maybe focusing on is like fluoride.

I feel like I've been hearing a lot about that recently. Yeah, exactly. Now, that is a whole separate can of worms, fluoride, and drinking water. So a lot of communities have added it to drinking water since the 1940s to cut down on cavities. And R. FK Jr. has said that if he is confirmed, he's going to push to get it out of the drinking water. And we're already seeing some states like Florida, their state surgeon general already has encouraged, you know, places to stop adding fluoride to the water. So there could be a lot of changes there. We'll see.

All right. So on to Will. Hey, Will. What's up? Hey there. So we're here to talk about the bird flu, and it's reemerged in the U.S. in farm workers late last year, and you've been monitoring it ever since. And just this month, California declared a state of emergency due to rising cases in dairy cattle.

But first, can you give us, like, a little refresher on how this infection starts? Definitely. So, you know, the basics are that a bird flu infection starts when the protein on the virus binds to a receptor on the cell. it wants to take over. This is the H.A. protein on the virus. Now, luckily, the version of H5N1 spreading in cattle has not evolved to target the receptors that dominate the upper airways in humans. Good. Yeah, that's a good thing because that's a key step in the path to becoming a pandemic virus. There have been dozens of known human infection so far, and there's some reason to believe that's probably an undercount. Luckily, most of the cases have been mild, and many are just presenting as, you know,

injunctivitis, an eye infection, or sometimes a mild cold. Okay. So as like the months have gone by since that initial outbreak, more infections have emerged, though, generally in agricultural workers, right? That's right. Mostly agricultural workers, though there have been several cases in North America without a known source of infection. One of those was in Missouri earlier this year. There was another in California. And then most concerning was a case in Canada. This was a teenager who became severely ill. They were hospitalized in critical condition.

They could not tell how this person was infected. There was genetic sequencing showing that it probably wasn't spread by cattle. It did not look like the version that's in the dairy cattle. It was pretty similar to what had been spreading in wild birds in British Columbia where this teenager was infected. So all of this adds to a general sense of anxiety about where this outbreak could go. Okay, what are you monitoring for bird flu, like going into the new year? Yeah, so the big fear is obviously this virus evolves and gets much better at infecting humans. And the more chances it has to spill over into a person, the more chances it has to mutate.

And scientists think, you know, that might have happened actually in this teenager in Canada, who seems have caught it maybe from a bird, that the virus actually evolved while inside of them. And then that's what ended up leading to such a serious illness. thankfully there is no evidence this person spread it to anyone else. And we did get a reminder of how things could go south here. There was a recent study from Scripps Research Institute and it looked at the protein on the virus that I had mentioned before to see how it would need to change to better infect humans. And to their surprise, they discovered it would take just one mutation. They were expecting it would take three.

Oh, gosh. That's right. So this doesn't mean there's going to be a pandemic tomorrow. tomorrow, there would have to be other changes in the virus to help it spread easily between humans. Scientists have an idea of what some of those can be. Others are kind of unknown at this point. A big thing we're watching, especially as flu season is underway, is that a person who's infected with seasonal influenza, you know, which humans catch all the time, could also be co-infected with bird flu. And that could lead to a process of genetic mixing known as reassortment. And this has been a

key process in previous influenza pandemics. It's possible it could happen in a person. It's possible it could happen in a pig. These are some of the things we're watching as bird flu stretches into the next year. Yeah. Okay, well, we're going to move on to Sydney and we're going to talk about obesity drugs like Wegovi or OZempec being used off label. Can you help us unpack why it seems like it's everywhere? I mean, because it kind of is everywhere and there's data to back that up. Brand name Wagovi sales have been increasing, for example, and the companies that make these drugs have been ramping up production to deal with the fact that they initially weren't able to meet this huge demand. And Zocdoc says more patients are trying to book appointments to ask about these drugs than really ever before. Do you mind just talking about how do they work?

Like OZemic started as a diabetes drug, how did it and these other like permutations end up being like effective for weight loss? Yeah, sure. So that's a fair question. And so they work basically by mimicking a hormone in the body that tells the pancreas to make more insulin. And that lowers blood sugar. And that keeps you feeling full, things like that. So it started as a diabetes drug, but it has been super effective at helping people lose weight. But the drugs have been in short supply thanks to really unprecedented demand, which has allowed this sort of strange thing to happen, which is that pharmacies can essentially make copies of brand name drugs when those medicines are in short supply.

And that process, which is different from the production of generic drugs, is called compounding. That's so cool. And the compounded versions have helped fill the supply gap. But they've also been a lifeline for patients whose doctors have prescribed these drugs for them, but their insurance won't cover them. So instead of paying more than $1,000 out of pocket a month, they can pay a few hundred, which is still expensive, but at least somewhat more manageable. But it's not a permanent solution once the shortages end, and they will eventually.

the compounders will have to stop. There's really been a ton of back and forth about that. One drug was taken off the shortage list, but might go back on. Patients who rely on the compounded versions are confused and scared and stockpiling and it's a mess. Ooh, where do you see all this going next year in 2025? You know, I think demand is only going to grow. But I, you know, I think access looks like it's going to continue to be a problem, especially as the compounding situation winds down. Insurance coverage is still an issue. The price is still. bill an issue. The Biden administration also proposed a new rule that would extend Medicare and Medicaid coverage to include obesity drugs like Wagovi and Zepbound, which is another one of these, though it will be up to the Trump administration to decide whether or how to implement that. Meanwhile, the drugs got approved to do new things like lower the risk of heart attack in some patients. Wow. And that very well may continue into 2025 and beyond as the research continues. On the

flip side, we may learn about new side effects as more people take these drugs for longer. I mean, that's a, that's a, some good news, some bad news. Okay, let's round out this round Robin with Alhandra. Hey, hey, Tina. So I feel like we've just been inundated with like heat news from like spring until maybe a week ago. So what's, tell me more about that. Yeah, welcome to the hot world now. This year was just really, really hot, like so hot. One of the hot. One of the hot. and we will soon know if it was the hottest year ever. The numbers aren't officially out yet, but the overall global temperature increase this year,

compared to the pre-industrial period back before we started burning tons of fossil fuels, it's probably going to be above 1.5 degrees Celsius or 2.7 degrees Fahrenheit for the first time ever. And it's important to know that one single year around that temperature level, that doesn't mean that we've crossed some threshold. And that's because there's still a lot of variation year to year and temperatures because of things other than climate change.

But scientists look at the long-term averages in order to assess total warming. And so officially we probably won't be past 1.5 for at least another couple years. But getting close to that major limit, that's not a great sign. And that's especially because there's just still not nearly enough climate action happening to slow down further warming. Yeah. So there's just going to be like, more. more heat in our futures then, I guess. That's basically what we're looking at.

But also, like I said at the beginning, the number two Google search of the year was excessive heat. And that, to me, says that people are at least paying attention. And maybe because of stuff like that, we've actually seen some policy action to deal with heat here in the U.S. There are a few states and cities that have passed heat rules protecting workers this year. And drum roll, the Biden administration, proposed a national heat standard for workers. Basically, a rule that would require employers to protect workers when it's really hot outside. That idea, it's been bopping around as like since the 1970s. So it's a pretty big deal that it moved forward at all. And recently we had you on as a kind of like retro what happened at the latest international climate talks negotiation COP 29. In that episode, you mentioned that in the coming year, countries have to submit like a target for how to reach their climate goals or targets. Is that the next big thing on the horizon for you to be reporting on?

Yeah, that's definitely a big thing for 2025. Like you said, next year's annual climate conferences, the cops, it's going to be a big one. And countries are coming up with new plans for how to cut emissions right now that they'll be rolling out in the next couple months. And those new goals, they're going to need to be much more ambitious than the ones that exist already. if there's any hope of keeping warming below 1.5 or even to see. And then, of course, there's a really big question mark right now about what the U.S. will do climate-wise. President-elect Trump has said that he'll pull the U.S. back out of the Paris Agreement.

That's something he did during his first term in office, too. And some of the people that Trump has nominated to run federal agencies are saying that they want to eliminate a lot of the climate-focused programs that have been developed in the last couple years. So we'll all be following these efforts at the federal level to de-emphasize climate action. But at the same time, we also expect there to be a lot more action happening at the state and local level, which is really interesting. Okay, well, Alhandra, Sydney, Will, Ping, thank you all for coming on the show to recap this big year of science. It's been awesome. Thanks so much.

Yeah, really glad to be here. Thank you so much. Thanks, guys. This episode was produced by Jessica Young and edited by our showrunner Rebecca Ramirez as well as Sadie Babbitts and Scott Hensley. Rebecca and Tyler Jones checked the facts. Quasi Lee was the audio engineer.

Beth Donovan is our senior director and Colin Campbell is our senior vice president of podcasting strategy. I'm Regina Barber. Thank you for listening to Shorewave, the science podcast from NPR. See you next year.