An end-to-end approach to (finally) put an end to this pandemic, go back to living life, and get ready for the next one.

This is year three of this pandemic. Looking back, there are many things we did well, but many more we didn’t. It’s been touch and go, with rare successes, such as in China, but at a high price in privacy and personal liberties. The key hurdles in the US and in other parts of the world have been disinformation, dogmatic opinions, rejection of science, nationalism, lack of integrated thinking, pandemic fatigue and lack of planning ahead.

In the third year into this pandemic, numbers are still getting worse. Shut downs are still used in some countries, but their benefits are always short lived and their negative impact are not worth the pros. The next wave gets worse than the previous one — i.e. Omicron. Vaccines are effective but a significant part of the population in developed countries refuse them, putting them and the rest of us at risk. Poor countries have no vaccines, tests are hard to find and therapeutics are also limited. We should be way ahead of where we are by now.

Since early 2020, the world has been caught in the biggest health challenge ever met for the past century. Despite numerous warnings and efforts by the World Health Organization, the CDC and equivalent institutions around the world, we were once again caught by surprise and unprepared to handle this pandemic at the local, regional and global level.

But this challenge is not the only one we have faced in this short beginning of the 21 century. Let’s look back for a moment and review a summary from “Managing Epidemics” by The World Health Organization (Managing epidemics: key facts about major deadly diseases. Geneva: World Health Organization; 2018. License: CC BY-NC-SA 3.0 IGO.)

“SARS — Severe acute respiratory syndrome — was unheard of before 2003. But it affected more than 8,000 people, killing about one in ten of them, causing fear and panic across the world, and inflicting enormous economic damage, especially in Asian countries.

In 2009, a novel influenza virus, H1N1, started to spread, creating the first influenza pandemic of the 21st century. But — and this is a reason for cautious hope — it was not as severe as expected thanks to recent preparedness efforts. The importance of these efforts is a core issue in this handbook.

In 2012–2013, a new virus surfaced in the Middle East, causing an epidemic of what became MERS — Middle East respiratory syndrome — that spreads fatally into many countries beyond that region.

The Ebola epidemic in West Africa (Guinea, Liberia, and Sierra Leone) in 2014 was unlike the previous 24 localized outbreaks observed since 1976. Instead of being restricted geographically, this one seriously affected three African countries and spread to six other countries in three continents, and sparked alarm worldwide.

In 2015, the Zika virus, transmitted by the Aedes Aegypti mosquito, triggered a wave of microcephaly in Brazil. This disease causes dreadful damage in the brains of unborn babies. Almost 70 countries, one after another, then experienced their own Zika epidemic. There are probably many more to come, because most of the global intertropical zone has a high density of Aedes Aegypti that transports the disease.

And so a clear pattern continues to take shape. Old diseases — Cholera, Plague, Yellow fever among them — often return, and new ones invariably arrive to join them. About 40 outbreaks of cholera alone are reported to WHO every year.”

Also, according to the same report, this pattern has another worrisome aspect — Epidemics are spreading faster and further. Just as fast, in fact, as an intercontinental aircraft can fly.

Based on that new reality, global health organizations have put in place monitoring and R&D programs, with international collaborations. These are aimed at identifying a pathogen resurgence or mutation that may trigger an outbreak.

When that first line of defense does not work — like in all cases listed above and many more in the previous centuries, we have to deal with an actual outbreak or series of outbreaks, and try to mitigate those before they become uncontrolled and global — before they become a pandemic.

Back to today: we have all witnessed the unprecedented global impact brought by Covid-19. Countries around the world have been scrambling to find the best possible way to respond to the devastating effects with uneven success. Across the world, as of January 2022, over 5.5M people have lost their lives, with more than 320M affected. Shutdowns, restrictions, physical distancing, remote work, disappearance of all activities that people enjoy in normal times all have a tremendous impact on the economy, businesses, employees, and people all over the world.

Every part of the global economy has been affected: brands in entertainment, retail, dining, hospitality, travel, sports and conferences, corporate campuses, education, healthcare and government to name a few. Bankruptcies piled-up, with unprecedented job losses, and financial stress on populations around the world. The mental health impact has also taken a toll that will be with us for years to come.

Everyone starts talking about the “New Normal” as if we must resign ourselves to being overcome by the disease, with limited ways to fight back. This is not sustainable. We must and should do better.

So, what‘s the path ahead at this time to get out of this pandemic? The key to tackling this pandemic successfully is a well coordinated combination of prevention behaviors, immunization via vaccines, knowledge via testing and data management to know who’s healthy or not, and therapeutics via a range of existing or soon to come solutions.

1 Prevention behaviors

We’ve all heard this — masks and “social” distancing are the first line of defense. National mandates are key. And it works best when there’s a consequence — such as a fine — for the ones who do not comply. This is a critical tool that should be the foundation of any plan.

2 Immunization

According to the Regulatory?Affairs Professionals Society?(RAPS), as of January 2022, there are 25 approved vaccines around the world. But according to the?New York Times, despite the fact that more than 4.7 billion people worldwide have received a dose of a Covid-19 vaccine, equal to about 61.2 percent of the world population, there are stark gaps between vaccination programs in different countries, with a majority of developing countries having little to no vaccine coverage. And to make things even more complicated, vaccine immunity is waning fast, requiring booster after just months. And worst of all issues, the virus keeps mutating and producing new variants (Alpha, Beta, Gamma and Omicron) that have the ability to elude transmit faster and the immune system.

3 Therapeutics

As of November, according to a?New York Times Coronavirus Drug and Treatment Tracker, there are 34 drugs and treatments approved for Covid-19 treatment. Solutions include Antivirals (to stop the virus from hijacking our cells), Solutions to mimick the Immune System (convalescent plasma, monoclonal antibodies, Interferons), to reducing Immune System Response (Corticosteroids, Cytokine Inhibitors, Blood Filtration Systems, Stem Cells) and other treatments. These are critical in treatment ill patients and curbing grave disease and death. The challenge is the availability of those drugs which as of today, is limited.

4 Knowledge

Visibility of the state of the pandemic and outbreaks in real time — The reason for large scale shutdowns and stay at home orders is the lack or absence of visibility on the disease progression across populations or groups in real time. This drives authorities to force entire populations or groups (100%) into life changing rules while only 1 to 10% of those individuals are sick are any given time.

Testing alone is not the solution. And even that has failed us since the beginning of the pandemic. Key reasons: lack of availability, price too high for recurring testing, long turn-around time, inconsistent accuracy and inconvenient sample type — nasal swab. Better testing solutions are urgently needed. Tests that are saliva based, easy to take by everyone, affordable (less than $10), highly accurate and with quick time to answer.

But testing once in a while is pretty much worthless. Reason why after 2 years in and significantly higher tests availability, the pandemic is still accelerating. A weekly testing schedule should be the norm. This will enable reliable contact tracing and minimization of contamination.

Since March 2020, the?FDA has authorized more than 400 COVID-19 tests?and sample collection devices, including authorizations for rapid, OTC at-home tests. But lack of insurance reimbursement made them out of reach for most families. This is about to change tomorrow with a federal mandate for full reimbursement.

With the financial hurdle out of the way, testing weekly at population scale would enable visibility of the progress of the pandemic and impact of population health programs in real-time. To do that, results must be automatically captured and stored through a mobile application.

All that data should then be centralized into an enterprise app (de-identified), and in full HIPAA and security compliance. With real-time models showing pandemic evolution to assess the results of health initiatives to fight it. This is the necessary tool for key “destination” organizations listed above to have the necessary actionable information to put an end to this pandemic, quickly.

There are countless test manufacturers from around the world rushing to grab a piece of this multi-billions dollar opportunity globally. But there are few Platform Solutions that can be effective at complementing Prevention behavior, Immunization and Therapeutics as a the “eyes” of the master plan.

5 Think globally and be there for each other

The stark disparity between countries when it comes to?vaccines, testing and therapeutic solutions highlights the lack of understanding of how a pandemic works, how to end it, and how to ensure we’re all supporting each other at the global level. Even if and when rich countries are able to make significant progress, leaving poor countries behind means a never ending endemic situation, with time for more variants with possibly much more dire consequences around the world. We must think globally and act locally, in every single country on the planet to ensure a true global end to this.

Getting ready for the next one

Accelerated human population growth and encroachment on the natural habitat will multiply the unearthing of pathogens we will need to face. The question is not whether we will have another pandemic but when, and how bad the pathogen will be. We must deploy a Global Preparedness Monitoring Program as proposed by the?Global Preparedness Monitoring Board?co-convened by the World Health Organization and the Word Bank. Countries around the work must commit to participating in a coordinated way to monitor, share data, and deploy active management programs to ensure we minimize or strop the next pandemics.

Let’s urge governments (national, regional and local), corporations, healthcare organizations, education and brands to seek such comprehensive solutions and implement them quickly, to will help mitigate and end this pandemic, and be ready for the next ones. Together is the only way out of this. And the only way to not let future pathogens catch us by surprise, and turn our lives, health and economies upside down.

By Ga?tan Fraikin / CEO / Addictive Health /?www.addictive.health?/ [email protected]. Ga?tan is a Health and Med Tech Unicorn Builder as Advisor, Board Member, VC + PE Funds Advisor, CEO & Investor. He drives Health Tech and Med Tech ventures to disrupt and scale from early stage to exit as CEO, Board Member, VC + PE Funds Advisor & Investor.