The secret weapon to fight a pandemic

It took us unprepared. We missed how much probable was the threat of a contagious and potentially deadly virus as the COVID-19 in a hyper-connected world. And we have neither a treatment ready for it nor a common reaction protocol to fight it in a proven, effective way. We are learning while racing against the time, while people are dying, and each country is taking its own approach despite the evidence that we are all interconnected. Singapore, primed by the experience with the SARS (that is a COVID) virus of 2002, reacted quickly and drastically. Many others underestimated the risk until the virus started spreading among their population, becoming a global problem. Governments are now working on getting us through this unprecedented human and economic crisis, looking for all the possible tools and ideas that can at least slow down the virus diffusion.

Given my expertise in digitalization, I can see how simulation can be the secret and, so far, underestimated weapon to fight a pandemic. No, I’m not saying simulation will solve everything, but when you have a fast-spreading, highly contagious disease, you need to take a swift reaction to contain and slow the threat down. Simulation will help you a lot and in many different ways.

SIMULATION LETS YOU TO SEE THE INVISIBLE

We cannot see viruses, how they spread in the air, infect other people, contaminate surfaces and the buildings we live in. What is happening, for instance, in a closed environment as a cinema or a mall? Why we had so many cases on a cruise ship? Are we safe on a bus? In all these places, we have forced air ventilation systems, and they move viruses with the air. Simulation can predict and let you see how air particles are moving into a closed area. It’s now possible to assess the level of danger of each of these places, to design and tune the air conditioning system in a way that the contagion can be limited.

Here there is a practical example made by the FAA Center of Excellence at Purdue University many years ago: you can see what is happening when someone sneezes in an airplane, how germs will spread around because of HVAC (the air conditioning system). Is it now clear why doctors are asking people with cough to use a mask?

SIMULATION LETS YOU TO SEE THE FUTURE

Simulation not only allows us to see the invisible, but it gives us another “superpower”: see it before it happens. One of the problems we are facing in these days is how to sanitize rooms, offices, hospitals. According to a preprint published this week by the National Institutes of Health, Princeton, and the University of California, (that you can find HERE) the COVID virus can survive for days on surfaces. Not only in the surgery room of a hospital but also on the handrails of the buses you take every day, on the doors and shelves of the malls you shop, in the office you go every morning. One interesting countermeasure can be to sanitize these areas at night, when they are empty or not in services. It can be done automatically through spray devices that must be placed in the right places to be sure they are effective. It’s also possible to use the forced ventilation/air conditioning systems to multiply their effectiveness in a building. How to design these spraying systems to be sure they will sanitize every corner of each room? Simulation is, again, the answer. You can put virtual spray systems in a place and then move them around. You can change the amount of chemical you spray, the number of jets and their position, the pressure and other parameters till you find the optimum to maximize the effect, kill the viruses, and don’t overload the system with too many chemicals. So you can do it at night, and have safe rooms and equipment the day after.

My Friend Luca Emili, CEO of the Italian startup InSilicoTrials, showed in a video how this could be done, all through a web-based platform that requires nothing else that the design of the room on a 3D cad file. No simulation expertise is needed as well, as the models are already there, done by international experts, and made available on a pay-per-use base. It means that simulation can be scaled and made available to anybody who needs it.

SIMULATION SPEEDS UP SOLUTIONS' DEVELOPMENT AND TESTING

Research and development of medical devices and drugs are costly and time-consuming. The launch of a new drug requires years, totally incompatible with the reaction time of an emergency. In silico (simulation-based) trials can drastically cut this time, with additional benefits as impressive cost savings while also reducing tests on animals and humans. The European Medicines Agency (EMA) and US Food and Drug Administration (FDA) have collated examples of impacts of model-based approaches for drug development, from the optimization of preclinical testing conditions to increased drug or medical device performance. Virtual models minimize the risk of failure of in vivo clinical testing while freeing up resources to accelerate medical innovation. The use of standardized and validated models also helps to comply with rules and recommendations of regulatory bodies. Today, for example, the evaluation of exposure and exposure-response relationships can be done virtually. It helps to shape clinical trial designs and dosing/regimen administrations. In this way it is possible to reduce trials sample sizes and to define a drug therapeutic window, expediting the overall drug development process.  Many other applications are already available, thus not so diffused despite the evidence of the benefits. Pfizer and Merck&Co/MSD have reported annual cost savings of €88M and €438M respectively through the use of Model Informed Drug Discovery and Development (MID3) for decision-making in drug development.  

 THE CHALLENGES, TODAY

I always say there are three essential pillars to use simulation. The first one is a proven, robust solver, based on physical equations. There are companies on the market that can provide them. The second one is computer power: this will help you to speed up your simulation, run many cases in a short time to find the optimum configuration. Suitable workstations are now available for a few thousand dollars, and cloud computing is a sound reality. The third part is the hardest to find: expertise. Simulation tools are not easy to use. Despite improved and friendly interfaces, wizards and automation, they still require expert people to be used. Platforms as InSilicoTrial are closing this gap.

There is a fourth challenge: people’s and companies’ mindset. Simulation has evolved so much in the last few years that is now able to predict the behavior of very complex systems with incredible fidelity, so we are ready for critical applications as in silico medicine. Maybe this crisis will generate so many needs that the industry will accelerate the adoption of this technology that has already proven its value in many other fields.