The Covid-19 pandemic is the monumental public health challenge the medical community has been fearing the past few decades. The price of this disease should convince Americans of the wisdom of our investment in biomedical research. If we seize the opportunity and capitalize on it, that investment will pay dividends.
As policymakers invest more than $2 trillion to stave off the economic impacts of the pandemic in the United States, the health sector is frantically working to treat the ill, discover effective treatments for the virus, and develop a vaccine that will be the difference between life and death for people around the world.
This heroic work must be supplemented by a coordinated approach if we are going to forestall both the continuing public health crisis and the economic disaster it is generating. We must:
- Create an electronic portal for the government to surface and sort the different approaches being developed to treat the virus and prevent it from causing harm in the first place and identify those that are most scientifically sound and clinically practical.
- Call upon established centers of excellence in academia and industry to switch gears and focus on developing and producing antivirals, vaccines, and other therapeutic solutions — much like automakers have switched to producing ventilators.
- Collect and collate the emerging relevant real-world data and evidence that can enable federal agencies such as the Food and Drug Administration to advance the design and effectiveness of therapeutic interventions.
All this requires committed leadership and a targeted strategic investment in biomedical research infrastructure and resources, with a focus on collaboration and information sharing — especially of the data emanating from this vast expansion of clinical research and development.
The returns on this investment would be substantial. How substantial?
Every month of the lockdown costs about $1 trillion, according to Stanford’s John Cochrane. Ten million Americans have already lost their jobs and the burden is falling disproportionately on the most vulnerable segments of the workforce: lower-skill workers with low wages and limited savings. And if the economy remains shuttered for too long, it will suffer much greater long-lasting damage.
Economists with the Federal Reserve Bank of San Francisco have estimated that the global financial crisis more than a decade ago caused a 7% permanent loss of output, the equivalent of more than the U.S.’s entire gross domestic product in today’s dollars, and translating to a lifetime income loss of $70,000 for every American. If this time around we can avoid a financial crisis, the permanent loss will be lower, but even half as much would still be a hefty $12 trillion.
As the economic pain becomes very real, more people will question whether the price we are paying is commensurate to the health threat. As job losses mount and the economic cost takes center stage, we might then swing in the opposite direction and abandon containment measures. This would be the wrong thing to do — and ultimately could cost us more in lives and dollars.
We need a calibrated approach — buoyed by the three priorities suggested above — that allows economic activity to gradually go back to normal while safeguarding vulnerable people and ensuring that the health care system does not become overburdened. Such a calibrated response requires confidence that an effective therapy can soon be developed and deployed.
That can be achieved as we reap the benefits of our decades-long investment in biomedical research. The past few decades have witnessed a metamorphosis in medicine: We no longer just observe manifestations of disease, but can now discern its genetic, molecular, and cellular mechanisms. This new paradigm has transformed our approach to both chronic diseases like cancer and infectious diseases like Covid-19.
One example of this is the rapidity with which the genetic sequence of the SARS-CoV-2 coronavirus has been unraveled, offering to vaccine makers a host of well-defined antigenic targets against which to rapidly develop a targeted vaccine. At the other end of the spectrum, researchers in academia and industry are repurposing drugs used for diseases like malaria or exploring cell therapies that direct our immune system to destroy a cancer cell to instead attack a virus-infected cell.
For every month of averted shutdown, progress toward a therapeutic response would save $1 trillion. If it can spare us the long-term consequences of a 2009-style recession, it could save us about $12 trillion. Even if we allocated $200 billion to biomedical research aimed at developing treatments, which equals the total U.S. medical and health R&D investment of 2018, that investment would yield an even better return than a sharp stock market rebound.
Detection and containment of SARS-CoV-2 are absolutely necessary but they are not sufficient. Capitalizing on advances in science and technology is needed to conquer this virus and will permit less restrictive social policies and isolation.
Eliminating this pandemic’s threat to public health, the economy, and our way of life will be the best return on our nation’s investment in biomedical research.
Andrew C. von Eschenbach, M.D., is the president of Samaritan Health Initiatives, former commissioner of the Food and Drug Administration, and former director of the National Cancer Institute. Marco Annunziata is co-founder of Annunziata + Desai Advisors and former chief economist for GE.