Dr. Elizabeth O'Day
We need public health and personalized medicine to combat COVID-19—NOT one or the other
At a recent Xconomy virtual conference about biopharma’s future in digital health, I spoke on a panel about the state of the precision medicine industry. Like many of our conversations these days, the discussion quickly turned to COVID-19. I was asked if the world’s collective financial and healthcare resources are better put towards public health than personalized medicine in battling the pandemic.
As I weighed in on the conversation, I thought about a recent essay published in The Wall Street Journal, Covid-19 Raises Questions About the Value of Personalized Medicine. The author argues that public health is the clear choice, suggesting that a dollar spent on public health will go further than a dollar spent on personalized medicine.
Public health is certainly playing a significant role in the global response to COVID-19. Recommendations such as washing your hands, following social distancing guidelines, and wearing a mask are essential in slowing the spread of this disease. However, pitting public health against personalized medicine is a false choice—and one that will only hinder our battle against this pandemic.
Over the next year, we will need to invest in both personalized medicine and public health to increase our effectiveness in reducing the spread of COVID-19 and treating people who contract the virus. Here are a few thoughts on how the personalized medicine industry in particular will help on both fronts:
Reducing the spread of COVID-19
The Wall Street Journal essay suggests that personalized medicine is focused solely on better understanding an individual’s genetics for more effective diagnosis and treatment.
Personalized medicine is much more than genomics. Broadly, the field focuses on how a variety of factors that are unique to each person— DNA and RNA (genomics) but also proteins, metabolites and even lifestyle choices, socio-economic status, and more, affect potential outcomes. Digital health trackers provide one interesting example that illustrates both why personalized medicine is not synonymous with genomics, and how personalized medicine can reduce the spread of COVID-19.One of the many challenges with COVID-19 is that upwards of 35% infected patients don’t know they have the disease, either because they are asymptomatic or are only experiencing mild symptoms and are likely spreading it others. To combat this we’re already starting to see companies develop solutions that detect small changes in an individual’s vitals, which can alert them if they have contracted COVID-19 at its earliest stages. One maker of fitness trackers, WHOOP, has made significant progress in this area. This personalized medicine approach will also lead to broader public health gains as individuals become empowered with the information they need to help reduce the spread of the virus.
Improving COVID-19 patient care
COVID-19 is CRYING out for a more effective personalized medicine approach when treating patients. Currently, doctors are doing their best to make well-informed decisions about which therapies to prescribe. We have all seen news stories where an individual was on the brink of death, their loved ones in despair and then a “miracle” drug saves his or her life. These stories showcase we have treatments that are effective against COVID-19. However there is no treatment that works for all COVID-19 patients.
Personalized medicine could allow doctors to more quickly determine which therapy a person is more likely to benefit from compared to others. With a personalized medicine approach we can replace scattered one-off “miracles” with consistent improved outcomes. This optimism doesn’t lie in wishful thinking, but in the knowledge that the personalized medicine industry has made incredible advancements in more effectively treating a variety of diseases in recent years. The Personalized Medicine at FDA annual report offers an inspiring summary of these breakthroughs.
Advocating for an expansion of personalized medicine efforts
As a newly appointed member of the Board of Directors for the Personalized Medicine Coalition, last week I joined a conversation with the bi-partisan Congressional Personalized Medicine Caucus to discuss our communities response to the pandemic. My colleagues Mark Stevenson, COO of Thermo Fisher Scientific, and Dr. Rajeev Venkayya, President of Global Vaccines Business Unit at Takeda Pharmaceuticals, reviewed progress in diagnosis and treatment. It is impressive and inspiring how quickly scientists and business leaders have mobilized. Dr. Venkayya detailed that truthfully the diagnostics and treatments we have right now, while advancing, are not perfect. He made a comparison to swiss cheese, where everything has a few holes in it. However when you layer the pieces of cheese together (diagnostics, masks, treatments, vaccine development) we can fill in those gaps.
During the meeting, I also urged an expansion of our personalized medicine efforts. We have existing technology that right now can uncover the biomarkers needed to better detect and treat COVID-19. Just as we push for increased public health measures we must also commit to increased personalized medicine. A combined public health and personalized medicine approach, what many call "Precision Health" will be far more successful in combatting COVID-19 than either would be alone