It came it spread it conquered – part 9 – Healthcare and Pharma

It came it spread it conquered – part 9 – Healthcare and Pharma

It came. It spread. It conquered.

Ever since Wuhan reported its patient zero for the novel coronavirus disease 2019 (COVID-19) in November, 2019, the world has not been able to heave a sigh of relief. The virus has penetrated and continues to penetrate into receptacles of almost every country you can name – the burden being distributed asymmetrically. The streets have been deserted, flights and trains have been suspended, companies have come to a standstill, and the common man has been trapped inside the four walls of his own house – for a period of time that even the highest authorities are unable to state. Quarantine and social distancing have taken the role of those uninvited guests in our day-to-day life, who barge inside without a knock. Hygiene and sanitisation practices have taken birth as a new religion, while people all around are going frenzy over immunity boosting techniques. As healthcare and pharma giants worldwide struggle to find a potential cure, SMEs and start-ups are also joining forces and working round-the-clock amid this invisible battle – or rather microscopically-visible battle. Albeit, keeping the possibility of mass commercial availability of a viable vaccine at bay, let us break down and scrutinise the consequences of this pandemic on businesses – sector by sector.

Healthcare and Pharma

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The coronavirus pandemic is one of the worst-ever disease outbreaks – after the Spanish Flu, the Swine Flu, the Black Death, and a couple more – any country could imagine of. What surfaced in China in November 2019 has now become a global crisis affecting 188 countries with over five million confirmed cases and three lakh deaths so far. And, this is not the end: the extent of the damage is beyond imaginations.  Symptoms of COVID-19 include respiratory problems, fever, persistent cough, sore throat, chest pain, diarrhoea, body ache, restlessness, breathlessness, fatigue, and loss of taste sensation; however, scores of instances have appeared where a patient is completely asymptomatic. Like SARS, it spreads through droplets from sneezes and by direct or indirect contact with an infected person. COVID-19 pandemic has stretched healthcare infrastructure of even the most developed countries, and is expected to cause economic recession unparalleled in the recent history.

The first line of COVID-19 defense has been general practitioners, who are engaging with patients and conducting tests to detect COVID-19 infections. practitioners at pathologies and testing departments at hospitals take up that responsibility. Patients with positive test results need to be separated from their family and have to be put into an isolation ward for treatment. (Not to be confused with ‘quarantine’ which refers to separation of individuals who do not show symptoms, but may have come in contact with the virus. For example, people who’ve returned from an international travel or a domestic flight need to self-quarantine themselves for 14 days at their empty houses, or remain in an institutional quarantine under government provided centres. Hence, isolation is for people with positive test results, where as quarantine is for people whom we suspect to have come in contact with the virus). Then, contact tracing is done and all those people who have come in contact with that positive patient have to be quarantined. In case of corona, the number of patients daily started to shoot up at a meteoric rate, with peaks reaching as high as one lakh new cases per day globally and 20 thousand daily new cases in the States. In China, the maximum count of positive cases was 14 thousand, where as, smaller and less populous countries like Italy and Spain started slowly but suddenly began to observe 7 thousand daily cases and 800 daly deaths each. The present situation in India shows around 5 thousand cases and 100 deaths daily. With such a large influx of critical patients every single day, hospitals and doctors had to operate 24/7 with some of them continually on shifts for weeks altogether without break. Almost all hospitals and nursing homes in these major countries reached their maximum capacity in only two to three weeks of the virus hitting their country. They had to install thousands and tens of thousands of new beds for more incoming patients. Hospitals had to convert empty areas such as backyards, basements, cafeterias, and even neighbouring open areas and buildings into new isolation wards. China brought up a brand new fully-functional hospital in 7 days, while back in Mumbai, large spacious open areas such as NSCI club and Wankhede stadium got converted into isolation wards. Furthermore, governments had to shell out fortunes for importing surgical testing kits, medicines, emergency operating equipments, and professional protective equipment (PPE) suits for the medical personnel. Countries like China and India ordered all its major biomedical manufacturing firms to start mass production of medical equipment to meet the extreme scarcity. If some patients started getting critical, they had to be shifted to intensive care units (ICUs) on ventilators. As a result, the demand for ventilators rose up like wildfire all across the world. Doctors and nurses working closely with affected patients started getting infected with the virus as well. This gave rise to reduction in medical staff that was already insufficient for the patients. Thus, governments of major countries had to call all the retired medical professionals and all the medical students who were in their final years, to balance the manpower. The case of BMC Mayor, Kishori Pednekar, who had retired as a nurse long back, returning back to her profession to help the ongoing emergency, caught the headline. Long story short, the healthcare sector has played a pivotal role in fighting against this pandemic. Had it not served as the backbone of the world, humanity might’ve succumbed to the wrath of coronavirus. Below attached is a photograph showing faces of Italian doctors after 72-hour non-stop shift of attending patients.Add alt text

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Doctors and nurses have acted as firewall in between the common man and the coronavirus, but the global emergency demands more than a firewall, i.e., an anti-virus shield. A vaccine will prove to be a lifetime immunity certificate against coronavirus, and all seven and a half billion eyes are towards a potential vaccine that would come to our rescue. Vaccine development generally takes couples of years, with six stages involved:

  • Research
  • Pre-clinical trial (testing on animals)
  • Clinical trial (testing on humans; this also happens in three phases – trial on approx 10 of people, on approx 100 people, and then on approx 1000 people)
  • Approval
  • Mass production
  • Quality AssuranceAdd alt text
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Keeping the current urgency in mind, authorities have asked researchers to directly reach the clinical trial if they find a particular vaccine promising. The authorities have also relaxed the approval process and kept the resources prepared for mass manufacturing beforehand. Vaccine development is one such platform that has brought entire globe on one platform and all firms are working in synchrony. As of May 22, 2020, as many as 200 vaccine candidates are being tested across five continents; with 30 of them in India, including standalone researches and collaborative projects with international pharma agencies. Out of those 30, six are touted as the ‘best candidates’, and three out of those six are already under human trials. Following is the COVID-19 drug and vaccine summary of the planet till date:

  • Hydroxychloroquine (HCQ) a drug majorly produced in India to fight malaria, has been claimed to provide some respite to COVID-19 patients. On March 21, 2020, President Trump claimed that these drugs were “one of the biggest game-changers in the history of medicine.”  In May, UK started trials for doses HCQ paired with chloroquine. However, nothing can be said about the long-term effects of HCQ as of now.Add alt text
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  • The plasma therapy in India, which showed promising results, has been speculated as possibly risky, although crisp evidence is still being hunted.
  • Pune-based Serum Institute of India developed a vaccine in collab with the Oxford University and got good results in pre-clinical trials.
  • PGI Chandigarh’s Sepis treatment drug coupled with mycobacterium w adjuvant, is another promising candidate.
  • Mumbai-based Glennmark and Bengaluru-based Strides have started clinical trials of antiviral drug favipiravir.
  • Antibody testing or serology testing is also in full swing in India. Antibody testing is also under examination by NHS, UK.
  • UK’s unnamed vaccine developed from adenovirus by Oxford Univ has show strong results, but ChAdOx1 nCoV-19 from the same Univ failed on monkey trials affecting them with coronavirus.
  • Israel Institute for Biological Research (IIBR) and another Israeli firm MigVax are very strong vaccines showing promising outcomes.
  • Rome’s infectious-disease Spallanzani Hospital stated that they are on an advance stage of checking vaccine on humans. Also, Italian researchers have described the results beyond expectations.
  • Currently, the mRNA-1273 vaccine by American company Moderna is the most potential candidate all across and all eyes are glued on its further results.Add alt text
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