Myoung Cha Profile picture
Jan 28 15 tweets 6 min read
1/ With the announcement of @AkiliLabs going public to accelerate their pipeline for ADHD, here are some thoughts on the intersection of gaming with health and why I believe video games (and perhaps the metaverse) might be a big part of the future for healthcare. $AKLI 🧵 Image
2/ One of the most exciting projects I worked on at @Apple with my HSI team was a health game powered by the Apple Watch called LumiHealth with the @sporeMOH in Singapore. Your behaviors in the real world mirror the mechanics of the game, earning your character (and you) rewards Image
3/ Apple recently reported some of the Year 1 results of LumiHealth last fall with some impressive milestones:
- 200k users participating in 7m challenges
- 39% increase in exercise minutes overall
- 88% increase in exercise minutes for sedentary groups

apple.com/sg/newsroom/20…
4/ There have been a number of activity-based wearable “games” that have launched, including a number from insurers around the world that have paired the “Earn Your Watch” mechanic with the Apple Watch Activity Rings.

aarp.org/home-family/pe…
5/ The engagement rates for these programs are often unbelievably high — higher than popular social media apps on a variety of well-known metrics like MAU, DAU/MAU, power curves.

This is the opposite of most episodic healthcare utility apps that payors and providers offer.
6/ Going back to LumiHealth, the most exciting thing the 1-year data suggests is the sustained increase in physical activity of a very large cohort, in particular the most sedentary users.

Just 10 min of daily walking can prevent thousands of deaths!

nytimes.com/2022/01/26/wel…
7/ For a sedentary population, a little nudge from a game might be a literal game-changing intervention for longer-term health; other countries might take notice of what Singapore is trying to do.

A drug that provided the exercise benefits of LumiHealth would be a blockbuster.
8/ Separate from full-blown games, the integration of game mechanics into health apps is bound to grow — goals, streaks, badges and rewards, competition. The Activity Rings are one of the most popular features of the Apple Watch because of a simple engaging game mechanic. Image
9/ It is outdated to think that games are only for the young. Games are the most popular category of the App Store by far, enjoyed by people of all ages.

aarp.org/home-family/pe…
10/ This is a good thread on why video games may be good for kids and explains in layperson’s terms why Akili “works” for ADHD.
11/ What Akili and digital CBT apps have demonstrated is the connection between games and mental health & neurocognitive function. Whether these benefits are “proven” through clinical trials, it seems games allow people to connect socially, stay mentally sharp, and reduce stress
12/ As for the future, the still-popular Pokemon Go foreshadows how health gaming might work in the metaverse, in particular when AR becomes more mainstream.

forbes.com/sites/jvchamar… Image
13/ Beyond “brain” games and programs, health is about what you do in the “real world”, not inside a digital universe. If AR can be designed to keep you engaged with the world around you, the opportunities to weave health into everyday life could be endless.
14/ I especially like @ZombiesRunGame, which “motivates” you to run away from zombies in an imaginary epidemic while you walk or run.
15/ To weave all of this together with web3 (how could I resist?), the marriage of coins with health games could be a way for people to “power up” their metaverse avatars through healthy behaviors. @Sweatcoin is a prototype of what this could become.

sweatco.in

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More from @cha_myoung

Jan 25
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.
Read 13 tweets
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🧵 Image
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. Image
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!
Read 12 tweets
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
Jan 16
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
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
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

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