Counting The Cost Of Pandemics

By Robert Ward

As soon as the world saw what was happening with COVID-19 coronavirus (SARS-CoV-2) in China, it was clear that there would be significant problems elsewhere. But as recently as just 60 days ago (Note: article written 3/18/20), few knew what we were in for.

The ripple effect, from both the virus and the public reaction to it, has touched businesses and organizations, large and small, across all industries and sectors. Major conferences like Mobile World Congress and SXSW have been postponed or canceled altogether. Major League Baseball has delayed the start of the season, the NBA has canceled the remainder of theirs. Schools and universities are closed. Businesses are shuttering temporarily. Even Disneyland closed. Governors and mayors have imposed draconian restrictions on the movement of millions of citizens.

We’ve seen previous pandemics, but we haven’t seen anything like this.

There have been dozens of pandemics throughout history with significant human toll. In just the last century, we saw several deadly viruses that wrought havoc in both economic and human costs. COVID-19 appears to be in class all its own. No one knows with certainty what the long-term effects will be on the global economy, and the full spectrum of learnings and insights to be gained will take some time to fully digest.

Estimates from any number of national and global financial institutions suggest that before we’re through with this virus, the international financial costs will be in the several trillions of dollars. That doesn’t begin to account for longer-lasting impacts on trade, investment, and work. At this stage of the game, no one can or should try to predict with certainty what the final tally will look like, but it is safe to say that the global impact will be considerable.

General containment measures, such as quarantine of individuals who are not sick, a staple of infectious disease control for centuries, are being used. It has been critical in efforts to slow down the spread or “flatten the curve.”

Quarantine measures came late when the threat was clear, so we can expect a more tightened approach going forward. It is also expected that our government leaders will open the pathways for early testing to become more readily available.

WHAT WE CAN LEARN FROM THIS PANDEMIC

There is a lot that can be learned from this pandemic not just about disease management protocols, but also in how we enable our medical community to act preventatively. We know it is better to fix the roof ahead of the storm.

Like other pandemics, COVID-19 has raised a necessary magnifying glass to the cracks in our treatment provisions. That view lays bare how ill-prepared our health systems around the world are when it comes to combating contagions like we’re seeing with this virus.

It is fair to say that public health professionals, physicians, other scientists, and innovators have made the treatment and defeat of killer infections a priority. We’ve seen a plethora of attempts to cure the next big thing in the last century and more. But too often the most aggressive efforts are reactive. We’re seeing that with COVID-19. What we need is a structure to encourage proactivity, and we cannot ignore that need when this pandemic is behind us.

For example, when the curve is flattened on COVID-19 and the immediate medical emergency is behind us, we will still be wrestling with the enormous potential consequences of antibiotic-resistant infectious diseases. Like COVID-19, the spectrum of that risk is enormous in both material and human terms.

There is a tendency to start broad and go narrower when we’re fighting a vigorous pandemic as we are today. Without known therapies or a proven vaccine, we cast a wide net to control the spread of the infection. We’ve seen that, in this case, with the public health measures encouraging social distancing to slow the potential spread. Once we learn more about the microbial enemy, we narrow the approach to a specific set of therapies or controls.

Apart from the context of this pandemic, we see the same thing in the hospital with patients suffering from sepsis. The beginning is nearly always the same — a broad-spectrum antibiotic infusion. The goal, initially, is to avoid missing a specific pathogen that is causing the problem. When there is a narrowed lab diagnosis, the treatment choices can be narrowed to target a specific pathogen.

Yet with the very best clinical intentions, we’re not doing well enough with the acute challenges we face with COVID-19 or the chronic challenges we face with sepsis and antibiotic-resistant pathogens that were here before this pandemic and will be here when it is behind us.

Setting COVID-19 aside for a moment, the WHO estimates that antibiotic resistance could lead to an additional 10 million deaths a year by 2050. As we stand here in 2020 then, we have a choice to make: Will we wait for the pandemic spread of the next drug-resistant contagion or will we be proactive with the way we think about preventing that next global risk?

WE NEED A NEW APPROACH

From what we have already learned from COVID-19 in just a few short months, it is clear that a different approach is needed. We must adopt a multipronged approach to tackling contagious diseases, and we cannot rely on the effective reaction or the varying efficacy of global health systems to keep us safe.

It is proven that we cannot rely on drug discovery or vaccine development after an outbreak occurs. To do that is to continue to blindly chase the next pandemic. Instead, we need to support real preventive innovations in therapy that are at the root, preventive. The human and economic tolls are too great to do otherwise.

We need to consider approaches available now that could be pathogen ‘agnostic’ and ensure that these novel approaches get proper visibility. It would be shameful if a mature technology is not supported which would be effective now, and in the future, simply because it doesn’t fit the expected mold of infectious disease interventions.

Funding and incentives for medical device development is the first step in enabling innovation. The opportunities are too great, and the costs, relatively incremental. It is where the smart money should be spent now. Opening new pathways for technological advancements in medicine will reduce the enormous human and economic costs that come with pandemics while also allowing hospitals and healthcare providers to deliver the best possible care to patients. That is all that really matters.

COVID-19 has dealt a sharp blow. In the last century – with Influenza, Ebola and other vicious contagions as teachers – we have failed to learn the lessons we might have. But there is still the opportunity to chart a new path forward beginning now. We have to start with an incentive for creative weapons to battle the biggest health threats – in particular, the ones that don’t yet exist today. This will require us to consider a combination of unconventional technologies and simple proven solutions. Those may come in addition to, or in combination with, the use of more conventional anti-infective drugs.

As we watch the COVID-19 numbers grow – both in terms of those infected and the associated costs to the world economy – we need to be working to build a future in which pandemics are a thing of the past.

Robert Ward is president and CEO of ExThera Medical Corporation.