Coronavirus Pandemia: Why Science Matters Now?

August 3rd, 2020
Image Source: Chemical & Engineering Society

This is my fourth blog post on the coronavirus pandemia and I will focus on science and how general people are getting more interested in biomedical research. I’ve written in several occasions that the scientific system is broken, and I’ve criticized how the scientific funding system works, the peer-revision process, the low salaries and long hours of work, etc. In fact, let me just remind the readers how the scientific cycle works (I’ve already discussed this in an old post – check it here): First, when you want to get into academic research you need to do a Ph.D. in a very “famous” laboratory; this is the “business card” to get a Post-Doctoral Training in an even better laboratory (either in the US or in Europe); second you will need to publish your research after long hours of work (working like a “slave”, Pardon my French…) with a very low salary – not very exciting right?; third, with good publications in high-level journals you will need to bring in research money from well-respected funding agencies since this will enable you to start your own laboratory in a different Institution. If that does not happen you are already “out of the game”; fourth, if you are successful in all the first 3 steps, which are tremendously difficult, you can start your own laboratory and get funding  (the statistics are terrible: less than 5% of Post-Doctorates get to this stage, so what happens to the other ~95%? Do another Post-Doc, become jobless, change profession or go into the private sector). Thus, it is very competitive and the “big labs” always get the funding and grants. It is a very old-fashioned system. Another interesting fact is this: when you do experiments, draw an hypothesis out of them, write an article with your own intellectual skills, most times you will need to pay to publish (and a lot; we are talking depending on the publisher and journal at least 1,500 US Dollars) and give all copyrights to the publisher (well, there are some “open source” options, however it is not working well mainly because the big publishers are not happy, they want to keep getting their profits). Then, after giving the publisher all the rights for your work, paying a lot to publish, getting nothing in exchange financially – just “scientific prestige” (check my old blog post on this subject here), the publisher charges people to download the article (a range of 30-50 US dollars per article!). This is outrageous. Another fact: the private sector has full access to all these scientific articles (paying for downloads) and use them to develop “products” that they will come back and sell to Academic Centers and Laboratories for a very high price. It is a terrible cycle. Even Nobel Prize scientists are not happy at all with how science works (see my blog post about it here). It is a win, loose, loose, loose game. The only one winning here is the Publisher and eventually biotech and pharma companies. The most important aspect that will be the focus of my post: general people that pay taxes (part of it go to the funding agencies to finance research) have no clue how science and the scientific system works. Now, with the coronavirus pandemia, I believe everyone in the world is trying to understand how this system works. I always get questions like: Why there is not a medicine for the virus? Why there is no treatment? Why it took so long for governments all over the world to catch up and we are still in this mess? Simple answer: Scientific Systems are unprepared for any global pandemia. The system definitely has to change. Science communication has to come out strong after that (please stop the “fake news”!). Why is it so difficult to deal with the spread of the disease and lack of trustful information from the media and the governments? I don’t know. Lots of politics involved here. However, I think the positive point is that general citizens all over the world are trying to understand the scientific system, how we respond to pandemic situations such as this one and are demanding answers (true answers!). Now we see strong collaborations between Academic Centers and pharmaceutical companies (i.e.: University of Oxford and AstraZeneca) for a vaccine (this already happened before, but it not the rule). I will discuss the race to a vaccine for the coronavirus in my next blog posts (coming soon…). Let me give, as I always do, a personal example on how the scientific system is slow and old-fashioned: I just had an article accepted in a journal recently and we got the Cover of the Journal. I will not cite names here to avoid problems, but we (mainly my ex-Ph.D. student) took our creativity, time, resources and designed a “masterpiece cover” for the journal. We sent it to the Editorial Office and got the reply saying that the Cover was very nice and we would need to pay a fee of 1,700 US Dollars to have it published with our article. I said what? I wrote back questioning that we took our time, resources and creativity to design a cover and would have to pay to give them our copyrights – no thank you! The Editor wrote back apologizing and waiving 100% of the fee. This is a “toxic” business that is really affecting careers of young scientists. Another important fact: several if not most scientific articles published are already “old-news” since it takes an average of six months to a year if you are lucky to get your study published anywhere. Thus, now that this pandemia has impacted the globe, I see a “fast and furious” race both in academia and in the private sector to develop vaccines and treatments. I hope after we get an efficient treatment and/or vaccine the whole scientific system changes for the better. In addition, I defend that all the scientific community find better ways to communicate with the general public, mostly non-scientists, with trustful information in a way they can understand – no technical stuff, please. Science communication is key and it has to change for the better. People say that there is always a good side for every history and I hope this pandemia changes the whole scientific system for the better. We will see. I have my fingers crossed: to overcome this global pandemia and for changes in the way science is done everywhere!

Coronavirus Pandemia New “Normal”: Now and Then

July 20th, 2020

Image Source: World Economic Forum, 2020

On my last blog post I wrote about the misinformation that we are having to deal with in a daily basis with the coronavirus pandemia (see my blog post here). I also discussed how this misinformation is negatively affecting our society and the individuals, especially people that are not very careful in selecting trustful media and/or social media sources to gather information. This blog post will be more “positive” since I will discuss something that I see people asking everywhere: what will be the new “normal” after the pandemia? I mean, when things get in a stage that we can be more comfortable in going out and there is a vaccine that is efficient enough in the future (hopefully!). Well, there are five specific things happening right now that we could use as examples on how things will be after the pandemia. Actually, these factors have been accelerated by the pandemia since all of them were already happening “organically” in a slower fashion. I will try to discuss and show examples on how these areas have been affected and will be completely changed forever. First, let’s talk about remote work or working from home; something that most people in countries with “lockdown” have been currently doing. I am one of these people. Actually, I have been working remotely for more than a decade now. Remote work came to stay. Some companies before the pandemia were already using the option of “working from home” for one day a week or more, however from now on I believe that this will became more of a rule than an exception. I have examples of working remotely with Teams of people in South America, Europe, Asia and other places. The technology and faster broadband internet are already here. This came to stay, however how people that needs to go to an office or a laboratory or even a production line of a factory to work will do in the near future is still a question mark. Second, in the same way remote work came to stay, telehealth and digital healthcare solutions are expanding. I see people having videocalls with their doctors, psychiatrists, family doctors, etc. Solutions and technologies that are facilitating this connection between the patients and their healthcare professional also came to stay. Of course, that a lot of things need to evolve, and the patient privacy is still an issue, but this will be the new “normal” in medicine. Third, the impact of this pandemia on education (high school and college/university levels): EdTech (or virtual education) and education online is becoming more widespread now. Before, it was just a small percentage of the schools and colleges/universities that offered online courses. Now, all students from the globe are facing a different way of getting classes via internet. This trend was already in place by companies such as edX, Coursera, Udemy, the Khan Academy, etc. During and after this pandemia, online education has become more widespread as the technology evolves and the students get more used to it. I do courses online since 2015 and I really like it; I do not see any problem here. I think that the old-fashioned “medieval” education “on-site” is gone forever. Fourth, is the e-commerce sector and how big players such as Amazon are monopolizing it and will dominate (check this article entitled: “How the coronavirus and retail closures are accelerating the rise of Amazon”). Well, commerce in general has been affected by the pandemia and now we see all the companies (small, midsize and big ones) improving their websites, apps and other ways for online sales. Since nobody is able to go to the stores, the products have to come to us. Well, this trend started more than 20 years ago and now I believe it will become something “normal”. Unfortunately, owners of stores and commerce that are or were not prepared to move their sales online will be disappearing. That is a fact. Fifth and last, I think the bigger impact now and after the pandemia will be on the way we relate to each other. The consequences of social distancing will not disappear soon. One interesting personal example is that I went to a store the other day to buy groceries (of course with a mask and hand sanitizer in my pocket) and what I felt and saw was every single person getting far away from me and the other people around. When asking questions to people that worked in that specific place, I saw fear in their eyes and trembling hands when getting “closer” to others. Social distancing came to stay for a while, and it will affect even more the way we lived before – connected all the time with our mobile devices in our hands and not socializing at all. In my opinion, this will really affect social interactions between people for some time, I would say years if not forever. These are some of my perspectives on the new “normal” that we are facing and will face from now on. The world will never be the same, that is for sure. A “brave” new world and ways to deal with people came to stay. Let’s just hope that people will become more distant socially but closer in a general perspective, aware of the human species fragility, the nature around us and our planet. We need to take really good care of our “home”; and by “home” I am referring to the globe. The virus will be controlled at some point. However, how we as humans will live after that will change completely.

Coronavirus Pandemia: Facts and “Fiction”

July 2nd, 2020

In this blog post I will discuss about the current situation of the coronavirus pandemia and how misinformation and the so-called “fake news” is really a problem for our societies and the world in general. For those who follow my posts and read them, last month I wrote about a cousin I’ve lost in the North of Brazil for this disease (check the blog post here). My family members and his family like several other families in the world are still overcoming the sadness and trying to understand what is going on. The questions I currently see are: Why? How? When we will get a ‘cure”, an efficient treatment and/or a vaccine? The fact is that there is no “magic bullet” yet, especially when the pandemia is in the current stage. Today, the latest numbers are that at least 10.7 Million people were infected worldwide and at least 515,000 people died of complications of the coronavirus infection (for more information check the trustful website from the John’s Hopkin’s University here). Well, first of all, as a scientist I get lots of questions about the virus, how it infects people and mainly why it kills people in a current rate of 5-10% depending on the place, country and/or region. First of all, what kills is not the virus itself: the viral infection in the respiratory tract, especially the lungs (other organs are infected too, it has been already reported) causes a hyper-reaction from the immune system of the person that destroys the lung cells and open the “doors” to bacterial infections such as the one that causes pneumonia. Thus, what kills is the “auto-immune” response to the virus and not the viral agent COVID19. In this context, the age, sex, health, presence of a complex disease (diabetes, cancer, etc) will be important factors that will affect morbidity. In addition, since everyone is genetically different, even in immune response to viruses, this is probably why we see young people dying, not just elderlies. One thing is for sure: my generation and probably the one before me (my parents) and the next ones never lived through a situation like this. That is why now more than ever, the use of correct and trustful information are very important. Let’s get to 3 main important points that I would like to explore as facts and fiction: 1) Current tests that are being advertised everywhere. There are several types of tests that work very differently. The most common and fast is to check for antibodies against the virus or against proteins of the virus in the plasma of people, that is a fact. However, testing negative doesn’t mean that you are free to go outside without a mask and live like nothing is happening. I’ve had a very interesting personal experience last week since I went to the pharmacy where these “fast” tests are being offered and people have to pay (not cheap by the way…). When I was in the line waiting to get my medication, a lady got a negative result for the test and jumped saying to the pharmacist: “so now I am free and can go outside without a mask!”. The pharmacist very gently told her: “Well, please understand that having a negative result for this test doesn’t mean that you could get the virus or that you’ve already got it and have no antibodies against it”. The lady turned to him very angry and said; “Then why I am doing this test and paying for it!”. This is the main problem right now: people do not understand that the tests are not a way of “getting out and living free”. The other tests that are more specific for the virus such as the “famous” PCR are more expensive and laborious. Not a lot of people can afford to do it. The summary in this first example is that I do not trust any of these tests since we are still understanding how the virus works. So why bother?; 2) Treatments for the virus. Fictions: there is no “magic bullet” yet like I’ve wrote above and the treatments are much more complex than “advertised”. It is and will be a combination of drugs to block the hyper-immune reaction, block the virus and also antibiotics for the worst phase when people get pneumonia and/or other bacterial infections. So, please people do not believe any of these “miracle drugs” being advertised everywhere, especially in social media and last 3) the vaccine: well there are at least 140 vaccines in several stages of tests (please check this article from “The Guardian” for more information) and just 2 of them are in the latest phases of the clinical trials. There is another problem here with facts x fiction: a vaccine against a virus is not easy to develop. For example, we still do not have an efficient vaccine against HIV till this day (and HIV is an RNA virus such as the coronavirus; the only difference is the cells they infect and the way they spread). Vaccines could be of the attenuated viral particle, proteins of the virus, nucleic acids of the virus, etc. I believe that we need to be pragmatic: it will take time to get an efficient vaccine. Several groups are working toward this goal, that is a fact. However, let’s be “real”: it will take some time, maybe a year or so. The main fact right now that I think everyone in the world should believe is that the only way to fight this pandemia is avoid being infected by the virus. How? Social distancing and isolation, unfortunately. People working in healthcare and services that are essential need to use masks and be careful. There is nothing else we can do right now. Last, but not least, I wrote before that “Science is Broken: How, Why and When?” (see my blog post from some time ago) and other critics to how the scientific system is in its medieval times. My hope is that people in general, now being directly affected, see how important science is and give scientists such as myself and several others some respect. I also hope that the system changes. In this type of situation I see people, even my family members telling me: why no scientist was studying this type of virus? Why is it so difficult to overcome this? I tell them in an ironic way: ask the governments and the academic system that does not work for the people. Finally, based on all the facts I have been reading and know until now my last piece of advice to everyone reading this post is to stay home and take the measures that prevent the infection (use masks, disinfect everything, etc), independent on what governments and other people tell you or you see in social media. The fact is there is a pandemia, we do not completely understand the coronavirus, there is no treatment and no vaccine 100% yet. Thus, take care of yourself and people you love. Let’s try to overcome this pandemia together (but socially isolated…) with facts and not anecdotal information that we get every day through the media. And most important: let’s stay mentally stable and sane. This is my message to all.

Pandemic Times, Healthcare & Family

June 4th, 2020

The blog post I am writing today is a sad and tragic one. This past weekend I just lost my beloved cousin, Bruno Falconi Fontoura. He was a Medical Doctor, a healthcare practitioner, anesthesiologist, and more than anything a husband and a father of two beautiful kids; a son and a daughter. Well, the title of this post embraces all the craziness we have been living this year: the coronavirus pandemia, how people that are in healthcare have been dealing with it and about family, the most important piece of this puzzle we are living right now. Bruno has been a Medical Doctor for almost 20 years in my hometown in Brazil, named “Beautiful Horizon” (“Belo Horizonte” in Portuguese, because it is located in a nice valley and the sunrise and sunset are just beautiful). He has devoted most of his life to medicine, working overtime for years, not being able to celebrate birthdays and family gatherings mainly because he was always on call. The last couple of years have been tough for him, depression came and sank in. This year, he decided to go to the north of Brazil to help in the “front lines” against the coronavirus pandemia and unfortunately died suddenly. Brazil is now the second in the world in number of cases and deaths because of the coronavirus. We don’t really know the cause of his death (it was ruled as cardiac arrest and respiratory insufficiency), but since he was dealing with a lot of coronavirus patients, I suppose it had something to do with it. We have been talking from far using technology (whatsapp, phone calls, etc) constantly and in one of the last messages I have received from him he desperately asked: “What is going to be of all of us, our and the next generations, after all this pandemia ends if we survive?” I replied with a long voice message since I felt his anguish. The short summary of my message to him was to keep doing his work the best he could, protect himself and I told him to focus in four main things. The four things I mentioned were: 1) take care of our general health: exercise and eat well; 2) avoid getting this virus since we still don’t have a lot of knowledge about it; 3) take care of our mental health, since we (and him personally with his profession) are dealing with deaths and a global pandemia – basically keep yourself sane – and last and the most important 4) be with relatives and family at all costs (of course, taking the measures to avoid spreading the virus, etc). These four itens I told him a couple of weeks ago are still what I believe in, but now more than ever I believe we need to gather with our closest family and stay home. The governments and society are not and will not help at all. We are losing this battle. This virus is an invisible enemy and not being a pessimist, it will take time to understand it and to develop a treatment and/or vaccine. Now, more than ever, scientists have to work just like healthcare professionals to help. After this loss I’ve really got shaken. When things like these that you see in the news and media get close to you, especially to a family member that you’ve grown up together, young, full of life and energy, a dad, a professional and the most important: a human being. Loss is always tough, but when there is neglection like what is happening right now it is called genocide. But I will not get into politics in this post, maybe later. Bruno, wherever you are I hope you are well. And my message to all that are reading this post is stay safe, stay healthy, stay home (if possible) and stay mentally strong. It will not be easy, but I think we can do it. For the people we are losing and for the next generations.

*In Memoriam of Bruno Falconi Fontoura, my beloved cousin. He is lived through his wife Katia, his daughter Ana Beatriz and his son Benicio. Photo Source: Personal album of me and Bruno, circa 1989 in our “golden years”.

Portuguese version:

Pandemia, Saúde e Família

O “post” que estou escrevendo hoje é muito triste e trágico. Neste fim de semana, perdi o meu amado primo, Bruno Falconi Fontoura. Ele era médico, especialista em anestesia e, mais do que tudo, marido e pai de dois filhos lindos; um filho e uma filha. Bem, o título deste “post” abrange toda a loucura que estamos vivendo este ano: a pandemia global do coronavírus, como as pessoas que estão na área de saúde estão lidando com isso e sobre a família, a peça mais importante desse quebra-cabeça que estamos vivendo agora. Bruno foi por quase 20 anos médico em minha cidade natal, no Brasil, chamada Belo Horizonte. Ele dedicou a maior parte de sua vida à medicina, trabalhando horas extras por anos, não podendo comemorar aniversários e reuniões familiares, principalmente, porque estava sempre de plantão. Este ano, ele decidiu ir para o norte do Brasil para ajudar na linha de frente contra a pandemia de coronavírus e, infelizmente, morreu repentinamente (insuficiencia respiratoria e parada cardiaca, que sao as principais causas de morte pelo virus…). Realmente não sabemos a causa, mas como ele estava lidando com muitos pacientes com coronavírus, suponho que tenha algo a ver com isso. Nós conversamos usando tecnologia (whatsapp, telefonemas, etc.) constantemente e uma das últimas mensagens que tenho dele foi: “O que será de todos nós, da nossa e a próxima geração, depois que toda essa pandemia terminar, se sobrevivermos?” Respondi com uma longa mensagem pois senti sua profunda angústia. O breve resumo da minha mensagem para ele foi continuar fazendo o seu trabalho da melhor maneira possível, proteger-se e acho que agora devemos nos concentrar em quatro coisas principais. As quatro coisas que mencionei foram: 1) cuidar da nossa saúde geral, exercitar-se, comer bem; 2) evitar pegar esse vírus, pois ainda não temos muito conhecimento sobre ele; 3) cuidar de nossa saúde mental, já que nós (e ele pessoalmente com a sua profissão estressante) estamos lidando com mortes e uma pandemia global – basicamente mantenha-se são e por último e o mais importante 4) esteja com parentes e familiares a todo custo (claro usando as devidas medidas para evitar a propagação do vírus). Esses quatro itens que eu disse a ele algumas semanas atrás ainda são o que acredito, mas agora mais do que nunca acredito que precisamos nos reunir com a família mais próxima e ficar em casa. Os governos e a sociedade não estão ajudando e nem ajudarão como deveriam. Estamos perdendo a batalha. Este vírus é um inimigo invisível e não sendo pessimista, levará algum tempo para entendê-lo e desenvolver um tratamento e/ou uma vacina. Agora, mais do que nunca, os cientistas precisam trabalhar, assim como profissionais de saúde para ajudar. Após essa perda, fiquei realmente abalado. Quando coisas como estas que você vê nas notícias e na mídia se aproximam de você, especialmente de um membro da família que você cresceu junto, jovem, cheio de vida, pai, profissional e ser humano ficamos assustados. A perda é sempre difícil, mas quando há negligência como o que está acontecendo agora, isso se chama genocídio. Bruno, onde quer que esteja, espero que esteja bem. E minha mensagem para todos que estão lendo este texto é permanecer seguro, saudável, ficar em casa (se possível) e se manter mentalmente forte. Não será fácil, mas acho que podemos fazê-lo. Principalmente, em homenagem as pessoas que estamos perdendo e para as próximas gerações que ficam.

*Em memória de Bruno Falconi Fontoura, meu amado primo. Ele deixa sua esposa Katia, sua filha Ana Beatriz e seu filho Benicio. Foto: Album pessoal, Eu e Bruno, ano de 1989, nossos “anos incríveis”.

Chimeric Bio (CBC) and Genomic Enterprise join forces to tackle big data

January 21st, 2020

This blog post will focus on the announcement of the two life sciences’ companies that will start to work together to provide new, user-friendly, and revolutionary mobile access of big data to biotechnology, pharmaceutical, life sciences and technology companies. There is a new trend highlighting the need for new technologies to address the big data challenges and associated opportunities at pharma right now in drug development, biomedicine and healthcare. This is mainly because there is a need to develop and use big data analytics tools’ from hundreds of thousands to millions of patients and samples throughout the drug development process. That is what the CEO of Novartis (NYSE: NVS), Vas Narasimhan, started to implement at the company when he became CEO. This new trend is important to accelerate drug discovery, the development of new treatments and target identification applied to complex and rare diseases. However, there are several challenges associated to the current tools’ in the market and changes in the pharma “culture” to adopt new technologies as discussed by him and others at the JP Morgan Conference in San Francisco in January of 2020 (check the article at Forbes “Novartis CEO Who Wanted To Bring Tech Into Pharma Now Explains Why It’s So Hard”). Thus, Chimeric Bio (CBC) and Genomic Enterprise will start a “joint venture” called MobileBiOS to provide the best in class scientific solutions, services and support to customers identifying specific medicines and treatments to various diseases combing it to the development of solutions for mobile devices. “I think this will be a very nice opportunity for clients that are looking for state of the art consulting services in biomedicine and healthcare. Tristan’s expertise and my experience after founding and co-founding four companies and being the Head of one of the Apple Labs Program in Brazil, South America will definitely make a difference that the market needs right now” said Fabricio Costa about joining forces with CBC. “ModbileBiOS will allow biopharma professionals to have immediate access to new big data analytics tools’ and the corresponding actionable results culminating from these analysis. CBC already offers a number of powerful big data solutions across various types of data including curated scientific and biomedical content, patient data, single cell data, clinical trials’ information, biomedical conferences, publications, regulatory information and patents.” remarks Tristan Gill about the new Joint Venture.

Genomic Enterprise’s mission is to provide consultancy services in several different fields involving STEM (Science, Technology, Engineering and Math) for the government, academic centers, universities, start ups, mid-size companies and big corporations globally. In addition, Genomic Enterprise creates awareness on the new scientific discoveries and technologies that will impact society worldwide or even locally. Fabricio Costa is the founder and CEO of Genomic Enterprise and he has more than 20 years of experience in top academic labs and companies such as The Ludwig Institute for Cancer Research, Harvard University, Northwestern University, University of Chicago, Start Up Health Academy, Singularity University, 1871 Chicago, MATTER, Shire Pharmaceuticals (acquired by Takeda – NYSE: TAK), Google (NASDAQ: GOOGL) (Ventures, Higher Education and Start ups), Apple (NASDAQ: AAPL) and others. Fabricio is also a serial entrepreneur (co-founded and founded four startups; two were successfully sold).

Chimeric Bio (CBC)’s main mission is to support a complimentary set of innovative life science offerings and deliver first class consulting services to customers. CBC accomplishes this by understanding the pharmaceutical customer’s challenges and offering solutions to help customers’ achieve these critical needs. CBC can define unique solutions that best meet the scientific and business needs for customers.  Chimeric Bio’s founder and CEO Tristan Gill is an accomplished life sciences professional. Prior to founding CBC Tristan has 25 years of experience in top labs and companies including Cold Spring Harbor Laboratory, California Institute of Technology, Paracel (a subsidiary of Celera Genomics acquired by Quest Diagnostics – NYSE: DGX), Rossetta BioSoftware (a subsidiary of Merck & Co.- NASDAQ: MRK), Ingenuity (acquired by of Qiagen – NASDAQ: QGEN), Bejing Genomics Institute (BGI), and Thomson Reuters (NYSE: TRI).     

Big Tech Digital Health Revolution?

December 6th, 2019

A series of breakthroughs in biomedical science and digital technologies are triggering a convergence between the tech industry and the life sciences industries that will quickly lead to more intimate and interactive relations among patients, their doctors and biopharmaceutical companies. The ability to share information and data has changed completely in the past 10 years with the emergence of both search engines, social media, and now tools for Artificial Intelligence (AI), especially with companies such as Microsoft, Google, Facebook and now Amazon getting into healthcare. In life sciences, novel web technologies have been used to track diseases in more efficient ways. Today, millions of people around the world that have access to the Internet will engage in Internet-enabled self-diagnosis for diseases by using search engines and other web tools. However, self-diagnosis is dangerous if the sources are not trustful enough. Another concern regarding these new technologies applied to healthcare and life sciences is patient privacy, data transfer and data storage (something “cloud” services now has solved with some specific concerns). Therefore, the question now is ‘‘can these tools be applied to healthcare and biomedicine in order to improve scientific and medical research?’’ I’ve been publishing articles about this digital revolution since 2012 (for some articles I’ve wrote on this subject check “Social Networks, Web-based Tools and Diseases: implications for Biomedical Research” and “Big Data in Biomedicine”). Well, this week the cover of the British magazine Newsweek and its headline puts Jeff Bezos, CEO of Amazon, in the forefront of solving the healthcare and life sciences problems now and in the future; not just in the United States but in the world (for more information check the Newsweek article here). Well, I am a little skeptical and concerned but excited at the same time on what is coming from Amazon (even Apple, Google and other tech companies are developing their own solutions). The truth is that the web has impacted our society, but over the next few years, the web and Apps will entirely re-invent the way scientists and physicians interact, especially with patients. There is indeed a conundrum faced by life sciences because both pharmaceutical and biotechnology industries need information from people (mostly patients), patients need information from these companies and the life sciences industry also need to collaborate outside their walls building connections with other industries (such as big tech and other institutions). Science and the biomedical field need to be more open and scientists/physicians have to be able to share data to speed up the process of transition between basic to translational research. As regulatory clarity emerges with better algorithms, AI and data encryption to ease privacy issues, more companies will adopt digital tools and these technologies will have the potential to revolutionize healthcare, clinical trials and research the same way that they are impacting our society. Developing solutions to allow better ways to share information will add value to the life sciences and biomedical communities. In fact, science and medicine are undergoing one of the most exciting changes in history. The full adoption of online platforms and telemedicine by physicians will transform medicine. Apps that can diagnose patients in seconds are already in the market. Alexa, the speech recognition device from Amazon could be (and will be) able to diagnose diseases based on what people tell it daily. A whole new world in healthcare could be build and the main players will be big tech companies. Healthcare professionals will start to interact and communicate in ways that will have an enormous impact on disease diagnosis, scientific progress, drug discovery and in the development of new treatments for complex, rare and unknown diseases. I bet Amazon has several “secrets” that it will be unveiling in the coming years applied to healthcare. Did anybody think of Amazon, an online Book selling website in the 1990s, as of what it has become? Let’s see what they will disrupt next in healthcare and life sciences’ fields.

Healthcare in Emerging Economies – a Sad Story

April 2nd, 2019
Image Source: Harvard Business Review

Healthcare is a very complex subject anywhere in the world. Some countries have an established structure in which the government subsidizes healthcare for the population and others trust on the private sector, also known as health insurance companies. There are also examples of hybrid systems: the public and the private sectors working concurrently. Independent on the system, the poor piece of the population always suffers. The subject of this blog post is going to be healthcare in emerging economies since I am doing an online Course at Harvard focused in entrepreneurship in emerging markets. Healthcare and Education are given as examples in this course of areas that technology barely touched in this course. The explanation for that, especially in emerging economies, is mainly due to restrictions of the government and lots of corruption in the system. Credibility, trust and transparency are not the best adjectives in emerging economies. Corruption is everywhere and the poor are the ones who will suffer. I will exemplify one of these issues, focused in healthcare (and also education at some degree since the solution we have built was with students), since I participated as Head of one of the most interesting Projects that the Apple International Program developed in Brazil, my home country. Just as a spoiler alert, this is not a story with happy ending, but worth reading about. Let’s start explaining the basis of the problem we were trying to address in my home country: most of the healthcare system is subsidized by the government in a Program named SUS (“Sistema Unico de Saude” or “Unique Health System” in English). This Program is running for decades and has very successful histories such as giving AIDS medication for free to HIV positive patients (this Health Program got many awards worldwide and was used by other countries). Our main goal was to evaluate the SUS Program as a whole since the government had a database called DataSUS with all the information on public hospitals, facilities and healthcare professionals in the country. To do that, a group from the Apple International Program decided to build a citizen centric App named “Heath Map of Brazil” and aggregate all the DataSUS information with geolocation in the country: for example, if somebody had a health issue, let’s say a heart attack in the streets of Sao Paulo or Rio de Janeiro, a citizen close to the person would do a first response and try finding the closest public hospital using the geolocation feature of the App. Also, citizens from Brazil would be able to give feedback using the App. The main challenge here was to evaluate the efficiency and efficacy of the SUS healthcare system in Brazil. The App was built after we had long talks to the DataSUS people to be able to have a direct connection to their database. The beta of the system was released in the capital of Brazil, Brasilia, where I have lived for a while. The idea was simple: make a geolocation map, such as Google Maps, of all public institutions from DataSUS and the people working in all of them, from nurses to doctors. Very simple task. Since the beta test in the capital worked nicely so we have decided to aggregate data from the whole country and let the citizens interact with it for one year. After this time, we have collected all the inputs from people using it and something shocked us all: lots of citizens in the whole country were trying to find public hospitals that never existed in their town (which I call “ghost places”), trying to find doctors that never worked in a specific place, have already retired or even died amongst several other infrastructure problems. With all this info in hand we started crunching numbers to see how much money was being poored in all of these “ghosts” that the citizens found using the App solution. Our jaws dropped; the numbers were in the billions of the Brazilian currency, even billions of Dollars! All of this money was going somewhere, but not to the right place. So, we decided to present this to the Finance Department of the Country at that time. People listened to us, of course. We had the numbers, the places that never existed but not where the money was going. Interestingly, after this presentation, the government cut our direct connection to the database DataSUS with all the healthcare data and the App started “dying”. There is no need to explain why. Corruption, lack of transparency and lack of trust. This money meant that people were getting rich with these “schemes” all over the nation. This is a very successful idea to help a government that unfortunately is very corrupt (and I am not saying and disclosing any political parties or names from the government involved). In the end, who is suffering with a terrible healthcare infrastructure, unprepared healthcare professionals and long waits to be accepted to do an exam in the public system: the poor people in my home country. Sad but true story. My take on this story is what I’ve learned along the way of building a nice solution that could help lots of poor people. But that doesn’t matter, does it?

Disclaimer: The opinions and views in this article are my own. In this article I have no political or party association with any governmental entity in Brazil.

Humankind’s History, Science, Technology and Beyond

March 1st, 2019

Brain under layers of circuit boards

Today I will write a post about the intersection between technology, science and human nature based on the last three books I’ve read. Since I am a passionate person that reads a lot and try to be on the verge of what goes on in the fields of science and technology (amongst other things), I’ve recently read very enthusiastically the famous “trilogy” of books from the author Yuval Noah Harari (Twitter: @harari_yuval). He writes brilliantly about our species story, how we are evolving and the challenges posed by fields such as science and technology to keep humankind “on track”. The way he portrayed our history as a species together with the challenges we have already faced (and are facing now) and our cultural aspects are just amazing. On his first book “Sapiens”, as a historian, Yuval gives the reader several interesting perspectives on how we became a society with cultural values and how money “was born” as a way to exchange goods creating empires such as the Persians, Romans, England and now the United States. In his second book, “Homo Deus”, he was able to show how humans are using scientific breakthroughs and technology to improve several sectors important to us such as health, finances, logistics, etc. In a world were mobile phones are in everybody’s hands and big data is the new “oil”, we face a lot of challenges with our own privacy and how to keep it private. Science and Technology always bring the good and the bad in humanity. The balance between both will be our “salvation” I guess. Yuval used several examples on how computer science, data science and artificial intelligence (AI) are changing our present and he also shows several scenarios on how it will impact our future. He also discusses the breakthroughs in biotechnology. Interestingly, he makes a very nice comparison between algorithms and how living cells work. In the end, we have biochemical reactions and several organic compounds in our cells and bodies that “use” codes that he calls biological algorithms to bring life to earth. An algorithm is a process or set of rules to be followed in calculations or other problem-solving operations, especially by a computer. In this case, Yuval discusses how human bodies and cells remind us of computer algorithms. Since we are now building algorithms using AI technologies that are already taking jobs from people and could be as smart as humans in the near future this makes complete sense. Some of these technologies have been already used. For example, genetic engineering is using algorithms to edit cells and babies based on the CRISPR technology in life sciences causing a lot of discussion in the scientific community. In his last book of the “trilogy”, “21 lessons for the 21st century”, Yuval brings up interesting philosophical discussions using very concrete arguments. He discusses how political models such as democracy and socialism in countries have failed us and how we need to rethink ways of improving our political views as individuals. Also, he discusses religion and how people have been reacting to it since the beginning of humankind. His point is that we as humans need to believe in something bigger than us. However, what about if a “God” as we imagine does not exist and we are just made of algorithms in a very random way? Again in his third book he touches the future of humankind and how AI and data science are and will impact our lives in a daily basis. I myself believe that scientific and technological breakthroughs are very important, but we need to think very carefully about their social impacts and privacy issues. Are they increasing or decreasing the gap between the rich and the poor people in the world? That is a very good question that is still open for discussion. I really suggest everybody to read all his three books. They complete each other and opened my mind to humankind’s history, our present and several nuances on our future mainly focused in science, technology and beyond. I can disclose here that I am not getting a dime to promote Yuval’s books, just felt like every one of us need to read, even with some criticism, his amazing book “trilogy”. I really enjoyed reading them myself.

Image Source: Time Magazine

AI and the Future of Biomedicine

November 23rd, 2018

81367868 - telemedicine concept with doctor wearing vr glasses

It took a while for me to write a new blog post (six months!), but I think it was worth it since I’ve been reading a lot about new technologies applied to biomedicine. Today my post will focus in Artificial Intelligence (AI) and how it could change biomedicine (and several other sectors) as we know today. Everything started back in the 50s, the fathers of the field Minsky and McCarthy, described AI as any task performed by a program or a machine that, if a human carried out the same activity, we would say the human had to apply intelligence to accomplish the task. That obviously is a broad definition, which is why you will sometimes see arguments over whether something is truly AI or not. AI systems will typically demonstrate at least some of the following behaviors associated with human intelligence: planning, learning, reasoning, problem solving, knowledge representation, perception, motion, and manipulation and, also, social intelligence and creativity. Well, tech giants such as Apple, Google, Amazon, Microsoft and others use AI daily to deal with the deluge of data they are acquiring every day. However, the biotechnology and pharma sectors are way behind in using these technologies. This scenario has changed in the last five years or so since pharma companies started looking in to what they call Real World Data (RWD) which is collecting patient data (in a clinical trial, for example) in real time. The way I personally see AI changing the biomedical sector is in five ways that I will describe here. First, I believe Real Time and Real World Data will be crucial to Clinical Trials and this will need a lot of AI technology. Imagine if pharma companies could enroll and collect real-time data on the patients of their trials. In addition, imagine a “situation room” in which the data points could be seen and accessed for each patient in a trial in real-time and the system could be improved by the AI Technologies (Machine Learning, for example). Novartis is already doing this and their new CEO think pharma companies have to become data companies. I totally agree with his statement. Second, we already know that clinical trials are hard on patients suffering from incurable diseases, mainly because the placebo group (they do not know which group is receiving the drug) will probably die or have more suffering. RWD can identify, using AI technology, small groups of patients that are responsive in the treatment group in clinical trials considered as a “failure” by the FDA standards. In addition, depending on the trial, if the treatment groups are having amazing responses, AI systems can be fast in detecting it. So, the trial can be stopped and both placebo and treatment groups will receive the drug that could save their lives. Third, speech recognition and Machine Learning (ML) are becoming usual in our daily lives. In this case, I imagine a future in which patients in trials could “talk” to Alexa from Amazon or other similar devices (such as Apple, Google and Facebook devices) and say how they feel daily (signs and symptoms, specific issues, etc). Data points collected from each patient daily will speed a lot the trials and drug approval will be faster. Fourth, AI is already being used by academic centers and several “start ups” in the biomedical field to do “in silico” drug design using several complex data generated from patients. Big data, in this case, will be able to test millions of complex interactions in seconds to evaluate drug efficacy and for new drug development. This will increase exponentially success in developing or finding drugs for specific complex diseases. Last, but not least, the fifth example is how the academic sector will be impacted. Several groups have already used AI to basically get the data generated in a scientific laboratory and write the scientific article. This is already a reality, meaning that the Ph.D. students and Post Docs will generate the data and input in an AI system to write the article(s) for them in a faster and more accurate way. This could also be applied to write patents. Image a future in which the academic sector is mostly “technical” and the “intellectual” part will be done by a computer using AI scanning all articles in a specific field to write a paper (or a patent…). This is already happening! Even though it is amazing what AI can do and how it could impact biomedicine, the main concern will be the privacy of the data from patients and samples used in trials and studies. Thus, solutions to better encrypt data will be necessary. Patient data privacy is an issue and it should be taken care carefully. The future of biomedicine using AI solutions looks very bright and full of challenges. I am glad to be helping shape this future using AI and several other technologies. That is a dream come true!

The Power of Persistence

April 30th, 2018

Persistence Figure

In this blog post I will explore my own experience with persistence in the Academic Sector. I was thinking about this history that went on for more than a decade and came up with some closure based on real facts. As a start, I will write about something that happened to me in the Academic arena that I’ve named “the power of persistence” and how it can affect young scientists. This history started almost 15 years ago, when I was doing my Ph.D. thesis studying cancer when I stumbled with some DNA regions that were transcribed even though there were no indications that these regions were translated into proteins. At that time, they called these regions “junk DNA” and they make up to 98% of our genome. I was excited but at the same time confused when discussing this with my Ph.D. advisor at that time. She told me that it was just something the method caught by error and to throw it away. She said: “keep working and looking for regions that are differentially expressed.” Well, even though I did what she said, I started digging the literature about regions of the DNA that are transcribed but not translated (now you can see how curious I am…). Some literature here and there but nothing very exciting. I’ve collected mostly everything published about these “junk DNA” regions that were transcribed and started seeing that several of them have some function and are more expressed in tumors or even less expressed when comparing with normal cells. However, lots of literature discussing that these regions could be artifacts like my advisor told me. Contrary to everything that was told me and that I’ve read, I had a gut feeling and thought: “There is something here. I am going to read everything about it and come up with a hypothesis”. Of course there were microRNAs and other “small” RNAs being studied and published but these guys were different. One year before finishing my Ph.D. thesis with what was “presentable” under the scientific “status quo” I came to my Ph.D. advisor and said: “ I have all this growing evidence about these RNAs that do no code for proteins and want to write a review about it. What do you think?”. Her response was blunt: “You won’t be able to because reviews are just for well-known and established researchers. You are a mere Ph.D. Student” (she did not want to tell me: you are a nobody; but that is how I felt). Hesitant, I started writing by myself a review article and started writing letters to Editors of Scientific Journals explaining the importance of this growing evidence. Of course, I staterd from top to bottom regarding the scientific journals. As I remind correctly, I’ve got at least twenty “Nos” (or more…). In the meantime, I’ve finished my Ph.D. thesis with something that my Ph.D. advisor was happy about and moved to the United States (I did my Ph.D. in Brazil) to do a Post-Doctoral Degree at Harvard University. With 90% of the review article already written, as soon as I’ve got to Harvard University in Boston, I showed the article to my new Advisor there. Guess what? Same answers: “this is nonsense and reviews are just for stars in Science” and “You are a nobody”. Interestingly, after sending numerous letters to the Editors, one of them, a japonese Editor at the Gene Journal replied and told me to send what I had until then. After a week that I’ve sent the piece, he replied: “I like it. Finish it and we will send it for revision”. This was 2005 and against all odds somebody at least gave me a chance. I was ecstactic! After 2-3 weeks more I got a positive response and the review article was accepted by the Gene jornal. Remember that I was told more than once that I was a nobody in Science and that review articles were for the “Stars”. More than a decade forward, the first review article about non-coding RNAs (ncRNAs) is one of the most cited articles from Gene (PMID:16111837) and after this one I wrote several more; two others for Gene – the “ncRNA Trilogy” as I classify it today (PMID:17113247; PMID:18226475) and other Reviews for different journals that include Drug Discovery Today (PMID:19429503), Bioessays (my review was in the Cover of Bioessays in 2010 – PMID:20544733). In addition, I edited and wrote a Book Chapter (for more information on the book click here) about this subject that was featured in several scientific journals and News outlets around the world. Today the Gene trilogy sum around 1,200 citations and all articles that I’ve wrote about non-coding RNAs approximatelly 1,600 citations. It might not sound like a lot; however, for journals that have a low to medium Impact Factor (IF), it is indeed a lot. In the meantime, there was an explosion of articles (experimental and reviews) discussing the importance of non-coding RNAs, especially the so-called long non-coding RNAs (lncRNAs) in several aspects of eukaryotic cells and the importance of those in complex and rare diseases. All of this story (I tried to make a long story very short for this post) is to show how powerfull persistence can be even if everybody around you tell you that you are wrong, or tell you not to do something. Even discourajing you saying that you are not capable or “famous” enough. Sorry for the word, but I think of it today as total “bullshit”. If you have an idea, identify or discover something interesting that has potential to become of importante not just in science but even to start a company go ahead. The sky is the limit. The take home message from this post is: believe in your “gut feeling” and go forward. Show them they are wrong! So wrong…