COVID, Protests, Wildfires Biggest Medical News in 2020: Readers

COVID-19, as expected, dominated answers in a Medscape survey asking providers what they would remember most about 2020, but several other issues grabbed national attention as well among the categories of most memorable, most exciting, most frustrating, and most shocking.

Almost all (95.4%) of 592 responses put the pandemic at the top of the most memorable story of the year.

Few in the medical community have been untouched by the virus and for most, it's not a memory at all but a daily, unrelenting threat that continues to rack up grim milestones.

It has already claimed more than 330,000 lives amid more than 19 million cases in the United States alone, and the devastation is far from over.

The pandemic has called for breakneck speed in vaccine development and has strained health systems, particularly intensive care units, like never before. It has necessitated changes that may permanently alter medicine.

Racial Injustices

Beyond COVID-19, almost one third (30.9%) of the survey's respondents said the most memorable news centered on protests in response to police tactics and racial injustice.

Responding to the Black Lives Matter protests that erupted in May in the wake of deaths of Black citizens at the hands of White police officers, volunteer medical personnel jumped in to help the injured, pouring water into tear-gassed eyes and treating wounds.

The protests increased pressure on medical schools, medical organizations, and journals to change training, examine practices, and more aggressively pursue diversity in leadership roles.

Wildfires, $8 Billion Opioid Settlement

Wildfires in western states were mentioned in 16.2% of responses about the most memorable topics of 2020, and Purdue Pharma agreeing to pay $8 billion after defrauding the US government related to opioid sales was mentioned by 12.5% of survey responders.

A Medscape Medical News story in September reported that "in one month, fires in California alone have scorched 3.1 million acres — an area larger than the state of Connecticut."

The expansive smoke clouds made the air unhealthy for much of the western US, according to the US Environmental Protection Agency, and it led to myriad health problems in emergency rooms and clinics.

On October 21, the US Department of Justice announced opioid manufacturer Purdue Pharma would plead guilty to misleading the federal government about its sales of OxyContin and pay more than $8 billion.

The agreement represented the "largest penalties ever levied against a pharmaceutical manufacturer," the DOJ said.

As part of the plea, Purdue admitted that from May 2007 through at least March 2017, it told the Drug Enforcement Agency that it had an effective anti-diversion program when, in fact, Purdue continued to market its opioid products to more than 100 healthcare clinicians who the company had reason to believe were selling the opioids for other purposes.

Fallout from opioid abuse is massive and growing. In 2018, according to the National Institutes of Health, 128 people died every day in the United States from overdosing on opioids.

Most Exciting Developments

The guilty plea and fine (39.6%), and the protests in response to policing and racial injustices (38.9%), were deemed the "most exciting" developments of the year, respectively, according to the survey, followed in third place by the multiple trials showing a new role for sodium-glucose cotransporter 2 (SGLT2) inhibitor drugs (29.5%).

Medscape Medical News reported that SGLT2 inhibitors should no longer be seen as primarily treating hyperglycemia in people with diabetes because their major clinical role has rapidly changed into treating or preventing heart failure and chronic kidney disease.

Metformin Recalls Frustrates Providers

COVID-19 again led the list of what was most frustrating for providers, at 80.5%, followed by the wildfires (31.6%), but "multiple recalls of metformin" was third, mentioned by 21.8% of the 503 responses to the question.

In November, two more lots of metformin — the extended-release mainstay drug for type 2 diabetes — were recalled because of possible contamination with a potentially cancer-causing compound. More than 175 different drug combinations with extended-release metformin have been recalled since late May.

Consumers can see all the recalled metformin products at this FDA website.

Ginsburg, Boseman Deaths Shocking

Although the pandemic by far was rated the "most shocking" development (82.6% of respondents), the deaths from cancer of two well-known people, Supreme Court Justice Ruth Bader Ginsburg (24.7%) and actor Chadwick Boseman (20.2%), were next in that category.

Ginsburg, the second woman named to the Supreme Court, died at age 87 on September 18 from complications of pancreatic cancer; "Black Panther" star Boseman died on August 28 at age 43 from colon cancer.

David J. Kerr, MD, professor of cancer medicine at the University of Oxford in England, wrote in a Medscape commentary that Boseman’s death should inspire more research into the understanding and preventing the disease.

"Chadwick Boseman has a fantastic canon of work that will be his legacy," he wrote. "But perhaps one other enduring aspect of the death of this young man is that it has led people like me to recognize that we need to do more to understand the biology of this disease, and how we can improve and personalize things like screening at a younger age for African Americans."

Election Played in Background All Year

Some answers and comments fell outside the listed survey choices for medical stories.

The US presidential election gathered quite a few comments from both sides cheering for or railing against President-elect Joe Biden or President Donald Trump and their policies.

Healthcare issues continue to be hotly debated in the political sphere.

Medicare-for-All plans were proposed by some of the Democratic candidates for president before Biden became the Democratic nominee, drawing heated arguments from supporters and critics in the medical community earlier this year.

Continuing attempts to dismantle the Affordable Care Act also received mentions as prominent news this year. In November arguments, the Supreme Court justices appeared to lean against scrapping the ACA. They will have until the end of the term, in June, to decide its fate.

Physicians made up the largest segment of responders in the survey with 72% of the responders, followed by nurses at 14.4%. Residents, medical students, pharmacists, physician assistants, and "others" made up the remaining responders.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News and Nurse.com and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick

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