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July 12, 2022
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A wall shows appreciation for volunteers who answer calls from the National Suicide Prevention Lifeline at a Samaritans call center. Boston, February 28, 2020. Jonathan Wiggs/The Boston Globe/Getty

911 for Mental Health’s Rough Rollout

It’s a great idea for a great need: Dial 988 and get urgent, personal mental health help.
Starting on Saturday, anyone in the US can punch in the 3 digits and talk with a trained counselor who can help them with a mental health emergency—including self-harm, suicidal ideation, and substance use issues—and connect them with mental health and substance use treatment, The New York Times reports.
But there are problems: State health officials are worried whether they’ll have enough staff to respond if they’re flooded with calls, according to Politico. And feds are concerned that most states haven’t arranged financial support for the long-term.

So, they’re not trumpeting the new help number.
Local, preferred: If callers can’t reach a local call center with people familiar with the community’s resources, they will be routed to another state or the national backup center, NPR notes.
  • Illinois, for example, answered just 20% of in-state calls to an existing lifeline number in the first 3 months of 2022—the remainder were sent out of state.
Great need: 16% of adolescents and 8% of adults in the US had a major depressive episode last year, according to US data analyzed by the Kaiser Family Foundation.

Related: She Writes Woman: Giving Mental Health a Voice in Nigeria – Nigeria Health Watch


The Latest


Nearly 24,000 “grave violations” against children—including killing and maiming—were documented in 2021, according to the Annual Children in Armed Conflict report released by the UN yesterday. UN News
UK officials have downgraded its monkeypox classification from a “high consequence infectious disease,” saying cases aren’t sufficiently severe; 1,500+ cases were  confirmed in the UK on Thursday, a 50% increase over last week. Forbes

Wuhan University has confirmed a cholera case in one of its dormitories over the weekend and has quarantined 3 close contacts; 254 students and others have tested negative. South China Morning Post Thanks for the tip, Xiaodong Cai! 
3 doctors whose Twitter accounts were suspended for posting COVID-19 vaccine misinformation have filed a complaint against the company; 1 of the complainants is internist/immunologist Robert Malone who worked on the process for developing mRNA vaccines. Medscape

COVID-19 News

Where Mantras Trump Medicine, Vaccines Are a ‘Violation’ – The New York Times

EU backs second COVID booster for over-60s, before variant-adapted vaccines are ready – Reuters

How the COVID-19 pandemic affected mental health and wellbeing, key determinants of health, and health inequities – News Medical

COVID vaccines and pregnancy: a review of the evidence shows they are safe – The Conversation

Undercounted Covid-19 cases leave US with a blind spot as BA.5 variant becomes dominant – CNN

Nitric oxide boosts oxygen in pregnant women with COVID-19 pneumonia – CIDRAP


In Life-Threatening Emergencies, Federal Law Trumps State

Health care providers “must” provide abortion services if a pregnant person’s life is at risk, the Biden administration said yesterday—arguing that federal emergency treatment laws offer protection even in states that ban abortions without any exceptions, the AP reports.
  • The 1986 Emergency Medical Treatment and Active Labor Act directs physicians to provide an emergency abortion if it is a “stabilizing treatment” for a patient they believe is experiencing an emergency medical condition such as ectopic pregnancy.
The Quote:
“Today, in no uncertain terms, we are reinforcing that we expect providers to continue offering these services, and that federal law preempts state abortion bans when needed for emergency care,” said Xavier Becerra, Health & Human Services secretary, according to Axios.
Will doctors be reassured? Some states with abortion bans allow medical exemptions—but determining what qualifies as an emergency can be challenging.
  • This uncertainty could “at best, ... make physicians hesitate to save the life of a woman; at worst, outright refuse to,” says Georgetown University’s Lawrence Gostin.


What will US abortion sanctuary networks look like? – Al Jazeera

Why finding accurate facts about abortion has become more difficult in post-Roe America – PBS Newshour



Deadly Delays

The odds were stacked against Yousef Al-Kurd, a 70-year-old in Gaza who needed open heart surgery.
  • Gaza, population 2 million, has just 2 heart surgeons (you’d expect ~55 for the same population in the US or Europe).
  • Medical supplies and equipment are scarce: Some disposable tubes used for heart bypass surgery have been re-sterilized more than 100 times in Gaza.
  • Getting permission to leave Gaza for medical treatment in Israel is nearly impossible.
In a must-read article, NPR journalists shadowed Al-Kurd for months–-documenting endless hurdles and delays but also help from a lawyer and a Israeli volunteer. 
NPR Goats and Soda


Over-the-Counter Contraceptives for the US?

A French pharmaceutical company wants permission to sell its hormone-based birth control pill over-the-counter in the US—setting up a high-stakes decision for the FDA following the Supreme Court’s decision to overturn Roe v. Wade.
HRA Pharma’s application caps off years of research to persuade regulators that  women can safely screen themselves for risks to the hormone-based pills, such as conditions that increase the risk of dangerous—but rare—blood clots.
Contraceptives push: The request comes as reproductive rights advocates step up their efforts to allow more prescription contraceptives—and, eventually, for abortion pills—to be sold over-the-counter.
Worth noting: The pills are already available across much of South America, Asia, and Africa.


Fixed Link to History

In yesterday’s summary on the US FDA’s creation of an advisory panel to examine pulse oximeters’ incorrect readings, especially among people of color, we included an incorrect link. 

Here are 3 studies of the blood oxygen measurement devices going back to 1990:
  • Reliability of pulse oximetry in titrating supplemental oxygen therapy in ventilator-dependent patients – Chest
  • Effects of skin pigmentation on pulse oximeter accuracy at low saturation – Anesthesiology
  • Dark skin decreases the accuracy of pulse oximeters at low oxygen saturation: the effects of oximeter probe type and gender – Anesthesia & Analgesia

Thanks to all the readers who alerted us.—The Editors



Famed Ukrainian medic describes 'hell' of Russian captivity – AP

Complexity in Global Health– Bridging Theory and Practice – Annals of Global Health (commentary)

Trend in Alcohol-Related Deaths Is Higher in Women – Undark

Kenyan BMI study could help influence global health policy – Medical Xpress

SA’s moonlight sonata: The illegal cash cow draining specialist care at state hospitals – Bhekisisa

Tackling typhoid, one finger prick at a time – SCOPE (Stanford Medicine blog)

Doctors forced to work overnight shifts at last minute in NHS staffing crisis – The Guardian

Medical aid in dying is still called 'assisted suicide.' An anthropologist explains the problem with that – The Conversation

Adding salt to your food at the table is linked to higher risk of premature death – European Society of Cardiology via ScienceDaily

5 things to know about the brain-eating amoeba that infected a swimmer in Iowa – NPR

Issue No. 2106

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