A Pandemic Silver Lining: Why Now is our Opportunity to Disrupt the Flawed U.S. Health Care System

There have been many moments in my long life when I’ve witnessed striking adversity. Among them, my arrival at Yale in 1970 as one of the University’s first Black professors. It was an era boiling with social turmoil and during the Black Panther trials. But I was undaunted. I spent three and a half wonderful decades as Professor of Epidemiology (microbiology) and Director of International Medical Studies at Yale.

However, I’m daunted now.

I recently read The Commonwealth Fund report on the state of health care. It compared the U.S. to 10 other high-income countries. According to the report the U.S. “ranks last overall, despite spending far more of its gross domestic product on health care.” How can the U.S. spend nearly $3.8 trillion on health care per year, similar to the entire GDP of Germany, yet we come in last on access to care, administrative efficiency, equity, and health care outcomes?

In my troubled state, I summoned the wise philosopher Rumi, who said “Where there is ruin, there is hope for a treasure.” That gave me hope and a realization: this pandemic provides us with an opportunity.

If now isn’t the time for a disruption to health care in the U.S., during a deadly and prolonged pandemic, I don’t know when is.

Of course, we’ve witnessed political, social, and scientific efforts to upgrade our health care system in the past – possibly too many times to list. Those efforts, while valiant, have not been sufficient to decrease morbidity and mortality in the U.S. Health care is and should be focused on prevention. But that’s not the way our current system functions. Without a true emphasis on preventative care, the outcome we’ve acquired is expensive, low quality and inefficient.

What we’ve lacked is disruption.

Fortunately, that’s an idea Americans tend to embrace. We’ve seen it with Amazon’s transformation of retail and Uber’s disruption of the transportation industry.

But disruption has yet to hit our health care system. That is, until now.

Among those leading the charge is my former student who studied infectious diseases at Yale Medical School, Dr. Ryan Saadi, MD, MPH. In June of 2020, Dr. Saadi joined minds with bone-marrow transplant expert Dr. Neal Flomenberg, M.D., professor and chair of the Department of Medical Oncology at Thomas Jefferson University, with the overall goal of bringing immunology products to oncology patients more quickly, affordably, and at a higher quality.

They focused on the biggest hurdle to T cell therapies—the need for the therapeutics to be personalized for each individual patient—and asked why must it be done this way? Many T cell products, such as CAR-T, are widely known for their efficacy in cancer, however they come at both a cost of time and money. Today, CAR-T requires that each patient meets with a team of doctors multiple times for a lengthy preparation and often the treatment requires hospitalization. The process is thus not cheap and does not occur quickly.

Doctors Saadi and Flomenberg determined that from a single T cell donor a common therapeutic can be developed and used to treat many patients sharing the same human leukocyte antigen (HLA) type. The convenience of “off-the-shelf”, meaning it has already been manufactured and is available on hand or literally on “the shelf” in a doctor’s office or hospital, offers timely and cost-efficient therapeutics by eliminating the need for specialized medical facilities which in itself will improve health outcomes.

Armed with affordable and transformational capabilities, they have since developed a therapeutic aimed at curing high risk COVID-19 patients under Tevogen Bio, a company focused on improving public health with its T cell products. Tevogen aims to be the first biotech company that is truly oriented to patient equity, which is among the reasons the Yale School of Public Health has partnered with Tevogen Bio on an initiative to improve public health.

The intrepid spirit Dr. Saadi and Dr. Flomenberg possess is not unique.

As Dr. Saadi’s professor, I noticed he exemplified some of the same qualities of another Yale graduate, Noah Webster, the author of the first American English dictionary. Webster also published the first public health and medical treatise - an evidence-based approach to public health. Webster was a disruptor of his time, his innovation changed the course of another U.S. public health crisis – yellow fever in the 1790s.

Like Webster, Dr. Saadi’s ability to ignore the background noise and focus on the basics of infectious diseases led him to solve problems early on in his career, such as his development of a new treatment guideline for Community Acquired Pneumonia which led to a 41% reduction in healing time, or time in the hospital.

My hope is that those in the health care industry are inspired by what Dr. Saadi and others like Noah Webster have created and develop their own novel ways to provide effective, expeditious and lower cost solutions. It requires disruptors who aren’t afraid to challenge the way things have always been done. Is there any other sector more important to achieve this than health care?

As this pandemic continues its deadly course, with new variants emerging and breakthrough cases discovered almost daily, the United States is ready for a disruption to public health. It’s not impossible, but will require collaboration, a tireless spirit, empathy and, of course, disruption.

For the first time since this pandemic began, I have hope.

Curtis Patton, PhD., professor emeritus at Yale University, is a scientist and public health expert. He served in a variety of administrative capacities at Yale, including division head of Epidemiology of Microbial Diseases and acting head of global health. He has also served as the director of International Medical Studies and chair of the Committee on International Health at Yale and currently serves on Tevogen Bio’s Board of Directors in an advisory role.