'This is not the same as Covid': a WHO expert on monkeypox

How worried should we be about monkeypox? Everyone isn’t going to catch it, experts stress, but it’s not clear transmission can be stopped. And it’s challenging to warn people at risk without stigmatizing them. STAT’s Helen Branswell asked WHO’s Maria Van Kerkhove to weigh in.

On how dangerous the current outbreak might be: “We believe that, with the current information we see in non-endemic countries, we could prevent onward spread. This is not the same as Covid. In terms of transmission, it’s really physical close contact when someone is symptomatic. … The worry that we have is, we don’t know the extent of infection so far.”
On several years of likely human-to-human transmission in Africa: “I think it’s grotesque that we’re only going to be paying attention to this in Africa because it’s affecting non-endemic countries right now. But that’s the sad reality.”
On alerting those believed to be at greatest risk without stigmatizing: "Given mistakes that were made in the beginning of HIV, nobody wants to mess this up. We want to be clear, we want to be accurate, we want to be helpful, and we certainly don’t want to harm."

Read the full interview here.

Faulty oxygen readings delayed Covid care for darker-skinned patients

Concerns about bias in pulse oximeters have been raised in the scientific literature for decades. They don’t work as well in people with darker skin, but that hasn’t changed the practice of medicine, a new study in JAMA Internal Medicine says. The researchers show how damaging inaccurate oxygen readings can be for people who need Covid care, suggesting that delays in treatment or denial of treatment could contribute to higher Covid-19 mortality rates seen in communities of color across the U.S. Faulty oxygen measurement occurred at higher rates than in white patients not only in Black patients, but also in Hispanic and Asian patients. Undetected low oxygen levels led to delays in Black and Hispanic patients receiving potentially lifesaving therapies such as remdesivir and dexamethasone, and in many cases, not receiving treatment at all. STAT’s Usha Lee McFarling has more.

Mistreatment in med school leads students to leave, especially among underrepresented groups

First there were papers linking discriminatory treatment in medical school to burnout and depression. Now a study in JAMA Pediatrics connects mistreatment to dropping out of medical school, potentially explaining why efforts to diversify medical school classes and medicine in general may be foundering. Based on a survey of 20,000 second-year medical students, the study asked about being publicly humiliated, physically harmed or threatened, or denied opportunities; receiving lower grades or evaluations; or experiencing offensive remarks based on race, ethnicity, or gender. The highest attrition rates came among students from underrepresented groups who reported mistreatment or discriminatory behavior. “We think there’s been a focus on recruiting diverse individuals and less attention to the learning environment,” said Dowin Boatright, a Black assistant professor of emergency medicine at Yale and senior author of the study. Read more from STAT’s Usha Lee McFarling.

Closer look: A costly Alzheimer’s treatment is spreading, minus science to back it up

The visual display of the Neurolith device helps clinicians know what brain regions they are targeting using sound waves. (STORZ MEDICAL)

Imagine your loved one has Alzheimer’s. You might try almost anything to bring them back from dementa’s haze. A growing number of people around the world are turning to shockwave therapy, also known as transcranial pulse stimulation, delivered through the scalp and costing $3,000 to $6,000. It’s largely unproven outside anecdotes, and the science behind it is far from convincing, experts say. “They’re raising false hopes,” Robert Howard of University College London told STAT contributor Jonathan Moens. “I hesitate to use the word quackery, but this is not scientific evidence-based medicine.” Only a handful of studies have looked at the effects of transcranial pulse stimulation specifically on Alzheimer’s patients. None was a double-blind randomized controlled trial nor did any look beyond three months. Storz Medical, which makes the devices, disagrees, saying the evidence is sufficiently strong, especially since Alzheimer’s patients have no viable alternatives. Read more.

Theranos whistleblower Tyler Shultz has some lessons to share

The Theranos story is the stuff of best-sellers, TV series, and movies. Sometimes things are just too good to be true, like needing just one drop of blood to revolutionize medical testing. Then you listen to whistleblower Tyler Shultz, who knew the technology wouldn’t work, but still fell under the spell cast by Elizabeth Holmes: “She was so good at it." She was, until he couldn't stand it anymore. He spoke to Matthew Herper at the recent STAT Health Tech Summit about the price he paid for going public. “Most mornings during that period of time I woke up thinking this is going to be the worst day of my life,” Shultz said. “And I was almost always right.” Read more on his struggle, his failed company, and his other takeaways.

Telemedicine works to evaluate children with genetic disorders, study says

Diagnosing children with a genetic disease has traditionally meant a doctor conducting a physical exam, then taking samples to send off for testing. Covid upended that. To see if the alternative of telemedicine worked, defined as reaching a diagnosis, researchers at Children’s Hospital of Philadelphia compared more than 5,800 encounters from before and after the pandemic temporarily closed offices in April 2020. To their surprise, the authors write in Pediatrics, using telemedicine to evaluate patients with rare genetic conditions did as well to deliver a proper diagnosis as in-person visits, with two exceptions. Collecting genetic samples and returning results took longer when done remotely, and families seen by telemedicine were more likely to say they were of non-Hispanic white ancestry, preferred to speak English, lived in ZIP codes with higher median incomes, and carried commercial insurance.

On this week's episode of the "First Opinion Podcast," First Opinion editor Patrick Skerrett talks with Seth Flaxman and Susan Hillis about children who have lost a parent during the pandemic. Listen here.

What to read around the web today

Young caregivers 'exist in the shadows,' offer crucial help. Associated Press
A doctor claimed he had a ‘miracle cure’ for Covid. He’s going to prison. Washington Post
Doctors in Arizona are trying to rewrite the surprise billing law to boost their own pay. STAT+
Has the ‘great resignation’ hit academia? Nature
Documents show problems at Novartis facility where production was recently halted. STAT+