Rising threat of fentanyl, wiggling cellular fingers, & the health crisis in Somalia

Ousted surgeon general rebukes Price on opioids

Dr. Vivek Murthy, ousted last month as surgeon general by the Trump administration, is speaking out publicly against HHS Secretary Tom Price's skepticism over a treatment for opioid addiction. Murthy fired off a string of tweets yesterday about the science supporting medication-assisted treatment, which Price questioned earlier this week. “If recent comments from the Administration indicate a shift away from an evidence-based, public health approach to the opioid crisis, I am concerned the negative impact on the health of Americans will be considerable,” Murthy told STAT. More here.

The health crisis in Somalia is escalating

Global health officials are warning that there’s an urgent need for funding to address health insecurity amid a devastating drought in Somalia. The WHO is worried that famine will lead to deteriorating health, making the population more susceptible to disease and infection. Here are the main concerns:

§ The drought has dramatically reduced access to clean water and food. An estimated 3.3 million people are going hungry each day in Somalia.

§ This year, there have been more than 36,000 cases and 690 deaths from cholera, which is usually spread through unclean water. It’s the largest cholera outbreak in Somalia in the past five years.

§ There has also been an uptick in measles incidence, with nearly 6,500 cases reported so far in 2017. Roughly 70 percent of those cases were in kids under age five.

§ The health sector in Somalia needs $103 million to address urgent health challenges, but has received just 23 percent of that money, according to the WHO. Health officials are appealing to the international community for more support to stop the crisis from escalating further.

Intelligence officials warn about rising risk of fentanyl

A new worldwide threat assessment from the intelligence community names an increasingly concerning risk to people in the US: synthetic opioids. Deaths from synthetic opioids such as fentanyl jumped 73 percent from 2014 to 2015 in the US. Early numbers from 2016 suggest that synthetic opioid deaths are continuing to rise. That’s raised a red flag for intelligence officials, who say the threat of fentanyl and similar drugs is “intensifying.”

Inside STAT: The science behind a hyped gravity blanket

(Dom smith / stat)

A Kickstarter for a "gravity blanket" that claimed to treat anxiety, insomnia, and PTSD has taken the internet by storm. People have quickly snuggled up to the idea. The campaign has already raised more than $3 million from over 15,000 donors. But when I asked the company about the bold medical claims it made — which violate both federal guidelines and Kickstarter policy — that language quietly disappeared from the site. Even with the new marketing message, the science supporting the blanket's supposed benefits is lacking. I've got more here.

Lab Chat: Capturing cells wiggling their fingers to feel

Microvilli moving across a t cell like a little sea anemone. (Ucsf)

The immune system’s T cells have to detect disease without the benefit of sight, so they rely on tiny fingers to capture information. Now, a new video technique is giving scientists an opportunity to watch how that happens in real time. Here’s what Matthew Kremmel of University of California told me about the findings, published in Science.

What does this new video technique allow you to do?

It allows you to look with the resolution that’s necessary to look at how membranes wave their fingers. Cells have these projections called microvilli that are very small. You couldn’t resolve these before. They’re too small to see, and looking at them using electron microscopy would kill them. This is a way to make a movie in real time to look at how a cell feels or senses another cell.

What did you see cells doing?

At any one time point, they’re not touching very much. They’re only touching little bits of their world for five-minute periods of time. That’s unexpected. We thought immune cells would always be scouring their world for signs of danger. Now we can watch that and see how efficient they are. That tells you something about what you can do in a normal cell setting. If you want to vaccinate against something, we know now that a cell can’t grab everything I ever throw at it. It also tells you how you might evade being detected by a T cell, to have something not be detected by the immune system.

The high burden of out-of-pocket costs in Medicare

An estimated 15 million elderly and disabled people are spending 20 percent or more of their household income on out-of-pocket medical expenses and insurance premiums, according to a new analysis out this morning from the Commonwealth Fund. The federal program doesn’t put a cap on out-of-pocket spending for the 56 million Medicare enrollees, but does allow people to purchase supplemental insurance to help cover those expenses. For low-income patients with chronic conditions like diabetes, out-of-pocket costs averaged more than $7,000 a year if they couldn’t afford that extra coverage. That’s a serious cost burden — and one that Congress should keep in mind as it considers Medicare reform, the authors say.

Drug industry execs take their concerns to HHS

Drug industry execs are meeting today with HHS Secretary Tom Price as the agency considers potential next steps to curb high drug prices. They’ll be discussing what can be done in terms of administrative actions through HHS and through federal regulation. What that looks like will depend in large part on Scott Gottlieb’s approach to shaking up the regulatory process as he settles into his new gig at the FDA. President Trump has said he’d like to scale back government regulations, but some in the pharma industry are worried that a less intensive approval process might make it harder to convince insurers to foot the bill for pricey new medications.