Good morning. Be sure to read our second item, from Helen Branswell, on an unusual monkeypox case report.

Over-the-counter hearing aids are coming this fall

After years of pressure from medical experts and consumer advocates, millions of Americans will be able to buy hearing aids without a prescription starting in mid-October. A new FDA regulation creates a class of hearing aids that don’t require a prescription, a medical exam, and other specialty evaluations. The devices will be sold online or over-the-counter at pharmacies and other retail stores, making them both cheaper and easier to get.

Currently, it can cost more than $5,000 per pair of hearing aids and fitting services. The move to OTC could save $2,800 per pair, White House economics adviser Brian Deese estimated. Insurance coverage is limited and Medicare pays only for diagnostic tests. The FDA estimates that nearly 30 million adults could benefit from hearing aids, but only about one-fifth of people with hearing problems use them. The Associated Press has more.

A reminder about monkeypox transmission

Doctors in California have reported a monkeypox case in a man whose route to transmission appears to be a bit of a departure from what has mainly been seen in the current outbreak, STAT’s Helen Branswell tells us. The man, who reported that he hadn’t had sex in the past three months, appeared to have contracted the virus in the U.K. in June while attending a large, crowded outdoor event where people in summer clothing — think exposed skin — were dancing. The event was not a rave and was not attended primarily by gay and bisexual men.

“There was … no sexual activity or making out or anything like that and we asked this pretty specifically,” said Abraar Karan, an infectious diseases physician at Stanford University. The case serves as a reminder that monkeypox isn’t solely transmitting through sex. “To me what’s interesting is that a lot of people are going to have close contact like this just by virtue of going to bars and clubs and events,” Karan said.

If natural biomarkers don’t work, why not make them?

Finding the right biomarker — such as DNA, peptides, RNA, or proteins — is key to finding cancers earlier, monitoring a treatment, or predicting if a certain therapy will work for a given patient. But for many cancers, the known biomarkers are hard to detect, don’t last very long in the body, or aren’t specific to cancer. So rather than search for natural biomarkers, scientists are creating completely new, synthetic ones, STAT’s Angus Chen writes.

Labs have been tinkering with synthetic biomarker designs, such as chemical probes that can interact with tumors or living sensors made of engineered cells. One example: “Some labs engineer probiotics that you find in yogurt where they can colonize tumors in the GI tract and create synthetic biomarkers,” Gabriel Kwong of Georgia Tech told Angus. Read more on their development.

Closer look: Reflecting on genomics, 20 years on

(JAMES DI LORETO/SMITHSONIAN)

In 2013, the Smithsonian National Museum of Natural History opened an exhibit to celebrate the 10th anniversary of the Human Genome Project’s completion. Now, as the exhibit wraps up, STAT’s Edward Chen asked scientists about how genomics has changed.

George Church, Harvard: “[It] had been sort of declared done in 2001, and then was re-declared done in 2004. And it’s actually still not done in my opinion.”
Eric Green, National Human Genome Research Institute, on using genomics to diagnose rare diseases. “They were like the very first home runs in those areas. But now it’s just routine practice.”
Joann Boughman, University System of Maryland: “The fact that the double strand of DNA is not a foreign concept, even to relatively small children, really makes our conversation different. And that’s been an incredible thing to watch over the last 40 years.”

Hospital mergers without antitrust scrutiny lead to much higher prices

Hospital mergers are not all created alike. Some state regulations shield them from federal scrutiny, allowing the merged entity to raise prices substantially, new research concludes. How much? In states with such rules, hospitals hiked prices between 39% and 51%, according to the study, coming out in the Journal of Law and Economics. Called state certificates of public advantage, or COPAs, the laws allow anticompetitive mergers to proceed under state oversight, avoiding federal antitrust lawsuits.

“When the gloves get taken off, they fully exercise their market power,” Chris Garmon, the study’s lead author and assistant professor of health administration at the University of Missouri-Kansas City, told STAT’s Tara Bannow. The FTC strongly opposes COPAs, and the agency outlined its rationale in a position paper this week citing Garmon’s study. Read more.

Opinion: The cult of silence in medicine must go

Covid-19 turned hospitals into battlefields, three doctors who practice in New York write in a STAT First Opinion. But that also meant malpractice liability was suspended, as doctors learned on the fly from each other and from their mistakes how to save lives. It was the time of immediate intubation, hydroxychloroquine, and other treatment protocols that turned out to be useless or even harmful.

But a December 2021 court ruling is a reminder that in New York State, anything a doctor says or writes — to colleagues, friends, partners, or even relatives — can be used in court against them. Doctors who commit an error that may have hurt a patient can take the ruling as a warning to stay silent, and as the pandemic revealed, that is counterproductive, say the authors. The Covid-19 epidemic almost broke the health care system,” Antonio Dajer, Christie Lech and Lucy Willis say, ”but also showed the way forward: no more silence.” Read more.

What to read around the web today

Hundreds of Somali-American youths held captive in rehab centers; ‘They were torturing me,’ Wall Street Journal
The forgotten virus: Zika families and researchers struggle for support, New York Times
Exclusive: Ex-Google CEO’s VC firm brings in hype-busting researcher to expand its biotech investments, STAT
Public health agencies adapt Covid lessons to curb overdoses, STDs, and gun violence, Kaiser Health News
Merck, a loser in the Covid vaccine race, reinvests in mRNA through a Cambridge startup, STAT
These scientists are working to extend the life span of pet dogs — and their owners, MIT Technology Review