Business Insider’s Lydia Ramsey shares how she covers the pandemic while living in one of its epicenters, the way hospital systems are handling the crisis, and new forms of doctor/patient communication.
Jeffrey Freedman: Hello and welcome to the RP Healthcast by RooneyPartners. I’m your host, Jeffrey Friedman.
Jeffrey: Certainly, the biggest health care story we have is the continuing pandemic. We now have over a million and a quarter American sick with the virus and over 72,000 that have died from it. While the news for the most part has been grim, there have been several stories of hope and perseverance that have been coming to light, especially here in New York, which has been through so much these past few months. To talk a little bit about this, our guest this week is Lydia Ramsey. Lydia is the senior health care reporter for Business Insider. She joined BI in 2015 and covers everything from science to healthcare mergers to drug pricing and to healthcare startups. She’s also in charge of a great weekly health care newsletter called Dispensed.
Jeffrey: Today, we’ll be talking with Lydia about her recent coverage on the coronavirus and her coverage on how hospital systems are faring in the face of the pandemic. We’ll also talk about other ways patients are communicating with their doctors outside of hospitals.
Jeffrey: Hi, Lydia. Thank you for joining us today and actually for taking time away from arguably the biggest health care story of our lifetime, so thank you.
Lydia Ramsey: Of course, happy to be here.
Jeffrey: To start, why don’t you talk about your personal experience covering the pandemic? What’s it like being a journalist covering the business of healthcare at this time, especially living in New York? You live in New York City, Brooklyn. How are you choosing which stories to report on?
Lydia: Yeah, it’s been an interesting ride. I think we all had our world’s turned upside down in March when we started to realize that this was going to be a reality we were all going to be living through, and in my case, reporting through as well. It kind of took a few weeks to figure out where I best fit in. It’s one of those things where I have a pretty broad health reporting background both from a scientific perspective and from a business perspective. In those early days, I tried my best to figure out what stories I could best tell based on my skills. A lot of that was looking at the inside of the hospitals on the front lines here in Brooklyn. I was hearing ambulance sirens all the time. I’m sure everyone else in Manhattan and elsewhere in the city of New York was hearing the same thing for a lot of March and the early April. That kind of drove a lot of my reaching out to hospitals around the city, nurses, doctors, other caregivers. I really tried my best to get a sense of what was going on inside. As a reporter, I wanted to make sure I was getting the full story but I wasn’t myself going to be able to get inside the hospital without freaking out my family, so I tried my best to figure that out, and it has been really interesting. It’s one of those stories where before this, I could cover a health topic and it would be really in the abstract. It’d be talking about an experience and having to think about some condition. That was something that had never affected me.
Lydia: In the case of COVID-19, this is a very real disease and it’s something that’s affecting practically everyone around the globe and social demographic wise be damned. Young, old, everyone is involved. Some of our reporters even seem to have gotten it, things like that. It was really a new experience for me to see like, “Oh, wow, this is something that personally affects me and it’s something I’m covering professionally.” That took a few weeks to figure out how exactly to handle that because it is a bit of a adjustment.
Jeffrey: Lydia, in healthcare business, hospitals and healthcare systems are among the hardest hit. Both because the flood of COVID-19 patients they have to treat but also because of the hits they’re taking at the revenues which you wrote about one of your recent stories. Can you talk about what you’re seeing here? Are these hospitals really expected to recover revenue once their broader operations are back up?
Lydia: Yeah, that’s going to be the big question. I think a lot of hospitals are understanding that that initial wave of patients we saw that that led to elective procedures being postponed and delayed across the country, that first wave seems to be hitting, we’re past that here in New York. We’re seeing that hit elsewhere in the country right now. Beyond that, it’s not like there’s going to be a magical point at which there’s not a single COVID patient in a hospital. Hospitals have to really figure out, “How do I go back to some semblance of normal and bring those procedures back online?” Because really I was talking to one health system and and the vibe I got was if these kind of money-making procedures, this normal business operation doesn’t come back online within the course of May, a lot of hospitals won’t be around to keep caring for COVID patients, which is kind of frightening to think about. These are pillars of our communities. They’re there to serve the communities. If financially they can’t make it work, they’re in a tough spot. That’s unfortunately the case for a lot of folks.
Lydia: To your point, it’s one of those things where you think about hospitals as nonprofit organizations. That’s typically how they’re structured, but they really are huge business operations. If that money dries up either from procedures or from people just deciding they don’t want to come back to the hospital just yet because they’re worried they might get COVID-19, that’s a really big issue. That’s not going to go away anytime soon.
Jeffrey: At the same time, you have other business verticals like telehealth really taking hold. A lot of people have never had a remote doctor’s visit and now it’s becoming a norm. Where do you see this settling for the telehealth players? Are there particular features that are expected to determine the winners or is it all about first-mover advantage?
Lydia: Yeah. It’s one of those things that I’m curious to get the answer to that and I think only time will really tell. It’s been really interesting for me to speak with some of the big telehealth companies. Last week, I was hosting a webinar with the CEO of Amwell and we were talking about just the types of visits that are happening right now. At first, it was a lot of COVID. I’m really nervous I might have the novel coronavirus but I don’t want to go to the ER. What should I do? Those kind of visits were happening virtually first, but now we’re seeing a lot more visits, more chronic care, and hey, I might have a lung condition that I want checked out but I can’t go in person. It would just be a bad idea. I can do it remotely. We’re seeing a lot more of those visits take hold. I’m going to be really curious if we see how something like Zoom really took over and became the video conferencing platform of record. I’m going to be really curious to see if there is a telemedicine winner here. We’ve seen a lot of places basically overnight set up video services either for their own practice or epic [inaudible] a bunch of other big IT players are doing it. I’m really curious to see if someone can crack the code on this and do it really well because I think it’s quite easy to set up a video system. I think it’s harder to set up an entire functioning, you’re basically trying to replicate what goes on inside the four walls of a hospital or a doctor’s office online to some degree. We’re talking billing. We’re talking about waiting rooms, things like that. I’ll be curious to see if someone can come in and and sweep the world, but right now, where I sit, it’s pretty fragmented. It’s based on who you were working with before, what they’re very good at, what kind of pain points do you have right now, what kind of patients do you need to be seeing?
Jeffrey: Yeah. It’s an interesting business story. I mean, WebEx was around forever, but it took a pandemic to really come out with Zoom and a real leader. I have to imagine as well that from a telehealth point of view, that should be around the corner, but with everything we know in healthcare in formal marketing, it takes a little bit longer. That’s your business hat. We’re going to ask you to take that off and maybe put your science hat on for a second. There’s a lot of discussion about how to treat COVID-19 and a lot of talk about existing drugs being repositioned as a treatment, Gilead’s remdesivir – it’s getting the most attention as a drug – just received emergency approval. There are other drugs though; 40, 50 drugs that are getting approval for initial testing. You wrote about a heartburn drug that’s being considered as a treatment. There’s a company I work with out of Florida using amniotic fluid. As part of a treatment, Pfizer just made an announcement about a new program yesterday that’s getting a lot of attention as well. Do you think there is ultimately going to be multiple treatments for the condition or is the industry thinking, “We’re going to have one treatment of standard of care?” Are these just band-aids until we come up with some sort of vaccine program which could be years away?
Lydia: Yeah. They’re all good questions. I think that the shortened [inaudible] of it is nobody quite knows. I think a lot of it will depend on how prolonged this virus kind of sticks around. I think we saw a lot of drugs get kind of shelved as pandemics or epidemic started to recede. We saw that with SARS and MERS to a degree, but I think one of the big things I’m learning a lot about as I cover COVID-19 is just how many different ways it can affect people. We’re seeing everything from symptoms like COVID toes, which is just like a frostbite-type symptom showing up in otherwise asymptomatic younger adults, often teens, and then you’re seeing blood clotting showing up in either severe cases of COVID or people who were sick enough to go to the hospital but got sent home after a couple of days but were not in a ventilator but they still got really sick. We’re just seeing so much showing up that I can’t imagine a world where there’s going to be one cookie cutter, great solution out there for everyone. Maybe there will be. Maybe there’ll be some great antibody out there that really works.
Lydia: I had a doctor at a hospital here in Brooklyn kind of really explain it to me really clearly that I thought was a really interesting theory. He basically bucketed out the disease into three groups. You’ve got the viral infection and that’s where something like an antiviral like remdesivir might come in handy, then you’ve got the clotting issue and luckily we’ve got a lot of stuff already out there to treat that. We’ve got blood thinners. We’ve got some clot-busting medications that are being developed, things like that. They already exist but they’re being explored for their use in COVID-19. Then, you’ve got this immune response that seems to be really wreaking havoc on people, especially those who have been sick for quite some time or are on a ventilator in the ICU. For those patients, something like an antibody treatment which a bunch of pharmaceutical companies are developing, and then there’s instances like convalescent plasma and some other ways of kind of triggering the immune system to mount a response to the virus in a different way. Those are where we might be able to see those work. It’s really interesting to me. I’ll be curious to see if his theory holds out. Those are ultimately the three buckets of disease areas where we’re worried about and kind of symptoms we need to treat, but I think everyone’s holding out hope for some kind of vaccine. Maybe the whole populations here in New York got it. That’s what some of the antibody surveys are suggesting that about a fifth of people got it here in the city. For someone who hasn’t felt symptomatic from COVID yet, I would be really optimistic and really happy to see a vaccine come online.
Jeffrey: Absolutely. I’m in the same boat. I’m not ready to walk down the middle of Times Square yet. I think every day we’re learning more about this disease. To think that there is this one silver bullet, I think it’s way too early. I agree with you to think that. All right. Shifting gears just a little bit. Back to business. Are you seeing an impact on the fundraising environment for healthcare or biotech companies? Some are benefiting, right? They’re saying they’re going down the COVID path but other’s clinical trials are drawing up because patients aren’t coming in. How have investors changed the way they evaluate new opportunities either public or private? What are you seeing?
Lydia: Yeah. It’s been one of those things where I think that we saw this hit a lot of other industries early into the pandemic. Retail was clearly an instance where there’s going to be a lot of issues and those showed up almost immediately. We saw a lot of layoffs. Same with the technology industry as we saw a lot of layoffs happening there and we’re still seeing it with companies like Airbnb. I think for the most part, the impact to biotech and and healthcare in general has been a little delayed with the exception of the hospitals because their financials are really taking an early hit. To your point, it is a really curious question. This question of what is going to happen now that clinical trials are put on hold. I really wouldn’t be surprised to see a number of fledgling biotechs who are in their early days and have the funding runway for one set of clinical trials over a set period of months. How does someone stay afloat like that? It’s a big question for me. I think a lot of people are trying their best to figure out how to be useful at a time like this. I think about the healthcare industry as a whole as either being sidelined or on the front lines. If you can find a way to be on the front lines, I think you’re going to find a way to be an integral piece of this and you’re going to find ways to get funding and things like that. The fundamentals of the business haven’t really changed. It’s just that we threw a pandemic into everything. It’s going to be interesting. I think it’ll depend almost entirely on who your backers are to some degree, how they did on their other investments. I’m going to be curious if we’re talking a year from now and realize there wasn’t that much of an impact on biotech actually because it’s been weird. I’ve been seeing in the health insurer space especially, they’re having a pretty good year so far. It’s a little jarring to hear.
Jeffrey: Right. Well, tying into that, last question. What do you see bubbling up to the top in the stories that you’re covering? Something that might grab everyone’s attention once we have a bit more normalcy in our lives. I mean, you put out a weekly newsletter, Dispensed, which I love and and you write every day, but once we have more normalcy in our lives, what do you think is going to be there?
Lydia: Yeah. I think personally, I have this beat before the pandemic hit that I was covering, the changing way you go to your doctor’s office. That was everything from urgent care to online visits to what CVS is doing, with the health hubs, what Walmart’s doing, things like that. I think in a lot of ways, my beat has completely changed on its head. Maybe health hubs are still an important piece of that but maybe they are a lot more virtual, things like that. I think figuring out the fallout is going to be the big health care story of the year. Who are the winners and losers? Who was able to come out of this stronger than ever? Who completely faltered? I think we’re noticing that in a lot of other companies. Taking Airbnb, for example, it does seem like laying off 25% of the company is almost exclusively connected to the fact that nobody is traveling at the moment and probably won’t be for quite some time. In other cases, I think the pandemic really exposed a lot of where things were going wrong. You see some parts of the pharmacy model already being in jeopardy; that kind of front store part of the store, that hasn’t been a good business for a while and I think something like this, a pandemic, only exacerbates that. I think it’ll be really interesting to see where people land. Can you survive this moment? Can you not?
Jeffrey: Unfortunately, you’re absolutely right, it is. I hope that in a few months when all this is a bit more normal and we get to see some of the shakeout and some winners, we can have you back and we could discuss this a little bit more and do a retrospective as to what occurred.
Lydia: Absolutely. That’d be great.
Jeffrey: Thank you so much for your time. We hope you enjoyed this week’s podcast. If you have any questions, comments, or future story suggestions, please reach out to us on social media or email us at RP Healthcast at rooneyco.com or visit us on our website at rphealthcast.com. Additionally, if you like what you hear, please follow us, review us, and share us with your friends and colleagues. Thank you. We hope you enjoyed the RP Healthcast.