Pandemic ‘Dividend’ Must Not Be Squandered

Source : IN VIVO

The shock of COVID-19 led many device and diagnostics companies to pivot, rapidly and successfully, to a response mode and then to medium-term coping mechanisms. They learnt much about the inadequacies of even mature health care systems to respond to an extreme public health emergency. Some were confronted with shortcomings of their own.

Many stressed the need for longer-term health care delivery planning and better cross-border collaboration. Excess capacity should be built into health care systems in readiness for similar events in the future, which are more, rather than less, likely to happen, according to the consensus.

But the fear already being voiced is that the pandemic “dividend” will move swiftly down the agenda when the collective need for rapid emergency solutions subsides. Normal operational and competitive pressures are likely to take precedence when market forces once again dominate.

Pre-COVID behaviors are already starting to return. But certain – overdue –  needs that were forced to the top during the pandemic, such as on data sharing, must continue to be acted on across the stakeholder spectrum.

That is the view of Henrik Ullum, professor, director and CEO of Denmark’s Statens Serum Insitut (SSI), expressed to In Vivo. Ullum, a speaker a recent high-level round-table on the theme of “the value of diagnostics” said: “It seems obvious that data integration and artificial intelligence are key to strong diagnostic development.” Just as it also seems obvious that somehow reimbursement needs to be enhanced to harvest the potential for health.

Ullum’s sentiments were echoed at an informative panel on post-COVID learnings at the 2021 MedTech Forum (MTF). The CEOs of Qiagen NV, Thierry Bernard, and of The Binding Site, Inc., Stefan Wolf (who until March 2021 was Thermo Fisher Scientific’s head of the global clinical diagnostics and immunodiagnostic divisions), were joined on the MTF panel by Stacey Shulman, Intel Corporation’s VP of the Internet of Things Group. The MTF panel was organized by MedTech Europe.

“If nothing else comes out of this pandemic, we’ve got to solve data sharing.” – Stacey Shulman.

Shulman, also general manager of health, life sciences and emerging technologies at Intel, stressed that one of the big learnings from COVID was that data sharing remained a challenge in the industry. “If nothing else comes out of this pandemic, we’ve got to solve that," she said.

Wolf concurred. His view is that the pandemic has shown that while a lot of information is available, it is not being used for the benefit of society. The tools available had not been fully leveraged to handle disease, he said.  “Timely information on testing: that is where we need to look closer,” said Wolf. 

Shulman focused on health care systems’ evident lack of readiness to rise to the pandemic’s challenges. “We need to prepare for what comes next. There is not an expert out there that does not think this is not one of many pandemics.” Some people have referred to it as a “practice pandemic,” she added. “We have to put in place a biosafety infrastructure, learn from this, and from the collaborations we have achieved to solve some of the current major illnesses.”

Different types of collaborations sprung up and worked to good effect during the pandemic. Intel, for instance, worked on a data collective for research scientists, which involved a range of companies and stakeholders. Getting companies to collaborate on medical issues was not easy before the pandemic, Shulman observed. But once the pandemic struck, they dropped their guard and started to work together. “We got to the results much faster.” The question is can this be sustained post-COVID?

Bernard said that the challenge of having to react to events at speed was a good lesson to keep in mind. Viruses and bacteria know no borders, he said. “This pandemic taught us the power of humility,” he added. The notion that health care businesses are always masters of their own speed and direction has been shattered. “It’s tempting to think we are in control of everything, with our business forecasts, but the pandemic showed us that major issues can happen.”

The pandemic confirmed the need for the ability to batch and process significant volumes of tests, and thus for large-volume automation. “But at the same time, decentralization of testing is gaining a foothold, and tests that have very good limit of detection (LOD), sensitivity, specificity and affordability are moving closer to the patient,” said Bernard. “A demand for home testing has been established."

There is still more opportunity to improve access to tests. Wolf noted that the diagnostics value considerations on 1) material flows; 2) where testing is done; and 3) the materials to do the tests themselves, should be borne in mind for future emergencies. But just as important is data flows. “We still haven’t fully connected the results for better management,” he said.

The MTF panelists revealed the extent of internal and external adaptation they had to manage as a function of the pandemic. Shulman admitted that even a company like Intel had to adapt technologically. “There were many challenges. We had to formalize conversations that had been more casual, and I had to build trust in the organization without [staff having] the proximity of one another.”

But in adapting to a new way of working and collaborating, Intel found that productivity went up, to the extent that the company would consider it for the long term. “It’s productive. Many people like it,” she said of the concept of flexible working.

Qiagen’s challenges were different. As a company at the forefront of the pandemic testing needs, it found that it needed a 24/7 supply of shift workers. Round-the-clock coverage helped the company increased its output 50-fold between December 2019 and June 2020.

“We decentralized decision-making and gave more empowerment to people, which seriously increased their creativity,” said Bernard. In one particular month, Qiagen launched 10 new products aimed at controlling COVID – some of which had not even been on the project list just two or three months earlier.

“The pandemic has shown the value [we] are bringing to society, and that was motivating for our people,” said Bernard. But as at Intel, the office/home working balance going forward is also on Qiagen’s agenda. The trend towards more mobile and flexible working must be considered, said Bernard, alluding to a mix of office-based and remote staff working in the future.

The pandemic has also potentially impacted methods of how to market and sell products. The question now being asked is: Are company visits and trade shows quite as vital as they were pre-pandemic? The answer is likely to be yes, but there is little doubt that companies' efforts will be calibrated in some way, going forward.

Another positive outcome, for Wolf, was that an intense and demanding period has actually been very rewarding in terms of certain changes happening in the health care sector. In spite of the early COVID-induced disruptions to The Binding Site’s business, Wolf revealed that he felt a high level of connection with suppliers, clients, employees, partners and patients. “This pandemic made things happen in health care and showed what value chain stakeholders bring to the table,” he said.  

Shulman observed that remote and digital health care was seen to work fully and well during the pandemic. There were proof points and challenges, and temporary regulations in some cases that will need to be made permanent, she said. In talking with many companies and seeing the broad trends that they too identified, Shulman said of remote/digital health care:“This is not one that we see going away.”

Bernard agreed. “We have seen an acceleration of digital activities and of making the best use of artificial intelligence and digital capabilities,“ he said, observing that these new efficiency tools are extending far beyond sales and marketing activities and into manufacturing operations, for instance. 

“We must continue to invest there,” he said, noting that more and more IVD customers are now more open to digital interactions.

Furthermore, the trend towards POC and the decentralization of testing will continue, given patients’ new-found appetite for their own health. But the proximity of health care professionals remains key for results interpretation, he stressed.

The commonly held notion that digital will take jobs away is starting to be seen as unfounded. Shulman observed that the early signs were showing that digital could be a job creator, contrary to the usual impression that it kills jobs.

Wolf shared this optimism about the growth of new, high-quality jobs in the health care industry. “Much work will need to be done to implement the learnings, and if we went down the road of evolving health care towards home testing and digital access for patients, etc, that would not happen without new resources being added.”

Industry leaders, aware that the digital revolution will impact traditional business models, still have much work to do, of course. But they are now at the stage where they understand their journey ahead, said Shulman. They have moved beyond the preliminary thoughts of whether digital will add value to the business. And they have gone beyond discussions over whether AI will be meaningful. “They are now putting plans in place, aware that it’s a long journey still,” she said.

Further back, the laggards are still mulling what health care transformation means to them, and whether they need to go on the digital transformation journey at all. But the journey takes a long while, as seen in the examples of fintech, retail and manufacturing. Shuman said: “Now we’re watching it happen in medical.”

She added: “Every company that provides a solution should be looking at how they can do something in this space. They need to be reflecting on ways to make sure the patient/consumer has the right amount of information.” At the heart of it, patients want to be more proactive in their own care, and companies must get onto that trend and analyze how they can both enroll patients and provide them with a sense of autonomy, she said.

Bernard noted that this has come at a time when the IVD industry’s value has never been as well known as it is now. Industry is faced with a great opportunity, yet at the same time, it needs to invest in medical education and in bringing tests closer to the patient. “People now know what PCR, antigen and antibody tests are. That is a revolution in itself,” he said. “We need to live up to the challenge.”

By Ashley Yeo