7 days in healthcare (August 7th-13th, 2023)

 

Summary

From the point of view of Biomedicine, the NEJM insists on the need to prepare doctors for the new era of clinical algorithms, since misuse of these algorithms can be dangerous for patients. MIT advances may make conventional mammograms obsolete, as a “wearable” device can detect breast cancer using ultrasound. New facts are detected in relation to the growth of resistance to antibiotics: a species of virus parasites and air pollution. In any case, the United Nations says that by 2050 these resistances could represent more than 10 million deaths a year. Walking 4,000 steps a day can lower your risk of death from any cause.

As regards Global Health, Chris van Tulleken, famous doctor and TV presenter, is publishing a book on “ultra-processed food”, those whose manufacturing process makes them rich in calories, poor in nutrients and difficult to stop eating them, which poses a major health threat. In the United States, cases of syphilis are increasing, while penicillin to treat them is in short supply, given the low interest in the production of antibiotics by pharmaceutical companies.

Regarding International Health Policy, it should be noted that the WHO monitors the new variant of covid (EG.5), although it classifies its impact on public health as low. In the United Kingdom, a laboratory is created capable of launching new vaccines 100 days after the start of any pandemic. Let us remember that in the case of the covid the term was one year, which already represented a remarkable feat, something never seen before. Also in the United Kingdom, both private equity companies and the CEO of AXA, detect great business opportunities in the face of the great crisis of the National Health Service, something that should not surprise anyone, since the market is characterized by solving unsatisfied problems for what the population is willing to pay. The Nuffield Trust publishes its monthly monitoring of NHS performance, with particular monitoring of test and surgical waiting lists, cancer waiting lists, emergency room waiting times and ambulance response. A laudable initiative, which could well be imitated in our country.

If we talk about National Health Policy (Spain), although the measurement of the covid is not as rigorous as a few months ago, there are indirect indications that the incidence must be rising, as shown in the large increase in the sale of the antigen tests. The Sant Pau hospital begins an ambitious multidisciplinary Robotic Surgery program, which includes five surgical teams. Madrid launches the figure of the administrative assistant in Primary Care, something hopeful, but whose results will have to be seen.

In the field of Companies, internationally, Novo Nordisk and Lilly ready to conquer the promising obesity market. At the national level, anti-obesity drugs also enter our country, although of the three that exist (Ozempic and Wegoby, from Novo Nordisk; and Mounjaro, from Lilly) in Spain, only Ozempic is available and the public system only prescribes it for type 2 diabetes, not for obesity. The consolidation of the nursing home sector accelerates: Colisée, Vitalia, Clariane (formerly Korian), Domus Vi and Vivalto Vie, the most active players.

Biomedicine

• Article in the NEJM: Physicians must be prepared for the era of clinical algorithms. The FDA began regulating these algorithms as medical devices, since poorly designed algorithms can cause problems for patients. This will have consequences for preclinical medical education and continuing education (https://www.nejm.org/doi/pdf/10.1056/NEJMp2304839)
• MIT Breakthrough: Wearable Ultrasound System May Detect Breast Cancer Earlier, may end Conventional Mammograms (https://news.mit.edu/2023/wearable-ultrasound-scanner-breast-cancer-0728)
• Small “hitchhikers” (literal translation: hitchhikers, a species of virus parasite) can promote resistance to antibiotics. United Nations estimates say that by 2050 deaths from antibiotic resistance may exceed 10 million lives per year (https://www.economist.com/science-and-technology/2023/08/09/tiny-hitchhikers-on-viruses-could-promote-resistance-to-antibiotics)
• A study suggests that antibiotic resistance is linked to air pollution. Although the study shows a correlation between pollution and antimicrobial resistance, a causal relationship has not been demonstrated (https://www.ft.com/content/7c57e077-3656-45d0-a6c4-167b2f6e921f)
• Walking just 4,000 steps a day may lower the risk of death from any cause (https://www.theguardian.com/society/2023/aug/09/revealed-walking-just-4000-steps-a-day-can-reduce-risk-of-dying). Original article from the European Journal of Preventive Cardiology: https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwad229/7226309?login=false
• Wegovy, Novonordisk’s weight-loss drug, reduces strokes and ischemic heart problems, according to a clinical trial (https://www.ft.com/content/b8617703-2608-4d2e-8d39-6d4ab1176ffd)

Global Health

• Book by Chris van Tulleken, doctor and TV presenter: ultra-processed foods are harmful because they are high in calories, low in nutrients and it is difficult to stop eating them. They dominate the diet in rich countries and are spreading rapidly in low- and middle-income countries. Processing can turn healthy foods into harmful ones (https://www.economist.com/the-economist-explains/2023/08/07/what-makes-ultra-processed-foods-so-bad-for-your-health)
• Syphilis cases increase in the USA amid shortages of penicillin. The incidence of syphilis the highest in 70 years, while there is a shortage of penicillin, given the low interest in antibiotic production by pharmaceutical companies (https://www.thelancom/journals/lancet/article/PIIS0140-6736(23)01665-3/fulltext#:~:text=Syphilis%20cases%20in%20the%20USA,number%20of%20cases%20since%201950.)
• Why hospitals in Nigeria lose their staff, especially doctors and nurses. They go to the USA, UK, Canada and Saudi Arabia (https://www.economist.com/emiddle-east-and-africa/2023/08/10/why-nigerias-hospitals-are-losing-their-staff#)

International Health Policy

• COVID19
  • Weekly covid report published by WHO, 10 August 2023. While five WHO regions have shown a decrease in cases and deaths, the Western Pacific region has shown an increase in cases and a decrease in deaths. covid is still a major threat. Maintaining surveillance and reporting is critical (https://reliefweb.int/report/world/covid-19-weekly-epidemiological-update-edition-155-published-10-august-2023)
  • On August 9, 23, the Director General of WHO publishes a statement to all States on how to address covid in the long term (https://cdn.who.int/media/docs/default-source/documents/ihr/covid-19_standing-recommendations_9-august-2023.pdf?sfvrsn=805ad4e4_8&download=true)
  • The WHO monitors the new variant of covid (EG.5) and classifies its impact on public health as low (https://gacetamedica.com/politica/la-oms-vigila-la-nueva-variante-del-covid-eg-5-and-classifies-as-low-its-impact-on-public-health/#:~:text=The%20WHO%20has%20indicated%20that,related%20to%20this%20new%20variant.)

• USA
  • Suicides increase by 2.6% in the USA (https://www.consalud.es/profesionales/suicidio-aumenta-26-en-eeuu-alcanzando-49000-record-2018_133359_102.html#)
  • Tech companies criticize government attempts, supported by broad sectors of healthcare, to regulate AI in healthcare (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01667-7/fulltext)

• United Kingdom and National Health Service
  • The United Kingdom opens a vaccine laboratory to have new vaccines in 100 days (https://www-ft-com.ezp.lib.cam.ac.uk/content/b3567166-fe85-4242-8252-25d5393835a6)
  • Private equity companies ready to invest in the face of NHS waiting list problems (https://www.ft.com/content/94184d66-517b-4893-8e06-df16efd135b3)
  • NHS problems offer business opportunities, according to the CEO of AXA (https://www.ft.com/content/d0d7e7d2-fe90-40b9-ab54-5821d5921a2b)
  • The UK doubles its investment in the life sciences industry (https://www.economist.com/britain/2023/08/08/britain-double-down-on-the-life-sciences-industry)
  • The Nuffield Trust launches a new version of its NHS performance tracker, where the waiting lists for both surgery and tests, cancer waiting lists, and emergency waiting times are monitored on a monthly basis. , and the speed of response of ambulances (https://www.nuffieldtrust.org.uk/qualitywatch/nhs-performance-summary)

• European Union
  • The EU increases its investment in R&D in health (https://www.consalud.es/industria/paises-europeos-incrementan-sus-assignaciones-en-i-d-83-esta-destinado-salud_133154_102.html)

National Health Policy

• COVID
  • The new eris variant, more contagious, alerts doctors to the rebound in covid (https://www.epe.es/es/sanidad/20230810/repunte-covid-nueva-variante-eris-contagiosa-alerta-90853454)
  • The sale of antigen tests for covid doubles in less than a month (https://www.eleconomista.es/salud/noticias/12399452/08/23/la-venta-de-test-de-antigenos-para-covid-doubles-in-less-than-a-month.html)

• Medical conflict
  • The doctors of Ceuta and Melilla, the only ones that depend on the central Administration, appeal to the EU after five months of strike (https://www.abc.es/sociedad/medicos-ceuta-melilla-apelan-ue-after-five-20230810191454-nt.html)

• Public health innovations
  • Hospital Sant Pau starts a multidisciplinary Robotic Surgery Program that includes five surgical teams. Hepatobiliary and pancreatic surgery (HBP), Bariatric and Esophagogastric, Colon and Rectal, Gynecology and Thoracic Surgery (https://gacetamedica.com/profesion/el-hospital-sant-pau-inicia-un-programa-de-cirugia-robotica-multidisciplinary-that-includes-five-surgical-teams/#:~:text=They are%20five%20the%20surgical%20teams,and%20Thoracic%20Surgery%20(CTO).)
  • Madrid eliminates the bureaucracy of doctors with the figure of the administrative assistant (https://www.redaccionmedica.com/autonomias/madrid/madrid-empieza-a-liberar-de-burocracia-a-sus-medicos-con-una-new-figure-4733)

• Pharmaceutical supply
  • More than 900 drug presentations suffer from supply problems in Spain, 2.72% of the country’s total portfolio, made up of 33,149 therapy presentations. 0.33 of the drugs in this situation are not substitutable by others (https://www.eleconomista.es/salud/noticias/12398876/08/23/mas-de-900-presentaciones-de-medicamentos-sufren-supply-problems-in-spain.html)

• Healthcare  concessions
  • Vox puts pressure on the PP in the Valencian Community to return to the form of concession in the hospitals that went under public management (https://www.eldiario.es/comunitat-valenciana/vox-presiona-pp-generalitat-valenciana -privatize-new-hospitals-returned-gestion-publica_1_10437351.html)

Companies

• International News
  • Novo Nordisk and Lilly, ready to conquer the obesity market (https://www.eleconomista.es/salud/noticias/12403548/08/23/novo-nordisk-y-lilly-velan-armas-para-conquistar-the-obesity-market.html)
  • Lilly has great success with its commitment to drugs against Alzheimer’s and obesity (https://www.ft.com/content/7381859b-d5c3-4349-887d-2f3f010aea55)
  • Novo Nordisk, maker of anti-obesity drugs, improves its sales predictions (https://www.ft.com/content/710c1048-7717-4553-a831-9e13ff27fb6c)
  • AstraZeneca signs a vaccine agreement with the Chinese company Cansino (https://www.ft.com/content/89a2e92b-6771-44fe-8958-b4b21f8bbe3d)
  • AstraZeneca buys Pfizer’s gene therapy portfolio for 1,000 million (https://www.eleconomista.es/salud/noticias/12399469/08/23/astrazeneca-compra-la-cartera-de-terapia-genica-de-pfizer-for-1000-million.html)
  • J&J and Roche unseat Pfizer from leadership in sales after covid (https://news.eseuro.com/negocio/2074036.html)

• National News
  • The new drugs against obesity enter Spain, where only Ozempic, from Novo Nordisk, is available. There are also Wegoby (also from Novo Nordisk) and Mounjaro (from Lilly) (https://elpais.com/salud-y-bienestar/2023-08-08/las-nuevas-drogas-contra-la-obesidad-reducen-up-to-20-the-risk-of-infarction-and-stroke.html#:~:text=The%20pharmaceutical%20Novo%20Nordisk%2C%20manufacturer,cardiovascular%20in%20people%20with%20overweight&text=L)
  • Investor boom in nursing homes, consolidation is accelerating. Colisée, Vitalia, Clariane (formerly Korian), Domus Vi and Vivalto Vie seek purchases to grow in Spain (https://www.eleconomista.es/capital-riesgo/noticias/12404756/08/23/boom-inversor-en-nursing homes-the-consolidation-accelerates.html)
  • Hipra and Accord Healthcare reach an agreement to market the covid vaccine in the United Kingdom (https://www.consalud.es/salud35/economia/hipra-accord-healthcare-acuerdo-comercializar-vacuna-covid-reino-unido_133102_102.html#)

 

 

 

This post is also available in: Spanish