BOSTON—As the Northern Hemisphere eyes another cold and flu season, one major question is whether the COVID-19 pandemic has better prepared the healthcare industry for future waves of new infections.
The answer is a little bit yes and a little bit no, according to a panel discussion on the post-pandemic future of diagnostics at AdvaMed’s Medtech Conference in Boston. There is still preparation to be done, and it may be needed sooner rather than later.
“We're expecting a bad season this year,” said Norman Moore, director of scientific affairs for infectious diseases at Abbott. “For those not aware, we have a crisis right now in this country with respiratory syncytial virus.”
“Turn on your local news and you’re going to find that all of your pediatric hospitals are full right now,” said Moore. “And usually with RSV what happens is it's more in the middle of winter.”
A leading cause of hospitalization among infants and small children, RSV cases fell during the past two years alongside influenza infections, as the spread of COVID spurred widespread mask-wearing, social distancing, and the closure of schools and daycare centers.
But now the country is beginning to see widespread RSV cases, as well as an early increase in flu infections, with COVID potentially making a triple-threat not far behind.
Another worrying sign comes from the southern hemisphere, where Australia has just begun to emerge from a “brutal” flu season, Moore said. And in the U.S., “COVID vaccine hesitancy has now bled over into influenza vaccine hesitancy... I’m a microbiologist, delivering happy news is not my job.”
“Prepare for right now. We know right now you have to expect the worst news, and this is not going to be a good year.”
One thing COVID-19 did bring was a large amount of investment in molecular diagnostics and research, said Shiraz Ladiwala, a former senior VP for strategy and corporate development at Thermo Fisher Scientific.
“The capacity of qPCR machines and testing, and the specificity of the assays produced, have increased substantially,” Ladiwala said. “We’ve also seen testing move from reference labs to the point of care.”
In addition, some test developers that reaped large windfalls during the pandemic have also spent those profits on acquiring new companies to grow out their diagnostics divisions. For example, with Roche buying out its long-time R&D partner TIB Molbiol, and Hologic tucking-in the PCR developer Diagenode.
“If you look at the diagnostic industry before the pandemic and after, you’ll see new names that came up because they took a chance and said, ‘I’m going to build the capacity to fulfill that demand,’” Ladiwala added.
Meanwhile, the country may not suffer the same shortages of ventilators and vital sign hardware that it saw during the early phases of the pandemic when devices had to be rationed worldwide, according to Jaime Osborn, leader of Philips’ electronic monitoring-as-a-service business.
“Now there’s kind of a tech graveyard,” Osborn said. “Now that volumes are going back down to a more normal, natural state, the question is what do we do with all of this equipment that we had to rapidly buy?”
One answer could be stockpiling and warehousing durable medical equipment until it’s needed most.
“We’ve actually explored models of hospitals and larger areas coming up with consortia—which, as we go through these waves of cases, different regions of the country could check equipment back in and then deploy it back out where needed,” she said.
At the same time, more hospitals are considering investing in monitoring equipment with more functionality, instead of relying on a single model tailored for a specific department. This allows health systems to flex up by quickly enabling more features on their hardware, “turning a mid-acuity hospital bed to a high-acuity or ICU bed as they’re needed,” Osborn said.
However, an added wrinkle to scaling up response efforts to the spread of a disease like RSV comes from ongoing complications within the supply chain, Osborn said, where the lack of certain specialized computer chips can hold back entire deliveries. “It doesn't matter how much you plan and how much you can possibly think about these scenarios—it's like the virus, it'll just mutate and find another way to get you.”
COVID-19 also provided clarity on which types of diagnostics—such as high-accuracy molecular assays, rapid antigen-based screeners, and long-term antibody blood tests—would be necessary for combating the spread of emerging infections. Abbott’s Moore recommended a combined approach.
“If I'm screening people and I can only afford to run PCR once a month, but I can run antigen testing twice a week, the antigen test can become more sensitive because you're picking cases up early in the infection,” Moore said. “We need all of the above to really perfect these pandemics.”
“Great, so I'm going to have those arguments again about what’s the best test to take before family holiday dinners again,” said the panel’s moderator, Deloitte’s Chris Park.