Science making the impossible, possible!! Albert Bourla – grand keynote at #TiEcon2022

I am eagerly looking forward to the opportunity to hear Dr. Albert Bourla give a grand keynote on Day 2 at #TiEcon2022 in May at Santa Clara, CA.

As Chairman and CEO, since 2019, Dr. Bourla has led Pfizer through one of its greatest challenges when the world was looking to scientists and pharmaceutical companies for answers to the sudden calamity represented by covid.  In a rare mode of cooperation and unprecedented speed, scientists began furiously working for a vaccine. However, their work was also proceeding against a backdrop of political drama that was unfolding in the USA. 

Very likely scientists and leaders of pharmaceutical companies had no interest in maneuvering the political minefield and yet it became unavoidable when Mr. Trump predicted a breakthrough vaccine  before Election Day. News of Pfizer’s success however, only arrived right AFTER the election was called for Joseph Biden. The story of Pfizer and its research partner, the German firm BioNTech, both of who declined the money from the federal effort, “Operation Warp Speed” and Moderna who accepted the money from the Government that was led by science denying President Mr. Trump, unfolded against the backdrop of politics, science, and incredible high stakes for humankind. The resulting accomplishments by these companies and others are as fascinating as they are impressive. Bourla was awarded the 2022 Genesis Prize for his leadership in the development of the Pfizer-BioNTech Covid 19 vaccine.

During his 25+ years at Pfizer, Bourla has emphasized his commitment to help ensure equitable healthcare access to medicines and patients. However, Bourla also opposes government interference in pharmaceutical pricing, which he has argued would hamper spending on development of new drugs.  As per a recent RAND Corporation report, US prescription drug prices are higher than in most other countries. The Biden Administration released a plan to decrease prescription drug costs covered by the Medicare program, and later dropped the initiatives, after objections from some key Democrats. Bourla has observed that drug prices are in fact going down and more importantly, drug prices are only a small portion of the overall US healthcare spending.

It will be fascinating to hear Mr. Bourla speak on these and other health and healthcare related issues at TieCon2022. During covid challenges, when many prayed as never before for the lives of their loved ones, world also realized that besides the divine, our next best hope for better life rests in the hands of #science.

Register ASAP for the #TiEcon2022 conference at @TiEcon www.tiecon.org to access early bird incentives.

Covid updates – July, 2020

Here are some covid updates from last couple of weeks. I have gathered info from zoom sessions. For more details, accurate sources, and veracity, please research further.

• CA expecting 19000+ deaths by Nov. 1
• US covid deaths top 150,000
• More than 6,300 covid cases in the US, are linked to colleges
• After some decline in people dying, now daily death counts are rising in 21 states
• 47% (that is, almost half the population) of US adults have some underlying condition that slightly increases the chance of severe covid illness
• Blood glucose level of 7 or higher leads to 33% chance of dying 60% chance of contraction
• Spain had 2,255 more cases in last 24 or so hours.  Britain imposed quarantine on travelers from Spain
• WHO warns of new EBOLA outbreak in Congo
• China reports biggest virus spike since end of Wuhan outbreak
• India has the fastest growing coronavirus cases in the world
• 23% of Delhi residents seem to have antibodies 
• North Korea is reporting their first covid case
• Plastic visors in place of masks are NOT effective
• Israel & Japan experience huge spikes in covid cases
• Chinese study found that people with type 2 diabetes had shorter telomere length
• Study found that aerosoles in covid patients’ rooms, had live virus floating around even after 5-6 days
• Research found no transmission of covid from infected moms to newborn babies, even after 2 weeks of breast feeding with proper cleaning protocols
• In another study, pregnant women who had virus, their placenta also had virus
• Study says mosquitoes cannot pass on covid from infected patients to non infected patients
• From 3334 patients with covid in NY hospitalized, 16% had DVT, stroke or heart attacks
• Presence of virus in the gut likely means that virus takes longer to leave the system and would lead to higher risk of liver injury
• Spain study found that about 5% of those who contracted covid  in large cities had antibodies while only 3% of those of contracted covid near the coast, had antibodies
• In one study, over 50% of people who contracted covid show some heart damage
• 85 babies under age 1 tested positive in one county in Texas
• Overwhelming fatigue, palpitations, muscle aches are symptoms that linger for 4-6 weeks after recovery from covid

On potential vaccines & treatments & safety products

• There are 42 potential vaccines — Most in phase 1, 14 of them are in phase 2 and 4 are in phase 3 
• Oxford/ AZ vaccine results look good in phase 1 / 2
• China’s Sinopharm is in phase 3 trial for covid vaccine
• Cage Bio developed sanitizers that offers protection for up to 4 hours
• Steroid treatment slightly reduces the need for mechanical ventilation 
• A client has very exciting and fascinating prevention strategy. If interested in investing then let me know & I’ll put you both in contact.
• Boehringer Ingelheim identified 28 new antibodies to fight the virus

Coronavirus: Treatments and Vaccines

Recently a science teacher said that treatment for covid with remdesivir or hydroxychloroquine is better than a vaccine. I said, treatment like that is good but a vaccine is better. She said, “no. since many people get adverse reactions from vaccines, a treatment is better”. So I decided to write this blog post. First, let us consider what are drug treatments and how they are different from vaccines.

Drug treatments: Currently over 70 companies are working on various drug treatments for novel coronavirus. Although this virus is novel, not all drugs being considered are entirely novel. For instance, like the previously considered malaria drug, hydroxychloroquine, Gilead’s drug, Remdesivir, that is in the news, is not a novel drug. Remdesivir is a broad spectrum antiviral drug that has been found to successfully prevent MERS coronavirus in rhesus monkeys. Besides antiviral drugs, there are other anti-inflammatory drugs. Scientists believe that in the end, what might work may be a sort of a cocktail or some combination of antiviral and anti-inflammatory drugs.

Drug treatments do not prevent Covid-19. These drugs are offered to patients who are already suffering from coronavirus. On the other hand, vaccines prevent people from contracting the disease in the first place.  

Drug treatments are not cures. 1) there isn’t a 100% response rate among people treated with remdesivir or any other treatment. So despite many drugs showing promise, there are a few people who will respond to a drug; many still die. 2) many who suffer from the disease but go on to recover, they still utilize huge amounts of hospital resources during their illness phase. 3) during the illness phase, these sick people also spread the virus with the possibility of making others (including healthcare professionals) sick. 4) even people who may recover with the help of these drugs from covid, may have suffered substantial damage to their lungs and that may reduce their lifespan or affect them in other ways.

Vaccines:  Vaccines prevent people from getting sick. So when people don’t get sick, they don’t spread the virus, don’t utilize healthcare resources, don’t infect healthcare professionals or others in the community, and don’t get any kind of long lasting damage to their lungs. Clearly, vaccine is a far superior way to deal with coronavirus.

Why are vaccines taking much longer than drugs for covid?

As I mentioned above, many of the drugs considered currently for treatment of covid are already in existence for some other illnesses or diseases. So there are existing drugs considered for either preventing covid deaths or preventing people from becoming sicker and helping them recover faster and ending hospital stays earlier.

Vaccines on the other hand, have to be developed. There are considerable challenges at each stage of vaccine research, development and manufacturing. First of all, pharmaceutical companies have decreased vaccine research and development in the last several years, because vaccine development and manufacturing is expensive, time consuming and offers smaller payback in terms of revenues. For each new virus and for all mutations, the vaccine has to be developed and then when the virus is not active then the vaccine is not useful. Clinical studies take place during the research and development phase. Only if the studies show the vaccine to be safe and effective then the vaccine proceeds to the next phase where it has to be manufactured in large quantities required.

During a pandemic like this one, not only do we need a vaccine quickly but the world will also need  hundreds of millions of doses for the entire world population.  Fortunately, pharma companies, scientists from all over the world, billionaires like Bill Gates and Governments and countries have stepped up to tackle this challenge, with an unprecedented spirit of collaboration.  There are measured expectations for an effective vaccine to be available within 12 to 18 months. That is an unprecedented and highly aggressive timeline. Bill Gates has offered to support manufacturing of top 7 candidates during the research and development phase. That means, even without the proof of effectiveness of any of them, he will foot the bill for manufacturing all of them, in the hope that at least a couple of them will prove to be safe and effective and the world will get required doses speedily. Meanwhile, countries like India are getting ready for manufacturing of vaccines. India has proven capability and expertise to ramp up production of vaccines, while keeping costs down. Regulatory hurdles are likely to be less severe as US FDA and other regulatory bodies have promised EUA (emergency use authorization) for drugs and vaccines that may help contain covid.

If drugs like Remdesivir work then that will help some people recover and recover faster; so let us hope that any one of these drugs alone or in combination with other drugs will reduce mortality, shorten hospital stays, and help reduce spread of covid. But ultimately we need a vaccine for covid-19 and the way in which entire world is coming together, gives much hope for availability of a speedy vaccine.

Herd Immunity for Covid-19?

Have you noticed only politicians and some lay people talk about #HerdImmunity? Scientists and business people seem to be talking about #testing, cure and vaccines. Amazon is planning its own tests just for their own workforce. Some of my clients are doing the same. Chemicals for covid-19 diagnostic tests are hard to find but businesses may tap into their global connections to acquire them.

So what is herd immunity?

Herd immunity is an epidemiological concept coming from an idea that ultimately if enough people in a population are immune to a disease then it stops spreading. For instance, if 80 people out of 100 can’t get the disease than the 20 people who can get it remain protected because they may be unlikely to actually get exposed.   

Herd immunity can be achieved in a community in one of the two primary ways.

1) Vaccine access and acceptance:

If a significant number of people get access to the vaccine, they accept it and avail of the opportunity and become non carriers of the virus then even if 5% may not have gotten the vaccine, they may not get the disease because there may not be enough people to get it from. But we don’t yet have a vaccine for coronavirus.

2) Virus has a free rein: 

This is how the politicians have been speaking of herd immunity. Herd immunity is also connected to the argument that the best way to end the social distancing is to allow the virus to run free or at least almost free and in the end the population will achieve herd immunity. This sounds like a creative new idea rather than something horrifying that we should try to avoid at all costs. But let us remember that this only happens after VAST numbers in a population, get infected. So that requires us to “sacrifice the vulnerable on the altar of the economy in vast numbers.”

What kind of vast numbers of fatality might we be speaking of? As per some estimates, herd immunity for Covid-19 can occur after at least 60 to 70 percent of the population develops immunity.  That means at least 60 to 70 percent of the people have to first get infected. Moreover, these have to be random infections. That means, several people would die with a highly contagious virus running free in a society, before herd immunity is achieved.  This would overwhelm our healthcare system and several healthcare professionals would die while working in a high virus load environment.

Even with all our social distancing measures in place, we have a high death count that has brought healthcare system on the brink of overwhelm, in many places. In New York, a dense state with high international travel, there was a death count of almost 15,000 in a population of less than 10M. Healthcare professionals from several other geographical regions traveled to New York to lend help. Can you imagine every state taxed that way beyond their maximum capacity to care for the patients? And that is the reason that scientists and business leaders are not advocating herd immunity as an ultimate preventive measure. We can be lay people and choose to remain ignorant and spread the forwards and myths about herd immunity OR we can listen to what science has to say over what the politicians may be advocating.

Summit, IBM supercomputer is our recent hero in the fight against Covid-19

The looming threat of Covid-19 and the grim reality of the toll that novel coronavirus takes on humankind, makes it imperative that we find a way to prevent the spread faster and with less cost. Currently nine out of ten drug therapies fail mostly between phase 1 trials and regulatory approval. The estimated cost of developing a new treatment is around staggering US $2.6 billion.  While this article won’t address it, I want to mention that many bio/pharma companies are working with repurposed drugs to find a cure and at least 69 drugs have been identified as treatment possibilities. Drugs also have side effects and need to be tested for safety. Let us focus for a while on search for the vaccine.

Many companies including Moderna, CureVac and BioNTech are working on vaccines. With the help of  Machine Learning, Artificial Intelligence and other technologies the hunt for new pharmaceuticals and appropriate chemicals is expected to be quicker, cheaper and more effective. Novel coronavirus presents the most unprecedented challenge to date because of the speed with which it spreads. 

Who better than a supercomputer made by a company that has been on the cutting edge of innovation for over a century, to take on this speed challenge? IBM scientists instructed the world’s fastest computer to tackle this challenge at its Oak Ridge National Laboratory in Tennessee. Summit can run 200 quadrillion computations per second. The scientists ran thousands of simulations to analyse which drug compounds could stop the coronavirus from infecting the host cells. 

Summit, an IBM supercomputer equipped with the “brain of AI” identified 77 compounds (from over 8000 compounds) that could be efficacious in preventing coronavirus from spreading in the host.  This is promising news in humanity’s quest for an effective vaccine against the virus. These findings are published in the journal ChemRxiv and give us hope although road is still long to get there.

With increasing computer processing power and advanced algorithms, AI has been employed to analyze large data sets with greater efficiency and will likely lead to many exciting innovations.  While AI and ML show promise to change every industry sector for the better, artificial intelligence, machine learning and deep learning have become the most widely discussed topics in the healthcare sector and the excitement keeps growing.  

I will be looking forward to hearing about new innovations AI/ML at #TiEcon2020. Stay tuned for new dates for the conference at http://www.tiecon.org and on this blog.

Healthcare and High-tech combining to combat Coronavirus Covid-19

As coronavirus is raging on, entrepreneurs and scientists are called upon to come up with innovative ways to deal with this deadly virus. For instance, after 11 Israelis were quarantined after disembarking from a cruise ship in Japan, Israel has become a “Living Lab” for technologies to treat the virus.  Israel, which has a large digital health sector, put out calls to entrepreneurs for proposals for new solutions to contain and combat the disease. Meanwhile, China is also taking a lead in exploring how futuristic technologies powered by artificial intelligence can help identify coronavirus symptoms, find new treatments, and track the spread of the disease.  Chinese scientists sequenced its genome and shared around the world within weeks.

 

Unlike MERS, but more like SARS, Coronavirus is very contagious and has a long incubation period when people feel fine as they unknowingly walk around, infecting others. After identifying infected people, it is challenging to care for them while trying to contain the disease. Some healthcare workers who cared for coronavirus patients have themselves died of infection. We also heard that even after learning of highly contagious and deadly CD-19 coronavirus, some healthcare workers from the USA were “improperly deployed” when sent to assist in bringing home the patients infected in China.

 

In caring for coronavirus patients, human touch needs to be avoided and assistance should be provided remotely. Robots and automated technologies are of great help here. Robots are being used to disinfect rooms, take laundry items, help check for symptoms and disease progression, deliver medications and communicate with family and healthcare providers.  Robots help disinfect surfaces and help in killing viruses and bacteria by emitting ultraviolet light.  Drones and self-driving vehicles can deliver medications and supplies, petrol public places, spray disinfectants and do general surveillance. 

 

Silicon Valley’s largest entrepreneurship conference, TiEcon 2020 has a dedicated track on health technologies. Amidst growing fears of coronavirus becoming a pandemic, emerging technologies like drones, robots, Artificial Intelligence, Machine Learning Digital Health and TeleHealth are likely to be game changers. Investors and entrepreneurs alike are focusing on the space with great interest. There will likely be exciting conversations as entrepreneurs from several countries (depending on travel restrictions), converge at TiEcon 2020, at Santa Clara Convention Center in CA, on May 8 and 9. If interested, you can register for the conference at www.TiEcon.org