With more than four million cases and just under 300,000 deaths to date, the pressure created by the coronavirus pandemic is enormous.
But Irish companies are coming out in force to try to solve the problem, tackling elements of everything from drug trials to innovative tech solutions to manage patient care.
The organisations stepping up to the challenge include everyone from universities and start-ups to Irish-founded companies operating globally.
Testing, we are repeatedly told, is the key to keeping the virus in check and hopefully eradicating it over time. Irish company LetsGetChecked has a stake in this, developing its own coronavirus test that is designed to be carried out at home.
The company has a track record in at home testing, initially starting with sexual health tests and has since expanded to include women and men’s health and wellness, building its lab capabilities. Last month it announced plans to add Covid-19 to the lines-up, initially offering its services to frontline healthcare workers in the US. It hopes over time to be able to offer the test to the general public, but healthcare workers are being treated as the priority.
The test is a simple two-step one: a blood test that is done via a pin pick, that gives results in 10-15 minutes, and a swab that is sent to the LetsGetChecked lab and confirms the earlier diagnosis.
The company also reached out to Irish health authorities to see if the test could be implemented here, again focusing on frontline workers as a priority. However, that seems to have come to nothing.
LetsGetChecked first wrote to the health authorities in mid March, offering its services to help test for Covid-19. A month later, the company was in talks with the HSE, but the offer was ultimately rejected, with the Government choosing to work only with the National Virus Reference Laboratory in UCD on testing.
It is understood that LetsGetChecked chief executive Peter Foley has written directly to the Minister for Health on the matter, but for now it seems the company's services will be offered to healthcare workers in the US instead.
LetsGetChecked is just one Irish company taking up arms against the virus. Irish life sciences company Teckro is playing its part in the fight against coronavirus by supporting drug trials being conducted to help find a treatment for Covid-19.
The technology that Teckro offers revolves around information retrieval and machine-learning technologies to help make clinical trials simpler and more transparent for doctors, researchers and patients, ultimately helping them to run faster. The company is currently supporting multiple drug trials.
Founder Gary Hughes is clear where the company fits into the picture. "The real heroes are the frontline medics who are administering these clinical trials or are introducing them to their patients, and scientists and drug companies who are designing these trials, the protocols and making these trials happen," he said. "We're really the conduit that enables the communications information flow to happen."
When it comes to research, Trinity College Dublin has a lot on its plate these days.
Researchers at the institution have been involved in various ways with the fight against Covid-19, from research highlighting a potential link between Vitamin D intake and the severity of Covid-19 symptoms, another paper that mooted a possible link with the BCG vaccine and lower rates of coronavirus deaths, and a recent paper that cast doubt on the effectiveness of bluetooth powered contact tracing apps in the fight against the spread of the virus.
Early in April, the university announced it would set up a research hub focused on urgent scientific breakthroughs to fight against the pandemic, working with doctors from St James’s Hospital, other Irish hospitals and global partners.
Among the projects it is taking on are the design of new drugs, a vaccine to combat the virus, and the development of rapid antibody testing capacity to identify current and previous Covid-19 infection.
University College Dublin has also been active on the research front, leading five projects funded by a grant from the Government. One of those projects will see the development and supply of reagents and materials for Sars-CoV-2 testing for hospitals in the Ireland East Hospital Group.
Open Orphan, meanwhile, is working in the UK on potential treatments for the disease through its subsidiary Hvivo. The Dublin-listed pharma services company is the result of executive chairman Cathal Friel reversing his pharma services business of the same name into drug clinical trials manager Venn Life Sciences last year.
The testing is being carried out on behalf of Nearmedic International, a Moscow-headquartered specialist pharmaceutical, biotechnological and medical company.
The work is important. The treatment being tested is potentially antiviral and anti-inflammatory, and could reduce both virus infectivity and disease severity. The plan is to test the drug against a panel of viruses, including the influenza virus, circulating betacoronavirus and Covid-19.
The company previously said it would restart a project whereby humans will be deliberately infected with a coronavirus as part of efforts to develop a vaccine to Covid-19. The project was originally suspended by Hvivo after concerns there was insufficient market demand for the product.
Residential and nursing homes have been at the forefront of the surge in coronavirus cases, with over half of deaths in Ireland related to these settings, and more than 30 per cent of the clusters in the country. The focus has turned to curbing the spread of the virus here, protecting the health and lives of those in residential care.
Digital therapeutics platform Zendra Health has taken up the challenges.
Founded by twin brothers Thomas and David Coleman, the company focuses on providing clinicians with a way to rapidly roll out medical grade digital therapeutics - the use of mobile technology to augment and enhance traditional healthcare therapies. When the extent of the coronavirus infection became apparent, they turned their attention to developing a solution to help.
“Nursing home staff are the new front line,” said Thomas. “They’re like our heroes, protecting the most vulnerable in society. They deserve the best tools and supports available to them. That’s what we use our technology for.”
The idea came about from a conversation with their sister Orla, who is director of nursing at St Luke’s Nursing Home in Cork, and was looking for a way to help staff manage and triage Covid-19 cases and maintain wellbeing. “They’re under overwhelming pressure as they try to mitigate the spread of Covid-19 within nursing homes,” he said. “There’s a multifaceted preventative approach and mitigating approach in terms of education, wellbeing, support and self-screening.”
App on trial
The company’s app complements this approach.
“We have this excellent technology that we could use to rapidly facilitate their needs, so we built a solution that helps nursing staff,” he said. That app includes a smart self-screening element, checking things such as temperature, and gives back feedback and advice on what to do next. It also provides a one-stop shop for the nursing homes on educational resources and information on wellbeing for staff.
The app is currently being trialled in St Luke’s care home, with plans to roll it out to other care homes.
That type of tool does raise questions about data and how it is used, but Thomas said the app is configurable according to each home’s needs. That means the data could be collected anonymously if needed, and regardless, the nursing homes retain control of the data.
Although Thomas says nursing homes have been slightly behind in terms of the technology and supports available to them, they now have the chance to leap ahead. He expects to see further innovation in the months and years ahead, when coronavirus – hopefully – has faded into the background.
It’s not just about treating Covid-19 patients though. Practical solutions for non-Covid-19 patients are also required during the ongoing pandemic. Recent trends indicate that fewer patients are presenting at hospitals with non-coronavirus related illnesses – not just emergency cases, but fewer cancer patients and other more common illnesses are presenting to health services since this began.
That could have a significant impact on the health system in the not too distant future, when non-urgent cases suddenly become more pressing, with a potentially poorer outcome for those patients.
There are also thousands of patients with chronic illnesses in Ireland that have seen some disruption to their healthcare. Health Beacon is one company that has seen the opportunity to help avoid further repercussions down the line. The company, which is headquartered in Dublin but has offices in Boston and Montreal, supplies its services in 13 countries around the world. "We started out as a company that was involved with medication adherence, trying to keep people on time and on track with their medication," said Kieran Daly.
Aimed at those who rely on injectable drugs, the company has developed a Covid-19 specific offering that includes a smart sharps bin and delivery of the required medication directly to your home.
The idea of a smart sharps bin – it takes a photo every time you throw an item into the bin, using the act of disposal as a proxy for consumption – may seem like technology for tech’s sake, but there is logic to it. It gives health providers insight into who may need additional support in sticking to their medicine schedule.
“What we have seen with Covid-19 is there has been a 20 per cent drop in injectable medication being taken since it hit,” he said. “Week by week as the lockdown was kicking in you see the impact and see less and less medication being taken on time, or at all.” He put it down in part to access, with some patients no longer able to get to their local pharmacy to pick up medicine, and fear due to being immunocompromised.
That led to the broadening of the injection care management system, working with health insurance and pharma companies to offer deliveries of the necessary medication to patients once a month.
“They saw it as a real pinch point for patients, just now while we’rein the eye of the storm,” said Daly. However, there could be further developments down the line when all this passes.
“It looks like people are starting to really think about what is sustainable and what can stick around long term. That where companies like HealthBeacon come in because there seems to be a demand from patients for these type of services. The players and the powers that be are really coming around to it pretty quickly, that there is a need to do something more digital.”