STI clinics, already stretched thin, strain under weight of monkeypox response

Monkeypox no longer dominates headlines, but the disease is pushing STI clinics — the default responders because the virus is mainly spreading through sexual contact among men who have sex with men — to their limits as they deal with the chronic underfunding of public health. Monkeypox transmission has slowed and testing and treatment is becoming slightly more accessible, but testing can take up to an hour, medications and vaccines can be hard to find, and payments to clinics don’t come near to covering their costs.

“When you’re working on the ground and you’re seeing how this is actually affecting people’s lives, there is a big urgency,” Shira Heisler of the Detroit Public Health STD Clinic told STAT’s Andrew Joseph, describing how people scream in pain when their anal lesions get swabbed or how the lesions can scar people’s faces. “Everyone’s doing overtime without getting paid for it, because no one else can do it.” Read more.

Ebola deaths and cases are rising in Uganda

The outbreak of Ebola disease in Uganda caused by Sudan virus has grown to 18 confirmed and 18 probable cases, including 23 deaths, WHO reported yesterday. The risk of a potentially serious public health impact is high on a national level, the global agency said, because there is no authorized vaccine against the Sudan virus, among other reasons. The agency also said it’s possible the outbreak began weeks before the first case was identified on Sept. 20, several transmission chains have not yet been tracked, patients went to clinics with inadequate infection control, and the patients who died were buried in traditional ceremonies with large gatherings.

One more worrying factor WHO cited: The disease was detected among people living near a gold mine, where the outbreak might cause some miners already incubating the disease to flee and spread the virus farther.

Google Cloud and Fitbit join forces for hospitals

Fitbit has moved way past tracking your 10,000 steps. Acquired by Google for $2.1 billion in 2021, it’s now part of an offering from Google Cloud designed to help hospitals meet challenges they face collecting and processing data from wearable devices. Called Device Connect for Fitbit, it combines Google’s data crunching expertise with Fitbit’s wearables know-how to reduce the technical burden required to run patient monitoring, research, and other programs using the company’s devices.

That includes tools to enable enrollment and consent as well as ways to simplify plugging data into Google Cloud, allowing organizations to run analytics, create visualizations, and use Google’s AI tools. The idea is to remove time-consuming grunt work in favor of focusing on care models, clinician workflows, and how to wrestle data into electronic health records, Fitbit Health Solutions General Manager Amy McDonough told STAT’s Mario Aguilar. Read more.

Closer look: Doctor calls for action against colleagues who spread misinformation

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Primary care physician Juliana Morris sees what Covid-19 misinformation means every day. Some of her patients refuse to be vaccinated, based on false theories about immunizations causing death or decreased fertility. A few fell severely ill from the virus just weeks after declining vaccination during a visit to her office. They’re not unusual: National polls say three-quarters of adults believe falsehoods about Covid.

The source of that misinformation is disturbing. Physicians account for three of the 12 individuals thought to be responsible for up to 73% of anti-vaccine content on Facebook. Because their lies have real and potentially deadly impact, there should be consequences, Morris writes in a STAT First Opinion. Some medical boards have acted against rogue physicians and a bill in the California legislature proposes strengthening such disciplinary action. “Legislation like this is sorely needed across the country.” Read more.

Cancer guidelines for harms of screening are uneven, review says

Weighing risk versus benefit depends on having good data. A new review in the Annals of Internal Medicine concludes that 33 guidelines for cancer screening lack consistent reporting on harms that may come from tests to detect breast, cervical, colorectal, lung, or prostate cancer. The harms include pain and complications from the test, distress from bad results, worry from false positives, and a cascade of further tests. Some examples: life-threatening colon perforation during colonoscopy or incontinence and erectile dysfunction after post-screening prostate cancer treatment that diminish quality of life. Defining harm is crucial, as an editorial notes: "How many persons overdiagnosed outweigh a single life extended?"

Reporting harm was the most complete for prostate cancer screening and the least complete for colorectal cancer screening. “Understanding the balance of benefits and harms for various risk groups and screening regimens is critically important for the decision of whom, how, and when to screen,” the researchers write.

Study: Argument that drug prices reflect R&D costs doesn't add up

There’s no debate about whether U.S. drug prices are rising. Brand-name pills go up 9% a year on average and injectable drugs have averaged a 15% annual climb. Soon Medicare will be able to negotiate some drug prices, thanks to the Inflation Reduction Act, but opposition has not quieted from drug companies and trade groups warning of irreparable damage to innovation in drug development.

A new study in JAMA Network Open examined whether drug prices reflect the high cost of R&D for those drugs, but found no such correlation for 60 drugs approved by FDA from 2009 through 2018 for which both investment and treatment costs were known. This lack of a link was not a surprise, the researchers write, but “this study offers empirical evidence that, in the U.S., drug companies charge what the market will bear.”

What to read around the web today

Exclusive: Democrats concede to clean user fee agreement to fund FDA, STAT
These scientists traced a new coronavirus lineage to one office — through sewage, Nature
Long Covid has forced a reckoning for one of medicine’s most neglected diseases, The Atlantic
Mental health crisis leads hospitals to create a new type of ER, Bloomberg
Opinion: FDA: Ignore a pharma company’s deceptive racial equity argument for keeping Makena, an ineffective preterm labor drug, STAT
Viruses to fight superbugs? Scientists are working on it, Wired