Coffee Break: Breaking American Science, COVID Undercount, Food Politics, St. Patrick, and a Brief Diversion

Part the First: The Slow Death of Biomedical Research Continues in the United States.  We have covered this before, but the entire unfolding situation gets more surreal by the week.  STAT News has been a go-to source, as in NIH will spend its full budget this year, agency director promises House appropriators.

The first shot in this one-sided war was the peremptory cancellation last year of awards already granted after rigorous peer review, ostensibly because they didn’t comport with the priorities of the Current Administration.  My research was NIH-adjacent and at times NIH-funded for most of my research career, so I have been there.  Funding levels always go up and down, but this was the first time a president decided to just stop the process.  There can be little doubt about why.  The Current Occupant doesn’t like these scientists because they tend not to like him.  They really didn’t like Barack Obama very much either, or Richard Nixon or Gerald Ford.  They thought the doubling of the NIH budget began under Bill Clinton was nice but probably a mistake (it was).  But I digress…

It is passing strange that the current director of the National Institutes of Health must now go before the House of Representatives and tell them that, yes, he will spend the money this year:

National Institutes of Health Director Jay Bhattacharya promised a House Appropriations subcommittee on Tuesday that, despite the sluggish pace of grant awards, the agency will spend its full budget by the end of the 2026 fiscal year.

Roughly halfway through the fiscal year, the agency has awarded 74% fewer competitive, or new, awards than the average for that same period during 2021-2024, according to an analysis by Johns Hopkins researchers.

That lag has raised concerns NIH would have to return unused funds to the treasury at the end of the year. But Bhattacharya said on multiple occasions during an oversight hearing before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies that the agency will fully spend its $48.7 billion budget.

Jay Bhattacharya, MD-PhD (Economics) continues:

“We will spend the allocation,” he said. “Scientists that are listening, don’t pay attention to the hype. We are in the process of identifying the excellent projects, grants are already going out the door.”

OK, then.  But as noted below, the damage has already been done, and on this escalation ratchet, just like the one operating in West Asia at the moment, there may be no going back.

One not so small thing, though, is likely to be missed in this direct quote from the Director, “We are in the process of identifying the excellent projects…”  The first thing a biomedical scientist learns when she or he enters the grants lottery is this: “Excellent” really means “terrible,” and an excellent proposal is unlikely to get funded no matter how good the review sounds on the surface.  The only applications funded are “outstanding.”  Of course, this is more than a little bit subjective, usually depending on the reviewers’ notions of what is “important.”  But it is telling that the Director of the National Institute of Health doesn’t seem to know this.  Most of his predecessors fully understood this, because they had been in the game at a high level. By the way, a few may disagree but the ranking goes something like this (going from memory here; I have not submitted a grant proposal to NIH or NSF in several years):

• Outstanding: Fund this application (of course, only about a third of these will get funded because there is no objective way to rank applications in the top third).
• Excellent: It didn’t totally waste my time but this research would be a waste of time and money and besides that, it is incremental (virtually all scientific research is incremental, especially that done by other research groups who are not the reviewer’s friend).
• Very Good: Not even close to the standard and further discussion would be a waste of our very valuable time.
• Good: How does this applicant remember to breathe?
• Fair: Can we vote this moron off the island, never to return?

I have been a proud member of all five categories.  You learn to try and try again while paying attention to the legitimate criticisms, hoping to “choose” the right reviewers next time.  And if you don’t develop a very thick skin instantaneously, survival is not an option.  But whether even entering the contest is worth the angst is very much up in the air at the moment, as noted in Part the Second.

Part the Second: ‘This is like the Titanic’. Yes, it is, but the iceberg is in plain sight dead ahead.  This is consistent with what I have heard from colleagues, former colleagues, research administrators, and friends who are leaving basic biomedical research for something else, all because what was once only very difficult and uncertain has become career suicide.  The STAT News article is here and the subtitle says it all, “Majority of Trump funding losses haven’t been reversed, despite court orders and Congress rejecting slashed NIH budget.”  I cannot be the only person reminded of Stalin’s question, “How many divisions has the Pope?”

 

The survey of nearly 1,000 researchers supported by the National Institutes of Health, the nation’s leading funder of biomedical research, paints a concerning portrait of the state of American science. More than a quarter of respondents have laid off lab members, and more than 2 out of every 5 have canceled planned research. Two-thirds have counseled students to consider careers outside the ivory tower.

Strikingly, despite courts reversing some grant terminations and Congress thwarting plans to slash the NIH budget, just 35% of respondents whose grants were cut or delayed said their government funding had been fully restored by the end of 2025.

Labs aren’t just shrinking. In some cases, they’re on track to shut down permanently, with early-career researchers among the hardest hit. A staggering 81% of junior tenure-track scientists said they are very or somewhat concerned that disruptions to their research productivity could threaten their chances of earning tenure.

In follow-up interviews, survey respondents told STAT that interrupted funding and changes in federal priorities caused patients to drop out of a diabetes prevention trial in Puerto Rico, forced an Ohio researcher on the cusp of losing her position to close her lab, and led one scientist to take a 95% pay cut in a last-ditch bid to avoid laying off staff.

Things are going according to plan:

In response to a detailed summary of STAT’s findings, the NIH said in an email that it remains committed to promoting research that improves health by supporting the best and brightest scientists. The agency, which is lagging far behind in the number of grant awards and dollars doled out this fiscal year compared with prior years, though it has committed to fully spending its 2026 budget, also blamed former President Joe Biden for creating conditions that required drastic change to fix.

“The Biden administration prioritized ideological agendas over scientific rigor and meaningful outcomes for the American people. This NIH is directing taxpayer dollars toward research practices that deliver results, with a focus on combating the chronic disease epidemic,” the agency said. “A major reset was overdue.”

Good to know. This is all Joe Biden’s fault.  But this tells the tale:

Those studying health disparities were especially likely to be in the NIH’s crosshairs. Director Jay Bhattacharya, who himself once did research on racial health disparities, has said the NIH remains committed to studying the health of minority populations. Still, the survey found that 68% of disparities researchers shifted their work to topics aligned with federal priorities, compared to 41% of all respondents. Similarly, 26% of these researchers had grants terminated, 11 percentage points higher than the overall rate, with the agency telling health equity researchers that their work was “antithetical to scientific inquiry.”

Antithetical to scientific inquiry…Yes, and the MMR vaccine causes autism.  What doesn’t seem to register among the citizenry is that once stopped, no scientific research project can be restarted by flipping a switch.  Multiply by thousands and you get the picture.  I suspect this general truth may become clear soon enough regarding the pumping of oil and natural gas out of the ground.  Incidentally, the $200B to be requested to fund the War in West Asia would fund 80,000 5-year NIH grants to individual scientists in our universities, medical schools, and independent research institutions such as the Salk Institute for Biological Studies.  Opportunity costs, anyone?

Even a one-month delay in the eventual renewal of a grant can push scientists out of academia, and out of the U.S., according to previous research (pdf). There are signs that this is already playing out in response to the administration’s litany of funding delays, terminations, and shifting priorities. Thirteen percent of respondents said they lost researchers to institutions in other countries, and 7% said that postdocs or other staff had rejected job offers.

…

Many universities cut back on graduate enrollment last fall, believing that they’d be better able to support smaller incoming classes. But while 70% of respondents said their institutions had admitted fewer students or rescinded offers, some students have still struggled to find labs willing to take them as cost-conscious faculty adapt to an NIH shift to fully funding many multi-year grants up front, leading to fewer new awards overall. The survey found that 22% of respondents’ labs had rescinded offers to students, staff, or postdoctoral researchers, and 11% had reduced lab members’ salaries.

Shut down this pipeline and science in the United States will come to a slow, grinding halt as the gears are stripped.  And one other thing.  The Director has said that he is restarting the process so early-career researchers can buy the equipment they need to get started.  Wrong again.  With a very few exceptions, laboratory instrumentation and equipment comes out of a separate budget provided by the research institution in the form of a start-up package.  Some of this may come from “overhead” paid by previous federal support for research, but that was Vannevar Bush’s founding vision that made American science the best in the world.  For eighty years this has been a political, social, cultural, and scientific perpetual motion machine.  In any case, the grant covers supplies and salaries for technicians and sometimes stipends for graduate students and virtually nothing for capital equipment unless that is funded by a separate award.

American scientists who can are leaving for other countries.  This will never amount to more than a few thousand scientists.  But as American science withers away, the research will be done elsewhere, with China leading the way.  Say what you will, and there is a lot to say, but China produces for use instead of only for profit.  And while this is happening, the vast majority of advances provided by Big Medicine and Big Pharma will also wither, because virtually all of them began as research projects that have been the warp and woof of my professional working life.

Could the National Institutes of Health and the National Science Foundation and the Centers for Disease Control and Prevention have been improved, incrementally?  Absolutely.  But once they are crippled, lame they are likely to remain for the duration.

Part the Third: Yes, Covid-19 Was  and Remains Deadly.  As reported in Scientific American earlier this week, COVID probably killed 150,000 more people in the first two years than official U.S. tolls show:

COVID may have killed significantly more people in the U.S. in the first two years of the pandemic than official records indicate, with as many as one overlooked death for every five recorded ones. That brings the total to nearly one million deaths just in 2020 and 2021.

That calculation comes from research published today in Science Advances that seeks to understand how many COVID deaths fell through the cracks of official reporting systems. The untallied cases show the burden of the pandemic in the U.S. fell most heavily on marginalized people.

…

In the new research, Kiang and his colleagues analyzed official records published by the Centers for Disease Control and Prevention for deaths occurring from March 2020 through December 2021 for adults aged 25 and older—some 5.7 million records in all. First, they fed a machine-learning algorithm the records of deaths in hospitals, which at the time were testing most patients for COVID. They trained the algorithm to recognize hospital deaths in which COVID was formally identified as an underlying cause. Then they used the algorithm to flag potential unrecognized COVID deaths by identifying records that looked like hospitalized COVID deaths but occurred in other settings where testing was less likely.

All told, the algorithm identified between about 150,000 and 160,000 potential unrecognized COVID deaths on top of the 840,251 that were officially reported. Those numbers suggest that for every five recognized COVID deaths, one additional death went unmarked. That ratio is on par with other analyses that have simply compared the total observed number of deaths with the number of total deaths expected based on historical data, says Daniel Weinberger, an epidemiologist at the Yale School of Public Health, but the new method is both more sophisticated and more granular.

Of course, “may” also means “may not,” so this should be kept in mind.  Still, the analysis is convincing and agrees with data on the number of expected total deaths over the same period.  Which reminds us to ask, “How can we do better next time?”  The political and scientific establishments did not cover themselves with glory in 2020 and following years, especially when compared with the HIV-AIDs epidemic.  CDC did outstanding work in the early 1980s when a mysterious infectious disease killed so many healthy young men in the Global North while not discriminating by sex in the rest of the world.  CDC and NIH scientists and epidemiologists and public health experts would do the same again, when called upon…if they still exist.

Part the Fourth: Food Insecurity Is a Problem of Political Economy, not Agriculture.  Since the Green Revolution agriculture writ large has been called upon to fix the problem of food insecurity in this modern world.  This is a category mistake, as noted by this opinion piece in from last week, Releasing agriculture from the food security mandate:

The state of food security is achieved if no one has to worry whether or how they can acquire—typically purchase—healthy and nutritious meals. In theory, food security could be addressed from two sides: increasing households’ purchasing power or lowering food prices. However, in practice, food insecurity is a by-product of prevailing political and economic systems. Agriculture produces more calories and nutrients than needed to feed humanity, so it is fundamentally an issue of distributive justice, where geography, education, ethnicity, gender, and other mechanisms of marginalization determine one’s food security—through access to wealth. Yet humanity has failed to eliminate poverty and instead of addressing socioeconomic causes of food insecurity, agricultural research and practice are called upon to compensate. This is not only unfair but bound to fail. It also diverts much needed scientific capacity from the long list of sustainability challenges that agricultural production systems must address.

As fertilizer stocks decline due to the current War in West Asia, we can anticipate that the “failures” of agriculture will once again become relevant.  But the failures are not with agriculture.  They are failures of politics and economics embodied in Big Ag and Big Food and Big War.  When political economy interferes with food production in favor of commodity production, things go south.  Amartya Sen has said that famine has never happened in a relatively democratic country with a relatively free press.  We might be living through another such experiment in the coming months, and “relatively” is doing a lot of work in the previous sentence…

Part the Fifth: A Belated Appreciation of St. Patrick.  Many of my friends in Savannah had a good time earlier this week.  Some of them still have a headache from drinking too much cheap but not inexpensive green beer (RFKJr would not approve).  A coworker who has ophidophobia mentioned that she wanted to live in Ireland because, outside of zoos, Ireland has no snakes.  In our neck of the woods, snakes are common.  Most of them will not hurt you, but in my experience they are very good at making you hurt yourself.  So, did St. Patrick really drive the snakes our of Ireland?  Of course not.  The real reason there are no snakes in Ireland is because of geographic isolation and cold weather.  But we already knew that:

Most scientists agree that the most recent ice age, which ended approximately 11,700 years ago, is the reason for Ireland’s lack of reptile diversity. By the time glacial ice from the era receded and temperatures warmed enough for the ectotherms, Ireland had broken off from the European continent and was inaccessible to roaming reptiles.

Even today, Ireland is simply too cold for most snakes. Because reptiles cannot warm themselves internally like mammals can, they tend to prefer warm temperatures between 70 and 100 degrees Fahrenheit (21 and 38 degrees Celsius) and can be rendered immobile or perish from lengthy cold spells. Ireland’s native common lizard (Zootoca vivipara) and the introduced slow worm (Anguis fragilis) are both much hardier and able to hibernate through the winter.

Geographic isolation and cold temperatures have actually hindered snakes from populating the wilds of many islands; New Zealand, Iceland and Greenland are all also snake-free.

Anyway, I included this tidbit because I liked the illustration at the primary link.  And also the cartoon sent to me on St. Patrick’s Day by a friend about an ill-fated blind date between St. Patrick and Medusa.  Silly but funny.  I do wonder though, how many of the young folks understand the joke?  Do they still read Edith Hamilton in eighth-grade English?  Do they know of Perseus and his shield?  Alas, I doubt it because there is nothing STEM about it.

Part the Sixth: Bonus Video.  This cannot compete semper loquitur’s Sunday Morning Movie, including the incomparable Dame Diana Rigg earlier this month, but it’s a pretty good short diversion in a fraught time:

MAHAspital (3:38). Enjoy!  I thank a good friend for sending this to me.

Thank you for reading!  See you next week.