Saturday 14 March, AM: The French Health Minister tweets about NSAIDs and corticosteroids
At exactly 11:38 a.m. on Saturday 14 March, French Health Minister Olivier Véran tweeted the following message: “#COVID-19 | Taking anti-inflammatory drugs (ibuprofen, cortisone…) could worsen the infection. If you develop a fever, take paracetamol. If you are already on anti-inflammatory drugs, or if in doubt, please consult with your doctor.”
I have been working with Synapse Medicine to provide reliable information about drugs for more than two years now, so I knew from experience that there were several ways in which this message could be problematic. On the one hand, many people would carry on self-medicating with certain drugs without even knowing that they are classified as NSAIDs. On the other, the tweet could cause hundreds of thousands of patients to panic and discontinue their ongoing treatments. The message was also likely to trigger a massive influx of calls to already overstretched emergency services and doctors.
I called our Chief Medical Officer, co-founder and trained pharmacologist Dr. Louis Létinier to share my thoughts with him. Within minutes, we had reached an agreement: we had to do something to help. That something had to be simple, easy for anyone to use and, above all, available in a matter of hours. The need was straightforward: patients showing symptoms of Covid-19 had to be able to check in just a few seconds whether a particular drug was known to worsen the infection. That’s what we decided to focus our efforts on.
I then called Alicia Bel-Létoile, our CTO, to ask her if she would be willing to work over the weekend and put together a task-force within our team that would be dedicated to this non-stop for the next few days. She was immediately on board.
Time for another conversation with Louis: we agreed it was imperative for us not to move forward with this project alone. The associated responsibility and impact in terms of public health were huge ー we needed to get the authorities involved.
Saturday 14 March, PM: A scientific consortium is born, the first mock-ups produced
For over three years, Synapse Medicine has been building a strong network of institutional partners with whom we collaborate on different aspects of research and development. This includes various university hospitals, the French Network of Regional Pharmacovigilance Centers (RFCRPV), the French Society of Pharmacology and Therapeutics (SFPT) and the French National Agency for Medicines and Health Products Safety (ANSM), to name just a few. We have been working with some of them for several years and I knew that they trusted us enough to follow our lead on short notice on a major project like this one. Louis immediately reached out to Prof. Mathieu Molimard (pharmacologist, Head of the department of Pharmacology at Bordeaux University Hospitals, member of the SFPT) and Dr. Annie-Pierre Jonville-Bera (pharmacologist, President of the RFCRPV association) to constitute a scientific committee.
I took over communications with the health authorities: I wanted to find out whether a similar project was already in the pipeline at the Ministry of Health to verify that ours wouldn’t be redundant, and I wanted to know whether this initiative would be helpful to them.
By 2:00 p.m., discussions were underway with all of the key players. The RFCRPV agreed to make its resources available to answer patient calls, in an effort to ease the pressure on the national emergency services. Prof. Molimard and Dr. Jonville-Bera put together a scientific committee that would meet daily to approve the decision trees as well as the recommendations to be published on the platform. The health authorities also came back to us with very positive initial feedback.
We now needed to build the entire website from scratch. This was at the peak of the health crisis, so every hour counted.
Fortunately, we were lucky enough to be able to rely on a team that remained extremely well-organised even as everyone was working from home. The first product specifications were drafted and approved that afternoon, allowing our web designer to create the first mock-ups. Parallel to this, our data science team was busy setting up the services that would eventually power the platform.
Our development team got to work in the afternoon and dedicated most of the night and all of Sunday to the task at hand.
Sunday 15 March: The first version and several iterations
The time had come for the thankless part of the job, which doesn’t warrant much description but is fundamental nonetheless: that Sunday was spent finetuning the initial versions, carrying out multiple tests and consolidating the website. All recommendations had to be formally approved and the website had to work with 100% reliability. Our teams are used to working to these types of standards, but the extreme urgency of the situation made this process particularly stressful.
During the night from Sunday to Monday we decided on a version of the website, which would go into production the next day.
Monday 16 March: Launching the website
At 1:00 p.m. on 16 March, the website covid19-medicaments.com officially went live.
By 2:00 p.m. it was featured on the website of the French Ministry of Health.
Between 2:00 p.m. and midnight that same day, almost 10,000 analyses were run on the website.
It would help as many as 700,000 people in the days that followed.
The following days…
At the peak of the epidemic in France, more than 100 analyses were being run on the website every minute. To date, over 700,000 people have used the tool. As many as 50,000 alerts about self-medication with NSAIDs have been generated, and tens of thousands of calls to emergency services have likely been avoided by redirecting them to the regional pharmacovigilance centers.
No personal data is collected on the website, and no cookies are installed on the user’s browser. Only the names of the drugs visitors search for are recorded, ensuring the data’s complete anonymity. All of the data is transmitted daily to the French National Agency for Medicines and Health Products Safety to help monitor the epidemic and its consequences.
The website is now listed almost everywhere, including on the excellent information platform maladiecoronavirus.fr.
It is continuously maintained and updated by our teams at Synapse Medicine in accordance with the scientific committee’s recommendations.
As a physician, public health specialist, epidemiologist and CEO of Synapse Medicine, I am incredibly proud of our team and of what we have achieved. This project has proven beyond any remaining doubt that it is possible for a start-up company to collaborate constructively with health authorities and to have a nationwide impact on people’s health.
Dr. Clément Goehrs