It's unclear how many medicines the U.S. has to fight monkeypox

As the world confronts a monkeypox outbreak spreading beyond countries where it’s endemic, the Biden administration has assured the public that the U.S. government has enough smallpox vaccine in its stockpile to immunize the entire population in the event of a smallpox or monkeypox emergency. Only 35 U.S. monkeypox cases had been confirmed as of Tuesday, but STAT’s Rachel Cohrs reports that the smallpox vaccine numbers publicly disclosed in May don’t add up: The stockpile of fewer than 101 million doses would be enough to vaccinate less than one-third of Americans.

Officials released more numbers Monday, but declined to elaborate on which vaccines made up the additional 200 million-plus doses required. Nor would they talk about antivirals, citing security concerns. Monkeypox is related to but far less deadly than smallpox, whose biological warfare threat explains why the U.S. is more prepared for monkeypox than it was for Covid-19.

Adding Omicron booster outperformed current vaccine, Moderna says

Speaking of Covid-19 and vaccine preparedness, Moderna reported yesterday that a new version of its vaccine booster sparked a better antibody response against the Omicron variant compared to its current shot. As STAT’s Matthew Herper explains, the bivalent vaccine contains mRNA coding for the spike protein for both the original strain of the SARS-CoV-2 virus and the newer Omicron strain. That echoes previous data on another bivalent vaccine, with mRNA coding for the spike protein for the original virus and the protein from the Beta variant. It also provided better antibody protection than the original vaccine.

The FDA has been holding public hearings on boosters for the fall as companies warn that choices of strains to include must be made soon in order for vaccines to be available by then.

Crime reports fell when mental health teams responded to emergency calls

Police officers spend a quarter to two-thirds of their time dealing with nonviolent people in distress from mental health problems or substance misuse. Amid calls to “defund the police” and reminders of the “broken windows” theory, research to support alternatives has been inconclusive. Some cities train police in crisis intervention to better respond and connect people with services. In other cities mental health practitioners accompany police on calls. A third way, sending mental health teams without police — explored in this 2020 STAT story — was tested for six months in downtown Denver.

A new study in Science Advances concludes that dispatching a mental health clinician and a paramedic on such calls reduced reports of targeted, less serious crimes (trespassing, public disorder, resisting arrest) by one-third, with no detectable effect on more serious crimes. “Community response models merit careful consideration,” the authors write.

Closer look: How to strengthen wastewater surveillance for public health

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Wastewater surveillance has hit its stride as an early-warning system for surging Covid cases or emerging variants. But just as its visibility and credibility as an effective pandemic management tool have grown, its fragmented nature across the country has threatened to undermine it. Writing in a STAT First Opinion, Aparna Keshaviah of Mathematica and Megan Diamond of the Rockefeller Foundation’s Pandemic Prevention Institute report on a survey of the multitude of state and local entities involved in monitoring wastewater for pathogens.

The good news: There is consensus about its value. The bad news: Only 21% of local agencies were likely to continue surveillance post-pandemic. “We’re at a pivotal moment, “ they write. “How we adapt our national system now to meet the diverse needs of our communities will make or break the future success of this innovative approach to monitor population health.”

How social isolation and loneliness differ

I’ve always thought that the social isolation and loneliness of old age are interchangeable terms. It turns out they are distinct states, and they matter in the risk of dementia, a new study in Neurology concludes. Researchers plumbed the U.K. Biobank for data on more than 460,000 people over age 57, whom they asked about social isolation and loneliness, tested for memory and cognition, and whose brain volume they measured on MRI.

Social isolation was an objective measure: living alone, visiting friends or family once a month, taking part in club or volunteer activities once a month. Loneliness was subjective: often feeling lonely or seldom confiding in someone. After 11 years, socially isolated people were 26% more likely to develop dementia than those who weren’t; loneliness was not strongly correlated. Social isolation may be a risk factor to target early, the authors say.

In mice, scientists ID brain cells that control how sick we feel

Do you know the brain controls our response to infection, not the immune systems? (I didn't.) Scientists exploring why people with autism had fewer symptoms of their disorder when they had a fever identified the specific neurons connected to immune cells that together orchestrate fever, lack of hunger or thirst, or fatigue when we’re sick. In mouse experiments detailed in a Nature study, the researchers mimicked fever to peer into brain regions involved in appetite, sleep, stress, and other states affected by illness.

They showed that neurons in the hypothalamus near immune cells close to the brain-blood barrier could sense immune signals, generate fever, and suppress appetite, suggesting pain or behavior could also be controlled there. Fever and appetite loss play a role in the body’s response to infection, but can be harmful when extreme or in cancer patients, for example.

What to read around the web today

Abbott received former employee’s warnings on baby-formula plant earlier than previously known, Wall Street Journal
New York let residences for kids with serious mental health problems vanish. Desperate families call the cops instead, ProPublica
FTC will investigate pharmacy benefit managers and their role in prescription drug costs, STAT
The state finally letting teens sleep in, The Atlantic
A vanishing word in abortion debate: ‘women,’ New York Times