Has your doctor's office called you to explain your risks of severe symptoms or dying from the novel coronavirus?
Has the billions of dollars spent on "big data" afforded the CDC with information they can share with Americans and the world on who is at highest risk?
If you answered "no," please read on.....
Anecdotal, but sensible, data shows that people with pre-existing conditions die from the disease at much higher rates compared to healthy people. However, all the information sitting in electronic medical records are doing very little, if anything, to help us make key decisions like:
who is truly at highest risk
who may go back to work
when can we open the economy
who needs to wear a mask
who needs a doctor consult.... and so forth
This just proves one simple point. The $3-4 Trillion Americans are spending on healthcare looks in the rear view mirror only and doesn't provide any information about what is in that tunnel you are about to enter. And our systems are not adequately integrated to mine the data that is there. These are not independent problems - they are interconnected. That is, they both exist and need to be solved together.
Here are a couple of questions?
1. Are we all the same?
Therefore if you have a diagnosis of heart disease, do you have the same risk of dying from COVID-19 as someone else with a diagnosis of heart disease? May I suggest the answer is no. Heart disease is a nice term but it doesn't give any real definition to your risk or how profound your condition is. Everyone with heart disease lies on a vascular health "continuum." Where you are on this continuum is what you need to know, and, of course, is your condition progressing or regressing based on interventions. The "endpoints" we use today are not strong enough to protect you.
2. I'm managing my condition - so I'm OK, right?
Study after study demonstrates that drug management of any chronic condition seldom increases longevity and often leads to other health problems. The best example is the ACCORD study that show diabetics, who very tightly control their blood sugar - with insulin, for example - die at much higher rates from complications of diabetes when compared to diabetics whose sugar was not as tightly controlled.
3. If I don't have a diagnosis of a disease or am on a treatment, them I'm at low risk, correct?
Unfortunately, more than half the people who develop severe chronic disease symptoms, do so suddenly. The medical community still cannot predict who may die from a heart attack or develop cancer. I guess cholesterol just isn't that predictive. Therefore there is a whole segment of our society that is "apparently well" while actually being at high risk of disease and dying from COVID-19, by extension.
The best response to a pandemic or any chronic disease is to achieve true health. This means your physiology, measured with biomarkers, show little or no risk, you are medication-free, and you feel great most, if not all of the time.
But what tests do I need - and who came up with them.....
This paper, by the Chinese, (https://doi.org/10.1016/S0140-6736(20)30211-7)
Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
set the tone for how to triage / risk stratify people with COVID-19.
Harvard Medical School, through Mass General Hospital, now risk stratifies hospitalized COVID-19 sufferers using the information provided in the Chinese paper:
Now you may know why Big Data and Healthcare has failed you. Healthcare is hung up on cholesterol, A1C and BP measurements. Yes, A1C is measured by Harvard, but that's the only test that is commonly acquired in a clinic visit that shows up on this list. And, A1C is actually a weak, backwards-looking marker for diabetes compared to fasting insulin.
Don't we want to look forward rather than backwards?
US and Globally - Healthcare is NOT running proper tests to look forward at your risk for the coronavirus pandemic - or chronic diseases, for that matter.
Italy reports the following from a sample of 355 people who died of COVID-19. At the time of this study, it represented 18% of all deaths in Italy from the disease.:
If there is a silver lining to the novel coronavirus pandemic, I hope it is a significant change to healthcare, with focus on measuring risk, not just "disease."
Get healthy, stay alive!
If you don't have access to testing, your next best action is to take any of these surveys:
Free 10 minute COVID-19 consults are now available. Write to me at firstname.lastname@example.org and provide your phone number.
Thomas J. Lewis, Ph.D.