Professor of Medicine at Yale and Director of The Yale New Haven Hospital Center for Outcomes Research and Evaluation Dr. Harlan Krumholz joins Yahoo Finance’s Seana Smith to discuss Moderna’s recent headway in an early-stage coronavirus vaccine trial.
SEANA SMITH: For more on this, I want to bring in Dr. Harlan Krumholz, Professor of Medicine at Yale and Director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation. And Dr. Krumholz, we love having you on the show. Thanks so much for taking the time to join us again.
Let's start with that news that we got out from Moderna. How big of a breakthrough is this?
HARLAN KRUMHOLZ: Well I think it is something, as Anjalee said, to celebrate any progress we make. Look, we're looking for advances, but to be honest, it's a baby steps still. I mean, it meant that it enables it to go to the next step.
Realize that this was tested on about 45 people, that about 30 of them got doses where they didn't really get a reaction. Actually, one person got a minor reaction in the middle dose. And it's a short-term evaluation, and we only had eight patients in which they were testing for the neutralizing antibodies, and we're still not sure whether those neutralizing antibodies will be protective in humans. We have some favorable information in mice that they might be able to be protected.
But this represents, in the large scale, a bit of a baby step. We need to temper a little bit of the expectations around this. He says as early as July and as early as in the year, but we don't know.
But let me say, let's not rob everyone of hope. Look, we want to see progress, and I thought that his comments were very well taken. They didn't overreach. He said that we're going to go next to the-- you know, to the trials. There will be a phase II trial, and then they'll go to a phase III trial as early as July. I think they're taking this a step at a time.
It's-- you know, look, the best news is that there are lots of people racing towards the vaccine, and they're working together. They're working together with governments. They're working together with each other. They're working together to ensure that there will be adequate number of people in the trials and that there will be adequate amount of vaccine when it's ready to go. So I'm hopeful about this, but I also know that this is a very early bit of information.
SEANA SMITH: Yeah, Dr. Krumholz, you say it's a baby step. We have to temper our expectations. So what do you think is a realistic timeline for a potential vaccine? I know before this breakthrough, before this update, a lot of people were saying 12 months at best, 18 months more realistic. What do you think?
HARLAN KRUMHOLZ: Well, you know, it's hard to make everything fall into line. So my hope is that certainly by next spring that we'll have the ability to give people vaccines. And if we do it earlier, great. That'll exceed expectations.
But part of this is getting people to recognize that we're in this for a while, even with good news from vaccine makers, even with this good news from Moderna. And I don't mean to, in any way, suggest it's not good news, but it's still going to take awhile. And I think we should be thinking that we're talking about spring or summer.
It would be fantastic if it occurs earlier, but that means our mindset needs to be put in the way about how do we protect people now? How do we protect people as economies are reopening? And we're going to be in this situation for a while, and effective medications are likely to take time also to come out to treat the virus So we're going to be in this predicament for a bit, and we need to be able to think about how we're going to make this work while we're waiting for these vaccines to come out, while we're waiting for effective treatments to be released.
SEANA SMITH: Yeah, and Dr. Krumholz, I want to ask you about pricing and, I guess, what the best way to go about this is because we just heard Anjalee, when I asked her about pricing, she said that Moderna was basically saying that they need to figure it out. They need to figure out the right price point. From your perspective, I guess, what's the best way to address this?
HARLAN KRUMHOLZ: Look, I think we need to understand that Moderna got, you know, close to $500 million from the federal government to help support this and that we're all in this together, and our end goal is to ensure that every person has access to a successful vaccine, that we're not shielding anyone from it because of cost.
So we've got to work this out together. We are losing an enormous amount in the economy every day that we stretch out vulnerable to this virus. So there's a lot of money that is a return if we can get a vaccine, but we have to be transparent and open about this. I think it's going to be a very public discussion. We have to be fair to the companies and the investment that they've made. We've got to be fair to the public and the investment that our governments have made. And we have to most importantly ensure that there's no one denied access because of their financial circumstances. We have to be sure that this isn't a matter of the haves and the have-nots but that everyone gets access if there's an effective vaccine, and that has to be the driving priority in this.
So, yeah, there's no easy answer to this, but it should be public and transparent. We need to be able to recognize who's really contributed to this, and there needs to be some overriding principles for access.
SEANA SMITH: Yeah, Dr. Krumholz, I want to get your thoughts on another event that's happening today, and that's the fact that the WHO is gathering today. They're pushing for a global coordination, and this comes-- global coordinated response. And, of course, this comes as we see the rift kind of deepening between the US and China. From your perspective, from a health-care perspective, I guess, what would an effective international response consist of at this point?
HARLAN KRUMHOLZ: Yeah, it would be a matter of us, you know, laying down our disagreements in the interests of serving the best interests of our entire civilization and recognizing that this threat, like others that face us as an entire civilization, require us to work together, share knowledge, to be able to generate knowledge and information that can be used by all, and this shouldn't be something that advantages one country over the other. And that kind of small-minded approach is likely to hurt us all in the end.
And so what we need are visionary leaders who are able to step across usual disagreements in this moment and say this is an opportunity for us to work together. It is essential. We cannot hide information. We must share information, and we must do it for the good of the planet and for every country that depends on a healthy population, which is everyone.
SEANA SMITH: Hey, Dr. Krumholz, last time you were on, we were talking about this. We were talking about the response not only in the US but also worldwide, and in that we mentioned testing and the importance of testing, especially here in the US as a number of states beginning to relax some of their coronavirus restrictions. I just want to get your thoughts, just an update on where you think we stand on testing and how much progress still needs to be made on that front.
HARLAN KRUMHOLZ: Yeah, we still have a long way to go, but there's a lot of good news on that front as well. The saliva tests have come out. That will make things a lot easier and spread around. There a lot of innovative companies that are producing the means for us to do the testing.
I think one of the most essential things for us to do is, again, to get people in the mindset that frequent testing is going to be helpful for everyone. In some places, I've heard that there's capacity for testing that's being unused, and I think that's because we're not getting the word out that people can be asymptomatic, not bothered at all, and actually be shedding virus.
And for people, especially essential workers, people with high contact with the public, service industry, we need to get into a routine, a cadence where testing just becomes automatic and we can tell who's shedding virus, who's not, and then be able to make the appropriate actions as a result.
It's not about testing the people who are symptomatic, but we have to be able to understand and identify people who don't even know that there's shedding virus. Look what they're doing in China. As cases started to occur in Wuhan, they said we're going to test 11 million people. We're going to test everyone. We're not just going to go after people who are symptomatic.
In this country, we need to get in the mindset that routine testing will help us get through this. Understand who's shedding who doesn't know it, people who don't know it, and to be able to stop the chain of transmission.
So we need to increase capacity, but we also need to change our mindset so that we all understand that even if you're feeling well, if you're in an industry where you're interacting with people a lot, it's going to be good practice to do frequent testing.
SEANA SMITH: And Dr. Krumholz, testing is so important when we also talk about graduating into the next phase of these reopening efforts that's going on across the country. And in that, one of the last phases will include schools, and that's become a hot topic over the last week or so. We had President Trump and also Dr. Fauci making some comments about potential timing of when schools could reopen, whether or not universities will be in a position to reopen in the fall. From what we know at this point, just what is your perspective on all of that?
HARLAN KRUMHOLZ: Yeah, I think it's going to be a challenge. Many places are intent on trying to help us return back to normal and get people together. The college experience, of course, intrinsically depends on people being able to interact, but the colleges are going to have to be ready with really massive ability to test. And then we're going to have to figure out, what are we going to do when the first person gets sick?
You know, these college dormitories are like cruise ships, in a sense. You know, you've got everyone together. They're all mixing. And so we're going to need to have plans in place. Are we going to start isolating everyone you've been in contact with, and how is that going to work? In many of the colleges, they don't have the capacity to put people in single rooms.
I mean, we've been talking a lot about this in Connecticut in a task force led by Rick Levin, former president of Yale, Linda Lorimer, leader at Yale. You know, they've been trying to work with all the others.
And the other thing we've recognized is the colleges are all very different. Some community people are living at home, some where people are going off to school. I don't think we've sorted this out well enough yet, and there are going to need to be clear plans not just about how we're going to be surveilling that population, how we're going to be caring for people who get sick, but what are we going to start doing when people start testing positive? Many of them are within cities, and how are the cities going to manage that when people within the college start becoming sick?
So there's lots for us to be thinking about. We've got just a little bit of time left before, you know, fall comes, but it's going to require, I think, a lot of good minds getting together and trying to put together plans and contingencies for this.
SEANA SMITH: Yeah, I certainly agree with you there. Dr. Harlan Krumholz, professor of medicine at Yale, also director of the Yale New Haven Hospital Center for Outcomes Research and Evaluation, thanks so much for joining us again on the show. We love having you on [INAUDIBLE], you giving us your perspective. So thanks so much.
HARLAN KRUMHOLZ: Thank you.