Dear clients and friends: Given your interest in health and medicine, we would like to share with you our collection of the most interesting perspectives on our industry's trends and developments. We are happy to share them with you — and hope you share your thoughts with us.

1. Delta: Ready for Take Off

Does the Delta variant demonstrate that “coronavirus will never go away”? The Atlantic thinks so:

The original SARS-CoV-2 virus had a basic reproduction number, or R0, of 2 to 3, meaning that each infected person spreads it to two or three people. Those are average figures: In practice, the virus spread in uneven bursts, with relatively few people infecting large clusters in super-spreading events. But the CDC estimates that Delta’s R0 lies between 5 and 9, which “is shockingly high.”

Even at the low end of the CDC’s estimated range, achieving herd immunity would require vaccinating more than 90 percent of people, which is highly implausible. At the high end, herd immunity is mathematically impossible with the vaccines we have now. This means that the “zero COVID” dream of fully stamping out the virus is a fantasy.

2. …And a Crash Landing

So if “zero COVID” is a fever dream, now what?

For our mental health, the picture isn’t pretty. Axios rounds up recent figures that put the workplace at the heart of the challenge:

44% of workers say they feel fatigued on the job, up from 34% in 2020.

A whopping 52% of U.S. employers say they are “experiencing significant workplace issues” with substance misuse or addiction by employees, according to a new survey from The Hartford. That's up from 36% in March 2020.

31% of U.S. employers say workforce mental health is having a severe or significant financial impact on the company, up from just 20% in March 2020.

3. Ode to the Humble Phone Call

Has Zoom irrevocably changed how doctors and patients connect remotely? Not so fast, says Dr. Jacqueline Shreibati in The New England Journal of Medicine. She shares how she came to understand the unique clinical value of the old-school phone call:

The first few months of telephone visits were punctuated by awkward pauses, but I gradually became more comfortable, even confident, with the silence. Since I was unable to look at or touch a patient, the only “data” I had were words and tone of voice. I became adept at active listening, listening for the intent and feeling in my patients’ voices.

There were also benefits for my patients. When they couldn’t see my face or other visual distractions, some patients seemed more willing to confide in me about sensitive topics, such as drinking or smoking habits. The flexible, on-the-go nature of a telephone visit also fit very well into my patients’ busy lives.

Also—remember voice-only conference calls? Those were the days…

4. Chain of Fools

The Harvard Business Review isn’t known for its thrilling plotlines, but the management magazine breaks with tradition to offer up this hypothetical: you rush to the hospital, you need an urgent treatment, the doctors know just what to do, but they don’t have medicine.

The villain isn’t a masked cat burglar, but global pharma supply chains:

An estimated 80% of the world’s active pharmaceutical ingredients come from China, India, and a handful of other foreign countries. U.S. dependence on these limited sources hit home when India imposed an export ban on medicines during the pandemic.

This dependence on a few foreign sources of these critical ingredients that are vital for the health of Americans means that our supply of finished essential pharmaceutical products is vulnerable to international economic, political, and public health crises.

5. Fake News: Now Peer Reviewed

Former editor of The BMJ returns to the journal’s opinion pages with a hatchet. His target: systematic reviews that wrongly “assume that research actually happened and is honestly reported”:

Although retractions are increasing, only about 0.04% of biomedical studies have been retracted, suggesting the problem is small. But the anaesthetist John Carlisle analysed 526 trials submitted to Anaesthesia and found that 73 (14%) had false data, and 43 (8%) he categorised as zombie. When he was able to examine individual patient data in 153 studies, 67 (44%) had untrustworthy data and 40 (26%) were zombie trials. Many of the trials came from the same countries (Egypt, China, India, Iran, Japan, South Korea, and Turkey).