By Bobby Guy and Carissa Jones*
As we write this, the COVID19 pandemic has held the world in its grip for more than 200 days –- from March to October 2020. A healthcare crisis is driving our daily reality, and the US healthcare community has been working hard to save lives and adapt to a new economic reality. COVID creates great uncertainty, and uncertainty is anathema to the US economy, as well as to the healthcare sector. It makes daily operations hard, it makes financing and cash management hard, and it makes long-term strategic planning all but impossible.
We often refer to the current period as The Great Hiatus, or The Great Pause – a time that we will remember in history as the space between the start of the global pandemic and our exit from it. What will it take to get back to social interaction, and how do we manage The Great Hiatus? In our opinion, there are four critical steps for managing through and then exiting COVID’s grip.
First, we must succeed at “COVID-containment”. What is this? It is widespread rapid testing, accompanied by reasonably effective treatments for COVID (“therapeutics” in the industry vernacular). If we can test or treat (we can do both right now), then we can socialize again. The University of Illinois, as one example, is using rapid saliva tests for its student body twice a week. We should be doing something similar across the country. Why aren’t we?
Rapid tests vary in cost, are not widely available, and are not perfectly accurate -- but these are hardly real criticisms. Clearly we have rapid testing methods, and clearly we have some that are affordable and sustainable. The federal government and leading state governments should be spearheading efforts to make them widely available and cost effective. Realize that it only takes one state doing this well to show the way for the entire US (and there is a major economic opportunity here also -- for the companies that can produce hundreds of millions of affordable rapid tests). As to accuracy, rapid tests are criticized as being less accurate than lab tests that take longer. But some rapid tests are now accurate above the 90th percentile, and even if rapid testing was only 70% accurate, isn’t 70% better than the 0% accuracy we have with no testing at all? Rapid testing, combined with social distancing and mask wearing, gives us significantly more ability to interact.
As to therapeutics, we have many that are showing early promise, such as Eli Lilly’s neutralizing antibody LY-CoV555 and Regeneron’s REGN-COV2 Antibody Cocktail, in addition to older, repurposed therapeutics such as Dexamethasone and Remdesivir. But, like rapid testing, we still lack broad implementation – patients with COVID have varying levels of access to healthcare, and we need a reasonably consistent protocol on who gets treated when (even if the “with what” changes as we get smarter). Right now, as a country we’re still confused on who can get tested, much less who can or should get treated. Therapeutics are a major opportunity to change the trend of the pandemic, and again, an economic opportunity for those who can produce and distribute them during The Great Hiatus. If we as Americans want to socialize again, rapid testing and therapeutics together are the combination that unlocks the quarantine door.
Second, we must have a new economic stimulus program for the US economy. The stimulus programs from the Spring and Summer have concluded, but The Great Hiatus continues. By late May, the US economy had shed more than 40 million jobs. Some of those came back through the summer, but many have not. Wall Street has held its own for much of the pandemic until recently; Main Street is a different story. This month, YELP reports that 61% of pandemic restaurant closures are permanent, and The New York Post reports that almost 90% of New York bars and restaurants couldn’t pay August rent. Consumer spending is the bedrock of the US economy, and we need additional stimulus programs to revive the economy. The US needs new stimulus now, not after another wave of closures, bankruptcies, evictions, and food lines.
Third, we must get past the election in November. Healthcare is rarely the driving issue in a major US election, but because of the pandemic, healthcare is likely to be at the top of the voters’ agenda this cycle. It is also likely to be one of the major legislative pushes after the election – with both major US parties now advocating for healthcare reform. In addition, political stability provides the economic environment that businesses need in order to flourish and grow. The US feels as divided as it has ever been, with racial and social unrest, frenzied political rhetoric, and the threat of the first presidential election in US history where both sides are not committed to a peaceful transition. The US needs to get past this election, hopefully in the peaceful way of first world democracies, and our government institutions need revitalization following so much acrimony and toxicity. The conclusion of a lawful and orderly electoral process will create the opportunity for the economy -- for businesses inside and outside healthcare -- to start growing and planning again.
Fourth and finally, we need a vaccine for COVID. Theoretically at least, a COVID vaccine is the final exit from COVID. However, we’ve all seen the reports that a vaccine could take a year or more to deliver to the world, and that it is unlikely to be 100% effective. If this is true, it is imperative that we take the initiative in the midst of The Great Hiatus, not just wait for a vaccine. More importantly, even if a vaccine is 100% effective, the uncertainties around the timing of a vaccine mean that we cannot afford to wait for one before returning to some semblance of normal life. When the quarantines began in March, many believed we would be on pause for 2 months and afterward life would resume. The assumption has proven badly mistaken, and time marches on.
We believe that social interaction is the key to economic and personal flourishing. Many of the tools that we need to return to social interaction during The Great Hiatus already exist. The healthcare industry, and all Americans, should be demanding them now. If we can achieve COVID-containment, additional stimulus, and a peaceful election, the return to social interaction is within our grasp.
*Bobby Guy is a Healthcare M&A lawyer with Polsinelli and the host of The 10 Minute HealthBizCast (“Exploring Ways To Make Healthcare Better”). Carissa Jones is the President of Mercodia, Inc., a US subsidiary of Sweden’s Mercodia AB, that specializes in laboratory tests for clinical research and diagnostics, as well as GLP-compliant bioanalytical services. Both Mr. Guy and Ms. Jones hail from Nashville, Tennessee.