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How Covid-19 could lead the way to better healthcare

Scientific innovation has accelerated in 2020 and that will benefit the public and investors alike
How Covid-19 could lead the way to better healthcare
  • The Covid-19 pandemic has highlighted the importance of keeping people out of hospital
  • Preventative healthcare – through scientific innovation and better lifestyle – should play an important role in post-pandemic planning

Every winter, Martin Pate and his friends spend their Saturday mornings in a hypothermic state while swimming in the unheated lido at Hampstead Heath. Their hobby makes them the perfect candidates for a brain trial – not because they are bonkers, but because ‘cold shocks’ can trigger the development of a protein that protects against dementia. 

In a 2015 rodent study, scientists at the University of Cambridge first discovered that the RMB3 protein forms after repeated exposure to hypothermic conditions and can lead to brain regeneration. Sidestepping the ethical ambiguity of causing hypothermia in humans by using trial participants who willingly plunge themselves into icy water, the scientists progressed their research by testing Mr Pate and his friends for RMB3. The study concluded that a significant number of the swimmers had elevated levels of the protein. 

That’s a promising development in the study and potential prevention of dementia, which overtook heart disease to become the UK’s leading cause of death in 2016. Dementia robs the elderly of their final years of life and costs millions in healthcare bills, to say nothing of the emotional turmoil for patients’ families. But it remains one of medicine’s biggest unsolved problems – one that will only grow in an ageing, sedentary population which is gradually forgetting to read regularly. 

Protecting the brain from degeneration through lifestyle changes, whether that’s cold water swimming or regularly completing a crossword (as recommended by a 2018 study), are positive steps in the fight against dementia. 

And neurological conditions aren’t the only illnesses for which lifestyle changes are increasingly being prescribed as preventative therapy. Cold water swimming has also been proved to decrease stress and blood pressure, thus reducing the chances of developing heart disease, obesity or mental health conditions; while ketogenic diets and periods of fasting can reverse the insulin resistance of type 2 diabetics and remove the need for regular injections. Pumping the body with drugs is not always the best solution to the modern world’s biggest health issues. Prevention is better than a cure. 

That is, except when it comes to paying for it. Amid the spending pressure on the NHS, public health grants – which are meant to fund physical activity, sexual health services and education around substance abuse, among other preventative measures – have seen the biggest squeeze, with funding down 22 per cent in the past five years. According to independent think tank The Kings Fund, the NHS’s plans for prioritising prevention of illness fall short of what is required. 

But the global coronavirus pandemic has highlighted the importance of keeping people out of hospital – a hotbed for picking up illness – and has increased the pressure on governments to invest in preventative care. Proven or suspected outbreaks of Covid-19 forced whole wards to close, with beds taken out of commission and elective surgeries postponed or cancelled as hospitals set up their own quarantines to stem the spread of the virus. An estimated 1m cancer screenings have been missed this year as hospitals closed their doors to all but the most immediate care. Childhood immunisation is at a seven-year low – ironic given the country’s current fixation with vaccines. And standard elective surgeries have been repeatedly postponed, often leaving patients with far more complex illness or injury.

The physical and mental health repercussions of Covid-19 are going to be felt a long time after the virus has been contained. 

 

Follow the science 

But the pandemic has provided many important lessons in health for both scientists and the public. The vast majority of severe cases and deaths from the virus have been in patients with other long-term conditions – obesity, diabetes and chronic obstructive pulmonary disease among them; all illnesses for which lifestyle interventions can make an enormous difference. The importance of regular exercise, sensible diet, decent sleep and low stress has never been so obviously important. Post-pandemic planning should take general health far more seriously. 

Good news then, that scientific and technological innovation has accelerated in 2020 and has laid the groundwork for better health monitoring. Mathematical modelling was used to map the potential trajectory of the pandemic in its infancy – even if questions remain as to whether the Imperial College modelling that informed the UK government’s response ultimately saved lives or resulted in lengthy and unnecessary lockdowns. Data-gathering from transport networks and mobile phone signals helped Singapore manage the pandemic far better than most densely populated countries. 

Use of data in preventative healthcare is not new. It was Hippocrates who said, “it is more important to know what sort of person has a disease than to know what sort of disease a person has”. But never before has it been possible to monitor health metrics so efficiently. Using the principles borne out by track and trace, NHS trusts should now be able to identify areas of elevated disease and map that information to genetics, ethnic or physical activity data to determine patterns in disease spread. This should inform more efficient preventative measures to help keep people out of hospital. 

Drug discovery and development has also accelerated in 2020. In January a team of scientists in China mapped the genome of the SARS-CoV-2 virus in record time – progress in genetics has rapidly decreased the speed and cost at which genomes can be laid out. This allowed two pharmaceutical companies to develop safe, effective genetic vaccines within a year. And unlike traditional methods, the Pfizer (US:PFE) and Moderna (US:MRNA) Covid-19 vaccines use snippets of genetic material to spark a controlled immune response; this makes them safe and far easier to produce in large quantities.

Once the world has emerged from the Covid-19 hole, the outlook for medicine – and the investment case in it – is positive. The only hope is that lessons of the pandemic are not forgotten.