I am an immigrant (permanent resident) and work in the pharmaceutical/biotech industry in the development of drugs against cancer and would like to offer an angle that has not yet been articulated with regards to what Trump has done in the effort to defeat COVID-19; the scale of which is unprecedented. In fact, the TRUMP administration’s actions early in the pandemic is what will ultimately end the pandemic.
Early in the pandemic, the TRUMP administration de-risked device and drug development by providing up-front funding through the various mechanisms including BARDA, DARPA, USARMRIID, DHS, NIH and multiple federal agencies. Like any other industry, the pharmaceutical/biotech/devices industry has to hedge the risk inherent to development and this risk hedging plays an enormous role in the timeline for the development of any drug, even in a pandemic situation. The time needed to develop any drug is not only about the risk/benefit to patients, it also about the risk to capital. What the TRUMP administration did in providing early funding to the multiple industry efforts essentially removed the risk from the consideration and allowed the industry to develop in parallel and at risk. Drug development is not only about clinical studies, it is also about manufacturing, scale-up, cold-chain and so many other elements, many that are usually developed sequentially and not in parallel – primarily because of the risk to the investment.
Essentially, because of the TRUMP administration's quick, early, and just as importantly, broad action; there are easily tens of shots on goal some of which were made available as early as March 2020 with diagnostics and others that will be available in the upcoming months for use in the medical arsenal to treat and prevent COVID-19 and allow for the complete re-opening of the economy. Operation Warp-Speed was initiated in early March with a focus on vaccine development and distribution. The same business approach and thought process was applied across multiple fronts, from diagnostics, to therapeutics, to even PPE and respirators. Who would invest upfront >500 million dollars or even closer to 1 billion dollars without having a reasonable expectation with regards to the outcome, with an understanding that there is less than a 50% chance of success and potentially no chance of return on investment if the pandemic subsides? Not a single company would, not on their own, unless one removes the risk element by providing funding. The rational development of any drug, particularly against a new disease, is a stepwise de-risking where after certain milestones are met, the risk of failure is reduced, and there is a better understanding on the return-on investment, only then are the larger investments made. It is not just the medical/scientific aspects that are important and which seem to be the sole focus of the plethora of pundits and experts showcased by the media, drug development is mostly a function of financial risk – afterall, these are business that have a duty with their stockholders. The TRUMP administration short-circuited that by removing the financial risk from the equation through up-front investments across multiple fronts (different technologies and mechanisms of action such as mRNA or DNA based vaccines, viral based vaccines, peptide based vaccines, anti-virals, anti-COVID antibodies, plasma therapeutics, etc) and enabling the industry to develop at risk with the understanding that not everything will be successful. This has never been done before at this scale and speed and the fact that the TRUMP administration did this so early needs to be lauded. This is a savvy businessman’s strategy – hedging the risk is not natural to scientists much less politicians. Americans are lucky that TRUMP is president – a politician would primarily listen to scientists, and scientists need data to inform decision making, this takes time.
It’s not that TRUMP does not listen to science much less that he doesn’t understand it – he looks at it from a business lens. By taking action early and removing the single most important factor in development which is the risk to capital, TRUMP, a businessman made the difficult and easily attacked decision to invest broadly and remove the risk/return considerations from the table.
No president in the past and no politician would have done this. One could try to argue that the Obama-Biden administration had the H1N1 pandemic.
H1N1 is not comparable to COVID-19 by any stretch of argumentation or imagination. H1N1 was a variant of the well-known, well-studied influenza virus for which vaccines had been developed and administered for decades. Vaccine development, and drug development in this setting is completely different. The risk is much better understood, and even then vaccines were only available at the scale needed after the pandemic peaked. In fact, Biden and the Obama administration and the American population were lucky that the Bush administration set up the National Strategy for Pandemic Influenza: Implementation Plan back in 2006. This mechanism was in place to generate and purchase H1N1 2009 vaccine and even then, the pandemic ended mostly on it’s own – as other influenza pandemics did in the past. You can ask any epidemiologist or virologist, in modern history herd immunity has only been achieved through vaccination. If the pandemic does not end mostly by itself like all influenza pandemics including H1N1, the only way to end it is through vaccination.
COVID-19 is nothing like H1N1 and the fact that a businessman saw this as early as March 2020 and took the steps that were taken is nothing short of miracle.
TRUMP was and is the right man at the right time.
It pains me to see that all of the focus is on masks and that the trump administration does not highlight this - much less the media, even FOX. This is a missed opportunity that should be highlighted over and over - regardless of the outcome of the election - COVID-19 will be defeated because of what the TRUMP administration did early on in the pandemic.
Don't let this message go unvoiced.
References:
An HHS Retrospective on the 2009 H1N1 Influenza Pandemic to Advance All Hazards Preparedness.
Institutional and Agency Responses to COVID19
Struck, M.M. Vaccine R&D success rates and development times.1996 Nature (14), 591-3.
Note: Reposted due to previous post being picked by Mr. Algo and blocked from view.