Contributed Commentary By Jeff Fischer
February 4, 2020 | It’s been approximately 17 years since SARS claimed nearly 800 lives and infected more than 9,000 people around the globe despite China’s quarantining efforts to prevent the spread of disease. With the outbreak and fast spread of Novel Coronavirus, including at least 106 deaths, as of Tuesday morning, the question on everyone’s mind is “Can the 2019-nCoV virus be contained?” Chinese officials are claiming the incubation period can range from a few days to more than a week, similar to influenza. As we are unable to contain the annual flu or the multiple circulating viruses that cause the common cold, if nCoV2019 sheds and spreads days to weeks before symptoms, true containment will likely not be possible. Slowing the spread of the virus and protecting the vulnerable is likely a better goal.
The United States is in a better position today to delay the spread of this novel coronavirus, protect the vulnerable, and keep the hospital system from being overwhelmed, than at any other time in history. If successful, it will create a model to diagnose and treat the population during future season and pandemic outbreaks.
Due to the gig economy there is an army of individuals that move interchangeably from task to task with little or no training. Mobile technology allows us to have almost any item delivered and many items picked up for delivery to others. Medicine, food, and other household items can be delivered within hours. Never before in history has it been easier not to leave one’s dwelling. If needed, especially in the large metropolitan areas, one can stay at home and wait out the worst of the virus.
The science of the asymptomatic spreader was something I learned at a very young age. When I was in the third grade, I had been not feeling well on and off for several days. Halfway through one school day, I ended up in the nurse’s office. The nurse tried to reach my mother and when she was unable, the next call went to my father, a pediatric infectious disease specialist. He answered the phone and was told I was feeling sick, and I need to be picked up. After asking the nurse to hand me the phone, my father asked me if I could finish the school day. I told him I could and handed the phone back to the nurse. She explained to my father that I needed to go home to prevent other children from getting sick. My father suggested she send the healthy kids home as some of them were more likely spreading the virus, as I was several days in. My point: early diagnosis and who to treat first is an ongoing lesson for those watching the coronavirus.
Two of the three Chinese nationals in France who have been diagnosed with coronavirus arrived without showing symptoms. As a precautionary step, airports in several countries are using scanners to take the temperature of passengers arriving from China but the people infected with the virus can take a fever reducer and go around security by coming off as healthy while being the carriers for the virus. Simple efforts will never be enough.
At-home self-testing will need to play a larger role in future for pandemic outbreaks. These tests will likely be most helpful for patients that are demonstrating symptoms; more sensitive tests will likely need to be available to identify asymptomatic carriers, the key to slowing the spread of virus. Ease of self-sampling will make blood marker testing challenging, so samples will likely focus on nasal swabs/ secretions, urine, and stool. Sample transport products and technologies that inactivate hazardous pathogens or contain them to ensure that the logistics chain is not exposed to infection will be crucial. New applications will allow laboratories to provide real time capacity to the individuals transporting samples to minimize testing time. Results can be sent directly to patients with prescriptions forwarded to the pharmacy for delivery. Then asymptomatic potential spreaders can stay home and isolate themselves from those not yet infected. Only patients that are having moderate to severe symptoms will need to seek active medical care. We need to unleash our best technology to contain an outbreak and we need smart people monitoring the data to anticipate next steps.
Screening can also be required in advance of certain activities such as entering a nursing home, visiting individuals with underlying health conditions, and receiving certain drugs that suppress the immune system. That way, entire hospital wards will not become infected and further transmit the virus.
The longer the spread of a novel virus is delayed, pharmaceutical companies and government agencies have more time to find effective drugs and vaccines. We have the science to make a major difference and contain Coronavirus. We must be smart, move rapidly, and educate the public that staying on top of their health. Following the doctor’s orders and not going to work with symptoms is the way forward. Yes, we have great technology and many moving forward to eradicate coronavirus, but it is up to everyone to stop the spreading virus in its tracks.
Jeff Fischer, MBA, is the President of Longhorn Vaccines and Diagnostics and is responsible for oversight of all non-scientific aspects of the organization to include regulatory affairs. Mr. Fischer co-founded the company and has served as its Chief Financial Officer from 2007-2017. From 1998-2005, Mr. Fischer served as an executive vice president and CFO in the biotechnology industry. He is a former infantry officer in the United States Marine Corps and holds an MBA from the University of Texas at Austin. He can be reached at jeff@lhnvd.com.