Low-cost ventilation designs allied to simpler configuration of wards can reduce the dispersal of airborne virus in emergency COVID-19 hospitals converted from large open spaces, say Cambridge University researchers.

The pandemic is stressing bed space capacity in hospitals globally. 

Healthcare authorities are trying to add thousands of additional bed spaces by temporarily adapting any available large open halls. Large air-conditioned halls tend to have top-down air-conditioning, which creates turbulent flows that can mix and spread droplets containing the virus very widely. 

At six full changes of the air in the hall in an hour it may take over 20 minutes to dilute the concentration of smaller droplets produced in a cough to below a tenth of their original density. 

This, say the researchers, is ample time for droplets to travel beyond 20m, putting healthcare professionals in particular at risk as they move about through “a slowly refreshing miasma.”

Professor Andrew Woods of Cambridge’s BP Institute (BPI) and Professor Alan Short of the Department of Architecture have developed a series of practical solutions to reduce the concentration of airborne virus experienced by patients and healthcare workers in buildings converted into makeshift wards.

The designs involve relatively low-tech adaptations to ventilation systems and ward configuration and are relevant for use globally.

The team recommends subdividing the large floorplate of a typical hall into enclosed patient zones, a minimum of 16 metre square, with some 10-20 beds separated by solid partitions up to 3 metre height, and lighter clear polythene sheeting above taped up to prevent air leaking in or out. 

Air is drawn through the back of the patient bays by an outflow ventilation duct, removing dirty air from the space and providing a clean corridor space for healthcare workers.

“Effective ventilation is critically important in helping to suppress cross-infection, and nowhere more so than in an infectious diseases ward,” says Professor Short. 

“Patients coughing or being ventilated will project droplets, some containing the virus, as an aerosol. They are so small that they may take tens of minutes to fall to the floor as the droplet evaporates in still air.”

Professor Woods adds: “Governments, healthcare decision-makers and construction workers are facing an extreme challenge in the urgent need to construct emergency hospitals. 

“Our work aims to highlight simple yet effective solutions that are relatively easy to install, implement, service and maintain.”

The team’s recommendations are based on physical laboratory experiments to test ventilation systems for two basic arrangements of beds: what is becoming a standard approach of placing hundreds of beds in an open hall with low level partitions, compared with arranging beds within enclosed patient bays so that, as far as possible, the exhaust air does not permeate the rest of the hall.

In the completely open version, ventilation air moves down to the ground and spreads out over the patient beds, leading to a highly mixed environment. When a patient coughs or releases aerosols, the flow pattern of the aerosols can extend across the space to other patient beds, even to patients across the corridor.

In the version subdivided into patient bays, the ventilation flow still comes down from the ceiling and moves into the patient bed-spaces and mixes, but a good proportion of this air is removed through exhaust ducts located behind the beds. 

When a patient produces aerosols within a bay, the aerosol concentration remains high in the bay and as air is drawn out through the exhaust duct this limits the aerosol transport into the main space.

“In a large hall, airflows mix up the airborne aerosols all too efficiently and disperse them through the space across patients and perhaps more significantly nurses and healthcare workers,” explains Professor Woods. 

“A small measure, such as the installation of part-enclosed patient bays with exhaust ducts can help reduce this dispersion.”

Professor Short added: “The strategies will work in many different climates. We’ve developed viable low energy ventilation models for converted spaces in many other climate regions from Temperate Northwest to the Mediterranean, from Continental climates in China and central India to the Mid-West of North America, Canada and marine coastal climates globally.”

In particular, the Cambridge team is working with Professor L.S. Shashidhara, Dean of Research at Ashoka University and adviser to the Indian government and architect C.S. Raghuram, to create viable conversions of marriage halls and sheds as emergency COVID-19 hospitals in India.

“Crucially, the measures we suggest are simple to implement as part of a rapid interior remodelling plan,” says Professor Short. 

“Our research shows that a small number of straightforward modifications would reduce risk in what is already a very risky environment.”

Because of the urgent need to share information relating to the pandemic, the researchers have released their preliminary report now, ahead of submitting to a peer-review journal. 

However, the designs are based on decades of research by Woods and Short on how particles like viruses are transported in mechanically ventilated spaces. 

The research was carried out in collaboration with colleagues at the Interdisciplinary Research Centre in Infectious Diseases, University of Cambridge.

Eisai, the Tokyo-based global pharmaceutical powerhouse, is the latest world leader in its field to provide financial and mentoring support for the Accelerate@Babraham initiative in Cambridge.

The Japanese business joins AstraZeneca, LifeArc and Mundipharma in backing the continued development of the fast-growing bio-incubator programme at the Babraham Research Campus.

Babraham says the additional funding will further enhance the ability of the campus to drive innovation in early science concepts and nurture new life science companies within the Cambridge cluster.

First launched in 2018, the Accelerate@Babraham initiative supports ambitious early stage life science ventures by giving access to appropriate short-term open access laboratory and office space, facilitating interaction with the academic community at the Babraham Institute and providing access to the campus’ global network, including mentoring and business support.

Derek Jones, CEO, Babraham Bioscience Technologies, which develops and manages the campus said: “Accelerate@Babraham doesn’t just focus on enabling access to laboratory facilities.

“We also match-make our startups with mentors who have experience specific to their needs and aspirations, in addition to curating a broad programme of events and activities specifically designed to progress ideas, challenge thinking and motivate these young entrepreneurs to strive for the next milestone in the development of their science. 

“As we enter our third year we have learnt much along the way and have the evidence to prove that our approach realises results.

“Our strategic partners, including Eisai, share our enthusiasm and drive to continue to evolve and improve the Accelerate@Babraham initiative year on year, with our collective aim being to support and encourage the next generation of talented individuals within the life sciences sector to succeed.”

Eisai is committed to delivering innovative products in various therapeutic areas with high unmet medical needs, including oncology and neurology.  Its work prioritises patients and their families through its focus to continually improve the benefits that healthcare can provide. 

As a global pharmaceutical company, its mission extends to patients around the world through investment and participation in partnership-based initiatives to improve access to medicines in developing and emerging countries. 

Kazumasa Nagayama, VP and chief strategy officer for Eisai Corporation said: “Eisai is delighted to be supporting Accelerate@Babraham and in so doing help to nurture the next generation of medicinal innovators.

“We believe that through supporting the vibrant UK innovation ecosystem, such as is being fostered by the Accelerate@Babraham initiative, we can accelerate the delivery of next-generation medicines to patients with unmet needs.

“It is a philosophy which we further support through our venture investment business. Eisai will support Accelerate@Babraham from our Hatfield Research Laboratories and this association will complement our existing External Innovation collaborative working model.”

A key activity within the Accelerate@Babraham initiative is the annual StartUP@Babraham competition. The competition supports ideas and/or companies that are pre-seed to seed stage (below £500k investment), the core objective of which is to help create new jobs, technology and therapies and to maximise the impact of the Cambridge life science cluster, both nationally and internationally.

Via a rigorous and competitive application and selection process, up to five early stage life sciences enterprises are selected to take part in the 5-month bio-entrepreneurial programme.

Applications for the third StartUP@Babraham competition opened on March 1; the programme itself will start in September.  Given the current environment due to COVID-19 the application deadline has been extended to June 17. 

Shortlisted applicants will be notified by July 1 and will be invited to pitch to a judging panel of business leaders via video or conference call in mid-July. Having spoken to all shortlisted applicants the judges will choose up to five winning finalists to be accepted onto the programme. 

To find out more and to apply visit: https://www.babraham.com/accelerate-babraham/accelerate-babraham-competition-2020/

The swift transition to a Covid-19 working environment and the economic uncertainty generated by that change has, understandably, had a big impact on the UK’s mid-market M&A scene, writes James Hunter, Partner at Mills & Reeve in Norwich.

Some existing transactions have continued but a target company’s business performance and trading risks in the new climate have now taken centre stage. Many new deals are on hold while companies (including targets and potential trade buyers) focus upon shoring up their own businesses whilst re-evaluating investment opportunities to ensure they offer short and long-term sustainability.  

Private equity investors are also taking time out to ensure their portfolio companies have appropriate support before they embark upon new investments. 

Whilst the transition to lock-down and the uncertainty created by current events has undoubtedly led to a marked reduction in M&A activity, the corporate team has closed 10 transactions for clients in the past few weeks. 

We continue to actively advise on around 25 ongoing transactions and have received many new M&A instructions since the lock-down commenced. Given that we are ranked third by Experian for the number of UK deals in 2019, this is a significant reduction on typical activity levels, but there are still deals being done and new deals starting.

We cannot be sure whether mid-market M&A activity levels in the UK will bounce back quickly, or whether a return to a more active deal landscape is going to be long and slow.  For any deals ongoing during the pandemic and indeed for those deals that come online in the near future, the risks and framework for deals have changed.

Due diligence

In the short term due diligence will focus more closely on strategies being deployed by the target to cope with Covid-19, looking closely at contracts with supply chain and customers, measures taken to furlough staff or change working arrangements, availability of finance and business continuity.

 In the longer term, these issues will remain important and how a business copes today might stand it in good stead during any future examination as part of due diligence. For many years, legal due diligence and most other due diligence has been undertaken without needing to access physical site locations and we expect this to become even more pronounced;

Pricing structure

Buyers will want to de-risk the price. There are likely to be more deals on deferred terms and/or involving earn-outs (which can be complex and make deals harder to negotiate) and buyers might be aggressive about seeking retentions.  

Locked-box structures have been championed by sellers in recent times but now it is likely buyers will be more insistent upon completion accounts (or partial arrangements) to delay the valuation date and push back some risk onto sellers. Another way to risk share might be to buy a partial stake, instead of a 100% interest, or to provide secured debt alongside an equity position.

Pricing sentiment

Valuation expectations are likely to have moved (downwards) and unlike 2008/9, this time the shift seems more likely to be on both sides of the transaction table, with a possibility that disconcerted sellers are keener to exit at lower valuations in order to de-risk themselves after the shock of being a business owner in such turbulent times.

In the mid-market there are many family-owned or owner-managed businesses which may be attracted by strategies which allow their owners to de-risk.  In a similar vein, distressed businesses might be forced into accelerated processes, likely to involve lower prices. Changes to the capital gains tax regime could also mean loan notes which allow sellers to defer CGT liabilities on earn-outs and other deferred consideration will become more attractive.

Mind the gap

Where a deal has a gap between exchange and completion (perhaps to allow a regulatory clearance or approval to be obtained) there will be more scrutiny than ever of ‘material adverse change’ and similar clauses.  It pays to front up to some of these discussions at an early stage, to avoid later misunderstandings and the potential for wasted costs.

Opportunities

Exchange rate movements and ongoing uncertainty about Brexit, as well as the likely timeframes for the beginning of recovery in different parts of the world, could make deal values in the UK attractive to overseas buyers.  

There has already been quite a bit of press commentary about the appetite of sovereign wealth funds and other cash rich buyers to make a move for the right kind of UK business.  In addition, UK businesses which emerge intact from the crisis could make swift moves to acquire unnerved competitors. 

For businesses which can create space to look towards their future strategic goals, this will be a time to keep a watching brief on competitors and markets, speak to advisers about possible targets or exit routes and maintain an open mind about structures and valuation. Whilst the M&A market is certainly subdued, we expect more deals to come on line as opportunistic investors begin to identify opportunities. 

Our understanding of the market, even in times which are changing rapidly, means we know how to get deals across the line. There is no legal aspect of an M&A transaction which cannot be completed during the current Covid-19 lock-down. Mills & Reeve has created its own Covid-19 project management toolkit “Executing M&A deals while in lock down”, which ensures the process runs as smoothly as possible during this uncertain time. 

For more information or to discuss any of the points in this note, please contact James Hunter or any other member of the Mills & Reeve corporate team.

The UK Government has pledged to make up to £250 million available to innovative companies facing financial hardship as a result of the Coronavirus crisis, with the prospect of increased funds if necessary, writes Zickie Lim, Partner at Mills & Reeve in Cambridge. 

The new Future Fund scheme is welcome news to start-ups, many of which have not been able to benefit from the existing Government support schemes.

Alongside the Future Fund, £750 million of support for SMEs will be made available through Innovate UK’s grants and loan scheme, with the first payments to be made by mid-May 2020.

Why is the scheme required?

The Government’s two existing support schemes for SME’s are the Small Business Grant Fund and the Business Interruption Loan Scheme operated by lenders (principally the major UK banks).

The Small Business Grant Fund provides relief on business rates charged on non-domestic properties. However, because start-ups often sublet property or operate from co-working spaces they are less likely to be eligible for the scheme than other SME’s.

To qualify for the Business Interruption Loan Scheme applicants must put forward a borrowing proposal to lenders that would be viable were it not for the coronavirus pandemic and demonstrate that the loan is affordable and that repayments would be made. This can prove difficult for start-ups, many of which are loss making initially.  

If start-ups fail to obtain funding and survive the Coronavirus pandemic, it will cause an innovation gap in industries including technology and life sciences. Countries such as France and Germany have already announced schemes intended to prevent start-ups from going insolvent because of the crisis. If the UK Government fails to provide adequate support there is a risk of setting the economy back in the innovation race. Widespread concern and intense lobbying from the start-up sector have exerted pressure on Government to come up with a more tailored plan.

What do we know so far?

The Future Fund is set to launch in May with the exact date still to be confirmed. We expect to see full details of the scheme made available over the coming weeks.

Matched funding required

The Future Fund will be delivered in partnership with the state-owned British Business Bank. It will provide eligible companies with unsecured bridge funding, with a minimum loan amount of £125,000 up to a maximum of £5 million. This is subject to at least equal matched funding from private investors. This bit is important as, for some start ups, securing these initial seed investors can be difficult in normal economic circumstances, let alone when the country is in lockdown during a global pandemic.

Use of funds

The convertible loan can only be used for working capital purposes. It cannot be used to repay any borrowings, pay dividends or bonuses to staff, management, shareholders or consultants or pay any fees or commissions of any external advisers in relation to the securing of this Government loan.

Interest payable – at least 8% per annum

The loan will incur interest at an annual rate of at least 8% per annum, which will be rolled up and paid on maturity of the loan or on its earlier repayment or conversion.  If the matched investors agree a higher rate of interest, then this will apply to the Government loan instead.  The interest will always be payable even if the principal sum is converted into equity.

Discounted conversion rates / 100% redemption premium

On the company’s next qualifying funding round the bridge funding will automatically convert into equity at a minimum conversion discount of 20% to the price set by that funding round. It is therefore possible for a higher discount to be negotiated. If this has been agreed with the matched investors then it will also be applied to the Government element of the funding. A qualifying round for these purposes will involve raising equity funding of at least the same as the amount invested under the Government loan and matching private investment (bridge funding). 

If the next fundraising is non-qualifying, (if the matched investors so elect), the bridge funding will convert at the agreed discount rate to the price set by that non-qualifying funding round.  So conversion in this case is a decision for the matched investors.

On a sale or IPO of the company, the loan will either convert into equity at the agreed discount rate to the price set by the most recent non-qualifying funding round (which will then be sold or admitted to trading as part of the IPO) or be repaid with a redemption premium of 100% of the principal amount of the bridge funding, whichever will provide the higher amount for the lenders. 

In the absences of a non-qualifying funding round after the date of the bridge funding but prior to the sale or IPO of the company, the loan will convert at the price per share calculated under the sale or IPO of the company – ie there is no discounted conversion rate in this case.

Maturity

The Government element of the loan will mature after a maximum of 36 months.  It is possible for the matched investors to agree a term longer than 36 months.   On maturity, the matched investors can decide whether to call for the loan to be repaid together with a 100% redemption premium or to convert at the agreed discount to the most recent non-qualifying funding round.

EIS?

Matched investors at this level are likely to be private individuals, many of whom would ordinarily be seeking tax reliefs for their investment under the Enterprise Investment Scheme (EIS).  If their matched investment is made by way of a loan on the same terms as the Government loan, EIS reliefs will not be available to them. 

It is not clear from the detail we have so far if the matched investment is capable of being made by way of equity investment – perhaps not from the tone of what has been said. However, if that were possible, then provided the company met the eligibility criteria for EIS and their matched investment were EIS qualifying, then such matched investors would be able to secure EIS reliefs on their matched investment. This would certainly help the company to secure matched investors in order to access this Government loan.

EIS reliefs would not be relevant or available on the Government loan element of the bridge funding.

Who can apply?

The full eligibility criteria are still to be determined. However, we already know that:

• companies will need to have already raised at least £250,000 in equity investment from third party investors during the last 5 years;
• if a company is part of a group, it may not be eligible. Only a UK-based parent company can apply; and
• companies will need to have a substantive economic presence in the UK, although there is no further guidance on what that might look like.

The application process will be subject to the company passing fraud, anti-money laundering and KYC checks.

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There have been many challenges in matching the offers of support from the manufacturing community to respond to the COVID-19 crisis with the dynamic and uncertain needs of the healthcare system, writes Tim Minshall, Dr John C Taylor Professor of Innovation and Head of the Institute for Manufacturing at the University of Cambridge.

Two examples of activities of the UK manufacturing community’s response between mid-March to mid-April 2020 in supporting the NHS with its response to COVID-19 are revealing.

The start: Deluge of offers of support

In early- to mid-March, as the scale of the likely impact of COVID-19 became clearer, there was an almost overwhelming wave of offers of support from the manufacturing community to address the needs of the UK healthcare system.

Aside from existing healthcare firms, offers of support came in from firms of all sizes across all sectors, offering to repurpose their manufacturing operations to address COVID-19 related needs, there were also multiple offers of support from local makespaces, schools and university departments offering access to their equipment to make whatever was needed, as well as individuals with technical experience asking what they could do to help.

In addition, numerous ideas were proposed and circulated for new or modified products that could address specific COVID-related issues.

Capturing data on what support was being offered

While the scale, range and enthusiasm of support on offer was extremely reassuring for the government, it wasn’t immediately clear how this support could best be utilised.

To ensure that offers of help from the manufacturing community were connected to the rapidly changing needs of the NHS, at a national level, UK government websites were used to capture information from businesses who might be able to assist with COVID-related challenges. These ranged from sites set up to capture the broadest range of offers of support through to sites capturing data on offers of support that addressed clear and immediate NHS Supply Chain requirements, as well as websites focused on specific challenge areas, such as those set up to mobilise efforts relating to ventilators (which, the minister for business and industry reported, attracted interest from over 3,000 companies).

In parallel, numerous unofficial, volunteer-run websites were set up for those who wanted offer specific capabilities, such as access to 3D printing that could address various COVID-related needs. For those who were proposing new or adapted product ideas, many were posted on social media to highlight their potential utility; or shared on one of the numerous semi-public project groups (using platforms such as Slack) that sprung up online; or emailed to anyone who was perceived as ‘someone who might be able to help take this forward’ within various government agencies or universities.

Useful data thus sat in many – often unconnected or overlapping – databases, networks, or rested with key individuals. For those who submitted data to various government databases, it wasn’t clear how this data was being used nor whether it was going to be given serious consideration.

The problem become one of matching the actual or potential – and rapidly changing – needs of the healthcare system with the most appropriate sources of support drawn from a fast growing and largely unstructured pool of data.

Matching offers of support to NHS needs

The matching of the offers of manufacturing capabilities and new product ideas to NHS needs in the midst of a rapidly evolving crisis was a complicated process as:

At a national level, there were huge margins of error on the predictions of the scale and timing of the surge in hospital admissions resulting from COVID-19, hence substantial differences in the estimates of what products would be needed, where and when.

At the regional level, the differences in the potential scale of impact of the surge across different parts of the UK meant that the individual hospitals had not only to develop plans in the face of high levels of local uncertainty but also to add often substantial contingencies in case other regions were overloaded and needed to transfer patients between healthcare trusts.

The UK healthcare system is complex and multi-layered with over 200 trusts, dealing with specific aspects of hospital and primary care (e.g. GPs, community pharmacy, dental, and optometry services, et al.) plus the extended networks of healthcare providers such as care homes. As the such, attempting to comprehensively map the needs and sources of supply for equipment required for patient pathways through the whole COVID-19 cycle (from admission through to return to the community) was extremely difficult.

To support this complex network, the NHS has a centralised model for the distribution of supplies. While this system is normally well-stocked, and reserves are kept to deal with major crises, the speed, scale and impact of spread of COVID-19 meant that the actual or anticipated demand for supplies of certain products could not always be met. The scale and complexity of the system resulted in multi-layered lines of communication between front-line clinicians and suppliers, which sometimes hindered rapid responses to fast changing conditions on the ground.

Given these issues, the balancing of supply and demand of equipment throughout the UK healthcare system as the COVID-19 pandemic has unfolded has been particularly difficult. In the following section, two examples are described of how the capabilities offered by the wider manufacturing community have been used to address emerging gaps in supply in the midst of this crisis.

Evolving gaps: From ventilators to PPE

Early on, there were well-publicised concerns at the anticipated shortfall in the supply of ventilators required in response to COVID-19. With around 8,000 being available but an anticipated need for 30,000, multiple parallel approaches to address this were deployed:

Buy more from existing ventilator manufacturers, whether in the UK or overseas. Given the pandemic nature of COVID-19, global demand for ventilators has increased substantially and, as such, the UK has to compete with many other nations also seeking to build up their supplies of ventilators. Increasing the output of existing UK ventilator manufacturers is also difficult as the supply of key components from global suppliers is now also constrained due to the rapid growth in demand.

Get more manufacturers to make ventilators. This could either be done by modifying existing designs or creating new designs to be accelerated through the approvals process and manufactured at scale in the UK. The UK government set the specification for minimal functionality required for such ventilators, and multiple partnerships and consortia were formed to deliver prototypes that met these requirements. From the responses submitted and filtered, the government then commissioned orders, subject to successful fast-track approval being granted, which was very likely given that the preferred options are either based upon existing designs or are based on clinically proven components. In doing so, the typical multi-year development cycle was reduced to 5-6 weeks.

Reduce need for ventilators in ICUs: Increasing the supply of equipment that supported patients’ breathing without the intubation required for full invasive ventilation in Intensive Care Units (ICUs) could reduce the number of ventilators required. Continuous Positive Airway Pressure (CPAP) machines are one example of such equipment. One high profile project that sought to address this need was the collaboration between UCL and Mercedes/McLaren F1 to develop a rapidly manufacturable CPAP device, the design details of which were made available for any manufacturer to download.

Prepare for ‘worst-worst case’: Some projects also sought to develop technologies that could be utilised in extreme cases, e.g. splitters to allow single ventilators to be used by more than one patient, or enhancing the performance of simple ‘bag valve mask’ or ‘ambu-bag’ devices by automating the bag squeezing. 

Some drew upon the significant number of open source designs for ventilator technologies, while others sought to develop new or partially new solutions. Some open source designs had already been proven in use in specific contexts but the use of these in the UK healthcare system would still require testing and approval (albeit fast-tracked, with certain exemptions permitted). Some projects chose instead to focus on developing and deploying solutions overseas in regions ‘that have traditionally been unable to get high-end medical equipment’; one such example is the Open Ventilator System Initiative.

Whether these approaches in combination will ensure that the UK healthcare system does have access to sufficient ventilators to meet demand has yet to be seen as we head towards the peak of the spread of COVID-19 in the UK, but the speed, creativity and levels of collaboration shown by the UK manufacturing community has been extremely impressive.

In early April, reported shortfall in the supplies of Personal Protective Equipment (PPE) available to frontline staff began to receive substantial media attention. Many of the problems arose from the rapid scaling the NHS’s centrally managed PPE supply chain designed for the ‘normal’, more predictable and stable operations of the healthcare system, coupled with extension of requirements for PPE across the primary and secondary healthcare contexts.

Though the UK government revised its planning and operations for the delivery of PPE on 10 April, during the period when the needs of some primary and secondary providers were clearly not being addressed in certain locations, the manufacturing community responded very rapidly, and in a ‘bottom-up’ manner.

Two modes of operation were noted: the re-purposing of production capabilities within manufacturing firms, and the emergence of what some labelled as ‘citizen supply chains’.

An illustration of this can be seen in the need for face shields. When stories emerged of a shortage of face shields in some hospitals, coupled with the Public Health England requirements for such equipment to be used in many primary care contexts, the response from the wider manufacturing community was rapid. The availability of open source designs, coupled with the publication of detailed production notes, enabled manufacturing firms, makespaces, otherwise unused university and school workshops and even individuals to start making face shields.

Many were not responding to specific calls, but rather started making the shields and delivering them to whoever asked, or in anticipation of possible needs within, for example, GPs surgeries and care homes.  The design and production process requirements of face shields make them particularly well-suited to this distributed model of manufacturing.

Whether such approaches could also be used for making a broader range of PPE at scale is now being tested, with multiple examples of firms attempting to do this. To support firms in different sectors convert their high volume manufacturing operations to the production of a broad range of PPE, the UK government has recently published detailed guidance notes. However, the situation reported in many hospitals in recent days show that there are still issues with PPE supplies.

The experience so far

These examples show how two large, geographically dispersed, complicated systems (healthcare and manufacturing) were attempting to find mutual points of connection to respond to rapidly changing and uncertain needs. One system is largely hierarchical (the NHS), the other self-organising (the broadly defined ‘manufacturing community’) but both are operating in a highly dynamic context. As such, effective collaborations between organisations within each system are always going to be difficult to manage. It has therefore been particularly impressive to see the multiple collaborations that have enabled both immediate and longer-term support to the delivered to the UK healthcare system by the manufacturing community to help address some of the numerous challenges of COVID-19.

These two examples also illustrate a broader issue of how the use of local manufacturing capabilities can act as a balancing mechanism to address short-term needs to give time to the national NHS supply chain to adjust at scale to changes in demand. We could be seeing the emergence of a ‘new normal’: What might now feel like an ‘all hands to the pumps’, short-term crisis response mode could be the basis of a more flexible, resilient, distributed UK manufacturing infrastructure.

• This article first appeared on the Institute for Manufacturing website.

Cambridge’s Sphere Fluidics, commercialising single cell analysis systems underpinned by its patented picodroplet technology, has won a Queen’s Award for Enterprise for Innovation. 

The award recognises the company’s excellence in patenting, developing and globally commercialising single cell analysis systems for biotherapeutic discovery.

Using its state-of-the-art picodroplet technology, Sphere Fluidics develops and commercialises novel, single cell analysis systems for the rapid screening and characterisation of single cells to enable leading edge research and accelerate biopharmaceutical discovery and development. 

The company’s flagship product is the multi-award winning, Cyto-Mine® System which integrates isolation, selective screening, sorting, and imaging into a single automated platform to streamline workflows, reduce costs, improve throughput and enable high-value cells to be captured in a single run.

Sphere Fluidics spun out from the University of Cambridge in 2010 and now employs 31 people.

Dr Frank Craig, CEO, Sphere Fluidics, said: “We are immensely proud to have our pioneering approach to single cell analysis recognised with a Queen’s Award for Enterprise. 

“This is a testament to the hard work and expertise of our dedicated team who have a deep understanding of the challenges faced by researchers in drug discovery, therapeutics and diagnostics.

“Sphere Fluidics’ technology is specifically designed to increase the chances of finding that rare molecule or cell that could lead to a life-changing medicine. 

“Our systems help make the development of new biopharmaceuticals faster and more cost-effective, improve monoclonal antibody screening, cell line development, and overall efficiency to help accelerate research into new therapeutic modalities. Our technology is highly innovative and is covered by 148 international patents and 18 trademarks.”

Sphere Fluidics is one of 220 organisations nationally to be recognised with a Queen’s Award, now in its 54th year.

Adder Technology, a specialist in connectivity solutions and high performance IP KVM, has won a Queen’s Award for Enterprise for excellence in International Trade. 

Cambridge-based Adder designs and manufacturers market-leading high performance connectivity solutions that are distributed globally via an expanding network of distributors, resellers, and system integrators to over 60 countries.

This award follows Adder’s previous commendations by the Queen’s Awards for Enterprise in 2001 and 2014, for International Trade and Innovation, respectively. Now in their 54th year, the Queen’s Awards for Enterprise are deemed the most prestigious business awards in the UK.

Founded in 1984 by current CEO Adrian Dickens, Adder is a global pioneer and leader in the design and manufacture of innovative enterprise technology that enables users to securely access and control computers from anywhere in the world via a standard IP network. 

The core technology, known as KVM (keyboard, video and mouse), is used around the world by customers across multiple industries – from pro-AV, broadcasting, and post-production, to command and control, and industrial process automation. 

In order to support its growing network of partners and customers around the world, Adder has established offices in key locations throughout Asia, Europe and the Americas.

Adrian Dickens, founder and CEO of Adder, says, “We are extremely proud to win another Queen’s Award – this time recognising our International Trade efforts. 

“Earlier in the year, we were delighted to announce a multi-million dollar investment to support our global expansion, and I consider this accolade as an acknowledgement of the fantastic work undertaken by the team at Adder. 

“This award will surely add to the momentum of the organisation’s growth as it reinforces our commitment to improving the connectivity needs of our customers.”

Adder started 2020 at pace with the announcement of a multi-million dollar global expansion, two successful product launches, the introduction of a 24/7 Elite Professional Service program and inclusion in the Sunday Times HSBC International Track 200, all within the first three months.

Global Graphics Software, a leading Cambridge developer of technology for digital printing, has also been honoured with a Queen’s Award for Enterprise.

The Cambourne company has been recognised for its excellence in innovation; the award recognises the development of ScreenPro™, an application that dramatically improves the speed and quality of inkjet printing making it possible for a wider number of goods – such as ceramic tiles, wall coverings and packaging – to be produced.

Justin Bailey, managing director of Global Graphics Software, said: “This accolade recognises their innovation and creative energy. I’m sure that, among the many other benefits to the business, this award will raise our profile locally and assist in attracting new talent in the future.”

Global Graphics Software’s roots are in Cambridge and go back to 1986.  The company sells technology to printing equipment manufacturers across the world, such as HP, Kodak and Canon.

A record five firms in Suffolk have won Queen’s Awards. They are pubs and brewery firm Adnams;  PCE Group, which makes automation systems; Pipeshield International which provides pipelines, cables and equipment for the offshore industry; Ant Group in Bury St Edmunds, which provides cleanroom equipment for various industry sectors; and Chorus Intelligence, which provides data cleansing and analysis software used by law enforcement.

Essex composite materials firm Dura Composites has scooped a second Queen’s Award for Enterprise, this time in the Innovation category, for its pioneering rapid-deployment train station platform solution known as Dura Platform.

This is a height-adjustable composite train station platform that reduces gaps between the train and platform edge to enhance passenger safety, is rapidly installed and therefore reduces passenger disruption.

Cambridge life sciences business Abcam estimates 2020 full year revenue  between £14 million and £16m lower – as calculated at April 17 – because of the global impact of COVID-19.

But the UK company, which sells life science research tools globally, has access to £280 million cash and facilities and CEO Alan Hirzel predicts the group will bounce back strongly when the pandemic lifts.

The share price rose immediately on Hirzel’s upbeat assessment as the UK market opened this morning – hitting the tickertape 46p (almost four per cent) higher at 1,202p with the market cap topping £2.6 billion.

Hirzel echoed the swings and roundabouts theme that many Cambridge technology companies are experiencing in international markets because of coronavirus. 

While its teams are working remotely wherever possible, Abcam has forged ahead on several business development fronts. It has boosted its supply chain and manufacturing flexibility to support increased demand for existing products used for SARS-CoV-2/COVID-19 research.

The company has also joined more than 20 collaborations across the UK, US, and China focused on SARS-CoV-2 drug and vaccine development and donated critical supplies such as PCR equipment used for testing.

Abcam has not furloughed any staff, nor has it participated in any of the other COVID-19 related government assistance schemes that have been implemented globally.

The group has a strong balance sheet and liquidity position, with proforma net cash of approximately £80m and a £200m revolving credit facility providing additional flexibility.

As announced in its half-year results, sales for the fiscal year as of March 9, had been approximately £3m lower than plan, reflecting the impact of the early stages of the pandemic, predominantly in China. 

Since then, Abcam reports that conditions in China have recovered gradually – however policy actions taken by governments around the world to limit the spread of COVID-19 have begun to have an effect on customers in other markets, including across North America and EMEA. Hence the lower full–year revenue forecast.

Hirzel said that over recent days Abcam had begun to see the reopening of labs in certain countries within Europe and a gradual increase in customer activity and revenue as a result. The company added that it was not feasible to give accurate guidance on future sales until there was greater clarity about the full duration and impact of the pandemic.

Hirzel said: “Our priorities are to look after our global team and our customers as the COVID-19 pandemic continues. We are privileged to have an important role in the research and development activity to understand and defeat this virus.

“Abcam’s unique technology and the business’s financial health are positioning our company to emerge stronger from this outbreak. I thank all our colleagues at Abcam for their agility in adapting to the evolving situation and their continued dedication to customers’ needs.”

A team of life-support system experts in Cambridge is spearheading a global initiative that could see thousands of grounded aircraft transformed into potentially life-saving hyperbaric oxygen chambers to treat COVID-19 patients.

Less than half of patients on ventilation are currently surviving the virus. For many of the most seriously ill, ventilation is unable to provide sufficient oxygen – and chronic hypoxia (lack of oxygen) is leading to death from multiple organ failure.

Hyperbaric oxygen therapy (HBOT) – the breathing of oxygen under pressure – has the potential to prevent patients deteriorating to the level where they require ventilation. It is standard treatment for many diseases where hypoxia is a factor. But a shortage of HBOT chambers has been perceived as a barrier to serious consideration of any such treatment option for COVID-19 so far.

Now life-support systems designer Lungfish Dive Systems is working with healthcare organisations and aerospace companies to explore the possibility of using commercial airliners as makeshift HBOT chambers, as they can be pressurised to the required levels for potentially effective treatment – approximately 1.6 times atmospheric pressure.

With thousands of aircraft currently sitting idle at airports around the world, close to centres of population, the move could help to relieve pressure on hospitals – treating large numbers of patients in a relatively simple, non-invasive way in a bid to prevent them requiring full intensive care. 

The therapy could also be rapidly deployed in the developing world where healthcare facilities are likely to struggle to cope with a large influx of COVID-19 patients.

A clinical trial of HBOT under conditions achievable in an aircraft is due to start shortly, involving patients at a hospital in Canada. Lungfish Dive Systems is also in talks to secure further clinical trials in the UK to determine factors such as efficacy, optimal dose, which patients might benefit most and any complications.

“It’s a race against time to secure partners for further clinical trials,” said Lungfish Dive Systems founder Dr Daniel Reynolds. “At the current casualty rates, if the treatment proves effective, one day’s difference in response speed could mean a difference of thousands of lives saved.”

Lungfish Dive Systems was founded in 2008 to commercialise advanced closed-circuit diving equipment. The Lungfish team has decades of experience in advanced life-support development for diving and research applications ranging from hyperbaric physiology to natural history filming. The company is currently providing equipment and support for a range of COVID-19 related efforts.

• Photograph – MAG London Stansted Airport.

The fastest launch of any clinical trial in the history of Cambridge-based Big Biotech, AstraZeneca, could lead to a treatment for the exaggerated immune response associated with COVID-19 infection in severely ill patients.

AstraZeneca is to initiate a randomised, global clinical trial to assess the potential of Calquence (acalabrutinib) in the treatment of what is known as a cytokine storm.

The trial design is based on strong scientific evidence supporting the role of the Bruton’s tyrosine kinase (BTK) pathway in the production of inflammatory cytokines and on encouraging early clinical data. 

Calquence is a next-generation, highly selective BTK inhibitor currently used to treat certain types of blood cancers.

The trial, called CALAVI, is based on early clinical data with Calquence demonstrating that a decrease in inflammation caused by BTK inhibition appears to reduce the severity of COVID-19-induced respiratory distress. 

The goal of the trial is to evaluate the efficacy and safety of adding Calquence to best supportive care (BSC) to reduce mortality and the need for assisted ventilation in patients with life-threatening COVID-19 symptoms. This large, multicentre, global, randomised trial uses a two-part patient-centric design developed in record time to accelerate data capture and analysis. 

Part one evaluates the addition of Calquence to BSC versus BSC alone in patients hospitalised with COVID-19 who are not in the intensive care unit (ICU). Part two evaluates the addition of Calquence to BSC in a cohort of patients in the ICU.

José Baselga, executive VP for Oncology R & D at AstraZeneca said: “With this trial we are responding to the novel insights of the scientific community and hope to demonstrate that adding Calquence to best supportive care reduces the need to place patients on ventilators and improves their chances of survival. This is the fastest launch of any clinical trial in the history of AstraZeneca.”

The CALAVI trial is expected to open for enrolment in the coming days in the US and several countries in Europe.

With many areas of the UK suffering major food shortages because of the coronavirus outbreak – and that’s before Brexit kicks in – the Government has rejected on appeal plans for a world-leading new AgriTech park in the Cambridge technology cluster.

But developer SmithsonHill has vowed to fight on despite losing the appeal to the Secretary of State, who found that the proposed development would result in unacceptable harm to nearby heritage assets.

SmithsonHill believes the ARC Cambridge proposal could use AgriTech innovation to develop more and better crops and end the food postcode lottery witnessed before and during the lockdown.

The ARC Cambridge site is just south of Cambridge, adjacent to the newly approved Wellcome Trust expansion site at the heart of the Life Sciences Cluster. At its nucleus will be a 30,000 sq ft innovation hub for AgriTech entrepreneurs and early-stage startups to grow their emerging businesses. ARC aims to support an estimated 4,000 jobs and increase regional GVA by £277 million a year by 2030.

Despite often empty shelves in supermarkets and warnings from farmers about workforce shortages to gather this years’ harvest, SmithsonHill’s appeal fell on deaf ears.

For many years there’s been talk of the 4th agricultural revolution and the need for AgriTech to rise up to meet the challenges faced across the food supply chain; many Cambridge companies in the sector are already facing the challenges head on.

A disappointed Emma Fletcher, MD of SmithsonHill said: “Our vision for ARC is to provide the facilities and ecosystem to help our agriculture industry adapt and scale – because the security of our future food supply is now more important than ever.

“The Secretary of State’s ruling is clearly disappointing – but we will continue working with local and national stakeholders and are even more determined to turn this globally significant opportunity into a reality.”

Ironically, in recent months the British government has helped SmithsonHill co-steer transatlantic trade missions including one between Cambridge and St Louis – heartlands that are kindred spirits in agricultural technology.