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Many gig workers experienced financial hardships during the COVID-19 pandemic, including food insecurity and trouble paying bills, according to a recent study published in Work and Occupations.
"In a nutshell, our study shows gig workers were harmed more by the COVID-19 pandemic than any other workers," said Dr. Mathieu Despard, a co-author on the paper and faculty member in UNC Greensboro's Department of Social Work.
Despardwho collaborated closely with first author Daniel Auguste at Florida Atlantic University and co-author Stephen Roll at Washington University in St. Louissaid the findings challenge the popular premise in the United States that gig work provides a sustainable alternative to traditional employment.
These results suggest that gig working can make it tricky for these individuals to make financial ends meet, said Despard.
"We have this very romantic narrative in this country that we're the land of opportunity. If you want to start your own business, you can go for it. But when you peel that narrative back, you begin to realize that people who are doing gig work are often struggling for economic survival."
The scientists found that about 33% of surveyed gig workers experienced food insecurity, 12% had skipped housing payments, and 33% had unpaid credit card findings between April 2020 and June 2021. Economic hardships were more pronounced for gig workers who had children, those with less savings, and those who worked multiple gig jobs.
Despard says that the unreliable nature of gig work can help explain why many experience more financial difficulty. For example, a food delivery driver may have one busy night followed by a day with little work. "This introduces unpredictable volatility, which can make it difficult to pay your bills and plan ahead," he says.
Their findings are relevant to the approximately 15% of Americans who have gig-worked at some point, according to the PEW Research Center.
A strength of the new study is the robust sample of gig workers, says Despard. The Social Policy Institute at Washington University in St. Louis's Socioeconomic Impacts of COVID-19 Survey includes responses from 4,756 workers from a range of ages, income, genders, and race and ethnicities. Approximately 29% of respondents had engaged in gig work in the three months before they were surveyed.
"It's a rigorous survey, and the respondents looked like the U.S. population," Despard says. "The data is nationally representative."
Despard says his research is, in general, driven by a desire to better understand the structural barriers that prevent Americans from reaching their financial goals.
"The bottom line is that it should not be this difficult for people to meet their basic needs because it has a toll on their mental health, a toll on their physical health, and it takes time away from their families," Despard says.
More information: Daniel Auguste et al, Democratizing the Economy or Introducing Economic Risk? Gig Work During the COVID-19 Pandemic, Work and Occupations (2023). DOI: 10.1177/07308884231202032
Australia is currently riding its next big COVID-19 wave into the holiday season.
And our ability to measure that wave has changed since the pandemic began.
The government used to rely on people testing to record the number of infections. Now, it looks to wastewater, how many scripts are being filled for antivirals, and COVID-related hospital admissions.
The definition of infected and the way the government records that data have also changed.
In that same vein, when it comes to being vaccinated against the virus, being able to record that data has become difficult.
Since the pandemic began, the government has moved the goalposts a few times on what the exact definition of being fully vaccinated is.
The Australian Technical Advisory Group on Immunisation's most recent update to the eligibility criteria for a booster says anyone over the age of 75 should get a vaccine if it has been six months since their last dose.
Adults aged between 65 and 74 should consider getting a COVID-19 vaccine six months after their last dose, along with those between 18 and 64 who are severely immunocompromised.
The first half of this year, before April 2023, shows a success story.On the whole, governments kept aged care residents who are pretty much the most vulnerable section of the population vaccinated.
The definition of vaccination changed occasionally, but, on the whole, almost all aged care residents were vaccinated.
The second half, since April 2023, shows what has happened in "post-emergency Australia". A new definition of vaccination applied.
The government now regards someone as vaccinated if they have had a booster shot or been infected with COVID-19 within the past six months. In other words, it wants all aged care residents to have some form of recent immunity.
However, the country has never managed to get more than two-thirds of aged care residents "vaccinated" under this definition.
And the vaccination rate has collapsed since September. It has now dropped below 40 per cent for this vulnerable part of the community.
According to Council of the Ageing CEO Patricia Sparrow, it is up to the aged care providers to work with the government to ensure their residents are vaccinated.
"It should be joint responsibility," she said.
"We need providers to particularly proactively facilitate timely vaccinations for their residents as they do with flu vaccination, and that they're talking to their residents and families about whether are they up-to-date."
The government says it is "committed to increasing the number of aged care residents who have their COVID vaccination up-to-date".
"The Department of Health and Aged Care is continuing outreach to homes with the lowest COVID-19 vaccine uptake," a government spokesperson said in a statement.
It said it was "working with Primary Health Networks to support residential aged care homes needing assistance with accessing COVID-19 vaccine providers".
The spokesperson pointed to the incentive for doctors and pharmacists to visit homes to deliver boosters from $57 to $118, although it seems as though the financial incentive has not been enough.
The government has recorded 58,500 aged care residents have received a booster dose in the past six months and those "rates continue to rise".
Bernadette Kelly, 93, got the COVID-19 vaccine when it first came out, and she had the follow-up shots when they came out, too. But with the latest booster, I didnt even think about it, she said. (Amanda Vinicky / WTTW News)
Bernadette Kelly, 93, got the COVID-19 vaccine when it first came out, and she had the follow-up shots when they came out, too.
But with the latest booster, I didnt even think about it, she said.
While the public health emergency is officially over, COVID-19 is still making people sick, and health officials say theyve entered a new front.
During the height of the pandemic, people became used to the public health system providing immunizations and treatments at pop-up mass vaccine clinics and public testing sites, Illinois Department of Public Health Director Sameer Vohra said.
Those have now largely disappeared.
Were moving to those things being delivered, just like you get everything else, with a regular health care delivery system, like doctors offices, he said.
Vohra said adjustment is a struggle.
The change, he said, is for all the good reasons. Were no longer in a public health emergency.
But its still a change that requires raising awareness and education.
Kelly ended up receiving her COVID-19 vaccine in early November, at a Rush University System for Health pop-up clinic at the Martha Washington Apartments senior community, where Kelly lives.
Kelly hadnt intended to get the latest booster; she was meeting her friends for coffee as she does every Monday. On this particular morning, though, Vohra was there, along with Centers for Disease Control Director Dr. Mandy Cohen and American Medical Association President Dr. Jesse Ehrenfeld.
While we all wish we could be done with COVID, it is still here with us, Cohen said. Its here and making people pretty sick. And what were seeing is in Illinois and the Chicago area, COVID starting to tick up. Were expecting to see more COVID here through the winter season. As we know, when we gather indoors this virus likes to spread. So we want to make sure folks know to get vaccinated now.
While early November was ideal to get vaccinated ahead of Thanksgiving, now is a good time leading up to those wholl be in large groups for Christmas festivities.
As has been the case since COVID-19 emerged, Cohen said its particularly important for those over 65 that are at the highest risk of going into the hospital or dying, still, of COVID.
Rush Hospital outreach street nurse Joshua Dueshop vaccinates a resident of the Martha Washington senior apartments in North Center. (Amanda Vinicky / WTTW News)
Rush Hospital outreach street nurse Joshua Dueshop says he is well aware that some people have COVID fatigue. But he tries to educate them that it will be like the flu, with an annual vaccine recommended.
My personal thing is, I tell them to get it (the vaccine) to protect the ones who cant babies, kids that cant get it, adults that cantget it, are immunosuppressed, Dueshop said. So even if you dont necessarily believe in it, you can get it. Youre still protecting them.
COVID-19 isnt the only concern.
RSV, or respiratory syncytia, and the flu are on Cohens radar, too.
Flu shots have long been recommended by the CDC.
But for the first time, theres now an RSV vaccine for adults over age 60.
Infants can also receive a shot to protect against RSV, though theres been a shortage that Cohen chalks up to pediatricians underestimating demand for the new product.
Cohen said public-private partnerships like the clinic Rush did at Kellys senior home show that the healthcare system is continuing to put to use lessons learned during the pandemic.
Follow Amanda Vinicky on Twitter:@AmandaVinicky
Start Slideshow
The United States went into the Thanksgiving holiday week with a high mortality rate and a modest surge of people entering hospitals with COVID-19.
The United States recorded about 214,382 deaths from all causes in October, according to early death data published along with U.S. Centers for Disease Control and Prevention flu tracking report. The death count was 0.3% lower than in October 2022, but it was 10% higher than in October 2019, before the COVID-19 pandemic came to light.
Another set of data, a U.S. Department of Health and Human Services COVID-19 and flu hospitalization tracking spreadsheet, shows that hospital admissions for COVID-19 continue to be much higher than they were during the week ending July 1, when the pandemic seem to be fading away.
For people ages 20 through 59, the number of hospitalizations reported for the week ending Nov. 18 was 3,593. In the median state, the working-age hospitalization count was 9.7% higher than in the week ending Nov. 11, and it was 263% higher than in the week ending July 1.
For a look at the 12 states where the working-age hospitalization count increased the most between the week ending Nov. 11 and the week Nov. 18, see the gallery above.
For figures for all 50 states, Puerto Rico and the District of Columbia, see the table below.
What it means:Clients and their financial professionals face the same old uncertainty about when, or if, mortality will get back to where it was in 2019.
The context:The current COVID-19 wave is much smaller than the surges that hit earlier in the pandemic.
Hospitals admitted about 147,000 adults with COVID-19 during the week ending Jan. 15, 2022, and about 16,000 U.S. residents died from COVID-19 during the week ending Jan. 16, 2021.
But theUnited States appears to be on track to record about 300,000 more deaths than it recorded in 2019, when 2.9 million people died.
The excess mortality is caused partly by COVID-19 itself; partly because of the effects of COVID-19 on health care, the health care system and society as a whole; and partly because of other causes, such as opioids.
Credit: Adobe Stock
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A new book explores why COVID-19 deaths disproportionately affected non-white Americans.
Mortality rose across all demographics during first few years of the pandemic, but COVID-19 hit non-white Americans the hardest.
According to the US Census Bureau and the National Center for Health Statistics, the largest increase in mortality in 2020 was among the American Indian and Native Alaskan populations, which saw an increase of 36.7%.
The increase in mortality was 29.7% among Black Americans and 29.4% among Asian Americans. For comparison, the increase in mortality among white Americans was less than 20%.
Melvin Thomas, a professor of sociology at North Carolina State University, is the author and co-editor of the new book Race, Ethnicity and the COVID-19 Pandemic (University of Cincinnati Press, 2023).
Here, he talks about the role that racial inequality playedand continues to playin shaping health outcomes in the United States.
Analyzing wastewater for SARS-CoV-2 RNA fragments could help more accurately predict future hospitalizations from the disease and allow health systems time to prepare for seasonal surges, according to new research published in the journal Infectious Disease Modelling.1
The COVID-19 pandemic, which has experienced ebbs and flows since it first began, has shown how important it is for hospitals to be prepared for a potential influx of patients. This is why its imperative to have forecasting methodologies that can provide advanced warning of potential surges in COVID-19 cases.
Predicting future hospitalizations using wastewater data helps get our public health partners in front of surges before they happen so they are prepared when new patients need to be admitted and can distribute resources accordingly, Dustin Hill, lead researcher on the study, said in a release.2
Investigators from Syracuse University conducted a study where they developed and tested a predictive model for incident COVID-19 hospital admissions using wastewater data. Data was collected from 109 wastewater treatment plants across 56 counties in New York State from April 2020 through June 2022.
The researchers included different covariates in the study, such as COVID-19 vaccine coverage in the county, comorbidities, demographic variables, and holiday gatherings. Wastewater samples were collected using 24-hour composite sampling, which were shipping to regional laboratories for extraction and quantification of SARS-CoV-2 virus.
Investigators found that SARS-CoV-2 RNA fragment concentrations in the wastewater correlated with new hospital admission per 100000 up to 10 days prior to admission. Models that included wastewater data were 15% more accurate when compared to models that only included clinical case data.
Additionally, predicted hospital admissions correlated highly with observed admissions, with an average difference of 0.013 hospitalizations per 100000.
Study limitations include that where someone contracted COVID-19 may not align with where they are hospitalized, that certain covariates were not available at the sewershed level, and that between-lab variance might be masking some correlations and effects that are stronger with single-lab analyses.
Our findings indicate that wastewater surveillance improves prediction models for hospitalizations by 11 percent over models that use case data at the county level and by 15 percent for regional hospitalization estimates, said Hill.2 When looking at how many beds a hospital has available, those percentages can make a big difference in whether that hospital is going to have space for new patients or not, and this data can help them get ready for changes.
In the United States, there is currently no federal law guaranteeing workers paid days off, and many are not entitled to unpaid time off.
According to a 2020 report from the U.S. Bureau of Labor Statistics, 78% of workers have access to paid sick time.1 This means that close to 1 in 4 workers may experience financial hardship when illness strikes.
COVID-19 can have significant effects on individuals wellbeing, causing a decline in their health-related quality of life. The infection symptoms, such as fever, cough, and fatigue often thwart productivity, making it harder to work and get daily tasks done.
COVID-19 vaccination, particularly the bivalent BNT162b2 formulation, has been shown to have very high efficacy against severe disease and moderate efficacy against symptomatic SARS-CoV-2 infection, according to the World Health Organization.2
A study published in October and led by Manuela Di Fusco, senior director of Health Economics and Outcomes Research at Pfizer, analyzed the effects of Pfizers BA.4/5 BNT162b2 COVID-19 vaccine on symptoms, Health-Related Quality of Life (HRQoL), and work productivity.3
The study enrolled 643 participants including 316 individuals who had been vaccinated and 327 who were unvaccinated. The unvaccinated cohort included individuals that never received any COVID-19 vaccine and those who were not up-to-date(if their last dose was over 12 months ago). The average age of the participants was 46.5 years old, with 25.7% having one or more comorbid condition. This study gathered patient-reported outcomes from individuals who were tested for SARS-CoV-2 at CVS Health test sites, targeting adults with a positive test result and at least one acute COVID-19 symptom.
The study utilized online surveys to collect baseline information on participants, including demographics, comorbidities, COVID-19 vaccination and infection history. Participants also provided information on COVID-19 antiviral treatment and changes in vaccination and infection status. The study measured outcomes such as symptoms, HRQoL, fatigue, work productivity, and activity impairment using validated measures at different time points over a four-week period.
The findings of the study revealed that the vaccinated group reported fewer acute symptoms, particularly systemic and respiratory symptoms commonly associated with COVID-19. Further, while all participants experienced some adverse effects on their overall HRQoL, the vaccinated group demonstrated a better work performance compared to the unvaccinated group. This was evidenced by lower rates of absenteeism and fewer work hours lost among those who had received the vaccine.
The researchers concluded that the vaccinated group experienced fewer and less persistent symptoms than the unvaccinated group. Moreover, their improved work performance highlights the positive impact of COVID-19 vaccination on individuals' ability to carry out their daily responsibilities effectively.
This study, funded by Pfizer, adds to the body of evidence supporting the role of COVID-19 vaccination in reducing the severity and frequency of symptoms experienced by those who receive it. Regarding their study on patient-reported outcomes, the authors wrote, it solidifies evidence indicating that the effectiveness of BA.4/5 BNT162b2 on COVID-19 disease could translate to extra benefits of reduction in the frequency and burden of symptoms, supporting faster recovery and return to work.
This article originally appeared in Managed Healthcare Executive.
Pregnancy-associated overdose deaths among women aged 10 44 years old consistently increased from 2018 to 2021, according to new research.1
From 2018 through the COVID-19 pandemic, the overall overdose-related deaths significantly increased. According to the Centers for Disease Control and Prevention (CDC) in 2020, 91,799 people died from drug overdose. The number marks a 30% increase from 2019.2 Despite the higher number of overdose deaths, limited research existed on trends in pregnancy-associated deaths from drug overdoses.1
The cross-sectional exploratory study, led by Beth Han, MD, PhD, MPH, of the National Institute on Drug Abuse at National Institutes of Health in Bethesda, Maryland, aimed at examining sociodemographic characteristics among women with pregnancy-associated drug overdose deaths. The team examined pregnancy timing, age, race and ethnicity, education level, and marital status, obtained from the National Center for Health Statistics. The investigators specifically compared overdose decedents with obstetric decedents and overdose decedents who were not pregnant in the past year.
Our results suggest that increases in pregnancy-associated overdose mortality reflect the persistent US overdose crisis, especially during the COVID-19 pandemic, the investigators wrote.
The study included 1457 pregnant and postpartum women who died from overdose, 4796 women who died from pregnancy non-overdose-related, and 11,205 non-pregnant females aged 10 44 years who died from an overdose. The team considered pregnancy-associated deaths as either females who died during pregnancy, were pregnant within 42 days before death (postpartum) or were pregnant within 43 days to a year (long postpartum period).
Han and colleagues found deaths more than tripled among pregnant and postpartum women aged 35 44 years old. For instance, for women aged 35 44 years old, the morality ratio increased from 4.9 per 100,000 mothers in January to June 2018 (95% CI, 3.0 8.0) to 15.9 per 100,000 mothers in July to December 2021 (95% CI, 12.3 20.4). Women 10 34 years old were more likely to die from pregnant-associated overdose than just pregnant women (75.4% vs 59.5%).
For each age group, the increased odds of death were:
When examining mothers aged 10 44 years old, late postpartum overdose ratios doubled from 3.1 (95% CI, 2.3 3.9) in January to June 2018 to 6.1 (95% CI, 5.0 7.2) in July to December 2021 (95% CI, 2.3 24.0; P = .02).
The team also observed pregnancy obstetric mortality ratios increased from 10.5 in June 2020 (95% CI, 8.9 12.0) per 100,000 mothers to 16.6 in December 2021 (95% CI, 14.7 18.4).
Other than age, the investigators compared education level, marriage status and location of death. The investigators found non-college graduates had a higher increase of mortality odds. For some college education, odds of death were 2.7 (95% CI, 1.7 4.3), but for less than a high school education, the odds were 3.9 (95% CI, 2.4 6.1).
Being unmarried had an 88% higher likelihood of dying; the likelihood of dying married was 62.1% (95% CI, 3.7 6.0).
Moreover, females had a higher likelihood of dying outside of their home but in a non-health care setting, with the odds being 2.5 (95% CI, 1.8 3.6). On the other hand, the investigators observed a decreased odds of dying in health care setting (0.1; 95% CI, 0.1 0.1) and hospital inpatient settings (0.4; 95% CI, 0.3 0.6) such as the emergency room.
Most pregnancy-associated overdose deaths occurred outside health care settings, indicating the need for strengthening community outreach and maternal medical support, the investigators wrote.
When looking at ethnicities, the team noted non-Hispanic American Indian or Alaska Native mothers in 2018 to 2019 and 2020 to 2021.Then, as for age, women aged 35 44 years old had higher mortality rates than younger age groups.
Pregnant overdose decedents were associated with increased odds of 75.4% compared to 48.35% for non-pregnant overdose decedents (3.2; 95% CI, 1.7 4.1) for ages 25 to 34 years to (3.3; 95% CI, 2.5 4.4) for ages 10 to 24 years.
We further found that pregnant and postpartum overdose decedents differed from obstetric decedents and nonpregnant overdose decedents in sociodemographic characteristics and place of death at the individual level and relevant health care resources at the county and state levels, the investigators wrote.
The team later stated 60% to 73% of pregnant and 74% of non-pregnant overdose individuals died at home or other nonhealthcare locations.
These findings are consistent with the phenomenon that overdose deaths occur frequently at drug-consumption locations," the investigators added.
Pregnant overdose decedents were more associated than non-pregnant overdose decedents of residing in a county with deep poverty. Though, early postpartum overdose decedents were associated with an increased odds of living in a county with no general hospital.
The team noted they used US mortality data, which did not include health insurance, family income, and employment statusand thus the story could not examine these factors.
Health insurance status, income inequality, poverty, mistrust in the health care system, stigma, bias, and cultural and language issues may be barriers to health care access for pregnant and postpartum decedents from obstetric causes, the investigators wrote. These social determinants of health need to be urgently addressed.
References
CHICAGO The Ed Burke trial has another challenge to its timeline after a defense attorney tested positive for COVID-19.
Following a break for Thanksgiving, Judge Virginia Kendall announced a little bit of a glitch in our proceedings after an attorney for one of Burkes co-defendants came down with COVID-19.
Todd Pugh represents Peter Andrews, a longtime aid to Burke, and will view the proceedings Monday via a video conference.
Its a significant development because Andrews directly factors into the Burger King portion of the trial. Evidence related to the alleged Burger King scheme is being presented Monday.
Nobody else involved in the trial has tested positive, though the 79-year-old former alderman, who retired in May after 54 years, and his attorneys were all wearing masks as a precaution.
Burke is facing 14 counts of racketeering, bribery and extortion.
Prosecutors have been outlining four alleged scheme in which they said Burke abused his public office to enrich himself or seek favors for friends.
When the trial last left off, prosecutors were presenting evidence of the so-called shakedown of a Burger King in his Southwest Side ward.
Burke is accused of holding up driveway permits to try to pressure the restaurant owners to hire his private law firm to do their property tax appeals.
Pam Smith, the regional director of operations at Tri City Foods, which operated the Burger King, testified Monday that she helped address Burkes concerns over overnight semi-truck parking in the restaurants lot.
She also discussed internal emails and conversations about how the company viewed delays in receiving permits from Burkes office. She testified that Burke was very powerful and could make life difficult for them in Chicago.
Since attorney Todd Pugh is not able to be in court, the plan was to only hear one witness Monday, pause the Burger King evidence, and then switch to a different alleged scheme Tuesday.
On March 9, 2020, Alpha Lee, Ph.D., and his two fellow co-founders at PostEra AI were living out of an Airbnb in Silicon Valley, trying to get their AI-driven biotech startup off the ground. While scrolling through Twitter, they noticed a tweet from Martin Walsh, a scientist at U.K.-based particle accelerator Diamond Light Source. Walsh and another group at Diamond Light had created the structure of a key SARS-CoV-2 virus enzyme.
We saw this and thought, This is a beautiful set of data, Lee recalls.Seeing a potential application for PostEras drug synthesis machine learning platform, he replied to Walsh, Would love to explore whether our ML/synthesis-aware generative models can help. Happy to work on it if you need extra hands!
Thus began the COVID-19 Moonshot project, a massive international open science collaboration between universities, companies, nonprofits like the Wellcome Trust and hundreds of scientists, to identify new drugs capable of blocking SARS-CoV-2. Earlier this month, the consortium published an article in Science detailing its methods and the results of its work so far, which include a patent-free lead compound. Moonshot is continuing as part of the AI-driven Structure-enabled Antiviral Platform, or ASAP, consortium, which is using AI and computational chemistry not only to discover new COVID-19 drugs but also therapies for other viruses.
What is the COVID-19 Moonshot project, and how did it start?
AL: The COVID-19 Moonshot initiative is a nonprofit, open science drug discovery initiative against SARS-CoV-2s main protease that started in 2020. Back then, we already knew that the main protease is likely to be an important validated target for antivirals, but at that time, there were no therapeutics or even late-stage development against that target.
The impetus for the project was a single crystallographic fragment screen, which is a data set of pieces of moleculesyou can think of this as a molecular jigsaw puzzle sitting in the binding site of the main protease. Our team at PostEra saw this beautiful dataset being shared ahead of actual publication, actually on Twitter. And then we got really excited about it and thought this might be an opportunity where we can actually crowdsource the imaginations of a lot of chemists, who at that time were working from home, to suggest what kind of combinations of these jigsaw pieces can nucleate towards a potent inhibitor, and going forward, a drug.
[PostEra] had this technology that could help do medicinal chemistry a lot faster with machine learning, and making molecules faster in particular. So we launched this crowdsourcing portal, inviting people to submit ideas on how they can turn these jigsaw pieces into a complete picture.
How many ideas were submitted? How did you pick the best one?
AL: We thought it would be a niche exercise, but many hundreds of people actually submitted tens of thousands of designs. And through iterative cycles of people submitting the compounds, and us making and testing compounds accelerated by computational chemistry and machine learning, we iterated toward a preclinical candidate.
AVD: As Alpha mentioned, there were a lot of ideas coming in. But the challenge was whittling down to what was actually doable because we had a very limited budget and we couldnt make all of those ideas. So there needed to be some very stringent prioritization. Thats where machine learning played a big role: It helped us decide where we would go with all these different ideas and how we would get to a compound that was actually synthesizable and cheap to make.
What other hurdles did you face?
AVD: In the early Moonshot days, it was quite a unique experience, because people were incredibly keen to contribute. While being very enriching, it came with its own unique challenges. We didnt have any logistics centers and it took a whole lot of effort from the early partners to set something up. Alphas website helped a lot, obviously, but the other thing that was absolutely crucial was the logistics center that we used to synthesize the compounds and distribute them to all these different collaborators worldwide. Im tempted to say we wouldnt have been able to progress without all that logistics support. It also does take a lot of discipline to stay involved.
Tell me about the compound thats on its way to the clinic. How does it work?
AVD: The compound, called DNDi-6510, is based on an earlier molecule described in the [Science] paper. There were further medicinal chemistry efforts to optimize bits and pieces of it.
DNDi-6510 inhibits a virus enzyme, the SARS-CoV-2 main protease, and thereby interrupts viral replication. The same protein is targeted by other protease inhibitors that are already approved for use in COVID-19 patients, including nirmatrelvir [a component of Pfizers Paxlovid] and ensitrelvir [in Shionogis Xocova, which is approved in Japan]. However, compared to these molecules, DNDi-6510 binds in a different manner to the main protease, which will expand the arsenal of SARS-CoV-2 antivirals and help to mitigate risks of being without efficient treatment for future mutated viral variants.
Where in the development pipeline is DNDi-6510?
AVD: No papers are published yet on late-stage lead optimization and preclinical development, though we are currently drafting them. We are working towards clinical trial agreement readiness and an investigational new drug application. We anticipate being ready to launch a phase 1 clinical trial in 2025.
Besides your lead preclinical candidate, what else came out of the data generated by the project?
AL: Shionogi independently made reference to some early Moonshot data in the discovery journey towards ensitrelvir, which in addition to being approved in Japan for COVID has fast-track designation in the U.S.
Where does open science fit into drug discovery beyond the pandemic?
AL: For industry, [the idea of] 100% nonprofit drug discovery for every disease is, frankly, an unviable proposition. But I think what Moonshot showedand what ASAP is currently showingis that you can disclose a lot of chemical tool compounds and nucleate the discussion on a lot of technologies in a very open way, and create a community that drives the field forward.
And Im reflecting on this from the AI community, which I also come from, where, yes, there are big tech companies that are extremely successful. But nonetheless, we still do publish a lot of fundamental technologies and share fundamental advances in AI in a pre-competitive way, which is an important reason why the machine learning community is moving really, really fast. I think this invites a question of whether the tech community can be an appropriate analogy for how we think about a more open approach to drug discovery.
AVD: I think the open science discovery angle obviously wont be applied to just any type of disease, but particular diseases that have a low chance of return on investment have a huge chance to benefit from this kind of open science. Im thinking specifically of neglected diseases, pandemic preparedness, tropical disease and rare disease. For the discovery stage, I think its not disputed much whether open science can add anythingtheres a general acceptance that structures, for example, are pre-competitive. The conversation changes a little bit around the hit compounds, and it definitely changes once you get to lead optimization. But I think for neglected diseases in general theres a huge opportunity here to utilize this system.
The challenge is going to be buy-infor COVID, we had this situation where the pandemic was happening and everyone was very keen to contribute. We might not be able to replicate that in the future, but what might be possible is to tap into the expertise that exists at pharmaceutical companies for this kind of neglected disease and channel it into discovery efforts. Thats part of what DNDi is very successful in doing already.
What are some lessons from this project that you think could be applied to drug development more broadly?
AL: A key lesson we can learn from COVID Moonshot is the power of open innovation. There will always be a need to balance between healthy competition and the open science approach of a rising tide lifts all boats. But I think there's space to be more open, especially on indications where there is no immediate economic return, such as pandemic preparedness, and neglected tropical diseases.
More broadly, COVID Moonshot also shows the potential of AI in accelerating drug discovery. For example, machine learning was used to predict synthetic routes, design ways to probe chemical space with high throughput chemistry, and generate new designs that balance between the multitude of often-competing properties a drug candidate needs to have.
AVD: One of the main learnings that Im taking away from the COVID Moonshot project is that there is a significant amount of goodwill to be tapped. The big question is, how do we do that? How do we channel it, how do we get that information, and how do we involve the people who want to contribute? Then also, what do we do with those contributions and how can we make it a fruitful collaboration?
I think Moonshot answered those questions, [albeit] in a very unique environment: the pandemic. But we can still take what weve learned into future projects.
