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Eric Topol Profile picture
@EricTopol
Jan 11, 2020 • 6 tweets • 8 min read • Read on X
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Why the 2019 @BLS_gov Jobs report is a red flag for American #healthcare: bls.gov/news.release/e…
A thread to explain
1. You may recall that in late December 2017, #healthcare jobs overtook retail to become #1 for the first time in US history
@BLS_gov 2. Since that time, the US has added ~1 million more #healthcare jobs, >50,000 more in 2019 than 2018. No sector grew more in 2019.
(NB Education + healthcare sum is ~90% healthcare related)
@BLS_gov 3. Healthcare added the most jobs throughout the past decade
wsj.com/articles/decem… by @EricMorath @TheAmaraReport
@BLS_gov @EricMorath @TheAmaraReport 4. Human capital, i.e. the workforce, is the #1 driver of costs of healthcare. In the US we now pay > $11,000 per person with the worst major outcomes of all 36 @OECD countries. There are no data to suggest that more labor support will improve outcomes.
growthevidence.com/growth-comment…
@BLS_gov @EricMorath @TheAmaraReport @OECD 5. So this is a feed the (broken) beast model. Nothing is being done to address it; the job growth is just celebrated.
Whereas the UK (which has better outcomes at half the cost) undertook an in-depth review & is implementing many worthy strategies
topol.hee.nhs.uk
@BLS_gov @EricMorath @TheAmaraReport @OECD 6. To break up the vicious cycle, costs have to be lowered. Besides getting rid of administrative waste
(> $812,000,000,000 in 2017, annals.org/aim/fullarticl… @AnnalsofIM),
a reduction in the workforce can be accomplished.

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More from @EricTopol

Eric Topol Profile picture
Dec 9
We're learning how to control the immune response, like a rheostat, even in the brain. Implications for understanding the basis and potential treatment of autoimmune conditions like multiple sclerosis, #LongCovid, #MECFS, and brain cancer.
A brief review of 6 recent, important reports
in the new Ground Truths, open-accessImage
Such as Programming T cells with brain-specific proteins and payloads
@ScienceMagazine science.org/doi/10.1126/sc…
Or peptide fragments of myelin basic protein that suppress the immune response @Nature nature.com/articles/s4158…Image
Read 4 tweets
Eric Topol Profile picture
Nov 13
New @NEJM
A whopping (~90%) reduction of progression to Type 2 diabetes with tirzepatide (GLP-1 drug, dual receptor) vs placebo in a randomized trial of >2,500 participants with obesity, absolute reduction of 10/100 treated

by @AniaJastreboff and collaboratorsnejm.org/doi/full/10.10…Image
In other GLP-1 new publications today
—Country-wide Sweden reduced hospitalizations for alcohol or substance abuse with these drugs
jamanetwork.com/journals/jamap… @JAMAPsych
—Concerns about discontinuation
jamanetwork.com/journals/jama/… @JAMA_current Image
Other new anti-obesity drugs in the pipeline, one that also increases energy expenditure
@NatureNV nature.com/articles/d4158…Image
Read 4 tweets
Eric Topol Profile picture
Nov 13
A dedicated issue of @ScienceTM on #LongCovid
—Sex-specific differences, with perspective by @VirusesImmunity and @SilvaJ_C
—Insights for therapies @AndreaCoxMDPhD
—Deconvoluting "Osler's Web" @MichaelPelusoMD @DeeksSteven @DrMaureenHanson @SaydahSharon
—+RECOVER Trial, Lyme diseaseImage
Image
Image
science.org/toc/stm/16/773
Where we have failed to date: finding an effective therapy. That has to change
science.org/doi/epdf/10.11…Image
Read 4 tweets
Eric Topol Profile picture
Oct 19
An elegant @Nature study by @AkassoglouLab has illuminated our understanding of the role of fibrin (component of blood clots), #SARSCoV2, and brain inflammation in Covid and #LongCovid.
This discovery and more in the new Ground Truths podcast, with transcript, key figures (such as as the one below) and citations. Open-access. Link in my profile.Image
Image
A clip from our conversation. Unknowingly, @AkassoglouLab was gearing up for understanding this complex pathophysiology for many years before Covid hit
For treatment, it's not just as simple as preventing fibrin clots. It's isolating the pro-inflammatory action of fibrin, targeted by the antibody
Read 4 tweets
Eric Topol Profile picture
Oct 9
Covid and increased risk of major adverse cardiovascular events (MACE) 3-years out

2-fold increased for any severity of Covid
~4-fold increase for Covid requiring hospitalization
"a coronary artery disease equivalent"
interaction with non-O blood types
@uk_biobankahajournals.org/doi/10.1161/AT…Image
"A major finding from our analyses was that the risk
of MACE among the subset of hospitalized COVID-
19 cases without known CVD (ie, primary prevention
patients) was comparable to (or even slightly higher than) the risk in patients with CVD, PAD, or diabetes but without COVID-19."
"one of the first examples of a gene-pathogen exposure interaction for thrombotic events"
I think it's the first one documented, likely others to be unraveled
Read 4 tweets
Eric Topol Profile picture
Aug 2
New US Covid genomic surveillance
The KP.3.1.1 variant is on the move to become dominant, more of a challenge to our immune response than KP.3 and prior variants (especially without new KP.2 booster when we need it for high-risk individuals) Image
It's the deletion 31/31 that makes the KP.3.1.1 spike different, but otherwise 2 mutations away from KP.2 (R346T and Q493E) Image
Buckle up; this wave isn't over yet d/t KP.3.1.1's emergence
Read 4 tweets

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