“Unless we understand how best to measure this, then…how do we open up society? How do we open up the world?” asked Dr. Jessica Mega, Verily’s chief medical officer, at a Techonomy roundtable I moderated entitled Testing, Tracking, Treatment, and Tech. To measure things will require platforms, a major theme of the discussion. Verily, a medical innovation subsidiary of Alphabet, has deployed its Project Baseline platform to help tens of thousands of Americans find testing for COVID-19, working in partnership with Rite-Aid, among others, and expects Project Baseline’s applications to grow steadily.
Paul Meyer co-founded the Commons Project, after years building disease surveillance systems in developing countries. It is building a non-profit public platform, Common Health, to aggregate medical data and put it under the control of individuals. Both that platform and Project Baseline had been under development for some time before the crisis hit, but have been reoriented for the age of COVID-19, because they can help measure and monitor a population at sudden collective risk.
Redeploying and reorienting resources and projects came up again and again. Jim Weiss, CEO of W2O, a healthcare-focused marketing communications firm, has many decades of experience in pharmaceuticals. He noted that some kinds of drug research, like relating to cancer, has been suddenly put on hold in order for researchers to reorient towards COVID-19. But it also turns out that many cutting-edge immunotherapies being tested for cancer and inflammatory diseases could prove valuable against this new virus. “Immunology is actually a common science to this,” he said. Meanwhile, prior to the crisis research for antiviral and antibacterial drugs had languished, but has now been suddenly revived, Weiss explained. He even expects genetic research to be reoriented to study whether variations in the effects of COVID-19 may be in part based on genetic differences.
All of this will be urgently needed. Even as we work rapidly towards therapies and vaccines, said Dr. Mega, “the best epidemiologists are projecting months of waves of this virus.”
As we began the session, we polled attendees, who were overwhelmingly pessimistic about whether the U.S. will have the medical and social infrastructure in place to open up the country by late summer (hardly an aggressive prospect given that many governors are opening up already). A full 61% were either not at all confident we’ll be ready, or certain we won’t be. As for testing, 78% want to get tested, but have either been unable to get one or haven’t yet tried. The 4% who had gotten tested all said it was hard to do so. As for who will best build solutions for our collective problems, 43% expect it will be the tech giants, and the remaining 57% said only public/private partnerships or some other consortium-style efforts will suffice.
Common Health’s COVID-19 efforts are aimed at assisting with what Meyer called a massive societal shift to a “public health mindset.” Corporate human resources departments, for example, Meyer points out, are among those suddenly turning their focus towards public health, though they’re not expert in it. Companies want to bring employees back but will need to track their healthcare status. But that is fraught because of privacy challenges. Common Health aims to be an intermediary, connecting at the back end to test results for COVID-19 and for antibodies, as well as, eventually, vaccination records. While that data will remain under the control of the individual employee, companies will be able to use Common Health to determine an individual’s status in order to help maintain a safe workplace. The Common Health platform aims ultimately to be a universal repository for privacy-protected healthcare data about individuals.
The question of immunity came up repeatedly. Weiss said that most people he talks to don’t believe longterm immunity is likely, either from infection or vaccination. He noted that would be similar to the flu. We don’t get immunity after we have it. And with COVID-19, we’ll probably have to go every year or two to get a booster shot of any eventual vaccine, he said. But on the positive side, Weiss invoked several experts who believe a vaccine offering at least short-term immunity will be available as early as the end of this year. Its use will likely be restricted to health care and other essential workers. It will be years before everyone has regular access to vaccines, simply by walking into a pharmacy. He recalled how little the world knew about HIV when the AIDS epidemic first arose. “But of course, now it’s a treatable disease.” Are we going to get a similar handle on this one? “Yes, we are,” he said.
What about the much-discussed “herd immunity”? What if we all just got exposed and hoped for the best? “The problem,” said Mega, “is that we’re still figuring out who actually goes on to have...very severe respiratory symptoms, or cardiovascular symptoms…We’re seeing clotting disorders in some people…The idea of just unleashing everyone is not…a good idea.”
You may have heard about the idea of so-called “immunity passports,” which document that someone has had the disease. Meyer called that “dangerous.” “What are the consequences,” he asked, “if people get different kinds of testing, given that there is still uncertainty about the validity, false positives, false negatives, and so forth?” He calls the idea that, for example, some buildings may allow people in only if they have had tests “scary, given the uncertainty around testing.”
Mega ended on a big-picture thought: “If there’s a silver lining here, it’s that there has never been a better time for partnerships, and for compassion.”
Weiss made a more down-to-earth point. Are you going to get on a plane in 2020, I asked him? No, he replied, he would not.
Techonomy drew on its live audience during the roundtable to conduct a few polls. Here are the results: