STAT investigation: Cue Health soared on an NBA Covid-testing deal but faces a rocky future

(MOLLY FERGUSON FOR STAT)

You may have heard about Cue Health when its Covid-19 test was being used within the NBA’s bubble. “If it’s good enough for LeBron, we want to democratize it and make sure it’s available to the American people,” said then-White House coronavirus testing czar Admiral Brett Giroir in October 2020 when announcing a $481 million deal to flood the country with Cue’s Covid-19 tests. At the time, Giroir was the White House's coronavirus testing czar. Maybe you saw a Super Bowl ad pitching its molecular test for home use — more accurate than quick antigen tests but more expensive than them. Like a PCR test, it detects viral RNA, but in 20 minutes with a small desktop reader.

STAT’s Katie Palmer describes how the company struggled to deliver on its promises to the government while trying to jump-start a business that could outlast the pandemic. Last week, Cue told employees it was laying off about 10% of its workforce. Read her investigation here.

Monkeypox DNA in San Francisco wastewater may signal undetected cases

A program set up to monitor wastewater in San Francisco detected monkeypox DNA three times last week in concentrations that may suggest some cases have gone undetected. The Sewer Coronavirus Alert Network, run by scientists from Stanford and Emory universities, detected monkeypox DNA in samples taken at the Oceanside treatment plant, which serves about 250,000 people on the city’s west side. The repeated detections suggest the results are real, said Alexandria Boehm of Stanford. “This is not an anomaly or laboratory error.”

Using wastewater surveillance for monkeypox is new. Still, the SCAN scientists estimate there would need to be four or five cases per 100,000 people living in the Oceanside plant’s catchment area to have readings of the levels being detected. To date, San Francisco has reported 10 confirmed and probable cases of monkeypox.

In other news, the World Health Organizations announced on Saturday that the ongoing monkeypox outbreak doesn’t yet qualify as a public health emergency of international concern, STAT’s Andrew Joseph reported.

What's next, after Roe?

The dust won't be settling for weeks after last week’s Supreme Court decision to overturn Roe v. Wade. Here are some of the issues STAT is following:

“States may not ban mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy,” Attorney General Merrick said in a statement. But it won’t be easy to crack restrictions in the more than 30 states that have enacted them, Nicholas Florko writes.
People may wonder whether federal laws will shield their reproductive health data from legal action. The answer is "No," Eric Boodman, Tara Bannow, Bob Herman, and Casey Ross explain.
Other rights founded on privacy — gay sex, same-sex marriage, interracial marriage, contraception — are also called into question. Olivia Goldhill explores the implications.
People under age 18 will be disproportionately affected, write Tracey Wilkinson, Julie Maslowsky, and Laura Lindberg in this STAT First Opinion.

Closer look: Watching out for ‘black swan’ outbreaks can prepare for future pandemics

(ADOBE)

Most people have heard about pandemic preparedness. But how can we be ready for something as rare as a “black swan” event? Writing in a STAT First Opinion, Nileena Velappan of the Los Alamos National Laboratory describes using Analytics for Investigation of Disease Outbreaks, a database containing detailed information about more than 600 outbreaks of 40 distinct diseases. There are plenty of data to nerd out on (as my colleague and fellow newsletter author Nicholas Florko might say) while worrying about the next plague — anthrax in hippos during dry weather in Zambia, Zika mistaken for dengue in Brazil, actual plague in India. When analyzing the role of the pathogen, host, and environmental conditions, human behavior in black swan outbreaks rose to the top. “Predicting the spread of infectious diseases, it turns out, isn't nearly as difficult as predicting human behavior,” Velappan writes.

Gilead to get $33 million from a clinic for exploiting its HIV patient assistance program

Imagine crews of van drivers cruising Florida streets looking for people who are homeless or poor and recruiting them for a patient assistance program for HIV medications. Gilead Sciences, maker of PrEP drugs Truvada and Descovy, alleged in 2020 that health care clinics, pharmacies, and lab testing facilities in Florida were exploiting these people to illegally obtain and resell thousands of bottles of its HIV prevention pills. Now Gilead has reached a $33 million settlement with one clinic, Well Care, in what Gilead alleged was a “dangerous and fraudulent scheme” to exploit a patient assistance program so individuals and companies could pocket tens of millions of dollars in profits.

STAT’s Ed Silverman has more today on the settlement, placing it in the context of concerns about product diversion, battles over the federal 340B drug discount program, and efforts to boost use of HIV prevention pills.

Air pollution's toll on people's hearts

A multitude of factors are thought to raise the risk of cardiovascular disease and death. One of them is air pollution, whether it's from traffic or indoor stoves or unclean air. Another is nighttime light that disrupts sleep. Socioeconomic factors also loom large, as does access to health care. To understand which factors matter the most outside high-income countries, researchers analyzed data from 2004 through 2008 on 50,000 people over age 40 living in a low-income, mostly rural province of Iran.

Their conclusion, published in PLOS One: Ambient air pollution (17%) and indoor air pollution from cooking without ventilation (36%) raised the risk of cardiovascular disease about as much as smoking tobacco. (Nighttime light was not a significant factor.) And if kerosene stoves for cooking inside the home seem remote, an apt comparison might be wildfire smoke in California, co-author Rajesh Vedanthan noted.

The final episode of the "Color Code" podcast explores the story of Vertus Hardiman, who as a child was permanently damaged by medical racism. Listen here.

What to read around the web today

Tick hunting: The prey are tiny, and the bait is human, New York Times
Long Covid symptoms are often overlooked in seniors, Washington Post
Pfizer says its Omicron-containing boosters outperform current vaccine, STAT
Hotels are taking wellness to extremes, from IV drips to MRIs, Wall Street Journal
Opinion: Arthur Ashe and AIDS: Did the public have the right to know his diagnosis? STAT