Pod Insights Short Wave The Biggest Health Stories of 2024 About this episode 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! Questions or suggestions for what else we should cover? Email us at [email protected] mailto:[email protected] !
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0:24 Speaker 01 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 memification 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,
1:09 Speaker 01 which we have Ping Wong on deck to talk through.
1:12 Speaker 02 Yeah, I mean, there are so many buckets to look into, from forever chemicals, to lead, to fluoride.
1:17 Speaker 01 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?
1:26 Speaker 03 Hey, there. Yeah, unfortunately, it's looking like it.
1:29 Speaker 01 Third, we have Sidney Lupkin to talk all things obesity drugs, which seemed to have gotten more and more popular ever since we first heard the word Ozempic. Yeah, even though, as we'll get into later, Ozempic is a diabetes drug. And I'm happy to have Alejandra Burunda in the house to round out our squad and break down all things heat. Hey, Ale.
1:49 Speaker 04 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.
2:02 Speaker 01 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 Short Wave, the science podcast from NPR.
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3:32 Speaker 01 Hey, short-wavers. 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've 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 skincare 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.
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5:11 Speaker 01 OK, Short Wavers, 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.
5:19 Speaker 02 Hey, Gina.
5:20 Speaker 01 Ping, and I wanted to start with you because part of your beat as a science correspondent is that your task is covering like, 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?
5:32 Speaker 02 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. 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 US are split about whether scientists should be actively focusing on policy, or if they should be staying out of the fray.
6:02 Speaker 01 Oh, wow.
6:02 Speaker 02 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.
6:09 Speaker 01 Wow.
6:10 Speaker 02 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.
6:23 Speaker 01 OK, 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?
6:37 Speaker 02 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 PFAS chemicals. That stands for per polyfluoroalkyl substances. We've talked about them. Here before and these are manmade chemicals that have been used for many, many decades in waterproofing, stain proofing 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.
7:18 Speaker 02 So the new PFAS regulation requires water systems that find even low levels of PFAS in the water to filter them out.
7:24 Speaker 01 Oh, wow. So that's PFAS and you said that there were two. What's the, what's the other one?
7:29 Speaker 02 So the other one is lead, which we have known about for a really long time. We know that lead is a neurotoxin. It's especially dangerous for kids and their 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 nine million lead pipes to be dug up, replaced with non lead 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 PFAS, on lead when the new Trump administration takes effect.
8:13 Speaker 02 Some of these things are being challenged in court right now, so we will see if what has been passed this year is kept and whether that momentum keeps going.
8:20 Speaker 01 Right. One of the chemicals they're kind of maybe focusing on is like fluoride. Like, I feel like I've been hearing a lot about that recently.
8:27 Speaker 02 Yeah, exactly. Now that is a whole separate can of worms, fluoride in drinking water. So a lot of communities have added it to drinking water since the 1940s to cut down on cavities. And RFK 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.
8:55 Speaker 01 All right, so on to Will. Hey, Will, what's up?
8:58 Speaker 03 Hey there.
8:58 Speaker 01 So we're here to talk about the bird flu, and it's reemerged in the US 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?
9:16 Speaker 03 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 HA 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.
9:36 Speaker 01 Good.
9:37 Speaker 03 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 infections 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, conjunctivitis and eye infection, or sometimes a mild cold.
9:58 Speaker 01 Okay, so as like the months have gone by since that initial outbreak, more infections have emerged, though, generally in agricultural workers, right?
10:06 Speaker 03 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. And 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, you know, where this outbreak could go.
10:50 Speaker 01 Okay, what are you monitoring for bird flu, like going into the new year?
10:53 Speaker 03 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 to 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
11:37 Speaker 03 discovered it would take just one mutation. They were expecting to take three.
11:42 Speaker 01 Oh, gosh.
11:43 Speaker 03 That's right. So this doesn't mean there's going to be a pandemic 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 is 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 this could happen to 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.
12:27 Speaker 01 Yeah. Oh, OK, Will. We're going to move on to Sydney, and we're going to talk about obesity drugs like Wegovy or Ozempic being used off-label. Can you help us unpack why it seems like it's everywhere?
12:39 Speaker 05 I mean, because it kind of is everywhere, and there's data to back that up. Brand name Wegovy 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.
13:00 Speaker 01 Do you mind just like talking about like, how do they work? Like Ozempic started as a diabetes drug. How did it and these other like permutations end up being like effective for weight loss?
13:10 Speaker 05 Yeah, sure. So that's a fair question. 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 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.
13:47 Speaker 01 That's so cool.
13:48 Speaker 05 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 a thousand dollars 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.
14:24 Speaker 01 Ooh, where do you, where do you see all this going next year in 2025?
14:28 Speaker 05 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 an issue. The Biden administration also proposed a new rule that would extend Medicare and Medicaid coverage to include obesity drugs like Wegovy 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.
15:02 Speaker 01 Wow.
15:03 Speaker 05 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.
15:14 Speaker 01 I mean, that's a, that's a some good news, some bad news. Okay, let's round out this round robin with Alejandra. Hey.
15:22 Speaker 04 Hey, Dina.
15:23 Speaker 01 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.
15:31 Speaker 04 Yeah, welcome to the hot world now. This year was just really, really hot, like so hot. One of the hottest, 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 in temperatures because of things other than climate change.
16:15 Speaker 04 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 of 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.
16:37 Speaker 01 Yeah, so there's just going to be like more heat in our futures then, I guess.
16:41 Speaker 04 That's, 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 US. There are a few states and cities that have passed heat rules protecting workers this year. And drumroll, 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.
17:23 Speaker 01 And recently, we Had you on as a kind of like retro, what happened at the latest international climate talks, negotiation COP29. 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?
17:43 Speaker 04 Yeah, that's definitely a big thing for 2025. Like you said, next year's annual climate conferences, the COPs, that's 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 of 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 2 C.
18:10 Speaker 01 Right.
18:11 Speaker 04 And then, of course, there's a really big question mark right now about what the US will do climate wise. President-elect Trump has said that he'll pull the US 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 of 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.
18:48 Speaker 01 OK, well, Alejandra, Sidney, Will Ping, thank you all for coming on the show to recap this big year of science.
18:56 Speaker 02 It's been awesome. Thanks so much.
18:57 Speaker 04 Yeah, really glad to be here.
18:58 Speaker 03 Thank you so much.
18:59 Speaker 00 Thanks, guys.
19:02 Speaker 01 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. Kwesi Lee was the audio engineer. Beth Anavina is our senior director and Colin Campbell is our senior vice president of podcasting strategy. I'm Regina Barber. Thank you for listening to Short Wave, the science podcast from NPR. See you next year.
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