In the middle of a pandemicIt’s comforting to have one of the most famous pharmaceutical companies in the world headquartered in your backyard. Since March 18, when Eli Lilly and Company announced a partnership with the Indiana State Health Department to expedite testing for the novel coronavirus, the company has tested more than 20,000 Hoosiers for COVID-19 – a third of 61,142 tests conducted across the state. And this week, the tests for key workers will be increased from 1,500 to 2,000 per day.
The man behind this effort is Dan Skovronsky, Lilly’s meek scientific director. If you could choose an expert to add to your team – in your city – Skovronsky would be right at the top. It’s probably why his phone has exploded lately. “Because of my job, my job, and the people who are worried about COVID-19 and being tested, they call and speak to me a lot,” he says.
It’s fashionable these days to rogue big pharma executives, a fact Skovronsky acknowledged in a speech at Purdue University last year. “I didn’t come here today to liberate the pharmaceutical industry,” he said. “I’m not going to tell you that some companies haven’t made mistakes in this. Some of our unpopularity can inflict itself. “
In an interview, he explains why life may not return to normal anytime soon and how the company is developing two therapies that, if approved, could relieve patients’ viral symptoms.
Guide me through the testing process.
The test samples are analyzed in a laboratory, but there is another bottleneck where the patient is sampled. The current process that almost everyone uses is called a nasopharyngeal smear. You can almost think of this as a very long Q-tip, but it’s flexible and soft that goes up your nose to your throat to take out the cells that might be harboring the virus.
How did Lilly turn so quickly to look for a novel coronavirus?
We have built a drive-through system here, inspired by the events in South Korea. I remember reading an article in early March in which South Korea had built a drive-through test facility that could test 300 or 400 patients in a day. We didn’t really know any more information than that, but we set out to build a drive-through testing facility that could test a thousand patients a day.
One of the big questions we have is how many people have COVID-19 and don’t even know it because it starts off pretty mild and they think they have allergies or don’t notice any symptoms, but still the virus replicates in theirs Body and probably they spread it.
We literally just built this from scratch. We thought about what is the most efficient way to get people through. We set up a call center to answer phone calls and had programmers write a database to collect the information. We put them together in just a few days. From an early age I had the rule that you had to be a volunteer to work there. So your boss wouldn’t tell anyone you were going to do this – you’d just volunteer and work a couple of hours and we have manned an army of volunteers who created this passage that is just remarkably efficient. They read stories of driveways where people spend the night in their cars waiting for their turn to be tested. Ours is nothing like that. We meet the demand in the city every day that people need to be tested, need to be tested, there are no queues, it flows pretty quickly. The test itself only takes a few minutes and then the patient drives home and receives his results very quickly. Many patients can get their test result a day or two later. Of course we do this completely free of charge. This is just a service to the community.
Do you ever envision a time when anyone in Indiana who wants a test can get a test?
We’re pretty close to be honest. The passage is therefore open to health care workers and first aiders. These are the first two groups we opened it to. Then we opened up to important workers – that’s a pretty broad definition of the state. We only use the government definition of essential workers. Basically, anyone who is still going to a job has to be an essential worker, otherwise they are not allowed to. We have therefore initially focused the main employees on people who interact with the public as part of their work. So people like grocery store workers or grocery delivery workers or people who come to your home to fix things – plumbers and people like that. Day care centers or geriatric carers. But we’ve since expanded it to include all key employees who have come into contact with other people.
Lilly has started a study to look at asymptomatic carriers of COVID-19. How did you decide to get this started?
One of the big questions we have – we, by and large, scientists studying COVID-19 – is how many people have COVID-19 and don’t even know it because it starts off pretty mild and they think they have allergies do not have or notice any symptoms, but still the virus is replicating in your body and they are likely to be spreading it. So we got the idea that there would be quite a few people who fit that category. I know from reading the literature what happened in China and Europe and now the United States, but also from personal experience. I know people who got infected with COVID-19 from another person who was asymptomatic at the time.
We want to know how deep this problem is in Indiana and how it is changing over time.
How critical are next month’s testing if Indiana is to reopen?
I think the chance here is exponential growth, which doesn’t mean a lab keeps getting bigger. This means that one lab will set up three more labs and these three other labs will set up three more labs. We have to go there. The conclusion is not guaranteed. I am not sure if it will be successful or not. There are many challenges and limitations, but we will do our best. When you think about the main ingredients to contain this virus, tests are one, two and three, and then four, five and six track the contacts of people who test positive and isolate. There is still a lot to be done and we have to be very diligent and very strict. Oh I know you feel fine, you are healthy, but you have been in contact with someone we now know has COVID-19 so you need to isolate yourself and stay home.
When will Indiana – or our world – return to normal life?
I don’t foresee that we will be back to what it was soon anytime soon. I think a little about September 11th. After 9/11 people kept saying, “Well, when are things going to get back to normal?” And they never really did that. We live our lives differently now. We still have good, fulfilling, and redeeming lives, but things are a little different. I think things will be different after COVID-19. In the short term, they will be very, very different. In the long run, it could be smaller things that we would all get used to. I don’t see us going back to work in Indiana or most of the US in the next few weeks. That makes no sense. While the cases may have peaked, as many people are still getting infected today as they have ever been before, right?
I don’t foresee that we will be back to what it was soon anytime soon.
We still have so many people who contract this virus every day. So this is not the time to let everyone out again. But if we continue down this path, over time we will kill fewer and fewer viruses in our community. That is what we focus on.
Then I don’t think we’re going to eradicate it. So we’re going to have a position where we’re trying to get people, waves of people, people who matter first, back to work, and yet there will still be a virus. So there will be little pockets of an outbreak.
So this is the machinery that we need to set up. If we can do that, we can go back to work, but we’re not there yet.
The second big change is happening – and this is probably the most important thing we can do as a company – the next big change will come when we have a way to prevent COVID-19. We’re working really hard on this therapy, we’re working on a couple of different therapies to help people suffering from COVID-19, but probably the most important one in the long run is a program that we need to develop antibodies that we give to patients become.
Tell me about some possible solutions that you are working on.
The first therapy is baricitinib. It turns out that people who are in the hospital and going to an intensive care unit have their immune systems overreacting to the virus, we think. Hence, it might make sense, although it may seem surprising, but it might make sense to dampen your own immune system and try to contain damage to your lungs and organs.
I don’t think we’re going to root it out. So we’re going to have a position where we’re trying to get people, waves of people, people who matter first, back to work, and yet there will still be a virus. So there will be little pockets of an outbreak.
Another molecule we’re looking at is a drug that we tested for cancer. It’s complicated, but in COVID-19 patients sometimes when they get really sick they get a lung condition called ARDS, or acute respiratory distress syndrome that has many different characteristics. One thing, however, is that the blood vessels in your lungs are leaking, which affects your ability to breathe. So this is a drug that may have an effect there. That is why we are currently also testing this on patients.
The third: We were able to get blood from one of the first people in the United States to survive the coronavirus. So this was a person who had coronavirus very early on, recovered, and then by looking at their blood found the part of the blood that likely helped them fight off the coronavirus and survive.
Now we took this antibody so we could just do doses for humans. We’re going to test this and if that works it could be huge.
We partner with AbCellera Biologics Inc. and the National Institutes of Health. in the next few months – until July actually. So it goes very quickly.
So you could have potentially viable therapy by September, for example?
Sure – if everything works, yes. But this is a risky business, and often things fail, or get more complicated, or take longer or more difficult, but we’re moving as fast as we can.
Is Lilly in economic jeopardy with this probable global recession we are about to expect?
Our business has never felt more real or important. We develop drugs that make people feel better. So when we see a global health crisis like the one we are experiencing today, companies like Lilly will respond naturally. This is what we do. We come to work every day to see how we can help sick people get better. The response in COVID-19 may seem remarkable from the outside. From within, that’s what we do.