A Time for Reflection

5 April, 2020

Dear Friends,

There are a few rare times when one is called to step up, and to work together, for the benefit of humanity. This feels like one of those times.

At Ahren, we have been searching deeply for what we can best, and most usefully do, for our entrepreneurs, for our LPs and for our society, including of course our loved ones.

I wanted to express a few thoughts I do not believe have been given sufficient attention. It is unlikely we will see a quick resolution of this situation – it may be months before there is real respite, and many more after that before we achieve any sense of “normality”. However, it is not deterministic. We, as a society, will together determine the outcome, in our actions from now on.

1. We may have been spared an even greater tragedy this time:

I am somewhat reluctant to bring this up now and it must in no way detract from the severity or suffering of this moment but feel it is important to recognise that this could have been even worse. The mortality rate in the low single digits for Covid-19 compares to a virus such as Ebola with mortality rate of c.50%. There have been few single events in history that have shut down global economies or overwhelmed healthcare systems so rapidly and we need to prepare now to avoid future pandemics. Suggestions:

  • International cooperation is an imperative, not an option.
  • Universal and regular testing and tracing – both old-fashioned and smart-tech needs to be employed.
  • Design and funding of cutting-edge immediate alert systems, including smart biological sensing of environment and materials, would be highly beneficial.

2. Human conflict:

It is possible that humans could end up in conflict if the situation worsens in societies that lack a social safety net and free healthcare, especially developing countries. It could create the two-tier society some have long predicted. On the flipside, we have seen incredibly generous acts and moving solidarity for fellow humans (more on this below) and we hope and believe this situation will bring out the best in people. Suggestions:

  • Doing what we can as individual actors to inspire, uplift, inform and protect the vulnerable in the best way we each can – please see (4.) below.
  • Of course, one of the great US traditions has been philanthropy and I know this is already coming to the fore. The British Government has taken positive steps on this front, with furlough pay support, use of private medical facilities for general public care, calls for ventilator provision etc., but more can be done. In Germany, there was a very rapid repurposing of sports halls, conference facilities and gathering places. In Asia countries, there was a remarkably swift medical care intervention. There should be no reason Western countries cannot do the same.

3. Scientific solutions:

Given the urgency, it is possible that rushing potential vaccines, antivirals and antibody therapies (understandably and v positively) into clinics might be done without the opportunity for due process. If this happens, I worry they may not pass safety tests in clinical trials, for example, if they create antibody dependent enhancement (“ADE”) of the form we have noted being possible. ADE occurs when non-neutralising antibodies facilitate the uptake of viral particles into immune cells called macrophages. The virus then can replicate further in a new host cell and be carried through the body, making the disease more severe. This phenomenon is rare but has been seen in Dengue Fever, HIV and preliminarily with the closely related SARS-CoV virus that caused the 2003 SARS outbreak. I believe it is important for the scientific community to try to under-promise and over-deliver: while it would be excellent if a quick treatment / vaccine was found, there is a high probability that there will be failures before success. This is the nature of science and scientific progress; we hope that the global community will recognise this and not be over-hopeful and then despair unwarranted. We simply need to keep going. As Ahren, we are investigating being involved in developing a potential therapeutic. Suggestions:

  • Coordinated global scientific effort with parallel trials, adaptive trial designs and global testing.
  • The scientific community and policymakers should try to under-promise and over-deliver.
  • Setting public expectations – avoiding over-expectation, and quickly countering mis-information regarding potential treatments.

We have set up a tracker to follow positive developments in each category: please see the link here. It is not exhaustive, but we hope is helpful.

4. Supporting each other:

If the vulnerable in society were in hardship before, they are even more vulnerable now. We have been moved by the actions of a number of you, including offering any resources you might have, to help others – we have seen offers of lodging / event spaces for repurpose into further hospital care; repurposing shower companies into ventilator production; and home food-delivery, as examples amongst other generous acts. We are proud to interact with you. Beyond Covid-19 itself, but as a result of this crisis, it is heart-breaking to hear of some de-prioritisation of other treatments, such as cancer care. We will set up a sharing system, such that if you do have anything you would like to offer to others in society, big or small, please let us know, and we would be glad to coordinate efforts.

My great hope in all of this is that we can use this crisis to serve some positive purpose. I hope a shift from self-interest towards acting as a humanity will not only happen, but that it will continue once we have emerged from the other side. Perhaps we will be able to use these same frameworks and connections without borders to tackle the other pressing needs with which we are faced. I am writing this as all of us, together, will determine this.

Best wishes to you and your loved ones,

Alice

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