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It’s never a good time to drink raw milk, but especially not now

April 29, 2024
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Morning Rounds Writer and Podcast Producer
Happy Monday! I'm manifesting at least one good breakfast sandwich for myself this week after smelling — but not eating — one at the office last week.  But I will NOT be drinking raw milk with that sandwich, and you can read more below on why.

h5n1 bird flu

Today in bird flu: Testing in cows will be more limited than initially thought. And raw milk is still a bad idea

ROBERT F. BUKATY/AP

New federal rules aimed at limiting the spread of the H5N1 bird flu virus among dairy cattle go into effect today, but detailed guidance documents released Friday by the U.S. Department of Agriculture reveal its mandatory testing order is less stringent than initially described. While that eases concerns from farmers and veterinarians about the economic and logistical burden of testing, it leaves questions about how effective the program will be at containing additional outbreaks.

The initial order last Wednesday required farms to ensure lactating dairy cows test negative before being moved across state lines. On Friday, USDA narrowed the scope, saying that farmers only have to test up to 30 animals in a given group. Read more from STAT's Megan Molteni on whether experts think that will be enough to detect and contain more outbreaks.

And as a reminder: The risk of infection from ingesting milk is believed to be very low because pasteurization should kill the virus. And while scientists generally warn against drinking raw milk, it may be even riskier to do so now, STAT's Helen Branswell reports. Experts told her that if a raw-milk consumer inadvertently drank milk from infected cows, the results could be bad. Read more from Helen on the danger of raw milk as bird flu continues to spread among dairy cows.


mental health

HHS releases a 10-year plan for suicide prevention

The U.S. Department of Health and Human Services released a 10-year plan to address the country's high suicide rate on Friday. Almost 50,000 people in the U.S. died by suicide in 2022. The report outlines goals to increase community-based suicide prevention measures, access to mental health care, and rigorous surveillance — all with a focus on health equity.

"What's exciting is that the plan takes a 'whole of society' approach," Hannah Wesolowski, the chief advocacy officer at the National Alliance on Mental Illness, wrote in an email to STAT. The report includes a three-year plan with explicit action items for federal agencies. The Agency for Healthcare Research and Quality, for example, was directed to produce briefs on hospital and emergency department utilization for suicidal ideation, while the Department of Housing and Urban Development was tasked with providing mental health first aid trainings to 500 people who may work with those experiencing housing challenges.

Those kinds of government directives were lacking in the last strategic report from HHS, issued in 2012. In 2021, the surgeon general released a call to action to fully implement 2012 goals that had still not yet been achieved. "A lot has changed in our society in that time," Wesolowski wrote. "But now that we have the strategies outlined, we have to roll up our sleeves and do the work."


smoking

There won't be a ban on menthol cigarettes (for now)

The Biden administration is walking away from a plan to permanently ban menthol cigarettes, at least for the moment. The minty cigarettes have historically been marketed to Black communities, and regulators had already pushed back the ban several times amid concerns that it would unfairly target Black smokers and potentially alienate voters. 

Yet the regulation is heavily backed by public health groups aiming to cut smoking rates and a number of federal health officials, who insist it is still in the works, just delayed — again. "It's clear that there are still more conversations to have, and that will take significantly more time," Health and Human Services Secretary Xavier Becerra said in a statement. Read more from STAT's Sarah Owermohle. 



artificial intelligence

The haves and the have nots of medical AI 

NORTH COUNTRY HEALTHCARE

In the small, desert town of Kingman, Ariz., there is little time for the local health clinic to support bureaucratic battles with insurers or keep up with administrative tasks. There's also little money for artificial intelligence tools to handle some of those tasks, like richer academic hospitals with better data systems can. But that could change if the Kingman clinic becomes part of the Practice Network, a group that aims to help smaller providers implement AI tools in settings where adoption is often stymied by technical and financial challenges. 

Participants accepted to the program will spend a year working with experts to test AI tools and incorporate them into their software systems and work routines. And with eight rural hospital closures across the U.S. in 2023 and another 700 at risk due to financial distress, the stakes are high. Read more from STAT's Casey Ross on what it takes to bring AI into rural clinics


first opinion

When did medical school become a research arms race?

Publishing clinical research has become one of the most important parts of a medical student's professional portfolio, and the way many residency programs rate their applicants. This was a jarring realization for second-year medical student Anmol Shrestha, who believed school was a place to learn about the human body and train in patient-facing skills like bedside manner. 

"The focus on research does not align with the skills that are most important for making good physicians," Shrestha writes in a new First Opinion essay. "The measure of what makes a good medical student and future physician should not be how many publications they have, but how well they understand and care for their patients." Read more from Shrestha on the ramifications of toxic publication culture in training


housing as health care

Housing insecurity prominent in one emergency department

Last spring, more than 23,000 patients came through the emergency room and were screened for housing needs at Vanderbilt University Medical Center in Nashville, Tenn. One in every 20 were homeless or experiencing housing insecurity — critical information for providers to support follow-up care. A study published Friday in JAMA Network Open details the ER's findings: Suicide was a top concern for patients dealing with housing insecurity or homelessness, who were also more likely to be uninsured and have multiple visits to the emergency room.

Readers should take a grain of salt when trying to extrapolate from studies focused on a single hospital or clinic, like this one. The authors noted that since the VUMC emergency department is frequently full, diverting ambulances to other institutions, the data may underestimate the prevalence of housing insecurity for those using emergency medical services in the area. To learn more, the authors wrote, more hospitals can implement similar screenings.


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In case you missed it: 

  • 'People are going to die this summer': Advocacy groups join Texas lawsuit over excessive heat in prisons, The 19th

  • Momentum builds for House bill cracking down on Chinese biotechs, STAT
  • McKinsey is under criminal investigation for its opioid work, New York Times
  • Another hospital sues MultiPlan, alleging scheme to 'suppress' payments, STAT

Thanks for reading! More tomorrow,


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