Navigating the Pandemic: How will COVID-19 change R&D?


Event Details

  • Date:
  • Categories:

COVID-19 has put the biopharma industry into a tailspin – big pharma, biotech and small startups are all emerging in the development of a treatment and vaccine for this pandemic. Will COVID-19 change the current R&D landscape and create a new norm for the biopharma industry?

Moderator:
Joan Koerber-Walker
President and CEO, Arizona BioIndustry Association (AZBio)

Panelists:
Brian Neman
Co-Founder and CEO, Sanguine

Todd Parsley
Director of Preclinical Research, Infectious Diseases at Noble Life Sciences Inc

Chris Moore, PhD
Senior Director, Immunology, Arbutus Biopharma, Inc.

 

John Fremer:
Thank you for joining us for the third webinar in our Navigating the Pandemic series. Today’s webinar will focus on how will COVID-19 change R&D? Our moderator is Joan Koerber-Walker, president and CEO of the Arizona BioIndustry Association. Our panelists are Brian Neman, co-founder and CEO of Sanguine. Todd Parsley, director of preclinical researcher and infectious diseases at Noble Life Sciences. And Chris Moore, PhD, senior director of immunology at Arbutus Biopharma. And now I’ll hand it to Joan.

Joan Koerber-Walker:
Thank you so much, John. And big thank you to our Sanguine bio team for bringing us all together today and also for providing resources to all of our researchers around the country as they’re working through these difficult times. So as we start off today, as John said, my name is Joan Koerber-Walker. And I have the honor of working with our fabulous team as we go through some of the questions that a lot of us are thinking about. And just to get us started, what I’m going to ask each of our panelists to do is just give a real brief description of who they are, where they work, and more importantly what they’re doing right now. So Todd, why don’t you kick us off?

Todd Parsley:
I’m Todd Parsley. I am the director of preclinical research, infectious diseases, at Noble Life Sciences. We’re located in Skysville, Maryland. And we specialize in preclinical development for oncology drugs/devices in infectious diseases including bacterial and viral infections in primarily animal models and in vitro models. We’re looking at respiratory diseases, RSV, influenza, and we’re working on some vaccine models with SARS-COV-2 at the moment.

Joan Koerber-Walker:
Thanks, Todd. And by the way as a grandma who had a brand new grandchild born on New Years Eve day who spent a week in the hospital with RSV, thank you for what you’re doing.

Todd Parsley:
Yes.

Joan Koerber-Walker:
Chris, your turn.

Chris Moore:
Hello everyone, my name’s Chris Moore, I’m a senior director for immunology… head of immunology at Arbutus BioPharma. We’re located just north of Philadelphia in Warminster, PA. We are an infectious disease company. We are primarily focused on trying to hepatitis B virus. Our company was founded by Mike Sofia who, as some of you may know, invented the cure for hepatitis C and we’re trying to do the same for hepatitis B. So we’re an R%D company, we’re a bio pharma company really dedicated to making medicines for infectious disease and we do have some SARS-coronavirus-2 work that we’re beginning up in collaboration with the SARS-coronavirus consortium. And so I am an immunologist. I’ve worked in the infectious disease field my entire career on all sorts of viruses such as RSV, rhinovirus, hepatitis C, hepatitis B. And we have some pretty interesting ideas on how to tackle SARS-coronavirus-2.

Joan Koerber-Walker:
Thank you so much, Chris. And last but definitely not least, Brian Neman. Why don’t you fill us in a little bit about what’s going on in your shop?

Brian Neman:
Yeah, absolutely. Hi everyone. My name is Brian Neman. I’m the co-founder and CEO of Sanguine BioSciences. And what we’re doing is making it easier for patients to participate in research and by doing that we’re accelerating the research process by making it easier for researchers to acquire the data and samples they need to do their work. What we’re seeing now is patients are, or individuals that are diagnosed with COVID, are interested to participate in research and there’s a lot of transparency and good will in the optimistic outcomes from the research process. So what we’re seeing is hundreds and thousands of individuals that are ultimately interested in providing their samples, testing information, and medical records for the purposes of COVID research and having to provide some feedback on how that’s affecting trials and also just translational research.

Joan Koerber-Walker:
Thank you so much, Brian. And Chris, I know our audience can’t tell but you’re dealing with a disruption right this minute in your business, but all of us have been handling some pretty big disruptions and it’s changing the way we’re doing things. What are some of the lessons that you’ve learned on how we can better respond to these emerging diseases in the future?

Chris Moore:
Well I think that we need to begin by recognizing that this is going to be a part of our future, that there will be emerging infectious diseases that occur, there will be things that we don’t know exist that will come out. And I think that the SARS-coronavirus-2 or COVID-19 has really pushed that to the forefront with everyone, not just a scientist. Having, for example, this coronavirus come out was not a huge surprise for me. I worked on the first SARS-coronavirus infection back in 2003. And so when we saw this one come out and we saw the sequence of this virus, we knew that it was very closely related to the first SARS-coronavirus infection. So while it feels incredibly new to everyone else because it has had a bigger impact on everybody’s lives than the first SARS-coronavirus, it’s not a big surprise to have this type of virus come out.

Chris Moore:
And so I think the first thing we need to do is recognize that it’s going to happen. And to not assume that we’re always going to be safe in terms of infectious disease and be able to develop the preparedness for those potential pandemics in the future. I think we need to learn from this virus as much as we possibly can while it’s here so that we can then leverage some of those learnings into developing potential therapeutics for future viral infections.

Chris Moore:
There’s a lot of things that we can do to identify medicines now, that might potentially have activity against future infections especially future coronavirus infections. We know a lot about the molecular genetics about this virus now and we can potentially target specific regions within that virus that are conserved across other coronavirus with the hope that we will have a headstart in developing therapeutics that will have potentially pan viral activity and activity against future viral infections. I think the pursuit, in our antiviral world, the pursuit of pan viral therapeutics really is a novel field and something that really needs to be pushed forth. Of course we can never be fully prepared for everything that comes out.

Chris Moore:
But I think the one thing that this has done which I think is pretty interesting is that it has made us understand that this can definitely impact our lives, impact everyone’s lives and it has also illuminated the dangers of other viral infections, for instance, like influenza. A lot of people did not realize how deadly influenza was until SARS-coronavirus-2 comes out and influenza kills 20,000 to 40,000 people every single year in this country and infects millions of people and that’s even with a vaccine.

Chris Moore:
So I think for us virologists, it’s good in that it’s highlighted what we do and it’s highlighted the need for further research and development in this area and funding in this area, we rely very heavily on academicians that work in their labs to come up with a lot of the mechanism work. We can’t do a lot of that basic science, frankly. And we rely… and so it really is a team effort amongst all the scientists that are out there and I think this is really, in some ways, has helped coalesce the community a little bit around a common goal of pursuing antivirals in the future.

Joan Koerber-Walker:
Thanks, Chris. And it’s interesting, Dr. George Post who is a friend of mine here in Arizona who was responsible for the first hep B vaccine. George, very interestingly, spoke to a conference that we held on January 16th of 2019, talking about how the next virus was coming and what we would have to be ready to do. And January 16th of this year, unfortunately, that became very prophetic. So Todd, I know you guys are doing a lot of work in this area, where have you seen things changing?

Todd Parsley:
Changing? Well, I mean, basic research is going to be the same going forward with vaccines or antivirals. I’d have to agree with Chris so far as having a pantropic antiviral inhibitors would be great progress towards future outbreaks of emerging infectious diseases. I guess where we see the most change is just with the repetitive of the preclinical research that’s going on right now. There’s not really good infection models for SARS-COV-2 right now. So people are, like I said, are skipping those small rodent model, you’re going right into chimpanzees or non-human primates for a lot of the vaccine work. So a lot of typical preclinical steps that you would go forth to get a vaccine to the IND stage are the phase one clinical trials, are kind of being passed over in an expedited type way. So that’s really where we’re seeing a lot of the change here in preclinical services.

Todd Parsley:
And I think a lot of the bottlenecks are in the lack of those rodent models and also a lack of BSL-3 facilities. So in the future, I think we need to start developing surrogate models that can be worked as BSL-2 to facilitate the production of the antivirals that would be necessarily for emerging diseases. But mostly [crosstalk 00:12:16]-

Chris Moore:
Yeah, I think Todd, you’re absolutely right that there’s very few places in the country that have access to the models associated with SARS-coronavirus infection. UNC comes to mind with Ralph Baric’s lab. I used to work with him back in 2003. But in 2003 with the first SARS-coronavirus came out, I remember that it killed a couple thousand people, if that many, mostly up in Toronto, and by that next year it was gone. And what I’ve seen happen since then is that not a lot of progress was made in terms of the expansion of those preclinical models that you’re talking about that are necessary for us to make medicines since that 2003 outbreak. And now we’re back to very similar coronavirus infection, almost the same except even more dangerous and more virulent. And we still don’t have a lot of BSL facilities and a lot of the same rodent models that haven’t been expanded since 2003.

Todd Parsley:
I think a lot of that is the BSL-3 facilities are costly to maintain and run. And if you don’t have active projects going on with it, it doesn’t really… it’s not feasible to keep a BSL-3 facility up and running in the [inaudible 00:13:44] of this.

Joan Koerber-Walker:
I definitely agree with that. I know that here in Arizona, Dr. Paul Kline runs the, in collaboration with NAU and TGen North, one of our three BSL-3 facilities. And they have ongoing contracts with CDC for all of the things the CDC can’t figure out what it is that come up on a regular day to day basis across the country. And that allows them to maintain those facilities because, you’re right, otherwise it can be prohibitively expensive. Brian, one of the big challenges that we’ve had throughout this crisis is not just the rodent models but patient samples whether it is for testing or for research, how are you guys dealing with that?

Brian Neman:
Yeah. In terms of how we’re acquiring patients and acquiring patient data is that what you’re asking?

Joan Koerber-Walker:
Yeah. I mean, how have things changed and what are you doing about it?

Brian Neman:
Yeah. I think that we’ve seen in a… so I think it starts with, well at least up until the past three or four days, I think everyone has been… or five days, everyone has been focused on COVID. That was the number one thing, now it’s number two. But when it was number one, the top focus was each individual out there in the community and the world is, “How do we accelerate research for this condition?” And so we’ve noticed that since this is a condition that everyone knows that they can get, the sort of interest from the community has been a lot larger than we’ve ever seen before. And so everyone thinks that they can potentially be a participant or can potentially be diagnosed with the condition. So they’re more likely to participate. So I think that the velocity of the increase in patient data aggregation from other companies in the space, you’ve seen Datavant, you’ve seen Health Catalyst try to put together their own HEOR or RWE registries and databases in order to provide that data to researchers.

Brian Neman:
So where we’re coming in to this and what we’re seeing is that there’s an insatiable need for news and updates and positivity and I think that being able to participate from home is making it easier for folks. The biggest problem that we see that we know of is something everyone knows, is access to medical record data. So no one’s in the hospitals now like actually shipping out these records. Medical data mobility, I think, is something that has not been talked about as much because if that were… I think that if we had the actual test results and the lab results, we can have more potent data for our clientele which is researchers like Chris because right now it’s just hard to get actual confirmations of diagnosis. So medical data mobility I think is important.

Joan Koerber-Walker:
I think the telemedicine has come a long way in the last couple of years but its use is really accelerated since the beginning of the year. And now a lot of those telemedicine applications are linking in with the patient record and more importantly are utilizing AI and VR to really get patient data, real time, instructionally. So I think that as we start to look at clinical trials that will be another way that we’ll be able to broaden our scope of collaboration across these different sectors to get things moving faster because, quite frankly, our patients and our economy are waiting for us to get it done.

Brian Neman:
Yeah. And what I’ve heard from Providence, just to close the loop, is that Providence is actually 75% of their way to their revenue target for fiscal year 2020. And a lot of that comes from the inbound of request of telemedicine because folks are much more likely to participate via telemedicine versus skipping or rescheduling appointments and pushing and pushing. So the likelihood of getting through the door the first time is much higher and then once that individual is in the door then these health systems have a good way of funneling them to specialists that generate more income for the center. I think that GPs and the number of patients that GPs are seeing has increased substantially.

Joan Koerber-Walker:
Yeah, and I think it’s really helping the GPs and all of us that are trying to manage testing resources because there’s a new syndrome that a doctor explained to me and he calls it psychosomatic COVID-19. And it’s that kind of like when you were in med school and all of a sudden you had every disease that you learned about, that so many patients think they have COVID and they have a strep throat or they have allergies. And so the telemedicine tools are really helping to triage those patients, give them the information and peace of mind they need and free up those necessary hospital resources for the patients that really need them. So Todd, going back, we talked a little bit about these promising therapies. And getting them through the process from the discovery and development phase into that preclinical testing but making sure that we’re doing it in the most efficient and the safest way for our patient partners, how do you see some of that changing as things are going forward?

Todd Parsley:
With the exception of it being expedited, I’m not really seeing a big change in how that works. I think you still have the same points to consider when you’re talking about the FDA guidance in getting to the clinical trials that you’re going to have to address. But so far as the standards going forward, I haven’t seen a lot of change at the moment. I think what this is going to bring on though is in the future we’ll have pre validated systems for testing the antivirals against different viruses. That would make it more rapid to get through the preclinical stage.

Todd Parsley:
So rather than being reactionary, and I’m hoping this is what’s going to come out of these consortiums that are being formed with all the collaborations that are going on with the SARS-COV-2, is that we start looking ahead at these different virus families that have potentially become these emerging threats and have validated systems that are kind of plug and play for getting these things through preclinical trials. Whether it be the initial in vitro analysis and cell culture with infectious systems are sometimes a surrogate model or even the animal models themselves, I think we’re going to start moving towards that. And I think this is kind of instigating that.

Joan Koerber-Walker:
Thanks, Todd. It’s interesting you bring up the collaborative model and we’ve all been around long enough to remember back now 17 years ago when Janet Woodcock released that very pivotal, clinical path paper on drug development. And that actually spawned the Critical Path Institute which is a joint venture here in Arizona with the FDA where pharmaceutical companies all over the world and patient groups and physicians collaborate to address these types of challenges. And that was done so that we could do more at a consortium level so that we could share things in a pre-competitive space. And to some extent we’ve now been doing that for over 15 years among those systems but when it came to COVID-19, that’s where we saw all of a sudden people like Pfizer saying, “We’re opening up our labs. Whatever you need, it’s here.” Right?

Joan Koerber-Walker:
Novartis opened theirs, Roche opened up facilities. So I think we have a lot of those types of resources that we’re seeing more collaboration than we ever have and hopefully it’s going to continue. So relative to these consortiums and this new spirit of collaboration, what are some of the things that you’re seeing, Chris?

Chris Moore:
Well I would just echo that I agree with Todd, and Joan I agree with you that we have to do these things in a pre-competitive space. Let’s face it, making a drug is very expensive. We also, as Todd pointed out, I haven’t seen a lot of changes in the way we do things in terms of developing the medicines because primarily of patient safety. We cannot bypass patient safety. There are just simply things that we have to do, there are checklist things that we have to do to make sure that patients are safe whenever we get the drugs into human beings. So that has to be done. Now, the other thing I wanted to say was, as what Todd said, he used the word reactionary, I think that’s a very good work in relation to the SARS-coronavirus-2. I believe we have been reactionary.

Chris Moore:
And what happens when you’re reactionary to something like this and you don’t work on this upfront is that the only real path to a very quick approval for something is through a repurposed drug. And so we’re seeing that with the clinical trials that have been done on hydroxychloroquine as well as remdesivir, we’re seeing these repurposed medicines actually move quite quickly through initial clinical trials and I think that’s very encouraging to see those studies being done to try to get to an outcome as quick as possible.

Chris Moore:
The reason why that’s so important is because those medicines we already understand their liabilities, we already understand the patient safety data for those medicines, for instance. So that is a very quick path to potentially finding something that works and I just saw today that there was some positive data that came out already on remdesivir in terms of hospitalizations. So when you’re reactionary, you don’t have a lot of time to make a new medicine.

Chris Moore:
And for us, for instance, in working through these consortiums, it’s primarily in thinking about the next pandemic because when you start from ground zero, you really are not going to make a huge impact on the pandemic at that time, right then. Now if this lasts and becomes season and it’s something we deal with every single year, then of course we can develop medicines for it. The other thing I want to point out is that you’ve got to understand the way pharma works. The benefit of working in a pre-competitive space is that some of the cost and the liabilities associated with making that medicines are defrayed from that pharma entity.

Chris Moore:
So when you work with these other institutions like BARDA or bio defense groups or whatever, they can take on some of the research that’s associated with finding the next pandemic because if you’re making a medicine for something that doesn’t exist yet, how can you guarantee that you’re going to get a return on your investment? I mean, that’s the truth of the matter. And that is a big part of why there aren’t a lot of medicines that are made out there for things that we aren’t here yet. So we have to, I think, working in that collaborative space in the consortiums or even with government, I think is the place where the pharma institutions are going to come together and be okay with working on and spending money on working on something that may or may not impact us in the future.

Joan Koerber-Walker:
Right. And it’s really interesting as we go through this, I work with hundreds of entrepreneurs around the country and have relationships with the various investor groups, and one of the things that was kind of the kiss of death was if you were trying to repurpose an old drug. Nobody wanted to talk to you, nobody wanted to fund your company, they all wanted new models, new molecules or new biologics with fresh IP. And now it’s the repurposed drugs that are going to be the lifesaver that we need right now. Now that’s an example, I think, of how we’re learning about things. And my grandma used to say, “Necessity is the mother of invention.” And you figure out how to fix something and then that stays with you. Brian, as you look at the things that you’re dealing with, with your teams, what are some of those changes that are happening that you think will stick with us?

Brian Neman:
So I think two things, I think that real world evidence is becoming even more important now. So real world data aggregation and then evidence from there. But really patient reported outcomes, medical data in the form of using that as the first step as Chris just mentioned and Todd touched on is repurposing existing assets from molecules and drugs. And what you’re going to need is to see how those drugs are working today. And that means that collecting data out there in the real world of what’s going on. So I think that real world evidence is going to be important. Collection of that consolidation and then I also think there’s going to be a convergence across the different departments. So I think having a shared data set or registries are going to be much… we’re going to see the value of having registries.

Brian Neman:
So, for example, if you’re doing research on hepatitis B, for example, it would be great if you had the outcomes data on top of the labs data in terms of bio banking information, the samples. So if you have, I think, all the different departments, all the way from outcomes and values and evidence and pricing and commercial market access, all the way to clinical development and then down to early discovery of biomarker development, I think that having those groups work together in a data committee to consolidate the data from the different sources, I think that that could be productive.

Chris Moore:
And I want to add something to that. So what Brian is doing in getting these samples and getting samples from patients is really a big deal for us. It is for us, I work on hepatitis B primarily and I work with, the interest of disclosure, I work with Brian on getting samples from his company. And the reason why that’s so important is because we have something in our business called phase zero studies, right? And these are the translational studies that will help us to understand the patient better. And COVID-19 is an excellent example of this. We don’t understand this virus very well and we don’t understand the disease very well. Us, in drug discovery, we cannot fix something that we don’t know is broken. So there needs to be more investment in doing the basic translational medicine approaches using patient samples and using patient databases and medical records to understand what we’re actually dealing with.

Chris Moore:
We can’t fix something, we can’t cure something that we don’t understand. And same goes for what we do with hepatitis B. Hepatitis B, for instance, is a highly heterogonous disease. Patients have a number of different characteristics and we’re doing a lot to try to understand the patient and the key to being able to cure that disease is to be able to understand what’s wrong, what’s wrong in that chronic infection. Now, for COVID-19, for instance, I’ll give you a quick example, remdesivir, they just came out today and there was only about a three percent change in mortality. But what they found that was that drug needed to be given as early as possible in the course of the disease.

Chris Moore:
And it really has no effect if the patient is already put on a ventilator. So what does that mean for us? So for us, or for me as an immunologist, what it means is that it’s likely during those later phases, it’s not the virus itself that’s actually kill you. It’s not the virus that’s doing the damage, it’s probably your own immune system to that virus. That’s why things like Tamiflu and things like that work really well very early on. So that’s an example of understanding that this disease has two aspects to its pathology. One is the viral infection, the virus which everybody’s thinking about. But the other is your own host immune response. And so that changes our approach to that particular infection.

Chris Moore:
It means that it probably will need an antiviral approach plus an anti inflammatory or plus an immuno modulator. So anything we can do to try to understand the patient better really does change… has a huge impact and changes the strategy of the drug discovery companies like us.

Todd Parsley:
And I [crosstalk 00:33:25] exactly with that Chris was saying in that you’ve got to separate the viral infection from the disease itself. And traditionally with antivirals, those are better given off early in the infection. With COVID, I think that’s kind of tough when you have a lot of asymptomatic people who are infected and contagious. Whereas then once the disease hits, you’ve got to find new targets of therapies for that. And there may be a lot of overlap between this viral disease and other infectious diseases within the immune response such as the anti IL-6 which I know has gone through some preclinical trials where we should also start focusing on repurposing drugs or researching areas that are happening with the COVID disease as opposed to just solely focusing on the virus itself.

Chris Moore:
Yeah, Todd, as you know having worked on RSV, for instance, RSV is a great example of this. By the time that children are actually sent to the ICU, there’s not a lot of virus left in those kids. The damage has been done and most of the damage now and the clinical manifestation of the disease comes from the immuno pathology that they’re having. So understanding the patient is really, really important.

Joan Koerber-Walker:
Well it’s interesting, we’ve done a lot of talking as an industry about patient reported outcomes and using this data in a more concrete way. During COVID-19, we’ve also seen the flip side of that which is there hasn’t been time for peer review, there hasn’t been time for a lot of other traditional scientific rigor put into some of these studies. And so instead of publishing in Nature, you’re publishing on USA Today or The Guardian. And so one of the things that I’m seeing across the community is this massive confusion and it’s causing them to doubt us as physicians and scientists because the normal differences of opinion that we’ve had in scientific forums is now playing out in the public’s fear and in some cases, hydroxychloroquine is probably one of the best examples, you can look on relatively common forums and you’ll see half of the science community saying, “Hydroxychloroquine works,” and the other half says, “It doesn’t.”

Joan Koerber-Walker:
And the public is just getting confused. How will science be better able to get this data, work with real world data, and then communicate it in a way that it shows that we’re still doing what we need to do from a rigor perspective and moving things forward faster? Brian, what do you think about that?

Brian Neman:
I think in terms of speed and how they accelerate, I think we still have a data portability issue, like I pointed out. I think a few big things, one brick and mortar issue would fix of, A, you need to be at this site in order to participate in research, that’s A. B, I think the portability issue needs to be fixed of where the data comes from, how [inaudible 00:37:03] can patients get it? The consenting and transparency issue also needs to be developed from an infrastructure perspective, patients need to know how their samples and data are being used. I’d say that those are the biggest key problems that are facing us today. But what I’m seeing is that CROs and the pharmas are now engaging in home visit operations to accelerate and keep their trials ongoing. I’m seeing that a lot.

Brian Neman:
I’m also seeing every, as Chris pointed out, that many of our clients, no matter what drug they’re working on at this point, it feels like they’re trying to see if they can see any sort of activity in COVID. So I think everyone is throwing darts against the wall at the target, see if it hits. So that’s what I’m seeing.

Joan Koerber-Walker:
It’s interesting, in the patient community, we didn’t have a COVID patient community until recently.

Brian Neman:
Right.

Joan Koerber-Walker:
But the patients in all the other communities are really concerns right now because everything has been COVID, COVID, COVID. And they’re wondering about, “Well, what about even the disease my baby is dealing with? What about the cancer that my spouse is dealing with? What about the arthritis that my mother is dealing with?” I think that as we have these conversations, it’s really important that we learn from the challenge and in some cases the tragedy that’s been COVID-19 is how we can apply these things not just to infectious disease but to all of the science that is working to make life better for patients right now.

Brian Neman:
Yeah. And what I’m seeing with that is clinical trials are finding a way to stay alive, so to speak. But I think that many of the trials are going to have to be restarted. And many of the translational programs they either restarted or just pressed the play button after being on pause for three or four months.

Chris Moore:
So let me address a little bit, Joan, if you don’t mind, what you said about peer review. So I’m a big proponent of open access and open source for all of our scientific literature. I remember, I mean, Todd and I are both old enough, we remember when the first open access journals started coming out. And there was a lot of pushback about that and I think in general it’s been a really good thing to have everyone have access to the data and the journal and articles that we reaped. The problem I see and without getting political, I’m not going to get political, but the problem I see is that everybody today is an expert. And it primarily seems to have invaded the medical community. Everybody seems to know about the disease better than the experts. And I don’t know if that’s just a Google education or because everybody has access to more information, perhaps that they’re able to develop their own opinions.

Chris Moore:
But, for example, hydroxychloroquine is a good example. So hydroxychloroquine is it’s IC50 for SARS-coronavirus is about four micromolar. The toxicity for in vitro is about 10 to 15 micromolar. For those of us that have been in the field for a long time, we know from experience that that gap in efficacy versus toxicity likely means that the antiviral effect of that drug is linked to its toxicity. You really need to be in the 10, 20, 30 nanomolar range before we really start to believe that something is going to have efficacy in the clinic. Now that is just knowledge that we have because we’ve been in the field for a long time.

Chris Moore:
And so therefore I knew that that particular drug did not have much chance for it’s antiviral effect in the clinic. And it hasn’t and it hasn’t done well, it hasn’t performed very well. Remdesivir is different, it’s about 40 nanomolar on COVID-19. So I don’t really know the full answer in terms of access to information. But I can tell you being in the infectious disease world and the virology world and even in my personal life because people know what I do for a living, I’ve had to dispel a lot of myths and conspiracies and ideas that people have about this disease.

Chris Moore:
And I don’t mind educating people on it. I certainly don’t know everything about it but I know what isn’t true. And it really has taken away from… it takes a lot of energy to do that. And I don’t think it’s very productive actually. When I go get my brakes fixed in my car, I don’t stand over the guy and tell him how to change my brakes. He knows how to change the brakes. It doesn’t mean that people shouldn’t question things, that’s a part of science is questioning and even laypersons should question the science. But when the facts are there and the data is there and the data is available and it’s been looked at and the truth is out there and at some point that truth has to be accepted.

Joan Koerber-Walker:
Yep. And it’s interesting, Chris, I have a pretty public role in my community. And because of that I’m the person that does the television interviews and the radio interviews and that type of thing. And so I have people… and my email is everywhere, I’m very accessible, so I have had some of the most interesting conversations who have the cure for the coronavirus and are willing to send it to me so I can take it and my family can take it too. We started with citizen journalists with the advent of social media 20 years ago and now we’re moving into a realm where everyone is a drug developer and everyone is a scientist. And who knows there may be someone who has a fantastic idea that shows merit, but some of them are just plain scary. But [crosstalk 00:44:25]-

Chris Moore:
And what’s been difficult for me is that even trying to educate or tell the truth about the data and what I try to do is I try to be as data driven as possible because if I start to start spouting opinion then it’s no different than anyone else.

Joan Koerber-Walker:
Right, and Todd, I know you have been working through this just like the rest of have, how are you seeing this evolve and things change?

Todd Parsley:
So as far as the publications go or… ?

Joan Koerber-Walker:
Or just how we’re sharing information and trying to get stuff done.

Todd Parsley:
Yeah, I mean, the same thing being approached by people I know who ask questions and are scared or have heard something. I think you have a real conundrum here with the response to the coronavirus and the need to get the information out rapidly conflicting them with the lack of the checks and balances that go along with peer review. So people, without looking at data, will read the discussion section in an article and that’s coming to conclusions that aren’t necessarily supported by the data. And I think that there diminishes the credibility of the scientists who are working on any of these fields, that as you get a lot of conflicting information from incomplete studies or studies that have not been peer reviewed and whose conclusions do not support the data. So I think it’s difficult for us as scientists to then really get on a pulpit and give the scientific data and the truth about the virus or the disease with a lot of misinformation or half information out there. So that’s kind of how I see it.

Joan Koerber-Walker:
Thanks, Todd. And probably the thing my husband laughs at the most is my husband says I’m a know it at all. And so he’s heard me say, “We just don’t know,” more times in the last few months than he’s said he’s heard me say in 35 years of marriage. So that is our biggest challenge is there’s so much we don’t know. And quite frankly there’s a lot that we won’t know until this emergency has passed. But, Brian, as we’re going through this process and as a company that has been focused not only in developing your own science but also in helping others move their science forward, what are some of the things that you’re seeing?

Brian Neman:
I’m seeing requests for longitudinal sampling. I’m seeing requests for outcomes assessments, the questionnaires asking for specific testing. So either DNA or GM/IgG. I’d say those are the big things, so longitudinal and the patient report, outcomes, and surveys. So that’s self reported information, that’s what I’m seeing [inaudible 00:47:47].

Joan Koerber-Walker:
Thanks. And I think before we move to the next part of our discussion, I just want to thank everybody that is watching online right now and remind you that if you are joining us via computer, feel free to use your chat button and send any questions that you have to Lisa and I am monitoring the chat and we will try and integrate that into the discussion. So with that, let’s kind of shift because we did promise people we were going to cover a couple of things. And this next one is, we have about 10 minutes to go, is the big one, okay? What’s the new, and I’m getting really tired of this phrase, but for want of a better one, what’s the new normal look like? Todd, do you want to kick us off?

Todd Parsley:
Is there an old normal? Society wise or scientific wise? I think scientifically we’re building a blueprint to how to address these future emerging infectious agents. And I think the new normal will be more of a collaborative and consortium type of situations that are set up to respond to these in a not reactionary way. Society wise, I don’t know, where we go from here. I think within a couple years we’ll know whether the vaccine is going to be efficacious or not and provide lasting immunity. And I think a lot of it’s dependent on those results whether we can produce an effective vaccine and prevent these recurrent outbreaks of this or it becomes like an influence type of situation where we have a different vaccine ever year. We’ve been able to deal with that as a society, so I think a lot of it where the new norm is depends a lot on vaccine research and whether we can find effectiveness with that. And then also treating the disease as well as preventing virus infection.

Joan Koerber-Walker:
Brian, how do you see, thinking about not just the society and general research, but you’re sitting in the office, what’s the new normal going to look like there?

Brian Neman:
In the office, highly dependent on the vaccine as Todd indicated. But let’s assume, for the sake of argument, because if there’s a vaccine you’re talking about a different world, I think that that normal looks a lot more like the normal that we saw before. I think that the new normal without vaccine is deferring schedules, who’s in the office, bigger offices, some folks that don’t need to be home, let’s say like account executives, the BD, have them outside. Folks that are doing research, probably inside, they need to have a brick and mortar location.

Brian Neman:
I think that in any way, shape, or form possible that folks can save money on real estate expenses they’re going to do it. I’m already seeing shifts, I mean, there was a company retailer yesterday that basically laid off 2,000 folks in California and they’re going to rehire 1500 to 2,000 in Pittsburgh, Dallas, Baltimore and a couple other areas. So basically I think there’s going to be less of a demand for commercial real estate. And I think sales and hiring and recruiting is going to look different too. Hiring VPs and executives via Zoom, I think, you’ve never thought of it, but I think that’s going to happen.

Brian Neman:
And I think there is going to be a change of benefits and I think that people are actually going to burn out a lot sooner because the expectation is that your commute is gone, and like Bay people, let’s assume average commute is like an hour and a half, hour a day. So people are expecting more productivity. Not leaders but speaking from even peer to peer within organizations. There’s going to be a lot more productivity expectations because, hey, what else are you doing?

Joan Koerber-Walker:
Yeah. One of the things that we’ve really seen damaged during this whole crisis is the whole concept of work-life balance. It’s pretty much gone out the window. So, Chris, what’s the new normal look like for you?

Chris Moore:
Well I can only tell you what my normal is now. I went back to work on Monday to the office. And I drove in and we had a tent set up and they put that six inch, nasopharyngeal swab up my nose, and we do a coronavirus test every two weeks. And we do temperature testing at the front door and we have unidirectional way of working in the lab where you can only go certain directions in the building. And we have eliminated the open floor concept and cubicles and we have our lab workers actually working in actual offices that we have that normally are for managers and above. And so we have isolated at the lab. And it’s a little strange, it’s bizarre.

Chris Moore:
But let me be optimist here, if we’re really talking about making predictions, I think we’ll have a vaccine the first of next year. I think there’s another really thing that has occurred is that the initial vaccine studies, at least the very initial ones, had shown that there is no antibody dependent enhancement of the disease. That is very important for vaccine development. During the first SARS-coronavirus infection, we found that in initial animal vaccine studies that the vaccine actually made the disease worse. I was very concerned that that would be the case with SARS-2.

Chris Moore:
At least so far, that has not been the case in the initial studies with the vaccine. That’s a big step towards actually being able to have a safe vaccine the first of next year. I think this will be over, I think that the coronavirus is a very stable virus. The polymerase that makes new copies of coronavirus is much more stable, has a higher proof reading than influenza and it does not recombine near as much as influenza does. I personally don’t believe that we’ll have a seasonal outbreak once the vaccine is here. But I think that our new normal will be that new normal until that vaccine is here. And I think it needs to be because I think it’s a very dangerous virus and we’ve never seen anything like this in our lifetime in terms of the number of deaths and the high mortality in such a short period of time.

Joan Koerber-Walker:
Thank you, Chris. And I agree. I have never seen anything like this in my lifetime. Brian, when we talk about the new normal, I spend a lot of time talking with students especially our undergrads, our grads, and our post docs, for some of them this quarter of the year has been a pivotal quarter in their education, in their doctoral studies, in their theses, they’re really wondering what the new normal is going to look like for them. Do you have some words of encouragement for the scientists that are going to be following us?

Brian Neman:
You mean graduate from post doc?

Joan Koerber-Walker:
Or even the undergrads that are aspiring to be graduates and post docs? I mean, what is the new normal going to be for them and what encouragement can we give them in a time when things are changing pretty rapidly?

Brian Neman:
Yeah. I think what they can do and I think that a lot of folks are doing early on in their careers, is supplementing their academic instruction with the more vocational skills and teaching. For example, we have some folks earlier on in their careers saying when they’re learning how to code, learning the data science, Python, development, data analysis, Tableau, Sales Force. Those sort of vocational skills which I think that China has done a fantastic job of creating vocational schools that are less about liberal arts studies and things like that and more, “What can I do with my hands and my fingertips?” And what I would encourage those folks to do is public library, LinkedIn Learning, those are some free assets that you can uncover through your city.

Brian Neman:
So the Los Angeles Public Library, just as an example, I’m sure other locations, they have LinkedIn Learning, it’s a free resource. So build the those skills, add them to your LinkedIn profile and learn about other skills and technologies that you’re going to have to use once you jump on board. So there are a lot of technologies that I’m sure Chris is using in his lab that it’s going to take some onboarding time for people to learn how to use the [LIN 00:58:32] system. So getting training on those things so that once you do head to the workplace, you can accelerate your learning curve and ultimately that drives ROY for your employer so you’re going to be more exciting as a candidate.

Joan Koerber-Walker:
Thanks, Brian. I know right now I’m developing a program we’re going to have starting in the fall to post docs that will be entrepreneurial fellows and they’re going to work with our business development and investor relations team and really start to understand what it takes to be an entrepreneur, build the company, raise money, things of that nature. Todd, what kind of words or wisdom or inspiration would you have for our future scientists?

Todd Parsley:
I think this whole thing that this is leading to is an expedited work at home type of culture for people who don’t have to go into lab or into the office and to brick and mortar type businesses. And I’d have to agree with Brian, find some skills and hone them that allow you to contribute from a distant location. Don’t just focus on the lab work and the bench work but develop a skillset that allows you and adds value to your CV and your skills to be able to work from home.

Joan Koerber-Walker:
I want to just do a quick round robin of closing thoughts, make it fast. Chris, rapid fire, here you go.

Chris Moore:
I guess my closing thoughts are to… let’s not be defeatist about this. I mean, I think that this is a very difficult time for everybody. But this will pass. We will understand this virus better and it will help us to understand the next pandemic. And then I’ll just say one last thing for those that want to get into science or those that are already in science, consider infectious disease. I think, as Todd knows, infectious disease over the years has become a little out of vogue in the biotech and pharma world. This is a good example of why it’s important and not to sound morbid but for those of us that work in infectious disease, this is the exciting moment. This is the moment where we actually can use what we’ve studied to try to help mankind moving forward. And it’s a big privilege to be able to do that.

Joan Koerber-Walker:
Thanks, Chris. And Todd?

Todd Parsley:
I guess I agree with Chris, this is an exciting moment in infectious disease research. This is what we’ve trained for. And I think it is keep your eye on the goal here of getting through this because we are going to get through this. We’ve got the best minds in the world working on this and coming together to put this together. Also, remember with everything else that’s going on in the world right now, it seems like the COVID is losing a little bit of focus. It’s not taking a time out, okay? Stick to the social distancing and the safety precautions that we’ve taken, let’s not put those to waste and let’s move forward and find solutions for this.

Joan Koerber-Walker:
Brian, closing thoughts?

Brian Neman:
Use this time wisely. If you’re an executive, now’s the time to reflect and understand your strategy. So if it’s time to identify the focus and put your foot on the gas to move forward so that when we do come out of this, which we will, you’re in a good position to do that. And if you’re in the earlier part of your career, use it as a time to sharpen your skills. So I think for everyone, I think don’t think of this as a time to shift back into a second or third gear, things are still moving all though they don’t look like they’re moving.

Joan Koerber-Walker:
So I want to thank our panelists, Todd Parsley, Chris Moore, especially Brian Neman and his team that put this together and brought us together today. And I want to thank all of you that are listening because the research community, the development community, the future scientists community, our clinicians and our patients who are stepping up to help at this difficult time. We are all working together to solve this problem, past problems, and future problems. And we truly do thank you and with that we’re going to wrap it up. Thank you and good-bye.

Todd Parsley:
Bye-bye.

Brian Neman:
Bye.

Chris Moore:
Adios.

John Fremer:
Thank you for joining Sanguine for our latest S3 webinar. For a full list of webinars and informative content, visit researcher.sanguinebio.com. Enjoy the rest of your day.