The Health Care Blog – Page 157 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Everyone has a role to play: Reducing your child’s risk of developing food allergies

Jul 17, 2020• 2

By RUCHI GUPTA, MD, MPH

The average American elementary school class includes two students living with one or multiple food allergies. That’s nearly six million children in the United States alone. And these numbers are climbing. There was a staggering 377 percent increase in medical claims with diagnoses of anaphylactic food reactions between 2007 and 2016, two-thirds of these were children.

As parents, we want the absolute best for our children. For many years, guidance around food introduction was unclear. Parents were told that babies, and especially those considered at risk for food allergies, should avoid some allergy-causing foods such as peanuts until they were three years old.

But thanks to ongoing research from our nation’s top allergists and immunologists, we are beginning to learn more and more about food allergies, including what new and expecting parents can do to reduce the risk of their children developing food allergies. In fact, studies now show that introducing a variety of foods early is the best course of action and has been shown to reduce the occurrence of certain food allergies like peanuts for many children.

For instance, the partially FARE-funded Learning Early About Peanut Allergy (LEAP) study showed a remarkable 80 percent reduction in peanut food allergies in high-risk infants who were exposed to peanut foods at a young age. Shortly after LEAP, there was the Enquiring About Tolerance, or EAT, study. This project, led by top medical researchers at Kings College London, found significant reductions in allergies to both peanut and egg after introducing small amounts of the foods into infants’ diets. The LEAP-on study soon followed, and had the same children from the original LEAP study remove peanut from their diets for 12-months. The results showed that they maintained their tolerance to peanut, indicating early introduction to babies can result in long-lasting protection from peanut allergy.

THCB Gang, Episode 18 LIVE 7/16 from 1PM PT/4PM ET

Jul 16, 2020

Episode 18 of “The THCB Gang” was live-streamed on Thursday, July 16tth! Watch it below.

Joining Matthew Holt were some of our regulars: writer Kim Bellard (@kimbbellard), policy & tech expert Vince Kuraitis (@VinceKuraitis), MD turned leadership coach Maggi Cary (@MargaretCaryMD), and guest Suneel Ratan, GM of Collective Medical Technologies (@CollectiveMed)! We discussed ACOs & fee-for-service problems, what the future of care looks like as a result of the November elections, and how to serve communities that are socioeconomically disadvantaged with calls to #DEFUNDHealthcare. Give it a watch below if you missed the live version

If you’d rather listen, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels — Zoya Khan

The Trump COVID Legacy: Bad Timing. Lots of Questions. Few Answers.

Jul 16, 2020• 2

By MIKE MAGEE, MD

What a strange irony. Trump decides, full-bravado, to challenge China to a trade war just months before China unwittingly hatches a virulent pandemic that collapses our deeply segmented health care system and our economy simultaneously. And rather than cry “Uncle”, our President then fires the WHO just as their experts are heading to China to attempt to unravel the mystery of COVID-19.

With the ongoing, cascading catastrophe of Trump’s mishandling of COVID-19, it is easy to lose sight that the next pandemic (fueled by global warming, global trade, and human and animal migration) is just around the corner. And we haven’t even begun to nail down the origin story of this one.

Unraveling the transmission trail requires international cooperation. As one expert recently noted, “Origin riddles for other new infectious diseases often took years to solve, and the route to answers has involved wrong turns, surprising twists, technological advances, lawsuits, allegations of cover-ups, and high-level politics.”

What we do know is that there are originators, intermediate hosts, and human super-spreaders….and COVID-19 appears to have begun in China. These are not new insights. We’ve seen this playbook before.

Health in 2 Point 00, Episode 135 | Amazon’s primary care entry, UnitedHealth’s digital DPP & more

Jul 15, 2020• 1

Today on Health in 2 Point 00, it’s the 4th shoe! On Episode 135, we’ve got Amazon’s entry into primary care through its pilot program with Crossover Health, UnitedHealth Group launching Level2, their own digital health diabetes prevention program, Health Catalyst acquiring healthfinch, Truepill raising $25 million and then investing in Ahead, a company which matches psychiatrists to patients. —Matthew Holt

The 2020 Pandemic Election

Jul 15, 2020

The 2020 US election will be vicious, with a nasty pandemonium following a nasty pandemic.

By SAURABH JHA, MD

When the COVID-19 pandemic is dissected in the 2020 presidential election debates, Donald Trump will be at a disadvantage. The coronavirus has killed over 100,000 Americans and maimed thousands more. The caveat is that deaths per capita, rather than total deaths, better measure national failure, and by that metric the US fares better than Belgium, Italy and the United Kingdom. New York City owns a disproportionate share of the deaths, but this hyperconnected megapolis is an outlier whose misfortunes can’t be used to draw conclusions about administrative competence for the country as a whole.

Nevertheless, even after introducing nuance, the numbers aren’t flattering. President Donald Trump may claim that the US dodged the calamity predicted by the epidemiological models, which foretold millions of deaths. To be fair, we don’t know the counterfactual — Jeremiads aren’t verifiable. The paradox of successful mitigation is that we can’t see the future we dodged, precisely because we avoided it.

Reducing the death count logarithmically, rather than merely arithmetically, won’t be celebrated because as bad as the worst case scenario could have been, the situation still looks awfully bad. Many still disbelieve the high death toll predicted by epidemiologists early on, particularly Trump supporters who believe the response to the virus, specifically the economic shutdown, has been criminally disproportionate. One can’t simultaneously believe that COVID-19 is no more dangerous than the seasonal flu and that Trump saved millions from the coronavirus. The constituency that acknowledges the lethality of COVID-19 and credits Trump for decisive action against it is small.

Triangle of Incompetence

Trump’s challenger, former Vice President Joe Biden, will charge that fewer Americans would have died had the Trump administration acted earlier. Trump may be accused of having blood on his hands, but such rhetoric is unnecessary. Biden’s team can simply show a montage of Trump’s bombast where he downplayed COVID-19’s lethality, dismissed doctors’ concerns about the shortage of personal protective equipment or exaggerated how well the US was containing the pandemic. Incidentally, the most iconic picture of the administration’s scornful indifference is the current vice president, Michael Pence, visiting a hospital without a mask, surrounded by health-care workers wearing masks.

Health in 2 Point 00, Episode 134 | Health Tech’s “PPP Blacklist”, Walgreens and VillageMD, & more

Jul 14, 2020

Today on Episode 134 of Health in 2 Point 00, Jess and I cover Livongo’s stock price swinging, Brian Dolan’s PPP “Black List” for Health Tech Startups, and Oak Street Health & GoHealth filing their S-1’s. We also get Matthew’s take on Walgreen’s deal with Village MD to become a primary care center, and Doctor on Demand closing a $75M round, bringing its total to $235M in funding —Matthew Holt

Virtually Better

Jul 14, 2020

By KIM BELLARD

The COVID-19 pandemic couldn’t have come at a better time for virtual reality. It has caused many workers to work remotely, introducing many workers to collaborative tools like Slack or Microsoft Teams and even more to video platforms like Zoom or Skype. But we’re just beginning to understand what collaboration could look like — such as virtual reality (VR).

As CNBC noted: “Virtual reality is booming in the workplace amid the pandemic.” Even a pre-pandemic Perkins Coie survey, done for the XR Association, predicted an explosion of immersive technologies like VR, augmented reality (AR), and mixed reality (MR). Elizabeth Hyman, President of XRA, said: “We are at the precipice of an integration of XR technology that will transform businesses and society for the better.”

The report expected healthcare to be the industry most impacted by immersive technologies (outside of gaming/entertainment).

Take VR-start-up Spatial, which thinks it has a better mousetrap. Chief Product Officer described their solution to MIT News:

Spatial is a collaborative, holographic, augmented reality solution. You can teleport to someone’s space, work as an avatar sharing that 3D space, and use it instead of a screen to manage a project, present an idea, and more.

Don’t you love the “and more,” as though the teleportation wasn’t enough?

Doctors and Democracy: Why Vote-By-Mail is Good Public Health

Jul 13, 2020

By ROB PALMER, ISAAC FREEDMAN, and JOSH HYMAN

Suppose tomorrow you were informed that patients could no longer have medications delivered to their homes. Thus, in the midst of the worst pandemic in recent history, your patients would have to go to pharmacies to get essential medications. Undoubtedly, you’d be puzzled, wondering why your patients must needlessly put themselves and others in harms’ way to care for their own health. In light of the change, you might even debate if it’s worth the risk of getting your own medications.

Thankfully, the common-sense practice of delivering medication to people’s homes seems here to stay. Yet many people will face a similar issue on election day this November: Fifteen states severely restrict who can vote by mail. In these states, millions of citizens will be forced to choose between exercising their right to vote and safeguarding their own health.

So long as SARS-CoV-2 remains a threat, in-person voting is a public health crisis. Unless we want to risk a spike in new COVID-19 cases, with the concomitant deaths and strain on the healthcare system, it is critical to ensure that anyone who wants to vote in the upcoming general election can use mail-in voting. Indeed, a peer-reviewed study published in May found a statistically significant increase in COVID-19 cases in the weeks after the Wisconsin primary, specifically in counties with higher in-person votes per voting location. The study also found a decrease in COVID-19 cases in counties with the highest rates of absentee ballots. Unsurprisingly, the study’s authors exhort policy makers to “expand the number of polling locations or encourage absentee voting for future elections.”

We Are in Store for the Greatest Change to Our Health Care System Since the Affordable Care Act. Here’s Why.

Jul 10, 2020• 1

By LOGAN CHO

The COVID-19 pandemic has been harsher and lasted longer than many of us would have predicted. While our media has been inundated with updates on death tolls and economic depression, there has been little conversation of healthcare beyond the era of COVID-19. The first question that we ask when we hear of deaths: was it COVID? We have grown to expect the primary cause of death to be of coronavirus. But the impact of COVID-19 will extend beyond the individual, effecting fundamental and long-lasting change to our healthcare system.

By this point, it is clear that the public health ramifications are reaching well beyond the physical impacts of the virus. Social isolation, economic depression, soaring unemployment, and mandated closures all contribute to the adversity that we have had to face – notwithstanding the explosive, ever-present sociopolitical climate of a pandemic that is killing Black Americans at a rate almost three times that of whites. This hardship will likely last for months more.

A recent Kaiser Family Foundation publication found that half of the public have skipped or postponed medical care due to the pandemic, with one-fourth reporting worse health as a result. Many of these people do not plan to receive the care they need within the next three months. The public is simultaneously reporting declines in mental health. Furthermore, over 30% say they have had difficulty paying for household expenses, like food, rent, and medications. The figures are disproportionately damning among Black and Hispanic populations.

Taken together, the inaccessibility of medical care, deteriorating mental health, increasing poverty, worsening access to nutrition, and host of other challenges present a dark, impending storm. Cancer, diabetes, and other chronic diseases will all be rearing their untreated heads post-pandemic. Communities and policymakers must therefore act quickly and decisively to heal not only a sick population, but a fraying social fabric.

A Conversation with John Ioannidis

Jul 9, 2020• 17

By SAURABH JHA, MD

The COVID-19 pandemic has been a testing time for the already testy academic discourse. Decisions have had to be made with partial information. Information has come in drizzles, showers and downpours. The velocity with which new information has arrived has outstripped our ability to make sense of it. On top of that, the science has been politicized in a polarized country with a polarizing president at its helm.

As the country awoke to an unprecedented economic lockdown in the middle of March, John Ioannidis, professor of epidemiology at Stanford University and one of the most cited physician scientists who practically invented “metaresearch”, questioned the lockdown and wondered if we might cause more harm than good in trying to control coronavirus. What would normally pass for skepticism in the midst of uncertainty of a novel virus became tinder in the social media outrage fire.

Ioannidis was likened to the discredited anti-vax doctor, Andrew Wakefield. His colleagues in epidemiology could barely contain their disgust, which ranged from visceral disappointment – the sort one feels when their gifted child has lost their way in college, to deep anger. He was accused of misunderstanding risk, misunderstanding statistics, and cherry picking data to prove his point.

The pushback was partly a testament to the stature of Ioannidis, whose skepticism could have weakened the resoluteness with which people complied with the lockdown. Some academics defended him, or rather defended the need for a contrarian voice like his. The conservative media lauded him.

In this pandemic, where we have learnt as much about ourselves as we have about the virus, understanding the pushback to Ioannidis is critical to understanding how academic discourse shapes public’s perception of public policy.