Philly’s health leadership void | Philly Health Insider

Good morning. This week, we’re going inside City Hall to find out why Philadelphia needs a new slate of public health leaders. Plus, Doylestown Hospital is on track financially to become part of Penn, CAR-T applications hit a potential setback, and COVID is surging again.

📮 Tell us about your (latest) COVID summer. Are you seeing an uptick in COVID cases among your patients (or, for that matter, your social circle)? For a chance to be featured in this newsletter, email us back.

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— Aubrey Whelan, Inquirer health reporter, @aubreywhelan.

There’s been something of a mass exodus from Philly’s highest profile health jobs.

Interim directors are leading the Department of Public Health and the Department of Behavioral Health and Intellectual disAbility Services. There are also temporary leaders heading the Medical Examiner’s Office, a division of the health department, and the Office of Homeless Services, whose duties overlap quite a bit with the city’s health agencies because of the vulnerable populations it serves.

Turnover at the top of all city agencies is normal during a new mayoral administration, and these departures came in the months before and after Mayor Cherelle L. Parker took office. Although Parker’s been criticized for not hiring department leaders fast enough, city officials say they’re “on track” in their hiring process at the health-related agencies, with short lists of candidates for several positions.

In a post-COVID world, where public health positions are increasingly politicized, convincing qualified candidates to take on these jobs can be tough.

The stakes here are high. We’re the poorest big city in the country, and our health-care system is a case study in how poverty and racism can contribute to unequal access to care and poor health. Having permanent leadership at the city health agencies matters. And a succession of scandals at these departments in recent years — from overspending at the Office of Homeless Services to the health department’s mishandling of MOVE victims’ remains — show how important it is for Parker to make the right leadership choices.

The big number: 189,491.

Excuse us while we play virus detective: That’s the number of gene copies of COVID that were present in a liter of wastewater at Philly’s Southwest water treatment plant on Aug. 5.

In layman’s terms, we’re flushing a fair bit of COVID down our drains.

City officials regularly test wastewater for viral activity from three plants in the city, one of the most accurate ways to track COVID now that most people are testing for the virus on their own at home, if at all. All have been reporting rises in viral activity lately, part of an unexpectedly large spike in COVID cases nationwide.

Right now, 33 states are seeing “very high” levels of viral activity, the CDC says; Pennsylvania is one of 11 more states seeing “high” viral activity in its wastewater. (Just think: How many of your friends have COVID right now?)

The CDC recently said that COVID is now endemic — a virus that behaves like seasonal flu, ebbing and flowing in predictable ways. But some scientists disagree with that call, pointing to our current uptick in cases as a sign that we can’t reliably predict waves of COVID just yet.

Each week, we look at state inspections conducted at an area hospital. Up this week: Chestnut Hill Hospital in Philadelphia, part of Temple Health. No problems were identified during on-site state inspections there between December 2023 and May.

Patients often tell Penn physician Amanda Swain that they thought they were perfectly healthy — until a wearable fitness device like an Apple Watch or a Fitbit told them something was wrong.

But these devices and the way they interpret vast amounts of data can also cause unnecessary stress for patients. Take heart rates: Some people, like athletes, just have naturally low heart rates, but a fitness device might consider a sub-60 bpm abnormal, Swain writes. Most patients can take their device data with a grain of salt, Swain said, consulting a doctor before making any drastic life changes based on a Fitbit alert.

But there are always exceptions. Just ask Erica Harris, pictured above, an ER doctor at Jefferson Einstein whose Apple Watch alerted her to her own irregular heartbeat while she was stuck in traffic one afternoon in 2021 and may have saved her life.

Columbia University President Minouche Shafik resigned last week after a controversial tenure marked by criticism across the political spectrum of her handling of campus protests over the Israel-Hamas war.

Her interim replacement, physician Katrina Armstrong, is the CEO of Columbia’s Irving Medical Center. Armstrong also has Philly ties: A Penn professor for 17 years, she held several high-powered positions there, including the chief of general internal medicine and the associate director of the Abramson Cancer Center.

A patient with lupus experienced a serious neurological side effect while undergoing CAR-T therapy for the disease, says a Philly-based biotech company that’s studying different uses for the groundbreaking cell therapy.

Cabaletta Bio says the condition was a known side effect of the therapy they’re testing, and “resolved rapidly following standard management.” It’s unclear if this will prove to be a setback for wider application of CAR-T, which has been heralded as a cure for some blood cancers. Researchers are now studying whether it could also treat other conditions like heart disease and autoimmunity.

📮 Is your hospital conducting research on how CAR-T could treat other diseases? For a chance to be featured in this newsletter, email us back.

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