Morning Rounds: Would a bird flu vaccine for cows work?

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Happy Monday! Are you watching the Olympics this week? As a former distance swimmer, I’m a big fan of watching Katie Ledecky smoke everyone in the mile.

Should we use flu shots on cows to stop bird flu from spreading?

More and more dairy cow herds are becoming infected with H5N1 bird flu, and the need to stop transmission is pressing — if not for the cows, then for us. As the virus travels among mammals, it’s possible that it could adapt to become better equipped to transmit to, and among, humans.

Multiple animal vaccine manufacturers are at work trying to develop a bird flu vaccine for cows. But would a vaccine actually help stop the spread? Experts who spoke to STAT’s Helen Branswell are divided on the idea. There are still questions about whether vaccinating cows would be an effective solution in the first place. And some experts wonder whether farmers would be willing to absorb the costs of vaccines, or to agree to stringent post-vaccination surveillance.

Read more from Helen on the debate. And after a week that saw the human count of bird flu cases hit 13 and the cumulative number of infected herds climb to 172, don’t miss today’s bird flu snapshot on all the latest developments.

Stronger Covid restrictions saved lives, per study

If every state in the U.S. had imposed Covid policies like those in the 10 most restrictive states, deaths from the virus would have been 10-21% lower between July 2020 and June 2022, according to a study published Friday in JAMA Health Forum. State policies were largely similar in the first few months of the pandemic, but began to diverge in the second half of 2020. Study analysis found that mask requirements (especially in schools) and vaccine mandates were associated with lower rates of excess deaths. On the flip side, a lack of mandates was associated with higher excess deaths.

The analysis can’t conclusively identify causation, only associations. Still, the results suggest that strong Covid restrictions saved lives, the authors wrote.

Mpox vaccine trial to start in three African countries

Researchers from McMaster University in Canada are planning a clinical trial to test whether receiving Bavarian Nordic’s mpox vaccine can protect people who’ve been exposed to the infection from getting sick or reduce the severity of the illness. The trial will launch next month in the Democratic Republic of Congo and will later include participants in Uganda and Nigeria. The researchers received $4.9 million (U.S.) from the Coalition for Epidemic Preparedness Innovations and the Canadian Institutes of Health Research, per a CEPI press release.

The trial’s results could be critical to combat mpox in the DRC, which has seen 11,000 cases and 443 deaths this year already, with children making up the majority of both, the press release noted. The study will invite over 1500 participants over the age of 10 from households with a confirmed mpox infection to participate. CEPI and Bavarian Nordic also have a separate clinical trial that will launch later in the year testing the mpox vaccine in children ages 2-12.

Keep up on the latest with STAT’s mpox coverage.

Will there be a Mark Cuban effect on drug shortages?

We’ve got two big problems with prescription drugs right now: They’re too expensive, and there aren’t enough of the most important ones. Mark Cuban — the billionaire entrepreneur perhaps best known for his assertive presence on the TV show “Shark Tank” — has decided to solve these problems for us through the creation of the Mark Cuban Cost Plus Drug Company. (That’s MCCPDC for short, if that name isn’t rolling off your tongue.)

Cuban claims that the pharmaceutical industry is “the easiest industry I’ve been in to disrupt.” But in a First Opinion essay, industry vet Ezekiel Emanuel and physician John Connolly argue that perhaps Cuban shouldn’t be so confident. His current approach will fail to make a significant dent in drug prices, they write. But by expanding his production forays, they argue, Cuban could make real progress addressing America’s drug shortage issues.

Read more from Emanuel and Connolly about why Cuban’s company can’t save us from high drug prices.

Health care workers have more medical, educational debt, study says

More and more medical schools are going tuition-free — which is great for doctors, but what about other health care workers? A new study published in JAMA Health Forum found that health care workers overall have more medical and school debt than other workers.

Medical debt among all health care workers tallied $19.8 billion nationally, while educational debt totalled $134.4 billion, according to the study’s analysis of nationally representative survey data from 2018-2021. Medical debt was more common among women than men and among Black health care workers than white ones. School debt was also more common for Black people, and less common for older people.

How to prevent tragedies like Sonya Massey’s death

Sonya Massey called 911 on July 6 to report a potential home intruder. “Don’t hurt me,” is what she said to the police when they arrived. “Why would I hurt you? You called us,” is how Deputy Sean Grayson responded minutes before he shot and killed her.

Massey had paranoid schizophrenia, and she was distracted, unsettled, and frightened. What she needed was reassurance, two emergency physicians write in a First Opinion essay. The interaction with police turned quickly from routine to deadly. “As two academic, Black women physicians, we have become familiar with the same speed at which we can turn from ‘pet to threat,’” they write.

Read more on the “pet to threat” phenomenon and the critical need for safe de-escalation tactics and specialized, mental health crisis response teams.

What we’re reading

• America is running out of generic drugmakers. Another one is on the brink, Wall Street Journal

• The recombinant shingles vaccine is associated with lower risk of dementia, Nature

• Disruptions loom for telehealth providers and patients as Congress inches closer to deadline, STAT
• Iowa abortion ban taking effect as residents flee out of state for care, Washington Post
• I’m a Black psychiatrist. I’m never prepared for the emptiness and grief I feel when police shoot a Black person, STAT