“This new equilibrium has not only nudged us to think differently but also prepare ourselves for new challenges.”
According to a recent McKinsey Global Survey, the pandemic has brought in years of change in a matter of months at the levels of organizations and industry. For example, the digitally-enabled products and portfolios within organizations have accelerated by a whooping seven years! Organizations that quickly adopted new strategies and practices while speeding up their own experimentation and innovations are the ones which successfully navigated through the new economic and business environment brought in by the pandemic. Interestingly, most of these changes are predicted to continue even beyond the pandemic. As the world collectively continues to adapt and evolve to the ‘new normal’, there are new opportunities that emerged while others have faded into oblivion. This new equilibrium has not only nudged us to think differently but also prepare ourselves for new challenges.
“Innovations in public health messaging and communication has been a huge success story in causing behavioural shifts for containment of this infectious virus and dispelling fears of the new vaccines.”
The pandemic is turning out to be the necessity for the emergence of many innovations as countries struggle to contain the spread of coronavirus with a mix of technology and social strategies. Innovations in public health messaging and communication has been a huge success story in causing behavioural shifts for containment of this infectious virus and dispelling fears of the new vaccines. However, we’ll zoom into a few technology innovations here that were bubbling under for a long time that found a vent of opportunity ironically due to the onset of the pandemic. Our collective strides pre-COVID-19 towards a digital economy suddenly found wings and have accelerated aspects of communication, education, financial services, e-commerce, and health & pharma to a receptive user base in ways that are expected to stay in the post-pandemic era as well.
“The next phase will require innovation on how we deliver more doses of the vaccines faster, to even the difficult to reach geographies, thereby opening up the largest logistical challenge ever for vaccination.”
The Vaccine Chronicles
Unarguably the biggest achievement that emerged out of the pandemic is the development of the COVID-19 vaccine within a year of the onset of the pandemic! Not just one but multiple vaccines have reached the market with many more in late-stage regulatory approvals. On an average, vaccines otherwise take about 10 years for its journey from discovery research to manufacturing and delivery costing nearly $500 million. The COVID-19 vaccines came to the market within 10-12 months of the first case being reported with billions of dollars in funding from different agencies pouring in for supporting the different stages of vaccine development.
The vaccine roll out has been equally unprecedented with nearly 70 million doses of the vaccine being administered in India with 4.3% of the population having received at least one of the two doses till early April 2021, i.e within less than 3 months! This is enough to vaccinate 2.6% of the Indian population. For India this was indeed a feat as both the vaccines were indigenously developed, manufactured and distributed. Globally, 628 million doses of the vaccine had been administered by early April, enough to cover roughly 4.1% of the world population.
The next phase will require innovation on how we deliver more doses of the vaccines faster, to even the difficult to reach geographies, thereby opening up the largest logistical challenge ever for vaccination. This will now be the defining factor for how soon the world populations are vaccinated and protected against COVID-19. When a vaccine needs multiple doses to develop sufficient immunity, a healthcare worker for its administration, visit to a healthcare facility during a pandemic, and transport and storage in sub-zero temperatures, then it is difficult to reach scale with the vaccination drive, especially in resource-poor settings. Fortunately, oral COVID-19 vaccines are in development and are at various stages of pilot testing. They might be able to address the challenge of large-scale vaccination efforts provided their safety and efficacy is sufficiently proven, in addition to its obvious logistical advantages.
“Genomic surveillance has come of age during the pandemic and is at the forefront of strategies for tracking and containing the virus.”
Genomics-back to basics
Another technology that catapulted due to the pandemic was the DNA and RNA sequencing technology. These have been around since the advent of the human genome project for nearly two decades but had been confined to the domains of scientific research (so called ‘theoretical backwaters’) and small scale clinical studies. For the first time the study of the genome (termed ‘genomics’) came into the public health domain for real-time monitoring, diagnostics, surveillance and critical decision making. In January 2020 the sequence of the SARS-CoV-2 was published, post which various diagnostic, therapeutic and vaccine efforts launched simultaneously. Now with the emergence and spread of the coronavirus variant, sequencing technologies are again being positioned to tip the scale between the virus vs vaccine dilemma.
Although 2021 is the year of the vaccine, it is also the year of the COVID-19 variants with the last two months seeing an increase in their spread leading to second, and at many places a third, wave of infection escalation. Genomic surveillance has come of age during the pandemic and is at the forefront of strategies for tracking and containing the virus.
In the past year, nearly 360,000 SARS-CoV-2 had been sequenced and stored in GISAID, a non-profit online database for sharing viral genomes. Similar efforts have been made in the UK as part of the COVID-19 Genomics Consortium (COG-UK). These efforts helped in identifying the B.1.1.7 variant in the UK leading to travel restrictions and policy interventions. Closer home, the INSACOG (Indian SARS-CoV-2 Genomic Consortium) is funnelling genome sequences from 10 network labs for public health decisions. Sequencing has become so important during this pandemic that the slow rate of sequencing in INSACOG due to hiccups attributed to resource and logistics is being considered as ‘potentially disastrous’ at a time when the variants (UK strains, South African strain and Brazilian strain) are being reportedly on an upswing in the Indian population with many states re-imposing partial curfews and lockdowns. For the period January-March 2021, only 1% (7664 samples) of the total positive samples were sequenced, as opposed to the target of 5%. Hopefully, the efforts will soon be stepped up considering the renewed urgency.
TeleHealth-doctor at a click of a button
Another domain which has been around for many years but that suddenly gained a lot of traction during the pandemic is the telehealth services and platforms. As the hospitals closed doors for non-emergency and non-COVID-19 cases across the countries last year, patients with chronic ailments and those requiring regular monitoring and medical advice were suddenly left high and dry. To maintain the continnum of care during social distancing norms, self quaratines and lockdowns, many hospitals, clinics and private practionars aligned with telehealth platforms to cater to this cohort. Businesses thereby re-invented their business model and implementation strategies in favour of digital interventions to stay relevant and profitable while providing the much-needed medical services to those who could afford and access it.
As compared to pre-COVID-19 times, the telehealth consultations increased by three times in India. Besides having obvious provider-side advantages like, expanding access to care, reduction of disease exposure to health workers and patients, optimizing use of the scarce personal protective equipment (PPE) and reduction in dependency on specialized facilities, and cost of maintaining infrastructure, there are patient-side advantages as well. Other than convenience of accessing care, the telehealth platform also served well in maintaining patient confidentiality, especially for diseases which have social stigma attached to it. Women, who are less likely to seek medical care for themselves due to social factors and domestic factors could also avail these services. This was evident as the men:women ratio for care seeking increased from 75:25 to 68:32 during the pandemic. Gynaecologists and general physicians were the most consulted by women. Interestingly, there was a 502% rise in online consultations by patients above 50 years of age and a 25% rise in late night consultations. Consultations for mental health issues also saw an upward trend.
Although these are promising trends, they are limited mostly to urban India. Similar trends were seen in developed countries as well. However, penetration of telehealth services in the underserved regions was low. A hybrid physical-virtual model is being tested by many to increase traction and acceptance in geographies with low uptake of telehealth services. A McKinsey Global Institute report of 2019 states that if telemedicine services were to replace 30%-40% of in-person consultations in India then the country can save upto $10 billion in healthcare costs by 2025. With the government coming up with a new telehealth policy for online consultations by video, audio or chat, this trend is expected to grow further in times to come.
“Many health APIs have now opened up that would provide resources and data sharing across healthcare institutions and datasets.”
Artificial Intelligence & data analytics-making sense of chaos
Needless to say, the adoption of digital technologies and vast quantum of data generated in healthcare, either through digital devices or due to electronic patient records, has brought about a higher growth in AI and big data, a sector that was already accelerating leaps and bounds. AI in healthcare has been enhancing chronic care management, care delivery, clinical decision support, selfcare, fitness, prevention/wellness, and remote diagnostics. With many hospitals and healthcare providers already tuning into remote patient management and diagnostics, the quantum of data has increased alongside. Applying analytics and intelligence by putting this data to use for upgrading their existing services and predictive care is another step. Many health APIs have now opened up that would provide resources and data sharing across healthcare institutions and datasets.
In summary, the pandemic has proven to be an unlikely catalyst for many innovations which were in the wings but came to the forefront by leveraging the opportunities that came along. Innovators and technologists have adapted quickly to this evolving environment and have not just created wider market opportunities for themselves, have discovered and reached a bigger customer segment within a few months which would otherwise have taken them years. These trends, which are likely to continue beyond the pandemic, now need to be contextualized to reach even the low-income segments to truly scale and create wider impact.
“Dr Swati Subodh is a scientist and healthcare professional in the field of Infectious Diseases. Her work spans from basic research to identification of high potential innovations for better public health outcomes. She has published widely and has led her research team in various government and industry supported projects.”