The New Table Stakes in the Fight Against COVID-19

As COVID-19 continues to disrupt the globe at a scale not seen since the world wars of the past century, BMO Capital Markets Chief Executive Officer Dan Barclay hosted a conversation with leading experts to discuss how government, public health and the private sector are joining in the fight against COVID-19, giving us all reasons for optimism.

BMO COVID-19 Insights podcast is live on all major channels including Apple, Google and Spotify.

Joining him on the call were Kevin McAleenan, Operating Partner, AE Industrial Partners and the Former Acting US Homeland Security Secretary, Sten Vermund, MD, PhD, Dean and Professor of Public Health and Professor of Pediatrics at the Yale School of Medicine, and Esther Krofah, Executive Director of FasterCures, the Milken Institute’s Center for Accelerating Medical Solutions.

“We’re here today to share perspectives about how the government, health and private sector are taking a leadership role in responding to COVID-19,” Barclay said to open the call.

Participants on the call discussed the multi-front, multi-sector fight against the disease, including “best in class” government protocols and responses, the critical importance of physical distancing to truly flatten the curve, and the work to develop treatments and a vaccine through private/public partnerships.

These coordinated efforts should form the new table stakes in the fight against the virus and allow authorities to start to plan for a return to some sense of normalcy. 

U.S. Policy Response Momentum

McAleenan opened his commentary to say that the U.S. response to COVID-19 started off slowly, but gathered momentum with the joint efforts of government and private sector leaders, allowing the country to now start to plan for an eventual reopening of the economy.

He pointed at coordination between Department of Defense (DOD) leaders, medical professionals and private sector companies to drive innovation in the supply chain, including addressing critical shortages in supplies to medical professionals fighting the disease in outbreak hotspots like hard-hit New York City.

“The team got together and innovated,” said McAleenan, moving early, for example, to source foreign equipment.

“A 30-day cycle on the water with these big containers coming from Southeast Asia was not going to meet the challenge, so they organized 80 flights of key equipment to various hotspots around the country.”

They also augmented domestic production by turning to the Defense Production Act to require the building of ventilators at GM and other factories.

The key challenge early in the crisis response was to coordinate federal support for local government responses to the crisis – through the Federal Emergency Management Agency (FEMA) – and augment the initial efforts of health and human services and public health authorities.

“I really think we are starting to see a turning point on supply chain issues with that team effort and with those best practises in place,” he said. “I think the federal system is going to start to actually become a strength for us in the next phase.”

McAleenan said he expects part of that next phase effort will be continued innovation in the application of FEMA authority, including a potential mandate to allow state and local governments to step in and start to purchase meals for those in need, employing private sector services like Uber Eats to deliver them.

“A combination of that federal authority and funding with a state and local executed program, I think, is going to be the kind of innovation we need to continue as this goes on through April and May, and we need to continue to innovate to provide support to those in need,” he said.

Next Phase

A next phase in the fight against COVID-19 will also see the White House Coronavirus Task Force give states the planning protocols for a restart process, and work should begin on planning how to reopen the movement of goods and people across borders.

“You are starting to see those conversations happen,” he said, including around how to loosen border restrictions to make air passenger travel viable again. This may involve employing biometrics and other technologies to enable contactless processes and allow for tracking of individuals who later become ill.

“This will be critical. With the latency period of this disease, with the ability to spread it without symptoms, we’re going to need those three elements – biometrics and contactless processing, spacing in areas that have not traditionally had a lot of space … and comprehensive and automated contact tracing.”

Physical Distancing

Yale professor Dr. Vermund said continued social and physical distancing measures will remain critical to “flattening the curve” of the pandemic and paving the way to a return to work.

He noted estimates by mathematical modelers that show physical distancing and travel restrictions helped reduce the current pandemic size by 25-30 percent. He said mask use could reduce it by an additional 10 percent.

Mitigation measures like lockdowns and social distancing have not yet been as effective in the U.S. as they have been in places like South Korea and China because they have not been as strict or as complete, largely due to cultural differences.

For example, “There’s a very strong mask use tradition in Asia due to pollution levels in the cities”, Dr. Vermund said, “so it was easy to coax folks to wear them, and, in fact, many started wearing them without being asked to.”

He pointed to the robust public health systems in European countries like Germany, comparing their ability to implement aggressive contact tracing of COVID-19 patients, on a level that wasn’t possible in the United States.

“We used to have vigorous contact tracing environments 30 years ago when we were battling sexually transmitted infections, and HIV, with contact tracing,” Dr. Vermund said, “but government cuts have gutted most of these programs in most states.”

Prevention Versus Emergency Response

Looking ahead to how the United States will handle this and future pandemics, Dr. Vermund counseled that, “We need to be more attentive to prevention, rather than emergency response, because we're going to save money, and we're going to save lives.” 

Emotion plays a big role in congressional allocations for funding in health research, Dr. Vermund pointed out. As an example, after September 11, 2001, the anthrax scare caused a fear of rogue scientists from enemy countries attacking the United States. Those fears led to a massive jump in investment in biodefense research, around $13 billion in just the past six years. In contrast, less than $3 billion was spent on pandemic respiratory virus research during the same period, at the National Institute of Allergy and Infectious Diseases.

“I think it's time for the business community and the public health community to be much more in touch,” he said.

“You know the hallmark of success in North America is our ability to mobilize resources and innovate,” Dr. Vermund said. “And I think we will look back a few years from now and be quite awestruck with the amount of innovation around how we handled it.”

Communal Race for a Cure

Some of that innovation may come as a result of organizations like FasterCures, the Milken Institute’s center devoted to accelerating access to life-saving medical treatments.

“Our mission is to accelerate the development of treatments across a variety of different disease states. When we saw all that was happening around the world, with the spread of this pandemic, we turned a lot of our attention and focus to what we can do in response to this virus,” said Krofah, the organization’s executive director and a respected leader in biomedical research, development and public policy"

She said FasterCures is focusing its efforts on four key pillars, including tracking treatments, how to accelerate development of treatments and/or vaccines, how to educate, inform and support policymakers and businesses, and how surveillance and technology can help moving forward, in the short-, medium- and long-term.

“It was really important early on for us to put our arms and legs around what are all the different treatment and vaccine candidates that are being considered for attacking the coronavirus,” she said.

 As part of the effort, FasterCures has developed a tracking document, available on the Milken Institute website (https://milkeninstitute.org/covid-19-tracker), where they are tracking 132 different compounds in preclinical or clinical research, as well as 86 vaccines that are also being considered, to tackle the virus.

The tracking document also includes data on where each compound stands in clinical development, when clinical trials are expected to proceed, and when results are anticipated to be published. It is currently being used by national and international companies that are developing drugs, government agencies and the public, and is updated on a daily basis, Krofah said.

Within the private sector, more than 135 different initiatives are underway, ranging from challenges to hackathons to scientific collaboration, she said. “I think what we have been attempting to do is to make sure that each of these different kinds of initiatives, as they are springing up, are connected with each other.”

What’s clear is that the public and private responses to COVID-19 have been unanimous. Rather than compete, organizations are building together for a better future.