Commercial > COVID-19 updates > Framing the future: Exclusive update on COVID-19 health care and medical advances 

Panelists

Dr. Jennifer Nuzzo and Dr. Caitlin Rivers, Johns Hopkins Center for Health Security 

Moderator

Jonathan Weiss, senior executive vice president, CEO of Corporate & Investment Banking, and interim CEO of Wealth and Investment Management, Wells Fargo & Company

Medical progress and health care response to the coronavirus has been nothing short of groundbreaking, with an unprecedented number of developments, discoveries, and critical decisions all happening in record time. 

Join us for an exclusive conversation before Memorial Day weekend with two leading scientists from Johns Hopkins renowned Center for Health Security active in coronavirus response efforts, moderated by Wells Fargo Senior Executive Vice President Jon Weiss. 

Our expert panel will help bring you up to speed on the latest critical information, insights, and medical milestones in the fight against this global health crisis. They will also provide analysis and insights on new scientific advances and will outline next steps in public health practices and innovation that may help pave the way to recovery. 

Don’t miss this exceptional opportunity to hear from leading experts in public health. 

Audio: Framing the future: Exclusive update on COVID-19 health care and medical advances

Transcript: Framing the future: Exclusive update on COVID-19 health care and medical advances

WELLS FARGO BANK, N.A.

Moderator: Jon Weiss
May 22, 2020
11:15 a.m. ET

The views expressed in this webinar represent the opinions of the authors on prospective trends in the international markets and the financial industry, and is intended for global financial institutions partners and customers, and other market participants who are customers of Wells Fargo. We do not guarantee this information but have obtained it from sources we believe to be reliable. Opinions expressed are based on our experience and judgement as of this date and are subject to change without notice. This is not an offer to sell or to buy any security of foreign currency.

OPERATOR: This is Conference # 8341458

Operator: Ladies and gentlemen, thank you for standing by, and welcome to the Framing the Future COVID-19 Healthcare and Medical Update Conference Call.

At this time, all participants are in a listen-only mode. Please be advised that today's conference is being recorded. If you require any further assistance, please press "star" "0."

I would now like to hand the conference over to your speaker today, Alison Hawkins. Thank you. Please go ahead.

Alison Hawkins: Thank you, and welcome, everyone. My name is Alison Hawkins. I am SVP of external relations with Wells Fargo, and welcome to our conference today, “Framing the Future, An Exclusive Update on COVID-19 Healthcare and Medical Advances.”

We have wonderful, (extinguished) guests today. I'll start by introducing Dr. Jennifer Nuzzo. Dr. Jennifer Nuzzo is a senior scholar at the Johns Hopkins Center for Health Security. She's an epidemiologist by training, and her work focuses on global health security, with a focus on outbreak detection and response, health systems, international and domestic biosurveillance and infectious disease diagnostics.

She directs the Outbreak Observatory, which conducts operational research to improve outbreak preparedness and response. She also co-leads the development of the first ever Global Health Security Index, which benchmarks 195 countries' best health and healthcare capacities and capabilities.

Dr. Nuzzo has advised national government and non-profit organizations, and previously worked as a public health epidemiologist for the City of New York. Dr. Nuzzo received her doctor's PhD in epidemiology from Johns Hopkins, an SM in environmental health from Harvard, and a bachelor's in environmental sciences from Rutgers.

Our next guest is Dr. Caitlin Rivers. Dr. Rivers is also a senior scholar at the Johns Hopkins Center for Health Security. Her research focuses on improving epidemic preparedness and response through the use of modeling and forecasting, data standards and data sharing and public health policy. She is currently focused on the U.S. response to the coronavirus outbreak.

Prior to her joining the center, Dr. Rivers worked for two years at a civilian – as a civilian epidemiologist at the Army Public Health Center, where she served in a variety of leadership positions. During that time, Dr. Rivers also participated in a National Science and Technology Council interagency working group, aimed at bringing pandemic prediction and forecasting and capabilities into the federal government.

Dr. Rivers holds an MPH in infectious disease, which she earned while concurrently studying for a PhD in genetics, bioinformatics and computational biology, with a specialization in computational epidemiology.

And last, but not least, our moderator today is one of the busiest people at Wells Fargo. Jon Weiss is the CEO of Corporate and Investment Banking and also the CEO and Wealth and Investment Management at Wells Fargo, where he serves on the company's operating committee. Jon also oversees Wells Fargo's international clients business.

Jon's been with Wells Fargo since 2005, serving in a variety of leadership capacities, including as president of Wells Fargo Securities, and he's based in New York City.

Jon, I'll turn it over to you.

Jon Weiss: Great. Alison, thank you very much. And let me start by thanking our clients for joining us today. We hope you are all well and staying safe, and we certainly appreciate the time you're giving us this morning. I hope you didn't have trouble getting onto the phone lines, as I did. We do appreciate our relationship with you and the business we do.

These discussions are an important way we try to bring to access to thought leaders on important topics to you, and I think nothing right now is more important nationally, or even globally, than the COVID-19 pandemic. It certainly challenged our society, the way we live and work, our health systems and our economies around the world. And Johns Hopkins has certainly been on the forefront of efforts to understand, to track, to respond to COVID-19.

Many of you may know, our CEO, Charlie Scharf, sits on the board of Johns Hopkins, and he was instrumental in bringing us today's guests. And let me add my thanks to them and my welcome to them, Dr. Jennifer Nuzzo and Dr. Caitlin Rivers. And we talked a little bit before, and we've all agreed to go by first name here. So I appreciate that informality. So thank you, again, Jennifer and Caitlin, for being with us.

So let me go straight to the first question, and I think we're going to have a great conversation here. The first question is, we're heading into Memorial Day weekend, where do you think we are in terms of our progress in this fight on the COVID front? And what do you think the summer most likely looks like for Americans? And will it vary regionally?

So let me direct that first question to Jennifer, and then, Catlin, please feel free to add your thoughts. Jennifer?

Jennifer Nuzzo: Yes, thank you. And thanks so much for having and for that kind introduction. In terms of where we are – I mean, across the country, there has been incredible progress made in slowing the spread of COVID-19 at a national level, but what it means for individuals really depends on where you live.

And so, while there has been, I think, overall sort of net-positive progress, there are still many parts of the country – largely smaller communities where the case count is still growing in a way that is concerning. And because these are generally smaller communities, they don't make the nightly news and the case numbers are likely small compared to what you hear coming out of big cities. But what we worry about in particular with these communities is that they often don't have the same kind of health care resources that we would see in a large city. So it just means there's fewer bandwidth – less bandwidth in the system to shift around in order to meet even a small rise in cases. And so that's where I think we really need to pay attention.

And I know this is something that the U.S. government is starting to think about. And they're starting to think in particular about rural communities and how to meet the health care demands in those places where you may already have – there'll be some counties where you don't even have a single intensive care unit. And so just thinking about how we can meet the demand for those communities such that we don't have deadly consequences, I think will be important.

In terms of going forward into the summer, clearly pretty much almost every state is in the process of reopening and how states are approaching that varies. And so what the impact of those decisions will be and case numbers, I think will also vary by location.

But ultimately, what it means, I think, for people is that we are not in any less of a risky situation than perhaps we were before all of these measures were put into place. The virus is still circulating and it's still out there. And as long as it's still out there, we remain vulnerable to it.

And so, for individuals that will require some level of continued protective action. Maintaining physical distance as much as possible and tying to limit your exposure to others, particularly those outside of your household.

I think the good news is that it's summer. And it'll be easier to be out and about and about and still limit our exposure. And so, outdoor environments, I think will be increasingly important and those are probably the better places to be than being crowded in indoor spaces with others. So I think there's going to be some flexibility.

One question we often get is whether we'll see a summer lull like we do with other respiratory viruses like influenza. And that question has not been answered yet by science. We don't yet know if we will see a lull in infections this summer. I personally hope that we do. It would be nice to have a break. But even if we do, we expect to see a potential rise in cases in the fall.

Jon Weiss: And that's very insightful. And I think your comments that you started with on the rural side of things are particularly interesting.

Do you – do you see it – and maybe I'll turn to Caitlin, do you see it as also regional? Because clearly there were several big cities hit first. Is it spreading to a particular region or regions? Or is it so spread out at this point that you can't see that kind of trend?

Jennifer Nuzzo: I don't see ...

Caitlin Rivers: I don't think we're ...

Jennifer Nuzzo: Oh, go ahead. Go ahead. Sorry. Sorry, Caitlin.

Caitlin Rivers: I don't – I don't think we can say that there is a different pattern in the epidemiology from region to region. I think what we're seeing is outbreaks that are very localized to communities. And that's not to say that their intensity is different from place to place, because it is.

But the drivers of infection and the patterns in the way that transmission is spread does vary by community. We see in large cities like New York City, which was extremely hard-hit, there was spread really all throughout the community. Whereas in more rural places, particularly in the Midwest, we think that special settings and institutions like meatpacking plants and correctional facilities are really the – have the virus right now. And so I think those trends will be something to keep an eye on as we move into the next phase.

Jon Weiss: So let me – let me adlib here and ask a question that occurred to me and may occur to a lot of the other people listening. When you talk about social distancing and actions that we can take even as we go outdoors, a lot of – a lot of discussion around whether masks work and masks help. And everything from bandanas to more sophisticated hospital-quality masks have been talked about.

Do they work to protect you from the virus or is it more protecting others? Maybe I can ask Caitlin to respond to that.

Caitlin Rivers: Sure. So masks like the non-medical, fabric face masks that are now recommended for use when spending time in the community don't protect the wearer. They protect everyone else.

We know that a substantial fraction of people who are infected don't have symptoms or they might have symptoms so mild they don't even really recognize that they're sick. And so the masks can help to keep those droplets and the spit, to be honest, that we all produce when we're speaking, or coughing, and sneezing contained and so as to help limit transmission from others.

And so that’s really the purpose of the mask and that’s why it’s that we all wear them when spending time in the community. They’re going to work best if we all participate.

Jon Weiss: OK and does that hold for medical quality masks as well?

Caitlin Rivers: No, medical quality masks like the N95 masks which are the shapes molded masks are very effective at preventing infection in the wearer. They’re very effective in healthcare settings. The problem is there’s not enough of them and so it’s important that we reserve those for our healthcare workers who are actively exposed to people who are infected, having very close contact. And so that’s the difference between the medical masks which we need to reserve and then the fabric face masks that we are all now wearing in the community.

Jon Weiss: Yes, great. I’m glad you made that distinction and also clarified that they’re really – we need them for the healthcare workers.

Jennifer Nuzzo: Can I just add – just add point ...

Jon Weiss: Sure, please.

Jennifer Nuzzo: ... that which is also healthcare workers are trained on how to wear those properly and they do require a level of fit and evaluation and proper usage of them. So it’s not – it is definitely a concern that we spare the masks for the healthcare workers but also if people were to get a hold of some N95 masks without the fit testing and the training on how to wear them appropriately, they may not actually be as protective.

Jon Weiss: That’s also a good point, thank you, Jennifer. So, back to you then, Jennifer, so I think we’re all reading about different scenarios and three scenarios that we’ve certainly heard that this could play out are number one sort of recurring outbreaks. And you described that a little bit in your opening comments. A second scenario is that we actually experience an explosive wave this fall. And a third is that we just live with this and with persistent infection on an ongoing basis until a vaccine or a therapeutic is discovered.

So what, how would you handicap those?

Jennifer Nuzzo: So putting aside that unknown about the seasonal affect and just the biology of the virus and what could happen. Not knowing what – we don’t know what’s going to happen in terms of will the humidity or temperature help to reduce infections. But in terms of how the case numbers will progress, that’s largely dependent on two things, one, it’s how individuals act; and two, it’s how governments respond.

And so in places where there are very strong public health capacities, you know they have the ability to test people, they have the ability to isolate people who are found to be infected. They have the ability to figure out who the cases may have exposed before they became known as a case. And find those folks and monitor them, it’s called contact tracing.

In places that have very robust public health capacities like that, I think it’s highly likely that they’ll be able to keep the case numbers down. I don’t think there is a scenario where there won’t be cases but they hopefully can keep the case numbers at bay.

And then there’s also the individual dimensions, the decisions we make about how to limit our exposure and how to reduce the risks of becoming infected in the first place. And the extent to which individuals and community groups and businesses participate in those discussions in a way that’s aimed at reducing risks not eliminating risks but reducing risks. I think that will also have an important contribution in keeping case numbers low.

Jon Weiss: So, Caitlin, given that and where we are in testing and in contact tracing here in the States, concerns that we’re opening too quickly? Do you have concerns that we’re opening too quickly?

Caitlin Rivers: I think ...

Jon Weiss: Or reopening?

Caitlin Rivers: Yes, I think what we’re seeing is decisions to reopen that take into consideration the enormous economic pressure that our communities are facing. And so that is factoring into the decision beyond just public health consideration. I do have concerns that not all communities have the capabilities and capacities in place to do the diagnostic testing and the contact tracing that Jennifer described.

We have not fully transitioned to managing our outbreak in this way. We made big progress and can continue to expand those capacities, that door is not closed. But I do think we have not fully moved the case based management and so the virus is still circulating in our communities unrecognized. And so I agree with the points Jennifer made that we will continue to see levels of infection I imagine more or less similar to what we’re seeing now.

Jon Weiss: So are there some lessons that we can learn from the way other countries has managed outbreaks in their geographies that we still have time to learn from and deploy here? I’m thinking places like South Korea, for example. On the one hand or other places that were hit very hard like Italy or London or other major centers?

Jennifer Nuzzo: So this is Jennifer, and yes. I mean, I think there are countries that have had really remarkable responses to this situation. People take in a slightly different approach, but one thing that it’s been clear is that not all countries have had to have the level of restriction that we have here in the U.S. They have been able to keep their case numbers down largely without closing down or locking down, but they’ve have very strong public health capacities, the ability to test and isolate cases and to do contact tracing.

So I think what that tells us in my view is that’s what we should aim for. These measures that we have implemented really in a moment of panic to try to slow down the growth in COVID-19 cases, I think there have shown that they can do what they were intended to do. They can help the case numbers not accelerate as quickly as they had been, but they’re extraordinarily disruptive and difficult to maintain.

And so, really I think we should be trying to build the public health capacities that could help us keep the case numbers at bay so that we don’t have to resort to broad lockdowns or broad population level restrictions. I think that’s one important thing.

Key to this will also be testing. I mean, I think all of the countries that have had – have had success have had greater capacity to test fairly early on that we initially had here in the U.S. Not every country is like South Korea where they – or even Iceland. Iceland has tested over 10 percent of its population, which is really extraordinary. Not every country has tested at that level, but they have been able to test fairly broadly particularly in outbreak scenarios.

And that’s still relatively difficult in the U.S. When we have outbreaks, say, in a nursing homes, it’s been difficult for nursing homes to not only test. Maybe they’re able to test the people who are symptomatic, but they really have to fight in many locations to test all the other residents and staff who are not symptomatic. And in the few instances when they’ve been able to do that, they’ve found large numbers of cases in people who otherwise looked fine, and that’s really important.

So I think it’s important for us to get to the point where we can do that kind of response of testing as necessary. I don’t necessarily think we just have to test huge proportions of the U.S. population absent any symptoms or risk factors, but I do think that we still have more work to do on expanding testing.

And we’re getting there. We at Hopkins started tracking testing that was happening in the U.S. and with our Johns Hopkins Testing Insights Initiative, and what we’ve seen is over the past month, the amount of testing that’s being conducted in the United States has expanded quite considerably, which is quite promising, but still more states don’t have the level of testing that’s scaled to the amount of infection that’s occurring within their state, so more work needs to be done.

Jon Weiss: Well, you also mentioned ...

Caitlin Rivers: If I could just underscore ...

Jon Weiss: Yes, please.

Caitlin Rivers: Just to underscore an important point that Jennifer made, I think over time some of the purpose of the lockdowns has subsided from our public conversations, so I just want to revisit the two goals of staying home to slow the spread. The first was to save our healthcare systems from being overwhelmed, which apart from New York City and a few other locations that did experience pretty serious overcapacity issues, that goal was largely accomplished.

The second important goal which I think gets less attention of the lockdown was to buy time to build our capacity to do the diagnostic testing and the contact tracing. It was really the intention that we would be able to transition to managing our outbreak in that way through the capacities that we put in place. And so, just want to highlight the two purposes of why we did all stay home to slow the spread.

Jon Weiss: That’s a really important piece of the continuum here. Now, Caitlin, let me just ask you on the – we talked a fair amount about testing there. How about contact tracing, though? Have we – are we deploying that aggressively in the U.S.?

Caitlin Rivers: This is a little bit harder to understand because contact tracing is something that we do all the in public health. We do it for sexually transmitted infections, for whooping cough, measles, all sorts of different infectious diseases, but it really happens at the state and local levels, and it’s those health departments at the state and local level that are scaling up their capacities.

And so, it’s more difficult to get an understanding at the national level of where we are because it’s all those different jurisdictions that are doing the hiring. But we’ve seen a lot of encouraging evidence that jurisdictions are moving aggressively to expand their capacities to do this.

Massachusetts, it’s hiring a 1,000 contact tracers. New York has a large program. My home state here in Maryland is hiring a great number of contact tracers in order to expand their capacities.

So though it’s harder to put numbers on, I can say that many – all states really have moved strongly to put these capacities in place. I think just over the coming weeks and months, we will have to continue to monitor to evaluate whether or not it is enough or whether we need to keep expanding or keep growing our capabilities to do that activity.

Jon Weiss: That’s promising. Thank you. So Jennifer, let me – we’ve heard a lot about modeling, and there’s been a lot of discussion as to whether a higher percentage or lower percentage of the U.S. population actually has been exposed, but we’ve also heard about the concept of herd immunity. Do you have any comments or thoughts on what percentage of the population probably has been exposed to COVID-19 at this point? And secondarily can you talk to us a little bit about this herd immunity concept and what percentage of the population would need to be exposed in order for that to play – to come into play?

Jennifer Nuzzo: Yes, so first of all this may be taking the concept of herd immunity and what that is. I mean, I think that word sounds nice. If you think, oh wow, I would like to have immunity then we can all kind of protect each other, but really what it means is that you achieve a state where the majority of a population has become infected. And so, that’s clearly not desirable given the potential that we know about this virus which is its potential to cause severe disease and deaths.

So herd immunity I don’t think is a really appropriate terms to talk about absent the idea of how much we would need to vaccinate our – how much of our population would we need to vaccinate in order to prevent the spread of the illness because I can’t imagine a situation where we should ever be willingly hoping people become infected so that we can further stop the spread.

That said, in terms of your question about the studies or what proportion of the population has already been exposed, so it’s – we don't have a good national estimate. There have been limited studies conducted. There’s some – many challenges with these studies. First of all, we don’t fully know what we’re measuring with the types of tests we would do. You’ve probably heard about serology tests or antibody tests, and those are tests that look for evidence of – that you have some level of immune response to the virus, but what that means if – what these tests can tell you is that you may have been – they tell you whether you’ve been exposed to the virus in the past. We don’t yet know if the results of these tests tell us if you are immune from the virus, so that’s one challenge.

The second challenge is that the tests that are currently in use have not been fully validated, so we don’t know if they are even giving accurate test results. There are efforts under way to try to understand how these tests perform. They haven’t gone through the same regulatory scrutiny as viral tests have, so the FDA does consider the performance of virus tests before it grants a test emergency use authorization, but that same level of check hasn’t happened for serology tests.

Nonetheless there have been some studies that have been done, and there are also problems with how you sample a population for these studies and whether that sample is representative. So once a study calculates a percentage of its study population that has evidence of having been exposed to the virus, it’s hard to then extrapolate to the broader population and say that that percentage represents what say the rest of a city may have experienced.

But the bottom line is that every single study that’s been done so far has largely confirmed that a small minority of a population has likely been exposed. So in Sweden where they are not taking the same level of – not implementing the same level of restrictions that other countries have been having, their approach has been described as one that is pursing herd immunity as a strategy.

I think Swedish public health authorities disagree with that assessment of their strategy, but nonetheless people have been very interested to see what the serology studies would say, and new data from Swedish public health authorities, they’re estimating that about 7 percent of the population that they sampled had evidence of prior exposure, which clearly is a small portion of the total population if that number is even fully accurate.

So bottom line, I don’t think we’re going to see a situation in which we have identified a community that the majority of our – the community has been infected and therefore we’ll see the virus go away.

Jon Weiss: Yes. So that 7 percent, do we think that 7 percent is high versus what we’ve likely experienced or do we just not know?

Jennifer Nuzzo: We don’t fully know. I mean, there had been a study in New York that was closer to 20 percent, but that – all of the studies have their own flaws. I mean, really what we need in order to answer this questions is a very well-designed sort of national sero-survey that is not just kind of where you capture people out of convenience or out of resource constraints. We really need a much better designed study in order to answer this, but I'd be highly surprised if we find any population where the majority of the inhabitants have already – have some evidence of prior exposure to the virus.

Jon Weiss: Yes, OK.

Jennifer Nuzzo: It's unfortunate (inaudible).

Jon Weiss: Yes, yes. So let's shift maybe a little bit to vaccine development, and Caitlin, maybe I'll direct this to you. So can you give us the latest perspective that you have on vaccine development, both here in the U.S. and around the world? And what's most needed? Is it – is it brilliant minds that are already working on it, is it financial resources, is there the right kind of collaboration globally, or is it just time and it just takes time to develop these vaccines?

Caitlin Rivers: Sure, there are a large number of vaccine candidates under investigation, so these are products that are early in the research and development pipeline that are going through the process of being tested and assessed to see if they're safe and effective and going through the clinical trial process.

Now the big question is how long will it take before we get a safe and effective vaccine. It is now a priority of the Trump Administration to have a product – that's their goal – by the end of the calendar year, but I think that is a more aggressive timeline than what I would expect. I think it's good to have it as a goal because it is – there is enormous public health need, but even the – even if we take the more conservative estimate that has often been offered by Dr. Tony Fauci of 12 to 18 months, that is still extraordinarily fast compared to the normal vaccine R&D timelines. And so that's – 12 to 19 months is more on the order that I am expecting.

Now one thing to highlight is that there is the process to identify a vaccine that is safe and effective and to get approval for use of that in the population, but it's another thing entirely to manufacture and distribute that vaccine. We will need hundreds of millions, if not billions of doses of this vaccine and it will take time to really move that through the manufacturing and distribution pipeline, and so I think it's important when we are thinking about how products are advancing and what timelines are realistic to also include that critical series of steps in our assessments.

So 2021 is what I am expecting.

Jon Weiss: And 2021 is a long year, so it – on the – on the front end of that, back end of that, or middle end are you thinking?

Caitlin Rivers: I don't have a sense. We don't have any products yet that really feel like home runs and that we – that I am confident will be a winner. It's still – there's a lot – it's very early in the process, there are many more steps to go, and so I don't think there's any – really any clarity.

Jen, would you – do you have any additional assessments?

Jennifer Nuzzo: Yes, I mean I – I think the – I mean first of all, the question is when is the science going to be settled, and I actually think 2021 is probably – the beginning of 2021 is maybe when the science could be close to being settled, but then there's still the whole production capacity and one of the challenges in producing a vaccine is you need a highly specialized plant in order to produce the vaccine, and of the candidates that are in clinical trials right now, they're all very different.

And so figuring out what kind of plant to build requires some guesswork in terms of what sort of vaccine may win, and then in the end, the plants only produce so much vaccine at a time. So when we will have sufficient quantities of vaccines to make an epidemiologic dent, I would guess late 2021 at a – at the most optimistic.

That would be ...

Jon Weiss: Yes.

J

ennifer Nuzzo: ... in my view still an extraordinary amount of time. And it all depends I think on what vaccine winds up winning. Different companies have taken different approaches, different countries are taking different approaches, and which one will come out first and whether – will we in the U.S. have access to it if it's not one – when will we gain access to it if it's not one that's made here?

Jon Weiss: Is there anything that you see that could speed up, Jennifer, speed up the science side of the equation? I think everyone understands the manufacturing side of it, but the science piece is a black box to many of us.

Jennifer Nuzzo: I really don't think so.

Jon Weiss: Is it – is it more ...

Jennifer Nuzzo: I really don't think so. I mean, there are ...

Jon Weiss: Yes. It's getting the resources, getting the money, getting – it's got the brilliant minds focused on it?

Jennifer Nuzzo: I think the brilliant minds are working on it. These things take time. You have to recruit people into these studies, you have to follow them, you really don't want to short circuit that because we've seen in previous vaccine development efforts that they've had to abort clinical trials because they found evidence of harm.

So we really want to take our time with the science. I think one potential shortcut is whether we are willing to lose money in our – in our guesses as to which vaccine candidate is likely to win and potentially build a lot of capacity that may not wind – ultimately be used.

And I think there are some things on the supply chain that we could potentially put more emphasis on, and apparently right now there's a real concern about availability of the glass vials that you would use to put the vaccine into, so making sure that we can hit the ground running when we do figure out which vaccine wins by making sure we have all of the production capacity and other supplies. That's really necessary.

But in terms of expediting the science, the only other thing that’s been suggested, this idea of potentially deliberately infecting people with the virus to see possibly more clearly if the vaccine protects human challenge studies. You may have heard about this, this is a really controversial idea. I am personally, deeply worried about that approach because first of all I don’t think we fully understand how people are going to be affected by the virus on an individual basis.

And so the idea of who is the right volunteer to recruit for that study so that we don’t harm them I think that’s a really difficult and ethically fraught thing to do. But also it’s not clear that it would gain us significantly more time, it may shave off weeks to months. In my view, it’s not worth the safety risk.

Jon Weiss: So, that’s a great discussion around the vaccine. Maybe we can turn to therapeutics and ask the question where are we in developing therapy to either ease the extent of the harm that the virus has on individuals or to shorten the experience or both? Or to actually cure it in an individual? How about, Caitlin, can I turn to you and ask what’s the progress on developing a therapy?

Caitlin Rivers: Sure, we do now have a product called Remdesivir that can reduce the duration of illness in patients who have developed severe illness. It is a modest effect but none the less we will take what we can get. And that, I think currently is the primary therapy available.

Now what we are working towards, again and any tool that we can add to our toolkit will be welcomed. But the holy grail if you will of therapies would be something that can taken as a prophylactic, meaning before you get infected or very early in the course of illness to prevent the development of severe illness.

Products that are able to intervene on illness in that way would be useful because they would actually change the epidemiology. They could conceivably prevent downstream infections because if you are able to protect people from getting infected, much like you would for a vaccines but it is a slightly different concept. Then you could start to change the topology or the nature of you outbreaks.

But if you are looking specifically for therapy that save people who have developed severe illness that is very welcomed from the medical perspective but it’s not expected to really change the course of our outbreak. I do think that in the coming months we will see more therapeutic options become available. And so that will really come before a vaccine and again any addition that we can make to our toolkit will be very welcomed.

Jon Weiss: So, Jennifer, do you have anything add on therapy before we maybe shift to more of the public health impact. I have a couple questions on that. But anything else on therapy be we shift?

Jennifer Nuzzo: I guess just one thing to flag because I think we’re getting increasing attention, you probably already heard about it as the idea of using convalescent (sera) and that’s basically antibodies against the virus from people who may have experienced it and recovered. I heard a briefing yesterday about it and it seems potentially quite promising. And possibly one of the more clear paths to getting a final product versus some of these other approaches that we’re still trying to sort out.

Jon Weiss: Interesting. Well let’s hope progress continues on both the vaccine and the therapeutic side of things. I do note that both of you are professors at the School of Public Health at Hopkins. And I guess I’d like to ask what if anything you think this has taught about the U.S. healthcare system that we should take away and learn from as citizens and also as business people?

Jennifer Nuzzo: So, Jennifer, I guess I can start. So, the beginning of the session in my introduction it was mentioned that I co-lead the development of the Global Health Security Index and what we did when we were putting that together was look at the public health and other capacities of countries around the world to deal with basically pandemic scenarios. And we published it in October and one of the things that we found, one of the clear findings from that was at the health system.

Whether they’re doctors or nurses or health facilities and personal protective equipment, all those things we need in healthcare to recognize and battle infectious diseases. But this was really the weak spot in essentially every country including well developed countries. So, the fact that we initially were confined to home in part to prevent our health systems from becoming overwhelmed was not really surprising given that.

So I think what we need to examine for our healthcare is and particularly for the business community, there’s been a lot of pressures to reduce costs, which are understandable because the costs are quite high. But kind of just in time inventories and cost cutting approaches in terms of staff and not trying to maintain excess staff. Those are really hard in the pandemic where you need a lot of bandwidth, extra bandwidth in the system.

So I think we really need to think about business models for healthcare that allow flexibility to expand when needed. And how we can afford that but it’s utterly critical because these events will become increasingly, the frequency with which these sorts of events will happen will continue to increase. We’ve seen that flu seasons can bring health systems to the brink.

And so just adding on to that a much more severe pandemic illness which we should expect to see more frequently in our future, we really need to think of how we can a health system that’s ready for that.

Jon Weiss: Yes, I ...

Jennifer Nuzzo: I would just add in our final moments ...

Jon Weiss: Go ahead.

Jennifer Nuzzo: ... if I could, that we have – continue to learn and relearn the lesson that our health system is only as strong its weakest link, whether it is the availability of ventilators or the availability of personal protective equipment. After one of the big hurricanes a year or two ago, it was saline bags that went shortage because the only facility that made those bags was hard hit. We really need to be thinking about how to strengthen not just our health system in terms of beds or doctors, but really even the consumable medical products and every – every step along the way needs to be strengthened.

Jon Weiss: Yes, I think there’s been a lot of light shown on supply chain tech questions, which both of you have sort of addressed there. We are pretty much at the top of the hour and maybe I’ll ask one last question before we let everybody get back to work from home, I guess. Is there anything that the private sector isn’t doing or that people on this call should be doing that would help the health care sector at this point in time? What’s the best advice you would give those of us that aren’t in the health care side of things to be doing that would help all of you and your colleagues?

Jennifer Nuzzo: Just quickly from me, get your flu shots because we’re heading into flu season and if we can reduce the amount of people that are coming into the health system with flu that will really help to increase the bandwidth in the fall for COVID-19.

And secondly, I mean, it’s really important that we isolate when we are not well. And, you know, I think businesses play an enormous role in terms of sick-leave policies and also the culture that encourages people to not show up if they’re sick.

We’re talking about testing and how testing is constrained across the U.S. but if you have symptoms and even if you can’t get tested, you should absolutely isolate yourself anyway. You don’t need a test to begin that process. So making sure that we do our part to limit the spread of disease and I’ve been really encouraged by the creativity that businesses have been showing in terms of how they can make their workspaces safer for their employees and their customers and so that kind of ingenuity I think will continue to be important.

Jon Weiss: Caitlin, anything you want to add to that?

Caitlin Rivers: I think those really captured it. I think we’ve seen enormous flexibility really for (want of) choice but nonetheless businesses and employees to work from home and I think carrying that lesson forward into the next phase, allowing employees to stay home when they’re sick and being flexible about how people manage their own health I think is absolutely critical. And that’s a lesson that we should carry with us.

Jon Weiss: Well I’ve never seen time go by faster than these last 45 minutes. So I want to thank Dr. Jennifer Nuzzo and Dr. Caitlin Rivers very much for being with us. And thank you also for your expertise and your knowledge and your leadership through this difficult time. We’re all learning from you and from your leadership so thank you.

And thank you also again to our clients for joining us. Hope this was valuable use of your time and that you picked up a few things that you’d thought about and needed some answers on.

And lastly, I hope everybody enjoys a wonderful, safe, and socially distanced Memorial Day weekend. All the best to everyone ...

Jennifer Nuzzo: Thanks so much.

Jon Weiss: So thank you very much.

Caitlin Rivers: Thank you.

Jennifer Nuzzo: Thanks.

Jon Weiss: All right. Bye-bye.

Operator: Ladies and gentlemen, this concludes today’s conference call. Thank you for participating. You may now disconnect.

END

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