A doctor’s view on managing the COVID-19 crisis
COVID-19 is at the top of agendas worldwide, and many articles have been published in the past weeks on the best way to move forward. In an interview with Supertrends, Jørgen Thorball, a medical doctor with a solid track record of developing medical innovations, makes some practical suggestions from the view of an experienced medical doctor and a visionary life science entrepreneur.
“With testing and treatment, I believe it is very likely we will be able to quickly manage the COVID-19 crisis.”
At a time when one of the hottest debates is about when, and not if, a vaccine will be the silver bullet in our war against COVID-19, Thorball notes that no vaccine has ever been successfully developed for a coronavirus so far. Although new technologies and significantly more funding are now available, success in developing a safe and effective vaccine has so far remained elusive.
Priorities: Vaccination or treatment?
Description automatically generated“If everything goes well, we may see a vaccine developed by the end of this year. By the middle of next year, it may be possible to vaccine the general population in the US, Europe, and other parts of the world,” Thorball believes. But he cautions that we should be realistic in our expectations: “Let’s not forget that this will be an innovative technology, which means we cannot assume that everything will go well. My sense is that finding a vaccine is a gamble, while finding the optimal treatment and testing is simply a matter of going through the normal working process of clinical trials. I am worried that we are not putting enough efforts into optimizing the treatments we already have within our grasp for patients and ensuring better preventive measures for high-risk populations.”
Scaling up the testing system to control the crisis
If we cannot bet on a vaccine, what should we bet on? Thorball thinks the key is testing and treatment. Unlike the development of a new vaccine, the process of testing and using existing medicine for treatment does not involve innovation, but optimization.
Advances in gene sequencing technology have enabled scientists to trace and monitor the COVID-19 pandemic faster than any previous outbreak. A significant decline in the cost of genetic synthesis also helps us to scale up the diagnostic tests.
In Thorball’s view, there are three levels of testing that can help with managing the COVID-19 crisis:
- Inflammation biomarker testing to screen who is at higher risk. We already know that the inflammation level is directly linked to mortality and the severity of symptoms. Biomarkers can be used to monitor the inflammation level. This can be used to help determine who in the population that will need higher level of protection and who will need to remain in hospital and be monitored more carefully.
- Diagnostic testing to screen who is infected and isolate those who are infected. “It may sound expensive to test everybody very often. But people tend to forget that the diagnostic test is a volume game. These tests can be at ridiculously low prices if we really want,” Thorball points out.
- Antibody test to identify who is presumably immune. People who already have antibodies can be assigned to higher-risk jobs, such as homecare etc.
If we combine these 3 testing methods in a smart program that adapts to the mix of people, their individual situation and the local infection pressure in a given week, then most people will be able to go back to a normal life. More and smarter testing will also help doctors improve current treatments as Thorball believes it is more promising to find a better combination of existing medical treatments that together can reduce COVID-19 mortality significantly. “With a much more efficient testing program and some improvement in the treatment and prevention that we already have or are in clinical trials, we are likely to push down the mortality to around the seasonal flu, which we should remember is the goal we should be aiming for, and we will rather quickly be able to manage the COVID-19 crisis,” Thorball believes.
Opening the human virome’s black box
One of the positive outcomes of the COVID-19 crisis might be a much-improved understanding of how viruses behave in and affect the human body. Thorball is hopeful that this may be the beginning of a new megatrend in research based on a more detailed knowledge of the human virome, i.e., the entirety of viruses living in and on the human body: “The human virome will be the new fantastic black box that’s going to open up.”
So far, the behavior and functions of viruses in the human body are not yet well understood. Scientists are eager to learn more about how they infect human cells as well as other microbes, such as bacteria, and why some viruses cause disease, while others do not trigger any symptoms at all. Thorball hopes that a closer study of the virome could help explain how certain viruses are integrated into the human genome.
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