Covid Innovation: a lot, not so great

Covid therapies are entering the pipeline at a rate 15 to 80 times faster than any previous epidemic with over 4 new therapies entering the commercial pipeline every single day

The relative share of “short term” solutions – non-vaccines and repurposed drugs – is unusually high. 23 percent of Covid therapies are vaccines, versus at least half for the previous three recent less severe epidemics. Over 60 percent of Covid therapies are repurposed drugs, versus no more than a quarter of those for Ebola, Zika, or H1N1.

the rate at which new vaccines enter the pipeline is essentially the same in February and April!

The increased entry driven by huge payoffs to any successful Covid therapies causes entrants to inefficiently race toward lower-value therapies. If enough small firms begin to race in this way, even the large firms that otherwise would have worked on vaccines will give up. And note that this pattern appears empirically: more severe epidemic leads to more entry by small firms, more work on short-term projects

Pessimism and positive thinking

Coronavirus phase 2

pessimism: antibodies not lasting, common cold coronavirus does not generate lasting antibodies, animal coronavirus creates trouble to vaccines https://twitter.com/statesdj/status/1252698979285991424

Positive thinkng, we can make a plan, Broad testing pun intended, Broad lab in Harvard https://news.harvard.edu/gazette/story/2020/03/broad-institute-races-to-enable-coronavirus-testing/hacked to make 1 million tampons a day,

Broad Institute races to enable coronavirus testing

 

Harvard plan to secure USA with tampons would cost 15 billion but actually worth, Roadmap to pandemic resilience https://ethics.harvard.edu/files/center-for-ethics/files/roadmaptopandemicresilience_updated_4.20.20_0.pdf

Propublia 3d on what to do: https://twitter.com/propublica/status/1253351877787467779

common sense considerations by an ex expatriate, no matter you think you re staying 6 months or 6 years make your place comfortable

phase 2 could last 12 months but also longe, a word of caution by Derek lowe. Let’s build up resilience like it could be 12 years, we won’t regret anyhow. WIn win

From Trolley to Mechanical Ventilator

how “problems” change over time, one day everybody is musing on a robot car who (that) must choose who to kill, then a small rna virus arrives and everybody turns to the problem of mechanical ventilators, except that not, nobody wants to acknowledge that in the Covid19 epidemics thousand of critical patients are subject to rationing life/death decisions based of a simple rule or a more complex clinical evalution algorithm? And the dilemma goes: you save a 60-yearld old man in perfect shape of a 35-year old pregnant woman with breast cancer ?

Facing Covid-19 in Italy — Ethics, Logistics, and Therapeutics on the Epidemic’s Front Line

New England Journal of Medicine has a retrospective on the ICU crisis in Italy where decisions around scarce mechanical ventilators are actually done, at time of writing over 4,000 people dead and this charts show the problem in stricking clarity

Death definition in Germany in a plague

(originates from widespread ideas in Italy that when you die of Coronavirus in Germany with comorbidity the death is then attribute to the comorbidity, so they come out better at numbers

info page on case collection at Robert Koch Institute https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Fallzahlen.html

RKI is mandated to keep tabs on  plagues by the Infection Protection Act https://www.rki.de/EN/Content/infections/inf_dis_down.pdf?__blob=publicationFile

The new normal (Covid edition)

How is going to be after we contain the epidemic ?

Pandemics don’t go away with the season, not for good, expect to see a new outbreak in Autumn

This is what this simulation says https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf and it hypothesizes a policy framework like thisScreenshot 2020-03-17 at 21.33.48

suppression strategies to cap ICU cases and preserve public health, awaiting a vaccine 18 months away

This is also what we know from a previous pandemic, the Asian Flu. Not quite a coronavirus but both rhinoviruses, quite as deadly and infectious although the Asian would kill the elder and the little kinds with Covid19 kills only the former.

It had 2 peaks in USA, in September and February and raged for 3 year in total