In early February, infectious disease expert Ian Lipkin got a call from Amazon. The Columbia University virologist, who was an adviser on the 2011 outbreak thriller Contagion, was in China to investigate the newly emerging coronavirus.
Amazon asked Lipkin if he could help the tech company reduce the risk of infection to their workers and customers. The first U.S. case of Covid-19 had just been detected in Seattle, where Amazon’s headquarters is located, at the end of January.
“I talked with them about ways in which they could contribute to the science around preventing, treating, and recognizing Covid,” Lipkin tells OneZero. Before then, he never had any contact with Amazon, except as an occasional customer. To him, the company’s interest in the science of the coronavirus made perfect sense. “Obviously, they want to do everything they can to promote public health and to ensure the safety of their employees, their products, and their customers,” he says.
In response to the pandemic, the tech behemoth is funding research into a potential Covid-19 treatment, developing its own testing capabilities, and backing a study on immunity. The results of those efforts could keep workers from getting sick, and in doing so, boost Amazon’s productivity by keeping workers healthy and on the job. The company’s foray into scientific research could eventually extend to consumers, too. Amazon has already made moves into the health care space, and its efforts during the pandemic could allow it to gain an even bigger toehold in the $3.6 trillion industry.
While these scientific endeavors could ultimately be good for Amazon’s bottom line, they haven’t seemed to ease the worries of the company’s frontline employees, who protested on May 1 with other tech workers for better safety protections, working conditions, and pay.
In recent weeks, Amazon has come under increasing pressure from state attorneys general and its own workers to release the total number of its employees infected with Covid-19. So far, eight warehouse workers have died of the disease, according to the company. Amazon’s lack of transparency has led some employees to begin tracking cases on their own. One employee told CBS’s 60 Minutes that she estimates at least 600 employees have tested positive.
Amazon says it is taking extra steps to protect workers at its fulfillment centers during the pandemic, like providing personal protective equipment, mandating temperature checks, and installing handwashing stations. In its first-quarter earnings statement on April 30, the company said it expects to spend $4 billion or more — its projected operating profit for the entire second quarter — just on Covid-19 expenses. That spending includes personal protective equipment, cleaning its facilities, higher wages for hourly teams, and developing its own Covid-19 testing capabilities.
“We have taken this seriously from the beginning,” CEO Jeff Bezos said at a May 27 shareholder meeting.
One of Amazon’s scientific efforts is to fund a clinical trial in New York to test an experimental treatment for Covid-19. The effort was spurred by conversations with Lipkin. When he first started communicating with Amazon in February, he told the company there wasn’t a proven treatment for the new virus but that a few preliminary studies in China showed that Covid-19 patients might benefit from receiving infusions of plasma — the clear part of the blood — from people who had recently recovered from the disease. Amazon was interested and offered to fund a trial at Columbia University, headed by Lipkin.
Lipkin told them a trial would cost a few million dollars — a modest investment for a company that brought in more than $280 billion in revenue in 2019. With a trial, “we can answer a question yes or no as to whether or not that’s going to be useful,” Lipkin says.
In late April, Amazon announced that it would provide $2.5 million in funding to Columbia University researchers to investigate whether plasma from Covid-19 survivors can prevent and treat the infection. Specifically, the trial will investigate whether plasma is effective as a treatment for patients hospitalized with the coronavirus and as a kind of temporary vaccine for those who are at high risk of exposure to the virus. A total of 450 individuals will receive intravenous infusions of either plasma from Covid-19 survivors or a placebo, including 150 health care workers, 200 close contacts of Covid-19 patients, and 100 patients in the intensive care unit.
“The study is a critical first step in understanding if plasma donated from Covid-19 survivors can provide effective preventative care for frontline health care workers and those at high risk of poor outcomes from the disease,” Amazon said in an April 23 blog update. When reached via email, an Amazon spokesperson told OneZero that the company couldn’t comment further on the effort.
The idea of using plasma from recovered patients, known as convalescent plasma, to treat or prevent serious infections dates back more than 100 years. Rich in antibodies — the protective proteins made in response to an infection — plasma taken from recently recovered patients can provide a temporary boost to the immune system. It was a common treatment for many types of bacterial infections before the discovery of antibiotics. More recently, it’s been used to treat viral diseases such as H1N1 influenza, Ebola, and other coronaviruses like SARS and MERS.
“It’s got a long history of success,” Lipkin says. “The presumption is that the antibody binds to the virus, and because it coats the virus, it prevents the virus from entering cells. It interferes with the ability of the virus to actually attach to the cells.”
He says the therapy is likely to be most effective at the beginning stages of infection or before a person is even exposed to the coronavirus. Once the virus gets inside a cell, the antibodies can no longer reach it, he explains.
Early results posted online on May 22 by researchers from Mount Sinai in New York show that convalescent plasma might have aided in the recovery of 39 hospitalized Covid-19 patients. Using electronic medical records from Covid-19 patients as a control group, the researchers found that those who received convalescent plasma had better outcomes compared to those who didn’t. But the study hasn’t undergone peer review and the results are far from conclusive. Bigger trials that randomly assign patients to receive convalescent plasma or a placebo, like the one Amazon is backing at Columbia, are needed to know whether the treatment is truly effective.
Dozens of other trials testing convalescent plasma for Covid-19 are either ongoing or just getting off the ground elsewhere around the country. Johns Hopkins University in Baltimore, the Minnesota-based Mayo Clinic, and Michigan State University are leading an effort called the National Covid-19 Convalescent Plasma Project, which includes Columbia and around 50 other institutions.
“If it’s found that you’re able to prevent infection, that would be totally transformative. You would be able to avoid the whole gamut of Covid,” says Evan Bloch, a pathologist at Johns Hopkins who’s involved in the convalescent plasma trial there.
Lipkin says he meets with Amazon weekly to discuss progress on the Columbia trial. If the treatment works, it would provide much-needed evidence that antibodies can treat or prevent Covid-19. It’s not yet known whether the presence of antibodies will do so. If plasma is effective, it would also be good news for the development of a vaccine, which relies on the idea of spurring the body into making antibodies against the coronavirus. Many workplaces, like schools, hospitals, and health care companies, require employees to get certain vaccinations. If a vaccine for Covid-19 becomes available, big employers like Amazon will no doubt be interested in immunizing its workforce.
Amazon is also trying to make it easier for recovered Covid-19 patients to donate plasma. Amazon Web Services, the company’s cloud computing services subsidiary, teamed up with Michigan State University in April to develop a public website for the National Covid-19 Convalescent Plasma Project designed to host, share, and track research on convalescent plasma. The website also maintains a registry for plasma donors. More than 11,000 potential donors have registered as of June 3.
Nigel Paneth, a pediatrician and epidemiologist at Michigan State University who’s a member of the national plasma project’s leadership team, said AWS made the website for free. “They put up a website in 24 hours, and we just populated it with content,” he says.
AWS also helped the Michigan IT team program a chatbot on the website so that visitors can ask a question — such as where they can donate plasma or who’s eligible for treatment — and get an automatic answer.
Paneth says the national plasma project also wants to create a central, one-stop-shop website to match Covid-19 survivors with a plasma donation location near them. He says Amazon is interested in developing an app for that purpose as well, but it’s unclear why.
Beyond convalescent plasma, Amazon is working on scalable testing and is building out its own lab for running tests. These efforts could help the company better monitor Covid-19 cases in its facilities. Amazon has assigned a dedicated team to work on testing and has begun assembling its first in-house testing lab. In an April 9 blog post, it said it could start regularly testing all its 840,000 employees, including those with no symptoms. It plans to begin testing frontline warehouse workers first. “Regular testing on a global scale across all industries would both help keep people safe and help get the economy back up and running,” the company said on its blog.
Amazon employees assembling equipment in the company’s first in-house coronavirus testing lab. Credit: Hardy Wilson, Amazon
Amazon is also backing a study at the Fred Hutchinson Cancer Research Center in Seattle to study people who are at high risk of infection, like warehouse workers. Researchers will observe how many people out of 250 participants get infected with SARS-CoV-2, as well as how long it takes for those infected to “shed” or get rid of the virus and whether those people can be reinfected. Study volunteers will collect their own nasal swabs and blood samples and send them to researchers every week. With the Food and Drug Administration greenlighting at-home coronavirus tests, warehouse workers could conceivably administer their own tests in the future. Amazon has been closely involved with designing the study, which will follow participants for six months. Amazon declined to comment further on the study.
Andrew Lo, director of the Laboratory for Financial Engineering at the MIT Sloan School of Management, says Amazon’s investment into Covid-19 scientific research is “certainly terrific PR” and could also help make its employers feel safe and keep productivity up. “Unlike many other companies where you can shelter at home and still be productive, Amazon has a tremendous number of warehouses, so they need the physical presence of their employees.”
“The results of the Fred Hutchinson study could be extremely valuable in developing policies for Amazon as to how often they test, how they provide support and medical care for their drivers and warehouse workers, and it could actually be a model for how other large companies can take care of their employees,” Lo says.
Mark Shmulik, a tech analyst at global asset manager AllianceBernstein, says the pandemic has been a “drag” on Amazon’s productivity and that spending on investing in treatments and testing could help the company get its warehouses functioning at pre-pandemic levels. “I think it’s the right place to be investing since it would not only benefit Amazon’s own operations but likely accelerate the development and adoption of new solutions across the broader market,” he tells OneZero. For instance, if Amazon started doing wide-scale testing of its workforce, other large employers and tech companies could follow suit.
Amazon’s recent efforts are consistent with its interest in health care. In June 2019, it acquired MIT startup PillPack, an online pharmacy that provides home delivery for prescriptions. Last year it also launched Amazon Care, a virtual medical service for its Seattle area employees. During the pandemic, Amazon Care was also delivering self-swab Covid-19 tests to Seattle-area residents as part of a research effort backed by the Bill & Melinda Gates Foundation. But in mid-May, the FDA stepped in and stopped the program.
If convalescent plasma proves to be effective against the coronavirus, Lo says Amazon is well-positioned to transport the treatment all over the United States and possibly in other countries. The National Covid-19 Convalescent Plasma Project has plans to massively scale up the plasma donation and transportation this summer if the treatment works. “Clearly as a delivery service Amazon rivals UPS, FedEx, and other organizations,” Lo says. In that sense, it wouldn’t be all that surprising if the company got involved in delivering plasma or coronavirus tests, too.