As the reopening of economies continues across much of Europe and North America and we witnessed the consequences as USA is leading in the covid 19 list by far greater margins though it’s worth taking stock of the epidemiological situation and trends that will define the months ahead. At the time of this writing, the official counts of cases and deaths from COVID-19 have passed four million and 280,000, respectively. Recent studies have made increasingly clear that each of these figures is a significant underestimate. Population antibody surveys suggest that official counts are underestimating the true number of cases by a factor of five or more (although in several cases the methodology has been called into question.
Reopening is a massive natural experiment—make sure you learn from it
We have never before attempted to shut down the modern global economy, much less reopen it in the setting of an ongoing pandemic. We have a few examples of strategies that seem to work better, or worse, but none of us know with any certainty the best actions. Even places with strong initial responses like Hong Kong and Singapore have faced challenges as they reopen.1 China has also seen an increase in cases in the past few days.2
In the United States, there is only a loose correlation between disease prevalence and plans for reopening. States with more cases generally plan to reopen later, but there are exceptions.
The two most populous countries on the planet China and India. Where China always intended to produce and tried to make others as consumers and to some extent it is fact and all done in the sake of open market but the world knows about tech giant Google’s exit from China. Chinese administration always inclined towards export even in this pandemic situation China is exporting low standard medical equipment those are allegedly manufactured during covid 19 and it shows how ambitious China is for its business where world is asking about the deliberate silence of the Chinese government and WHO on the global spreading of infection on other hand we have India the largest and most ludicrous market with 1.4 billion consumers along with inspiring possibilities.
Post covid 19 a new world order can be witnessed Possibly. In India PM Narendra Modi and his administration is set to pump a huge ₹200 billion to the fuel manufacturing sector and provide an ideal alteration to that of China.
In vaccine development against Covid 19 USA is developing it with positive and promising signs.
Moderna an US based has said the second phase involving 600 people will begin soon, and third phase trials to begin in July.With a promising sign of development we can expect it later this year or in early 2021.
A similar point can be made about businesses’ plans to reopen. Companies are planning different approaches, even based on the same underlying fact base. This implies that leaders across the public and private sectors should build learning and adaptation into their reopening plans from the start. Relevant lessons might come from other geographies, other sectors, or from peers and competitors. Leaders should be prepared to incorporate new information and alter their approaches, either incrementally or radically, as new information becomes available.
Resurgence seems to be not a question of if but when, where, and how bad. Many experts are focused on a potential second wave of COVID-19 in the northern hemisphere this autumn.3 This is certainly possible. But focusing on the risks of autumn and winter causes us to look past the summer, which is risky because it is sooner and because it is when many jurisdictions will be reopening and testing
Here are five areas to watch:
The great vaccine-platform race. At the time of writing, 13 vaccines are already in clinical trials, and the full pipeline spans a massive range of platforms, including RNA, DNA, inactivated viruses, protein subunits, and virus-like particles (VLPs). The virus and viral-vector approaches are traditional; others are nascent. Each platform will start to produce data in the months ahead, starting with evidence of vaccine safety and then potentially demonstrations of immunogenicity (and even efficacy) toward the end of the year, though we still need to better understand the link between immunogenicity and correlates of protection. While having multiple platforms in development increases the likelihood of a successful vaccine, each platform has different competitors, ranging from smaller biotech companies to multinationals, as well as distinct manufacturing requirements, with implications for the scale-up of capacity.
A more nuanced understanding of the uses of different therapeutics. The initial discussion on drugs has focused almost exclusively on repurposed antivirals and antimalarials for treatment. The 200-plus candidates currently in development cover a broad range of use cases—from post exposure to prophylaxis, and from mild and moderate to severe cases. The more than 1,700 active trials are expanding the focus from drugs that directly attack the virus to those that confer immunity and to those that target complications of COVID-19 such as cytokine-release syndrome (CRS) and, more recently, acute respiratory distress syndrome (ARDS). Labs are deploying a wide array of platforms, from repurposed antivirals (as mentioned above) to monoclonal and polyclonal antibodies to neutralize the virus to immune modulators for ARDS/cytokine storms, and even cell-therapy approaches for late-stage disease. The emergency-use authorization for remdesivir is an important milestone for COVID-19 drug development as well. In the coming months, we anticipate that a more nuanced understanding of the different use cases and the types of approaches being tested will help reduce the mortality rate of COVID-19 and also change the standard of care.
A new normal and unrealized opportunity for data sharing. Unlike the experience with prior epidemics (including Ebola), COVID-19 has been characterized by unprecedented sharing of prepublication data, analyses, and results via medRxiv, a collaborative platform. This proliferation of information can support innovation and has been rapidly integrated into both the media and policy discussions—sometimes, however, to unfortunate effect. Looking forward, as the scientific community seeks to make meaningful interpretations of the thousands of running studies, we need to bring together the patient-level data from the hundreds of small, undersize, not-well-controlled, compassionate-use, and observational studies, in a responsible way. Meta-analyses of such studies will help us know if therapies actually work, at what dosing and clinical regimen. There are efforts underway in the ecosystem to address this—and hopefully a collaborative model emerges that could remain with us post pandemic.
The impact of novel R&D models. Competitors are collaborating in ways never expected.10 Companies are banding together in multilateral collaborations, some formal and some informal, to advance innovation. For example, leading plasma manufacturers are partnering in novel ways to produce a single unbranded immunoglobulin product; more than 15 pharmacos are collaborating in a COVID-19 R&D forum to advance, individually and collectively, the most promising drugs and vaccines; and decades-long competitors Sanofi and GSK are partnering on COVID-19 vaccine development. Novel master protocols, often with inspired names (such as Solidarity, Recovery, and ACTT), are being used to simultaneously test multiple drugs.11 Innovators are deploying novel development plans and trial designs as well; for example, Pfizer and BioNTech are simultaneously testing four vaccines in their combined Phase I/II study. These approaches are not without risk given the parallel work in traditionally sequential stage-gated processes.
The challenge of separating the signal from the noise. With Ebola, a substantial R&D mobilization ran into difficulties recruiting patients to test all of the approaches being considered. Some of these same challenges are happening with COVID-19. Ensuring that studies are well controlled and appropriately powered will be critical to understanding what actually works. Further, data sharing will hold the key to advance our understanding and interrogation of the benefit/risk trade-off. Multiple prioritization efforts are attempting to do this but are still in the early stages. In some ways, the scale of the mobilization may be the biggest challenge.