COVID-19 is raining down its fury on India in a way the world hasn’t seen before. The country has averaged about 300,000 cases daily for nearly 2 weeks now. Oxygen is running low; crematoriums are overwhelmed, and the government has been slow to mobilize global allies and its +28 million diaspora effectively. In the short-term, Indians seem to have forgotten they live in areas that don’t yet have herd immunity or a largely vaccinated population. India did not do enough over the last fourteen months to prepare adequately for variants of the virus, or to learn from the multiple waves of the virus that slammed other nations. Long-term, this crisis is a reflection of India’s chronic underinvestment in health care. According to its own data, India spends less than 3% of GDP on health care – the lowest among OECD nations.
For Americans looking to support efforts to bring oxygen, additional ventilators and vaccine raw materials to India, there are several wonderful initiatives to connect with immediately. Some of the organizations include The Desai Foundation, which has grassroots teams providing community-based healthcare in the three hard-hit states of Maharashtra, Gujarat and Rajasthan. The American India Foundation is setting up 5000 hospital beds in Delhi, portable hospitals around India and sourcing cold-storage facilities for vaccine doses. Another large American charity, SEWA International, is sending 400 oxygen concentrators to India this week.
The situation in India is further evidence that COVID-19 will remain with us for years to come. Even though nearly 50% of American adults have now been vaccinated against COVID-19, the United Nations estimates it will be 2024 before many of the poorest nations of the world get access to adequate supplies of a vaccine – even with the Biden Administration’s announcement that the United States will be shipping excess vaccines doses to the developing world. Between now and 2024 there will be new variants, further breakdowns in the medical supply chain and donor fatigue in the West. It is also likely that India will have multiple waves over the next two years.
For these reasons, it remains imperative that the world continue to support non-vaccine innovations to prevent, monitor and treat COVID-19. Fortunately, many of the world’s top researchers and entrepreneurs began thinking about this challenge in 2020 when the pandemic first hit and were not deterred by the amazing speed with which vaccines were developed.
Photo of the iSAVE Ventilator from Project Prana
One such effort, launched out of Brigham and Women’s Hospital in Boston, has developed a nasal spray-based shield to prevent the transmission of SARS-CoV-2. Using a novel biomaterial, an experienced team of researchers and entrepreneurs developed the nasal spray formulation to capture and deactivate respiratory pathogens in the nasal cavity, thereby preventing transmission of SARS-CoV-2. According to researchers Nitin Joshi, PhD and Jeff Karp, PhD, the materials for the nasal spray were already recognized as safe by the FDA, so the team re-organized to develop an optimized formulation that demonstrated a greater than 99% probability of killing Influenza A and SARS-CoV-2 viruses within minutes of contact time. The team also demonstrated that the formula could kill 99% of E. coli bacteria within minutes. In early studies, a single dose of the formulation administered into the nasal cavity has been shown to be effective for more than eight hours of exposure, which is much higher than previously developed nasal formulations.
The team believes the product will provide an additional layer of protection alongside common PPE like surgical masks and N95 respirators. The hydrogel can also hydrate nasal lining, which promotes nose breathing and helps with the deactivation of inhaled pathogens. They hope to receive emergency approval to make the spray available by Fall 2021 in certain markets of the world. A team at Northwestern University is working on a similar concept with support from the National Science Foundation.
Another such startup is Neopenda, which has developed the NeoGuard, a wireless wearable vital signs monitor designed for resource-constrained health facilities. The device, which was originally developed for neonatal patients, fits like a headband on both children and adults. It enables more responsive and appropriate care for critically ill patients, and ultimately helps prevent patient mortality. The device measures pulse rate, respiratory rate, peripheral blood oxygen saturation and temperature of critically ill newborns which allows caretakers to catch preventable and treatable conditions earlier.
As the situation in India has shown, health systems can be overwhelmed quickly and technology solutions like NeoGuard are a powerful tool for health care providers to monitor large patient groups with viruses like COVID-19. According to Sona Shah, the Founder and CEO, “monitoring vital signs helps to identify suspected COVID-19 cases for further testing, then monitor COVID-19 patients for signs of clinical deterioration or improvement, and triage high risk individuals to prioritize their care and allocation of scarce resources like ventilators and oxygen. By designing for the lowest levels of infrastructure, we have been able to readily adapt our neonatal monitor for use in a variety of use cases and patient populations— including for adult COVID-19 patients.”
The company recently closed a funding round and received the CE Mark approval by the European medical device regulatory authorities. Neopenda has launched in Kenya and Uganda, with pilots in Tanzania, Nigeria and Rwanda.
Project Prana, out of the Massachusetts Institute of Technology, has been attacking another challenge – the technical limitations of oxygen ventilators, which only support one patient at a time. In resource-constrained, hard-hit regions like India, this design challenge is putting hundreds of thousands of patients at additional risk. Project Prana has developed an open-source splitter that would allow each ventilator to serve at least two patients without effecting the oxygen amounts provided to each. “The Individualized System for Augmenting Ventilator Efficacy” (iSAVE) also enables independent control of volume and pressure for each patient and incorporates safety measures to accommodate sudden patient deterioration and cross-contamination.
These amazing innovations still need to make it to hospitals, clinics, patients and consumers worldwide. They will be transformative in the current fight against COVID-19, but also relevant to the next pandemic as well. Because unfortunately, the difficulties of ramping up vaccine production, supply chain management, cost and vaccine hesitancy will remain with us through this pandemic and into the next one. Hopefully, the lessons learned from the rapid development of the vaccines can be applied to non-vaccine innovations as well. Large, unrestricted financial support, shared tech transfer and expedited regulatory participation would be much appreciated by these innovators and entrepreneurs and hopefully reduce the chances of another crisis like the one playing out in India.
