Tuesday, April 7, 2020

COVID "GOOD" NEWS - When to Reopen the Economy (Scott Gottlieb et al); Other COVID Headlines

Scott Gottlieb and coauthors have released an American Enterprise Institute white paper on when and how to open the US economy as fast as possible.

  • See coverage at Politico here.
  • See coverage at NYT here.
  • See the AEI 20-page white paper online here.
    • SEPARATELY, Gottlieb et al. released a COVID surveillance plan, 17pp, via Duke Margolis Center, here.
They suggest loosening and reopening should occur when
  1. Hospitals can treat all patients, without crisis mode.
  2. State can test everyone who is symptomatic.
    1. This could require 750K-1M tests per week nationwide.
  3. The state can monitor confirmed cases and their contacts.
  4. There must be a preceding sustained reduction across 14 days.
Co-authors of the white paper include Lauren Silvis, who is on both the AEI and the Margolis white papers.  She is a former FDA attorney who is now on the team at TEMPUS.

McKinsey also has a new white paper on rebooting post COVID economies - here.

Precision Medicine News

WSJ has an article on a theme I've considered important, taking a genetic, genomic, precision medicine approach to who gets sick and not call it solely a "roulette wheel" if you die at 30, or "a higher statistically change" if you're in the 10% who die at 65.   Genetic factors (in HLA, in cytokines, in T-cell receptors, etc) could be a driver we don't understand yet, multiplied by factors like age or respiratory reserve.  In this article, 23andMe is featured.  Other approaches are coming online, such as an open-access collaboration for samples by Adaptive Biotechnologies and Microsoft (here).  Adaptive is also partnered with Amgen working on monoclonal drugs with genomics support (here).

Digital Health News

Rockhealth reported $3B investments in digital health (broadly conceived) in 1Q2020.

For Somewhat Less Cheerful News...

NYT ran an article on the "real epidemic map" we'd be seeeing on maps if testing were fully up to speed - here.

NYT ran an article (as did WSJ this week) on ongoing shortages of testing supplies, staff, equipment.  Here.

Test Shortages

Some of the test shortage news shouldn't be surprising, even if we were making estimates a few weeks ago.  DNA probes seem to be the fastest thing to produce.   However, RNA extraction kits, RNA swab kits, and platforms/lab staff are limited resources that increase slowly.   An RNA probe factor could go from normal shifts to 24/7, so production rises 3X.  Good.  Linear.   But demand could rise 100X, exponential, leaving a 97% gap that will rear its head quickly.  Shortages of staff and platforms emerge as 7-10 day wait times.   (This paragraph thanks to my Operations class professor, when I took that class in MBA school 20 years ago.)