The governors of Washington, California and Oregon on
Monday announced they were working on a joint plan for reopening their
states’ respective economies once it is safe to lift coronavirus-related
restrictions.
“COVID-19 has preyed upon our interconnectedness. In the coming
weeks, the West Coast will flip the script on COVID-19 – with our states
acting in close coordination and collaboration to ensure the virus can
never spread wildly in our communities,” Oregon’s Kate Brown (D),
California’s Gavin Newsom (D) and Washington’s Jay Inslee (D) said in a statement Monday.
“We are announcing that California, Oregon and Washington have agreed
to work together on a shared approach for reopening our economies – one
that identifies clear indicators for communities to restart public life
and business,” they added.
The plan will address particularly vulnerable populations at sites
such as nursing homes and long-term care facilities, building up
hospital surge capacity even once the pandemic recedes, addressing the
virus’s indirect effects on disadvantaged communities and ensuring that a
system for testing, tracking and isolation of patients is in place
after restrictions are lifted.
“COVID-19 doesn’t follow state or national boundaries,” the governors
added, saying they will also each develop state-specific plans. “It
will take every level of government, working together, and a full
picture of what’s happening on the ground.”
The West Coast, one of the hardest-hit regions of the country in the
early stages of the pandemic and home to some of the first areas to
impose aggressive social distancing measures, has seen hopeful signs
even as leaders strongly encourage citizens to continue maintaining
social distancing to continue the trajectory.
California has seen 21,794 confirmed cases of the virus
and 651 deaths from the virus as of Monday, while Oregon has seen 1,527
cases and 52 deaths and Washington has seen 10,224 cases and 491 cases.
The announcement came the same day a coalition of governors in the
Northeast unveiled a similar pact.
“We didn’t start with a timetable. We said want it ASAP,
but we want it smart. This is about being smart first, not political,”
New York Gov. Andrew Cuomo (D) said.
The battle against COVID-19 is about to enter the next step in the
United Kingdom. Each day, the British Government holds a press
conference to reveal the latest statistics and outline policy.
Today, the Health Secretary, Matt Hancock, announced:
“Today I wanted to outline the next step: a new NHS app for contact
tracing. If you become unwell with the symptoms of coronavirus, you can
securely tell this new NHS app and the app will then send an alert
anonymously to other app users that you’ve been in significant contact
with over the past few days, even before you had symptoms, so that they
know and can act accordingly.”
Contact tracing is not new and other countries have used it
successfully. It means that if people are told to self-isolate
immediately after coming into contact with COVID-19, then it means they
could avoid passing on the pathogen even if they appear to be
symptom-free.
But, unsurprisingly, concerns have been raised about privacy, as the
app seems to track people and their movements in some detail.
The National Health Service, Britain’s public health system, is
dearly prized by the British people, providing world-class care, free to
all at the point of care. Its importance just now cannot be
underestimated.
NHSX, the technological branch of the NHS, has been working on the
software alongside Apple and Google, for this app which uses Bluetooth
technology. Experts in clinical safety and digital ethics are also
involved, Hancock said. Along with privacy issues, there’s the question
of whether it will actually work. ‘The more people who get involved then
the better informed our response to coronavirus will be and the better
we can protect the NHS,” Hancock explained.
In other words, if nobody installs the app, it’s worthless. Various
experts have suggested that for the app to be effective, 60% of British
adults would need to download it and sign up. Once that happens, how
near they come to other users will be recorded and alerts sent to
self-isolate if necessary.
As for privacy, Hancock said: “All data will be handled according to
the highest ethical and security standards and only used for NHS care
and research, and we won’t hold it any longer than it’s needed. And as
part of our commitment to transparency we’ll be publishing the source
code, too. We’re already testing this app and as we do this we’re
working closely with the world’s leading tech companies and renowned
experts in digital safety and ethics.”
The announcement came on the day that the U.K. total of deaths from
Coronavirus passed 10,000, reaching 10.585, with 78,991 cases recorded.
One of that number, the Prime Minister Boris Johnson, left hospital
today after several nights in intensive care. Among those who have died,
was Tim Brooke-Taylor, it was announced today. Brooke-Taylor, known to
millions in Britain as one of The Goodies, a surreal and hilarious
comedy show that rivaled Monty Python, was a brilliant and gifted writer
and performer. His trademark affability and good-natured lunacy was
evident in his work to the end (he was still appearing in the brilliant
anarchic “antidote to panel games”, I’m Sorry I Haven’t A Clue, just
weeks ago). He is among the latest people to lose his fight with
Coronavirus.
The app, which should be available to download within weeks, is
another weapon in the fight against COVID-19 and could potentially speed
an end to the lockdown operating across the U.K. https://www.forbes.com/sites/davidphelan/2020/04/12/covid-19-uk-government-unveils-contact-tracing-phone-app-as-next-step-in-fighting-disease/#6c8956f539ac
Ford, which will begin production Tuesday of air-purifying respirators in partnership with 3M MMM , will produce reusable medical gowns from airbag materials and expand Thermo Fisher TMO Scientific’s ability to make COVID-19 collection kits for patient testing.
Respirator production is happening at Ford’s Vreeland facility near
Flat Rock, Michigan. Beginning in late March Ford and 3M have worked
together to prepare the necessary supply chain to make at least 100,000
respirators. The respirators will use 3M’s air filters that block
airborne contaminants such as droplets carrying virus particles.
The work will be done by about 90 UAW workers.
Ford and 3M announced the partnership last month. Ford also has begun
making medical face masks at a transmission plant in Sterling Heights,
Michigan.
What’s new is that Ford will now work with an airbag supplier, Joyson
Safety Systems, to make reusable gowns, and collaborate with Thermo
Fisher Scientific to boost capacity at its Lenexa, Kansas site to make
more COVID-19 testing kits.
Ford is providing engineers from its Kansas City, Missouri, assembly
plant who will adapt Thermo Fisher machinery to make more glass vials
required in the company’s tests that are using in drive-through COVID-19
testing centers.
“In just three weeks under Project Apollo, we’ve unleashed our
world-class manufacturing, purchasing and design talent to start making
personal protection equipment and help increase the availability and
production of ventilators,” Jim Baumbick, vice president of Ford
Enterprise Product Line Management, said in a statement.
The medical gown production came out of discussions between officials
at Ford and Beaumont Health in metro Detroit. Together they came up
with specifications and an appropriate design. Ford and Joyson have
already make more than 5,000 gowns and plan to increase that to about
75,000 a week by late April.
“The need to protect our medical teams is heightened and Ford’s gown
production could not have come at a better time during this crisis,”
said David Claeys, president of Beaumont Health hospitals in Dearborn
and Farmington Hills, Michigan.
Finally, Ford is converting a former automotive parts plant in
Rawsonville, Michigan, to manufacture ventilators in partnership with GE
Healthcare. As with the respirators, UAW workers will do the work,
which is expected to start the week of April 20. The goal is to product
50,000 ventilators by July 4.
A similar effort is underway in the U.K. where Ford is working with
other medical equipment companies to make about 15,000 ventilators at an
engine factory in Dagenham. https://www.forbes.com/sites/greggardner/2020/04/13/ford-adds-gowns-covid-19-tests-to-its-medical-equipment-initiative/#aed31274152f
In contrast to governmental paralysis and confusion
caused by the pandemic, pharmaceutical and biotech firms around the
globe are swarming Covid-19 in an effort to stop it in its tracks. Last September,
Gallup released an opinion poll that surveyed Americans’ views of U.S.
businesses, ranking 25 different sectors from very positive to very
negative. The pharmaceutical industry came in dead last, lower than at
any time since Gallup started the poll in 2001.
“We’re below Congress, below bankers, below tobacco,” lamented Ken Frazier, chief executive of drug giant Merck.
What a difference a global pandemic makes.
Today the world is depending upon the pharmaceutical industry to not
only save lives, but economies around the world. At this very moment,
pharmaceutical companies and biotech startups from San Francisco and
Boston to Tianjin, Tokyo and Galilee, are staging a multi-front battle
against the novel coronavirus akin to the sea, land and air assault
conducted by the allies against Nazi Germany on D-Day during World War
II.
There are no fewer than 267 different COVID-19 remedies in
development, according to an analysis by Umer Raffat, a senior managing
director of investment bank Evercore ISI, with more experimental
treatments being added almost daily. This includes testing drugs already
available but designed for other ailments, new experimental
therapeutics, and vaccines that are being developed from scratch. [see Table of Top 50 below]
The attack against coronavirus is coming from all sides. There are
synthetic peptide-based vaccines consisting of two or more linked amino
acids created in a lab to immunize against the virus; there are so
called nucleic acid vaccines genetically engineered from DNA or RNA
sequences of the pathogen; antiviral medications, similar to Tamiflu,
that target the virus itself; there are new remedies using existing
arthritis drugs to contain the immune system, which sometimes
inadvertently kills patients as it unleashes its force on COVID-19.
Underlying the multitude of efforts underway is the reality that most
drugs in development are ultimately unsuccessful.
“A lot of companies are doing the rational thing: testing therapies
already in their pipeline which have a plausible mechanism of action. We
need to get drugs into clinical trials rapidly so we can quickly learn
and double down behind promising results and follow the winners,” says
Vivek Ramaswamy, CEO of Roivant Sciences, a drug development firm that
acquires hidden gems among forgotten drugs in the pharmaceutical
pipelines.
“The idea is to find the best horse in each of the categories.
Antivirals plus host immune response modulation makes a lot of sense,
but we need to find the best therapeutic in each category, for the right
patient population.” says Ramaswamy, who studied biology at Harvard,
was a hedge fund analyst and earned a Yale law degree before he began
building his innovative biotech firm in 2015. “For antivirals, is it a
nucleoside, or an antimalarial which prevents viral propagation in a
different way? For immune response modulation, is it anti-IL-6 or
anti-GM-CSF? The answer may differ by patient population. Let’s sort
those questions out quickly.”
Ramaswamy says that it’s difficult to have a national strategy for
the coronavirus predicated on a vaccine that would provide immunity to
COVID-19 because it will take a year to a year-and-a-half,
optimistically, to have something ready for use on a national scale. But
if latency occurs and the coronavirus becomes a perennial problem, akin
to the seasonal flu, vaccines will be important.
Sanofi’s vaccine unit is partnering with the federal government’s
Biomedical Advanced Research and Development Authority, piggybacking off
work that was done on a SARS vaccine and its recombinant vaccine
program. But Sanofi doesn’t expect trials in patients for about a
year-and-a-half.
Kolchinsky doesn’t expect any large-scale vaccines until the first
half of 2021, at earliest. As a result he thinks all establishments that
rely on public gathering should remain closed until then — from
restaurants and sporting events, to subways and maybe even
schools. “We’ll know if any of the first wave of vaccines are working
during the June to October 2020 window. We can make better predictions
as we see that data roll out,” Kolchinksy says. He thinks the mRNA
vaccine could become available by the end of 2020, but it will likely
require multiple doses per patient, which could translate into hundreds
of millions of doses needed per month. Says Kolchinksy, “I’m keeping an
eye on vaccines that could take just one dose to work, which could be
the case for J&J’s vaccine.”
Another important and perhaps more pressing front in the war against
COVID-19 is therapeutics because they promise to have an immediate
impact on people already afflicted by the influenza as well as tamp down
the impact of an expected second wave of the pandemic. Former FDA
Commissioner Scott Gottlieb is urging the federal government to set up
robust partnerships with companies working on therapeutics, just as it
has with the vaccine makers.
Kolchinsky says it’s too early to tell which of the many therapeutics
being tested will work, but he expects drug combinations will emerge.
He adds some drugs might start to be available by fall to treat the most
serious cases and that doctors might alter the way available drugs,
like antimalarial remedy chloroquine or hydroxychloroquine, are used as
fresh data on their efficacy become available. Hydroxychloroquine is
already being used in some hospitals in combination with antibiotic
azithromycin, often used for bacterial infections like strep throat and
bronchitis.
Kolchinsky says that the attention being given to the malarial drugs
is warranted because the drugs have shown some efficacy in pre-clinical
in-vitro work. So far the early studies in people have been mixed, but
it appears they may work better if someone infected with Sars-CoV-2
receives it early in treatment, much the way Tamiflu is administered.
The trouble is coronavirus can have mild symptoms often ignored
initially until it suddenly gets much worse. Malarial drugs like
hydroxychloroquine require a prescription, so by the time they are
prescribed by a physician, their efficacy against COVID-19 could be
diminished.
In Japan, Fujifilm Holding subsidiary Toyama Chemical’s antiviral
favipiravir, also known as Avigan, is showing promise in reducing the
severity and duration of COVID-19. In a limited test of patients from
China, those treated with favipiravir, which was approved as an
antiviral for use in Japan in 2014, tested negative for the virus after
four days compared to the 11 days it took the control group to recover.
Gilead’s antiviral remdesivir has shown preclinical promise but it
needs to be administered early and intravenously. The concern is that
people infected with Sars-CoV-2 might get it too late in the cycle.
Results from some of remdesivir’s clinical trials are expected as early
as this month.
David Witzke, co-managing partner of Avidity Partners, a biotech and
healthcare hedge fund firm, points to rheumatoid arthritis drugs that
inhibit the pro-inflammatory protein known as cytokine IL-6 as being
potentially promising for COVID-19 patients in later stages, often in
ICU units and on ventilators.
These drugs could be effective in reducing the risk of a cytokine
storm of the body’s immune system. Cytokines are molecules that signal
cells to marshal an immune response. In some COVID-19 cases,
particularly younger patients, the overzealous molecules actually cause
the immune system to not only vanquish the virus but go on to attack
organs like the lungs and liver, causing failures and ultimately
death. Sanofi and Regeneron’s Kevzara are working on a therapeutic
designed to prevent such cytokine storms.
“Anti-inflammatory drugs, the IL-6 antibodies, like Actemra at Roche
and the products at Regeneron, seem to be helpful in patients when their
lungs get full of inflammation,” says Witzke. “These are drugs on the
market [today] so they are available and if they are helping these late
stage patients that will be a benefit. We are more optimistic about
those drugs.”
Another set of remedies known as JAK inhibitors reduce IL-6
antibodies, but also attack a whole host of other pro-inflammatory
cytokines. Jakafi and barticinib are two arthritis drugs in development
by Delaware biotech firm Incyte and pharmaceutical giant Eli Lilly that
are now being studied. JAK inhibitors are riskier because they offer a
broad attack, akin to firing a shotgun rather than a rifle, at the
problem. But the JAK inhibitors could also diminish the risk of a
cytokine storm. Data on JAK inhibitor effectiveness on COVID-19 should
be available by summer. Roivant’s Gimsilumab targets another cytokine,
GM-CSF, which has been identified as causing severe respiratory distress
for COVID-19 patients in China who required intensive care.
Another hotbed for coronavirus cures are monoclonal antibodies, which
are antibodies that bind to the spike proteins of COVID-19 and
ultimately neutralize it. Monoclonal antibodies can be “cloned” from
blood plasma and Regeneron is a leader in this effort. For the novel
coronavirus it has cloned antibodies from the blood of mice, which have
been infected and recovered from the disease. If Regeneron’s new
treatment proves effective in clinical trials it could be available by
the fall. This could be a game changer because monoclonal antibodies can
be used both as a cure for infected patients, as well as a kind of
vaccine for the general population.
Depending on the half-life of the monoclonal antibody, a person could
have coverage for up to a month, which could be very useful for those
with a family member who has come down with an infection. Regeneron,
which is selecting two antibodies for its COVID-19 cocktail treatment,
is following the playbook that worked for it against the Ebola epidemic
in the Congo.
“Regeneron is one of the best protein engineering companies in the
world and they have one or more monoclonal antibodies. What is very
encouraging is the virus does not appear to be mutating at any great
rate,” says Witzke.
Eli Lilly and San Francisco’s Vir Biotechnology, are also using
monoclonal antibodies to create their cure but they are harvesting their
antibodies from human patients who have survived COVID-19. Antibodies
naturally produced against the virus are being engineered into a remedy
that the companies hope to mass produce. Vir said in March that it has
identified multiple human monoclonal antibody development candidates
that effectively thwart the virus and anticipates that human trials
could begin within three to five months.
In a way, Vir and Eli Lilly are putting a modern spin on treatment
that has been around for more than a century—using plasma and its
antibodies from patients who have recovered from a viral infection and
giving it to patients infected with the virus. In fact using
convalescent plasma for treatment was effective against diptheria in the
1890s and scarlet fever in the 1920s. What drug companies like Vir and
Eli Lilly are doing today is much more targeted because their
researchers are actually picking out the specific antibody.
In the meantime, U.S. blood donation centers are already ramping up
efforts to collect plasma from recovered coronavirus patients the
old-fashioned way while the efficacy of such efforts is still being
studied.
“If I was a patient, I would be interested in it. It’s a quick way to
get antibodies from survivors into you and you can do that
immediately,” says Witzke, noting that he is an investor with no
training in medicine. “I would rather have a more targeted approach like
what Regeneron is doing but if you’re in a tough place today, I would
turn to [plasma] immediately.”
The Race Is On For COVID-19 Cures
The table below represents some 50 different
drugs, vaccines and remedies now being developed to combat the
coronavirus pandemic.
Company/Organization
Drug
Supportive Early Data
Trial Ongoing?
Antivirals – drugs designed to attack and treat SARS-CoV-2 infection.
University of Minnesota
hydroxychloroquine
Some
Yes
University of Oxford
hydroxychloroquine
Some
Yes
Population Health Research
chloroquine + azithromycin
Some
Yes
Fundacao de Medicina
chloroquine diphosphab
Some
Yes
Gilead
Remdesivir
Yes
Yes
First Hospital Affiliated
Favipiravir, Baloxavir marboxil
Some
Yes
Zhejang Hisun Pharma
Favipiravir / Avigen
Some
Yes
J&J, Gilead
Danunavir / Cobicistat
Yes
Yes
Vaccines – drugs designed to foster immunity to Covid-19.
ALT, University of Alabama
AdCOVID
No
3Q 2020
Arcturus Therapeutics, Duke-NUS
LUNAR-COVID19
No
No
BioNTech, Pfizer, Fosun Pharmaceuticals
BNT 162 = mRNA vaccine
No
April 2020
Cell-Sci, University of Gerogia
LEAPS COVID-19
No
No
Dynavax, Clover Biopharma
COVID-19 Trimer
No
No
Heat Biologics, University of Miami
gp96-mediated vaccine
No
No
Inovio Pharmaceuticals, Ology Bioservice
INO-4800 = DNA vaccine
Some
April 2020
MIGAL Gallee Research
oral vaccine
Some
No
Moderna
mRNA-1273
No
Yes
Sorrento Therapeutics
I-Cell COVID-19
Some
No
Vaxart, Emergent Biosolutions
five Covid-19 vaccine
No
2H 2020
Anti-inflammatory – therapeutics that target the immune system and prevent the virus from causing lung injury.
Ampio Therapeutics
nebulized Ampion
Some
No
Can Fite Biopharma
Piclidenoson
No
No
First Affiliated Hospital
Fingolimod
Some
Yes
InflaRX, Beijing Defengrei Biotechnology
BDB-1
Some
Yes
Mesoblast
remestemcel-L
Yes
No
Regeneron, Sanofi
Kevzara
Yes
Yes
Roche Holding
Actemra
Yes
Yes
Sino Biopharmaceuticals
Diammonium Glycyrrhizinate
No
Yes
Tasly Pharmaceutical
T89 (Dantonic)
No
Yes
Tongji Hospital
Jakafi
Some
Yes
Antibodies + Immunomodulators- a therapeutics approach that makes proteins to help the immune system neutralize the virus.
AstraZeneca
monoclonal antibodies
No
No
Celltrion
monoclonal antibodies
No
No
Dydadic International, IIBR
monoclonal antibodies
No
No
Kiniksa Pharmaceuticals
mavrilimumab
Some
No
Eli Lilly, AbCellera
Antibody
No
No
Regeneron
multi-antibody cocktail
No
No
Sorrento Therapeutics, Mabpharm
STI-4920
No
No
Vir Biotech, Biogen
monoclonal antibodies
No
No
Vir Biotech, Generation Bio
non-viral gene therapy
No
No
Vir Biotech, NIH
human monclonal antibodies
No
No
Vir Biotech, WuXi Biologics
monoclonal antibodies
No
No
Vir Biotech, Xencor
XmAb
No
No
Plasma Immunoglobulins – antibody-containing blood plasma from recovered Covid-19 patients.
CERS
optimized convalescent plasma
Yes
No
China National Biotec Group
Convalescent plasma
Some
No
Grifolis
Convalescent plasma
No
No
Moun Sinai Health System
plasmapheresis
Some
Yes
Takeda
TAK-888
Yes
No
RNAI – therapeutics that use a biological process to intefere with the virus.
In a letter to employees, Quest Diagnostics (NYSE:DGX)
Chairman, CEO and President Steve Rusckowski announced that, due to
COVID-19 headwinds on testing volumes and revenues, he will take a 25%
pay cut over the next 12 weeks while board members will forego 25% of
their cash compensation over the same period.
Other temporary cost-saving measures include
suspending the company’s matches for 401(k) and supplemental deferred
compensation plans through the end of the year, approving furloughs for
employees with diminished work (9% of workforce enrolled), reducing
hours for non-exempt employees where possible in order to preserve jobs,
reducing overtime, freezing hiring and promotions and dismissing
temporary and contract workers.
On the COVID-19 diagnostic front, it has performed
almost 800K virus tests to date (nasopharyngeal samples) and now plans
to launch antibody blood testing.
