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1 big thing: Worry over bird flu response

Illustration: Sarah Grillo/Axios

A growing number of high-profile public health experts are raising alarms over what they say are lackluster efforts to track and contain the spread of bird flu across U.S. dairy farms.

Why it matters: If this is a test of whether the U.S. is better prepared to respond to a potential pandemic threat after COVID-19, we're not getting high marks.

The big picture: It's been nearly three months since the H5N1 bird flu virus was found to have spilled over to cows, but experts say we're far from having a reliable picture of how widely it's spreading.

  • Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, told Axios there's not even enough information to know whether cases among cows are trending up or down.
  • The University of Minnesota's Michael Osterholm said it's also important to figure out how long it takes for infected herds to clear the virus to get an idea of the risk window for workers.
  • While officials say the risk to the general public remains low, a big worry is whether the virus eventually mutates in a way that allows it to easily spread between humans.

What they're saying: "It's been shocking to watch the ineptitude of just doing the surveillance, being able to talk about it, tracking the infections, understanding where we are," former Gavi CEO Seth Berkley said recently, according to Stat.

The other side: There are key differences between the initial COVID and H5N1 responses, said CDC principal deputy director Nirav Shah.

  • Scientists already have two decades of research on this bird flu strain, providing a strong understanding of how it generally behaves. There are also medications that work and an on-the-shelf vaccine that can be manufactured quickly, he said.
  • "That puts us in a different position," Shah told Axios, adding that the CDC "would like to pull every lever possible" to increase testing in humans.

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2. Missing opioid treatment

Illustration: Aïda Amer/Axios

Very few Medicare enrollees who survive drug overdoses receive the gold standard for addiction treatment afterward, a new federal study shows.

Why it matters: The health care system can do much more to connect high-risk seniors with opioid use disorder treatments and prevention measures, the findings suggest.

What they found: Just 4.1% of nearly 137,000 traditional Medicare enrollees who had a nonfatal drug overdose in 2020 received highly effective medications for opioid use disorder like methadone and buprenorphine within 12 months, according to the new study in JAMA Internal Medicine.

  • About 6% filled a prescription for overdose reversal drug naloxone, and 18% received psychotherapy or counseling within a year of overdosing.
  • 17.4% had another nonfatal overdose in the year after their initial overdose, and 1% died from an overdose.
  • Those who were prescribed naloxone, medication-assisted treatment or behavioral health services had lower risk of dying from another overdose, the study found.

"There's a lot more people who could benefit from treatment that don't appear to be receiving it," Wilson Compton, deputy director of the National Institute on Drug Abuse, told Axios.

Read here

3. The value of hep C treatments

Illustration: Annelise Capossela/Axios

Doubling the number of Medicaid enrollees receiving hepatitis C treatments would avoid about $7 billion in health care costs over a decade, according to a new CBO report.

Why it matters: About 70,000 people in the U.S. get the liver infection each year, and complications in untreated patients can be 10 times as costly as administering antivirals in earlier stages of the disease.

What they found: CBO looked at two scenarios: slightly increasing the treatment rate from 5% of Medicaid enrollees with hepatitis C to about 5.5% over five years, and doubling it from 5% to 10%.

  • The first would save about $700 million over 10 years, while spending on testing and treatment would increase by $500 million over that period.
  • The second would save about $7 billion, and spending on testing and treatment would total $4 billion over that period.
  • Higher spending on testing and diagnosis would be offset by better health outcomes, which would have a positive ripple effect on public benefits programs.

Catch up quick: Pricey drugs over a decade old and costing $11,500 to $17,000 per course can cure the vast majority of hepatitis C cases without side effects.

  • But diagnosis and treatment have been hindered by low levels of awareness about the virus and the challenges of reaching high-risk populations.

Read here

4. Surgeon general's warning label plea

Photo: Bryan Bedder/Getty Images for Project Healthy Minds

U.S. Surgeon General Vivek Murthy called on Congress yesterday to require social media platforms to display warning labels alerting users of the potential harms the platforms pose to teens' mental health.

Our thought bubble: While there's been bipartisan interest in reining in social media, it seems unlikely we'll see Congress soon requiring tobacco-style warnings on platforms.

  • Murthy's latest policy prescription, coming about a year after he issued an advisory about social media's risk to kids, may best be understood as an effort to use his unique bully pulpit as the nation's doctor to build momentum for a signature issue that's a top parental concern.
  • It also keeps up pressure on platforms as they take steps to negate some harms amid lawsuits over their roles in the youth mental health crisis.

Zoom in: Murthy's essay in the New York Times also calls for other measures that Congress could consider without having to make thorny calculations about how to mandate social media warnings, which Murthy acknowledges on their own wouldn't make these platforms safer for kids.

  • Among those measures: restrictions on collecting sensitive data from kids, requirements for platforms to share their data on health effects, and subjecting platforms to independent safety audits.
  • And Murthy's essay calls for an all-encompassing societal approach, from schools and parents creating phone-free zones to peer support among teens to increased vigilance from health care providers.

"We have the expertise, resources and tools to make social media safe for our kids," he writes. "Now is the time to summon the will to act."

5. Catch up quick

💉 FDA approved Merck's pneumococcal vaccine for adults that aims to provide broader protection than currently available products. (CNBC)

🤖 OpenAI's latest health care venture uses its AI models to help create cancer screening and treatment plans. (Wall Street Journal)

🧠 Alzheimer drug Leqembi's potentially fatal side effects may be obscured by the "soothing" acronym used to describe them, doctors say. (Los Angeles Times)

🐕 The recent cancellation of 100,000 pet insurance policies has created a major pre-existing conditions problem. (USA Today.)

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