Pressed by activists, White House reboots rollout of monkeypox treatments and vaccine

Facing heated criticism over a slow-footed, error-prone response to monkeypox, federal officials vowed yesterday to accelerate access to vaccines and treatments for an outbreak that has largely affected men who have sex with men. The Biden administration will make available 1.8 million additional doses of the Jynneos vaccine and 50,000 courses of the antiviral Tpoxx. STAT’s Jason Mast has more on vaccine supply and Tpoxx red tape.

Also yesterday, New York City health officials released new data saying more than 92% of over 63,000 monkeypox vaccine doses have been given to people who identify as LGBQ+, but disparities persist.

23.3% of doses given went to Hispanic or Latino New Yorkers (16% of the population that may be currently eligible for vaccination).
10.2% of doses given went to Asian or Pacific Islander New Yorkers (7% of those eligible).
12% of doses given went to Black New Yorkers (31% of those eligible).

Late-stage cervical cancer cases are rising amid an overall decline

Cervical cancer is both rare and preventable. Thanks to Pap screening, HPV tests, and the HPV vaccine, cases have declined with one exception: stage 4 disease, which has slowly, steadily increased from 2001 to 2018, a new study in the International Journal of Gynecological Cancer says. It’s a worrying and paradoxical trend that experts believe has only gotten worse with the Covid-19 pandemic.

While the highest incidence of cervical cancer is among Black and Hispanic women, the greatest increases in late-stage, often fatal cervical cancer were among white women and women overall age 30 to 34, the researchers found. Rebecca Perkins of Boston University School of Medicine, who was not involved in the study, told STAT’s Angus Chen people are just being missed. “It’s a failure of the screening system in terms of, probably, people not being able to access care.” Read more.

New data on Covid infections among unhoused people come with a warning

STAT’s Usha Lee McFarling brings us this report: A new study from CDC researchers found that Covid-19 infection rates among people experiencing homelessness appeared to be lower than those for the general public. But the research, conducted from January 2020 to September 2021, came with a warning from the authors that the numbers should be viewed with caution because the collection of health data in populations that experience homelessness is so problematic. The authors had expected that case rates among unhoused people would be higher due to their increased risk for infectious disease and to the many outbreaks recorded in shelters.

Challenges in assessing case rates for unhoused people include the issue that community testing sites did not collect information on housing status and the fact that people experiencing homelessness often do not seek or receive medical care so may not have been tested.

The new paper “emphasizes — more than anything else — what a problem we have of data on homelessness,” said Margot Kushel, a physician who directs the UCSF Center for Vulnerable Populations and was not involved in the research. “Public health departments and health care institutions do a terrible job of recording who is and who isn’t homeless. In many public health forms, they don’t even ask.”

Closer look: Black engineers work to fix long-ignored bias in oxygen readings

(COURTESY JOSHUA BURROW)

As Usha Lee McFarling puts it, this is a problem Kimani Toussaint was built to fix. Like many people who are Black, Toussaint was concerned that the pulse oximeters used to treat and monitor Covid-19 patients didn’t work as well on darker-skinned patients. But unlike many people who are Black, he could do something about it. He’s an optics expert whose lab at Brown University creates precision techniques to image and assess biological tissues. He and his doctoral student Rutendo Jakachira (above) are developing a pulse oximeter to work well on all skin tones.

They are not alone, even though only 5% of America’s engineering workforce is Black. Valencia Joyner Koomson, a Black associate professor of electrical and computer engineering at Tufts University, is working on “smart” oximeter devices that are adaptable and less sensitive to skin tone. Read more.

Opinion: Long Covid needs Operation Warp Speed

When the Biden administration released its national action plan to address longer-term impacts of Covid-19, it touched on how to reckon with those effects that will weigh on health systems and the economy for decades to come. The plan offers a good start for addressing long Covid, but leaves much undone, science writer Ryan Prior and Kimberly Knackstedt, who served as the White House’s first director for disability policy from 2021 to 2022, write in a First Opinion. While the report details ongoing scientific research into long Covid and social support services for it across the federal government, they say, it falls short of robust, far-reaching goals. They offer three guideposts:

Use a disability lens.
Look to similar post-infectious diseases.
Employ patient-centered communication and implementation.

Read more about what it would take to launch an Operation Warp Speed for long Covid.

Physicians watching physicians behaving badly

The title of a new survey from Medscape describes a problem and offers an explanation, too: Physicians Behaving Badly: Stress and Hardship Trigger Misconduct. The survey of 1,500 physicians and health care professionals around the world reports 41% have seen doctors behaving inappropriately at work, up from 35% last year. There’s sexual harassment (a surgeon repeatedly fondling a nurse’s breast with his elbow during procedures) and racist language (a doctor using a slur when angrily walking out on a family).

There’s bullying of coworkers and patients. And this: “A California surgeon attended traffic court via an online conferencing application, while performing surgery in the operating room.” Best metric: In a kind of warped version of Lake Wobegon, where all the children are above average, physicians were asked if they themselves had behaved poorly, mistakenly or knowingly. Only 15% said yes.

What to read around the web today

Some rural hospitals are in such bad shape, local governments are practically giving them away, Kaiser Health News
Anti-vaccine organization Children’s Health Defense says it was banned from Instagram and Facebook, Vice
Opinion: From one dying breath to the next, Scientific American
‘We’re finally here’: Harvard graduate spearheads custom gene therapy for younger brother, Boston Globe
Google workers press company to stop collecting abortion data, Wall Street Journal
Opinion: Genetic research provides new clarity about the ‘whys’ of autism, STAT