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Myoung Cha

Jan 25 • 13 tweets • 6 min read

1/ Japan has fared better throughout COVID than most western countries (146 deaths/million vs. 2,590 deaths/million in the US) despite:
- Very low public trust in gov’t
- Less trust in science
- No mandates

How has this been done and what can we learn? 🧵
nytimes.com/2022/01/24/opi…

2/ This trope around Confucius societies “winning the COVID-19 war” with “authoritarian mentalities” doesn’t neatly apply to Japan where only 4% of people surveyed in 2020 say they trust the government “a lot”, compared to 9% in the US and 12% in the UK.

wellcome.org/reports/wellco…

3/ Japan has led the way with vaccines among the G-7 without a government mandate and way higher vaccine hesitancy pre-COVID than the U.S.

4/ Many who oppose vaccine mandates and strong government response to the pandemic point to the Japanese approach as a way forward in the US, UK, and other countries, but this misses a key cultural and historical context.

eppc.org/publication/ja…

5/ While the 3C's slogan was important, the concept of “jishuku” (self-restraint) was a big reason the message worked in Japan without mandates or coercion, a theme revisited at various times in Japanese history — including the 3/11 Fukushima disaster.

tandfonline.com/doi/full/10.10…

6/ This collectivist concept of “jishuku” doesn’t really exist in the U.S., which ranks #1 in the world in individuality versus other countries ("we're #1!").

7/ This “extreme” individualism serves countries like the US well in many ways — entrepreneurism, competitiveness — but the pandemic required us to play a team sport to beat the virus in a society where everyone wants to play tennis or golf.

freakonomics.com/podcast/the-pr…

8/ Can you believe that the US is still somehow ranked #1 in pandemic preparedness? I am guessing the rankings don’t take into account how hardwired our individualism is in society.

ghsindex.org/country/united…

9/ Collectivism also predicts mask use in a country. Not surprisingly, mask use in Japan is amongst the highest in the world.

pnas.org/content/118/23…

10/ Even with the N95 giveaway in the US, will people use them?

cnn.com/2022/01/19/pol…

11/ In retrospect, the altruistic messages about working together and helping each other might have been feel-good but the wrong approach. Maybe a more “selfish” message around vaccinations and masks would work better.

usatoday.com/story/opinion/…

12/ Perhaps something more graphic and hard-hitting needs to be the uncomfortable message that needs to be broadcast to “save yourself", which hopefully persuades people to make their own decisions versus the kicking and screaming against vax mandates.

tobaccofreeflorida.com/blog/powerfula…

13/ The other crazy idea is to appeal to people’s competitive drive. Maybe more things like this?

alabamapublichealth.gov/covid19vaccine…

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Myoung Cha

@cha_myoung

Jan 23

1/ The pandemic has felt endless, so the beginnings seem like a distant memory. Does anyone remember the worst-case model of 1.5-2.2m deaths that the White House used to “shock and awe” in March ’20?

To date, there have been 864k deaths in the US.

A look back below🧵

2/ Before this press conference, Trump compared COVID to the flu with only “22 deaths”, “life & the economy go on.”

Sound familiar?

If only the current death rate — with all of the advantage of our vaccines and therapeutics — were as low as the flu today.

https://twitter.com/cha_myoung/status/1477422069251915777

3/ The current 7-day average of COVID deaths is 2k+/day with yesterday's number of 3,866 deaths being one of the worst days ever during the pandemic.

At this rate, this is a 20-50x difference from what the average flu season is like!

https://twitter.com/cha_myoung/status/1477422069251915777

Read 12 tweets

Myoung Cha

@cha_myoung

Jan 18

My ten “surprises” in healthcare for 2022 — events that the average person would only assign a one out of three chance of taking place but which I believe have a better than 50% likelihood of happening. Styled after Byron Wien’s annual predictions. 🧵

blackstone.com/news/press/byr…

#1: There is at least one new variant that emerges in 2022 that drives another omicron-sized surge of cases and hospitalizations, putting renewed stress on the healthcare system.

#2: Employers capitulate in mandating in-person return-to-work (with a few notable exceptions) for 2022. A widely distributed workforce enhances the value proposition of national, scaled healthcare players and virtual solutions.

Read 11 tweets

Myoung Cha

@cha_myoung

Jan 16

@CarbonHealth

1/ How “mild” is omicron?

When compared against Delta hospitalization and death rates, the numbers look better.

When you look at how sick people are when they seek care, the data tells a different story.

Some data from @CarbonHealth since early December 2022 thru present🧵

2/ Symptomatic COVID+ patients are showing up to our clinics with more symptoms than COVID- patients presenting with flu-like symptoms:

3 or more symptoms: 58% (+) versus 43% (-)
4 or more symptoms: 38% (+) versus 25% (-)

3/ Most common COVID+ symptoms are cough (65%), sore throat (51%), headache (45%), and runny nose (45%).

COVID+ symptoms are 1.5-2.0x overweight cough and fever compared to COVID- patients

Read 6 tweets

Myoung Cha

@cha_myoung

Jan 13

1/ Even with the Supreme Court invalidating the Biden vaccine mandate, large companies are likely to take matters into their own hands with “sticks” (versus “carrots”). Even with a “mild” variant, economic consequences are significant enough to impact corporate behavior 🧵

2/ With hospitalizations surging (with fewer deaths) among the unvaccinated, the bill will come due at some point — to the tune of $20,000+ per hospitalization.

healthsystemtracker.org/brief/unvaccin…

3/ Beyond hospitalization costs, the higher case rates of unvaccinated people have implications for productivity loss due to absence along with short-term disability costs. Chart below shows the trend for NYC.

Read 11 tweets

Myoung Cha

@cha_myoung

Jan 10

1/ With the omicron wave putting untold pressure on staffing across a wide variety of industries, it is not inconceivable for these staffing shortages to become more “endemic” with behaviors that have likely changed forever. 🧵

2/ An estimated 5 million people are isolating at home due to omicron, which could “deal a significant hit to the economy over the next month or two.”

wsj.com/articles/omicr…

3/ In historical flu seasons, the current omicron-driven work absentee rate would be ~2x the average peak of workplace absence due to all illnesses in the US (largely flu).

Read 14 tweets

Myoung Cha

@cha_myoung

Jan 6

1/ One of the biggest policy failures over the last 2 years is the lack of COVID testing, particularly evident now with omicron — both the supply and the quality of what we have available at scale. Where is our Operation Warp Speed for diagnostics? 🧵

2/ Based on the sheer scale of testing volume, it’s clear many are concerned with exposure to omicron and are not yet “done with COVID”. Labs are reporting >1.5 million PCR tests per day right now. But this is a massive underestimate of the total volume w/antigen tests in the mix

@AbbottNews

3/ Based on recent disclosures, the leading antigen test kit mfg. production volumes right now are estimated to be ~120 M tests/month

@AbbottNews: 50 M/month
@QuidelDX: 70 M/month

This is ~4x the reported daily PCR volume with a clear hunger for even more from consumers.

Read 16 tweets

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