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In science and health policy news this week:Real versus Satire?Unfortunately, mostly real. I am pondering some evidence based posts on...

In science and health policy news this week:
Real versus Satire?

Unfortunately, mostly real.

I am pondering some evidence based posts on evidence bases…

TLDR: Pertussis is awful, and can be severe, vaccination rates dropping all over contributes to MASSIVE surges, we have good vaccines to...

TLDR:
Pertussis is awful, and can be severe, vaccination rates dropping all over contributes to MASSIVE surges, we have good vaccines to help
but
the overall antivax resurgence plus underresourcing of public health means some who wouldn't have died will die.

Pertussis vaccine (combo pertussis/diptheria/tetanus) is >80% effective - under vaccinated 3X more likely infected....

Pertussis vaccine (combo pertussis/diptheria/tetanus) is >80% effective - under vaccinated 3X more likely infected. https://shorturl.at/De28r.
Immunization in pregnancy lowers risk for babies-but sadly antivax messaging in pregnancy makes things complex
https://shorturl.at/h7GxN

Pertussis can be cyclical, therer may be some post pandemic flare after lower circulation, BUT many countries have seen lower vaccination...

Pertussis can be cyclical, therer may be some post pandemic flare after lower circulation, BUT many countries have seen lower vaccination coverage over the past 5 years (often more around 70% fully immunized rather than >80%).
Misinformation spillover.
https://shorturl.at/JS9tl

It's nasty at any age, but for babies: about 1/2 are hospitalized, they can get pneumonia, encephalopathy with seizures, possible brain...

It's nasty at any age, but for babies: about 1/2 are hospitalized, they can get pneumonia, encephalopathy with seizures, possible brain damage, and up to 2 % die. The bacteria is in airways, starts like a cold, antibiotics don't help (may reduce spread)

https://shorturl.at/SJerM

Vaccination protection drops over time and a "nuisance" bad cough illness in youths and adults can spread pertussis in the...

Vaccination protection drops over time and a "nuisance" bad cough illness in youths and adults can spread pertussis in the community to vulnerable babies who get initial vaccines at 2 months and to vulnerable adults: vaccine in late pregnancy can pass protection to newborns

Worldwide issues: Spain, the UK, the Philippines, Netherlands, Croatia, Serbia, Denmark multiple US and Canadian regions have major...

Worldwide issues: Spain, the UK, the Philippines, Netherlands, Croatia, Serbia, Denmark multiple US and Canadian regions have major increases (many in the realm of 5-10X increases) - still 90% lower than the prevaccination era but that uptick is going UP.
https://shorturl.at/EIqf3

When a cough can kill: pertussis (vaccine preventable!) I've seen increasing pertussis #- like a 2702% rise in Brazil (about 6000 versus...

When a cough can kill: pertussis (vaccine preventable!)

I've seen increasing pertussis #- like a 2702% rise in Brazil (about 6000 versus 200 cases) 2023-24 in Brazil, with 27 deaths, mostly in babies. There is likely more case finding-testing in people with care access

So…Building up primary care teams with varied expertise, and fair remuneration would pay off across the health system. ButNot seeing...

So
…Building up primary care teams with varied expertise, and fair remuneration would pay off across the health system.
But
Not seeing anyone moving down that road presently….those changes would improve public health care access, but NOT gain profits for shareholders.
10/10

who may not have any specific training or experience in diagnostic assessments, or in some cases, maybe practising in a belief system that...

who may not have any specific training or experience in diagnostic assessments, or in some cases, maybe practising in a belief system that doesn’t correlate with current evidence basis medicine, although may be “sciencey looking.”
9/10

And with even less quality control, people doing virtual $ doc in a box assessments that often result in frankly inappropriate referrals...

And with even less quality control, people doing virtual $ doc in a box assessments that often result in frankly inappropriate referrals (Neurologist referral for headache, with no physical exam done ?) that clog things further- or,
seeing “alternate” providers,
8/10

I’m seeing our health structures dissolving here -fragmentation between parts of acute care and community and long-term care making things...

I’m seeing our health structures dissolving here -fragmentation between parts of acute care and community and long-term care making things more difficult, loss of structures that use to support practice improvement, and people forced to seek care in walkins, emerg
7/10

Most docs are good people. It can be a punishing job so many are in it for their patients. Other health professionals with nursing and...

Most docs are good people. It can be a punishing job so many are in it for their patients. Other health professionals with nursing and pharmacy backgrounds can provide complementary expertise, but that’s often most efficient in a team- working their strengths together.
6/10

(AND they have to deal with new TiKtok diagnoses with possibly angry patients!) Interruptions to health services in the pandemic really...

(AND they have to deal with new TiKtok diagnoses with possibly angry patients!)
Interruptions to health services in the pandemic really showed how crucial good longitudinal primary care can be to keep people (eg diabetic patients) well and out of hospital. It’s been rough.

5/10

It’s pretty lean for a lot of situations - and exploits many docs/small business owners/employers. The vet thing made me ponder- family...

It’s pretty lean for a lot of situations - and exploits many docs/small business owners/employers.
The vet thing made me ponder- family docs are often devalued- they take on huge work hours and responsibility for less per hour take home than some skilled trades.
4/10

if I went to MY doc for possible hypothyroidism, government would pay my doc (dep on who- how long) maybe 25-40 dollars on my behalf. Lab...

if I went to MY doc for possible hypothyroidism, government would pay my doc (dep on who- how long) maybe 25-40 dollars on my behalf. Lab work?-free. AND my doc would pay their nurse office staff team, office rent, decor, gauze, equipment from that.

Whelp.

3/10

Last visit I thought if labs are often inconclusive he seems the same why and I spending 300-500 a visit? And, then thought of 🇨🇦 vs...

Last visit I thought if labs are often inconclusive he seems the same why and I spending 300-500 a visit?
And, then thought of 🇨🇦 vs 🇺🇸 a bit
If we had private medicine where you worry about insurance or just pay, you might choose to wait on things. Possibly scary.
2/10

I took my dog to the vet (he’s older but very rarely ill) - for a limp but came out with maybe hypothyroidism and elevated liver enzymes....

I took my dog to the vet (he’s older but very rarely ill) - for a limp but came out with maybe hypothyroidism and elevated liver enzymes. So labs visit only costs 360. Animal lab values can be harder to interpret too so not sure it helped.
1/10

Non infection post.This just made appreciate my book wall and look suspiciously at my computer. Go hug a book. “We have absolutely no idea...

Non infection post.
This just made appreciate my book wall and look suspiciously at my computer.
Go hug a book.
“We have absolutely no idea how durable cloud storage is but I know archival paper lasts three centuries and we should think long and hard before abandoning it.”

tend to focus on the positive benefits and say "science" and doctors recommend" - and underplay the potential side effects....

tend to focus on the positive benefits and say "science" and doctors recommend" - and underplay the potential side effects. It may still be a reasonable option, but people should have ALL the info to help them assess if it is worth it to them.