Leaders in the health tech industry are skeptical that a COVID-19 vaccine will be available by 2021.
That’s one of the takeaways from the latest Healthcare Prognosis Report, an annual 300-person survey published by venture capital firm Venrock that gathers opinions from members of the health tech industry on what to expect in the upcoming year. As the firm was working on the 2020 survey, COVID-19 landed in the United States and dramatically altered the course of the healthcare industry. Venrock subsequently decided to do three surveys over the course of eight weeks to get a more accurate reading of how industry leaders were feeling about the pandemic and to chart their changing perspectives. The list of contributors skews toward entrepreneurs, those working on healthcare delivery software, and health industry investors.
The first survey was sent out at the end of February, right as the first U.S. cases were discovered. The second survey was sent out four weeks later, by which point 1,500 Americans had died of COVID-19. At that point, 45% of participants believed a COVID-19 vaccine would become broadly available by 2021. By the third survey, optimism about a vaccine waned. That one went out at the end of April, when at least 90 vaccine candidates for COVID-19 were in development, seven of which had advanced to phase I trials. Despite this, only 31% of those surveyed thought a vaccine would be broadly available by 2021.
Respondents expressed similar doubts about the rapid development of treatments for COVID-19. By the time the second survey was issued, both remdesivir, an antiviral once tested as a possible treatment for Ebola, and chloroquine and hydroxychloroquine, which have been used to guard against and treat for malaria respectively, were being tested as potential treatments for COVID-19. The survey shows respondents were hopeful about them: Slightly more than half thought a good treatment would become available by 2021. In a subsequent survey, only 39% were positive a treatment would emerge within 18 months.
According to Bryan Roberts, a partner at Venrock whose portfolio includes 10X Genomics, Devoted Health, Doctor on Demand, and Lyra Health, the people who take his firm’s survey are predisposed to thinking about innovation in terms of its ability to scale quickly, which is inherently difficult for vaccines.
“I think that between survey two and survey three it became clear that there was not a silver bullet that somebody could pull off the shelf that would be an awesome therapy,” Roberts says of COVID-19. “I would argue the same thing is true of vaccines.”
It became clear that there was not a silver bullet that somebody could pull off the shelf that would be an awesome therapy.”
Given the challenges of biomedicine, there are no guarantees that a vaccine candidate will succeed. One study found that over a 20-year span, an average vaccine had a 6% chance of making it to market. Notably, HIV still does not have a vaccine 30 years after it rose to prominence in the U.S., though it does have lots of treatments, including ones capable of suppressing the worst effects of the disease and mitigating its spread.
Development is not the only cumbersome aspect of making a vaccine that’s accessible to everyone. Building up vaccine production facilities traditionally takes years. Companies that are working on COVID-19 vaccines are already discussing how to scale manufacturing infrastructure for candidates that are still in an early stage of development. Even with significantly crunched timelines, it could take a long time before a vaccine is widely available. However, biomedical companies, the government, and philanthropists are working to scale up vaccines quickly. Moderna, a company with an mRNA vaccine in clinical trials, says that it will have tens of millions of doses of its yet-to-be-approved vaccine by 2021, thanks to funding from the Biomedical Advanced Research and Development Authority. Johnson & Johnson, meanwhile, has announced a partnership with a manufacturer to supply 1 billion doses of its proposed vaccine. There is no guarantee that either Moderna or Johnson & Johnson’s vaccine will ultimately work.
Venrock’s survey is less an indicator of when a viable vaccine or treatment for COVID-19 will actually emerge and more reflective of the tech industry’s expectations. The survey also indicates areas where health tech businesses might be investing, such as big data platforms and in-home care. COVID-19 and social distancing restrictions have pushed patients online, away from the doctor’s office and into video sessions and text chats with health professionals. The survey respondents expect that until a vaccine for COVID-19 is available, people may prefer to go online for their healthcare needs when possible.
As for big data, there is still a lot to learn about COVID-19. The virus has highlighted the importance of more open data in healthcare. One reason biomedical companies have been able to rally vaccine and drug development for COVID-19 is because Chinese researchers sequenced the genome of the coronavirus and published their findings early on in the outbreak. That kind of rapid scientific sharing has allowed researchers around the world to get to work developing medicines to combat the virus. While information about the coronavirus is being shared right now, disease research has not traditionally been so open. Medical research is often distributed across a web of publications and proprietary company databases in ways that are inaccessible to scientists broadly. There isn’t a single platform researchers can easily access to search and analyze all past research—a major hurdle for biomedical innovation. Companies that use artificial intelligence to discover drugs were already thinking about how to amass and leverage big data before the coronavirus outbreak. However, the conversation around building big data repositories and analytics for health research has become more urgent.
It’s important to remember that investors and health tech experts are not soothsayers, though they enjoy pontificating and placing big bets on the future. In the first survey, the vast majority of participants predicted deaths from the coronavirus in the U.S. would total less than 10,000. As of this writing, deaths related to COVID-19 in the U.S. have topped 100,000.
“It reinforced for me how hard it is for any of us to quantify dramatic changes in existential risk,” Roberts says.