Many things are forced to change and it creates lots of opportunities especially in the way people work together.
“tens of thousands of software engineers are cooped up at home getting frustrated with their current tools and wondering if they can spot some pain point, or mechanic, or small difference to the flow, and solve some opportunity that no-one ever quite realised was there.”
Success can happen even if things look entrenched. The anecdote about Dropbox is telling – everyone told Drew Houston ‘there are dozens of these already’ and he kept replying ‘yes, but which ones do you use?’
There are already some interesting new ideas in the chat app market.
It shows that the majority of the improvement in mortality since the 1900 in the United States has come from improvements in infectious disease mortality.
A really excellent post from FT Alphaville trying to understand the lockdown.
They point to analysis by Sir David Spiegelhalter, former president of the Royal Statistical Society and co-chair of the Society’s Covid-19 task force.
He produced the pictured chart.
“The pattern shows Covid deaths increase exponentially with age … this follows the pattern of normal risk. Whatever risks you’ve got, this just seems to exaggerate them — pump them up and pack a year’s worth of risk into a few weeks. Covid deaths are a fixed proportion of the people dying . ..”
Two extra points added to this are those exposed to excessive viral loads (healthcare workers) and the 10s of thousands of unnecessary deaths from less emergency care.
Moving away from the numbers – the moral discussion at the end is the most interesting part.
A really brilliant article on the state of Covid vaccine development.
It gives a great overview and introduction into vaccines in general.
There are 115 vaccines in development (78 currently active).
There is a vast range of vaccine types (as the diagram shows). The article explains what all these types are.
“We are only going to find out, in the end, by dosing people. Lots of people. With therapies targeting the immune system, there is in the end no other way to know, because of the complexities of the human immune response and its wide variation in the human population .. some of the steps are going to have to be done on a scale never before attempted … there are going to have to be some shortcuts.“
There is one thing that can’t be skipped – how long immunity lasts. This question can only be answered with time.
On safety – “Now you see the exact bind that vaccine development has always been in, because the whole point is to treat millions, even billions of people who are not currently sick, to protect them against disease while not doing more harm along the way by setting off the body’s fiercest and most alarming biological responses.“
On manufacturing – “My guess is that scale-up and manufacturing could well be the biggest chance for the timelines mentioned earlier to blow up“.
There is a willingness to pre-fund manufacturing, across all these varied types of technology, before efficacy is established by Bill Gates and others.
However, these views are outdated (data tends to run to 2010), often fail to account for start-ups (i.e. by following a pre-existing cohort) and are an extrapolation of a trend.
The pictured chart is an updated graph of the number of new drugs or new molecular entities (NMEs) per $bn of R&D spend.
Interestingly it has actually been stable for much of the 2000s and can be explained in part by the industry having better information and how it is used. This article explains in depth.
Interestingly surveys suggest Chinese consumers are cautious despite lifting of the lockdown.
“A Morgan Stanley online survey of 2019 consumers in 19 provinces last week found that while most respondents—86%—were leaving the house for work, most were still reluctant to go out to shop, eat or socialize. And 69% said they would go out for essentials only, down from 75% in early March—still extremely high.” (Source: WSJ).
The chart below is also interesting showing how activity across a set of indicators has fared so far in China post the lunar new year as the country opens up.
In short – activity will take some time to recover.
“In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%).”
Crucial to understand the limitations of this data – the need for a randomised placebo controlled trial.
Gilead’s (GILD) CEO Daniel O’Day in an open letter expresses this.
These trials are ongoing with results coming in end of April/May.
“While it may feel like a long wait for data given the urgency of the situation, it has been only two months since the first clinical trials began. Given that it can take a year or more to have the first clinical data for an investigational treatment, it is remarkable that we expect to have the first remdesivir trial data so soon.”
The latest buzz from Chicago is also just a snapshot and drawing conclusions is “scientifically unsound“.
