The Biggest Health Stories of 2024
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Hey, short wavers. 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

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, 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 to fluoride. And we'll get to all of them briefly before turning to Will Stone, who we have here to talk about bird fluoride.

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 Lepkin to talk all things obesity drugs, which seem 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 Barunda in the house to round out our squad and break down all things heat.

Hey, Oli. 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.

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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.

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Okay, 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. 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, 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? 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, but

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

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

little preface of trust, I want to get into what I at least see as one of 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 PFAS chemicals, that stands for per-polyfluoroalkyl substances. We've talked about them here before. And these are man-made 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. So the new PFAS regulation requires water systems that find even low levels of PFAS in the water to filter them out. Oh, wow. Mm-hmm.

So that's PFAS. And you said that there were two. What's the other one? 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 in drinking water have been banned since the mid-1980s, but there are still more than 9 million lead pipes that were installed before that that are still in use and in the ground. Wow.

So all of that is really great, but there is work that remains. 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.

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. 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. 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 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. 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 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 conjunctivitis, an eye infection, or sometimes a mild cold. Okay. So as the months have gone by since that initial outbreak, more infections have emerged, though, generally in agricultural workers, right? Yeah.

That's right. Mostly agriculture 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

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. 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

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 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. 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 in a person. It's possible it could happen in a pig. These are some of the things we're watching as bird flu.

Bird flu stretches into the next year. Yeah. Oh, OK. Well, we're going to move on to Sydney and we're going to talk about obesity drugs like WeGoV or Ozempic being used off label. Can you help us unpack why it seems like it's everywhere? I mean, because it kind of is.

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 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? Yeah, sure. So that's a fair question. So they work basically by mimicking a hormone in the body that tells the pancreas

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. 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, 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 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 some

Some good news, some bad news. Okay, let's round out this round robin with Alejandra. Hey. Hey, Dina. 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 hottest and hottest

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 pretty high.

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.

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. Yeah. So there's just going to be like more heat in our futures then, I guess. That's basically what we're looking at. Mm-hmm.

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 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 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 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? 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 2 C. Right. 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 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.

Okay, well, Alejandra, 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. Kweisi 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 Sure Wave, the science podcast from NPR. See you next year. This message comes from NPR sponsor Merrill. Whatever your financial goals are, you want a straightforward path there. But the real world doesn't usually work that way. Merrill understands that.

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