May 25, 2020

Covid19 The Pandemic (Almost) Nobody Saw Coming

Of all the changes 2020 had brought, almost nobody saw coronavirus disease 2019 (COVID-19) coming.

First reported in late December 2019 in Wuhan, China, the newly discovered coronavirus (2019-nCoV) quickly made its way around the globe, killing thousands and sickening hundreds of thousands more. There is quite a bit of information out there to disseminate we felt it time to give an overview and a few thoughts on Covid-19; as this situation is fluid we do expect to add more information in future posts.

On March 12, 2020, the World Health Organization declared COVID-19 a pandemic, meaning the disease had spread to multiple continents around the globe. Like other pandemics, COVID-19 seemed to move swiftly, taking governments, healthcare providers and citizens by surprise. 

Not everyone was blindsided, though – a handful of experts in global health, the biosciences, national security, emergency response and economics got together in October 2019 to talk about what would happen if a global pandemic suddenly hit the world’s population. The experts discussed how Americans and others around the world would fare if a novel and highly transmissible coronavirus outbreak reached pandemic proportions.

Just as its real-life counterpart did, the fictional coronavirus jumped between countries and continents via international air travel. In both accounts, the virus caused problems for health care systems, economies, and political leaders. The fictional scenario assumed governments would first try closing borders and banning travel, but by the time authorities enacted border closures and travel bans, carriers would have unknowingly transmitted the disease to others before developing symptoms. The experts also projected the travel bans would disrupt trade and worsen international cooperation.

The simulation provided a shocking glimpse into the near future, but in today’s rapid-fire news cycle, very few people took notice. When the predictions began to come true in the form of COVID-19, many people regarded the threat somebody else’s problem because it was occurring in another country and could never reach the shores of our nation. Others thought COVID-19 was nothing more than a seasonal influenza. They were wrong on both counts.

COVID-19 is Here, and it is More than Just a Flu

The first patient with COVID-19 walked into a U.S. emergency department on January 19, 2020. Today, thousands of Americans have tested positive for novel coronavirus.

COVID-19 is similar to the flu in many ways, and is significantly different in other ways. Both are infectious illnesses, for example, and both cause a dry cough and fever. Influenza causes aches, chills, fatigue, and headache and chills; these symptoms are less common with COVID-19. Flu symptoms come on suddenly, getting worse over a day or two. Symptoms of COVID-19 develop gradually, worsening over the course of several days.

COVID-19 is different from the flu in other ways:

  • Difficulty breathing and shortness of breath are the hallmarks of COVID-19 – they are also signs to seek immediate medical attention; flu does not cause shortness of breath and difficulty breathing
  • COVID-19 is more likely to kill than the flu – about 3.4 percent of people with COVID-19 have died and seasonal flu generally kills far fewer than 1 percent of those infected
  • Unlike the flu, there is no vaccine for COVID-19, and it will probably take a year to develop one
  • There is no treatment for COVID-19
  • Children, who are typically at high risk of contracting flu, are at lower risk for COVID-19 than are older adults

With a higher basic reproduction number, which is the number of infections one infected person can cause COVID-19, is more infectious than the flu. COVID-19 seems to have a basic reproduction number somewhere between 2 and 2.5, so the average person infected with the coronavirus spreads the disease to 2 to 3 other people. The basic reproduction number of seasonal influenza varies from year to year, but is often about 1.28.

COVID-19 is wreaking havoc on nearly every segment of the population, but it presents special danger to some. Director of the National Alliance on Mental Illness (NAMI) HelpLine Dawn Brown reported an increase in calls to the NAMI hotline. Callers expressed a wide variety of concerns, including feelings of depression and loneliness from social isolation, worries about job stability and income, fears of getting sick, grief over the death of a loved one, and homelessness. “Right now, the bigger concerns are around anxieties about the unknowns, you don’t know what you don’t know, and the people we serve tend to be a little more vulnerable to anxiety and panic.”

What Happens in the Future Depends Largely on What We Do Today

Arguably late to the situation, the U.S. government issued The President’s Coronavirus Guidelines for America, which directs citizens to listen to state and local authorities, stay home when sick, self-isolation measures, and good hygiene. States have issued a variety of public health emergency declarations, including the activation of National Guards, school and business closures, and limits on event sizes.

The medical community geared up quickly in response to the pandemic. Hospitals began enacting preparedness plans, clinicians developed treatment plans for critically ill patients, and researchers immediately turned their attention to developing a vaccine. Mayo Clinic announced the development of a new test that provides results in 24 hours.

The actions of individuals, families, businesses and communities will have the greatest influence in how the pandemic ends – they will also bear the brunt of its consequences. In even the best case scenario, hundreds or thousands of people in the United States could perish; new research suggests the number of deaths in the nation could exceed 2 million.

While nobody knows exactly how COVID-19 will change our lives, almost everyone can agree that the changes will be profound.

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Frank Magliochetti owes his professional success to his expertise in two areas: medicine and finance. After obtaining a BS in pharmacy from Northeastern University, he stayed on to enroll in the Masters of Toxicology program. He later specialized in corporate finance, receiving an MBA from The Sawyer School of Business at Suffolk University. His educational background includes completion of the Advanced Management Program at Harvard Business School and the General Management Program at Stanford Business School. Frank Magliochetti has held senior positions at Baxter International, Kontron Instruments, Haemonetics Corporation, and Sandoz. Since 2000, he has been a managing partner at Parcae Capital, where he focuses on financial restructuring and interim management services for companies in the healthcare, media, and alternative energy industries. Earlier this year, he was appointed chairman of the board at Grace Health Technology, a company providing an enterprise solution for the laboratory environment.

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Mr. Frank Magliochetti MBA
Managing Partner
Parcae Capital


Shingles on the Rise

Shingles on the Rise

Shingles is increasing in the United States, according to the Centers for Disease Control and Prevention (CDC), and health experts are not quite sure why.
A recent retrospective study of 2,848,765 Medicare claims showed the incidence of shingles increased 39 percent from 1992 to 2010.
About Shingles
shingles_frankmagliochettireportNearly a third people in the U.S. will develop shingles, otherwise known as herpes zoster or simply “zoster,” during their lifetime. While most people who get shingles will develop it only once but some get the disease two or three times. The risk of shingles increases with age, especially after the age of 50. Children can get shingles, but it is uncommon.
Signs and symptoms of shingles include pain, itching, or tingling of skin just before the development of a painful rash of blister-like sores. Symptoms typically develop on one side of the body, often on the face or torso. Fever, headache, chills, and upset stomach may occur. Severe pain in the affected area, known as postherpatic neuralgia (PHN), is the most common symptom of shingles.
Shingles develops as the result of exposure to the varicella zoster virus (VZV), which is the same virus that causes varicella disease, also known as chickenpox. The virus remains dormant sensory ganglia after the individual recovers from varicella; the virus can reactivate to cause shingles years later.
Are Chickenpox Vaccinations Accelerating the Increase of Shingles?
Researchers are still working to understand why the virus reactivates. It appears that an individual’s risk for shingles increases as immunity to VZV declines, as happens with aging or with the development of immunodeficiency associated with certain illnesses or treatments.
Some research suggests that exposure to varicella disease can actually boost immunity to VZV and reduce the risk for reactivation as shingles. Other research does not show this effect and the results “reflects the uncertain influence of varicella circulation on zoster epidemiology.”
Rates of chickenpox fell dramatically in the years following the implementation of the childhood varicella vaccination program in 1996, leading some scientists to speculate that the rise in shingles in adults was the result of childhood vaccination against varicella. These researchers reasoned that adults exposed to children with the virus would build immunity against varicella, and that widespread vaccination of children would provide fewer opportunities for adult exposure.
Results from a recent CDC study seem to disprove this theory. Researchers in that study used Medicare data from 1992 to 2010 and found that shingles rates shingles_frankmagliochetti-reportwere rising even before the introduction of the varicella vaccine in 1996. Furthermore, zoster rates did not accelerate after the introduction of the program.
The researchers in the CDC study also looked for any link between state varicella vaccination coverage and zoster rates, and found that the rates of shingles did not accelerate as states increased vaccination coverage. In fact, the incidence of shingles was the same in states with high vaccination coverage as it was in states with low coverage.
Furthermore, countries without routine varicella vaccination programs are experiencing similar increases in shingles rates in adults.
Like the wild-type virus that occurs in nature, the attenuated vaccine virus can reactivate to cause shingles. Children who get the varicella vaccine appear to have a much lower risk for childhood shingles than children infected with the wild-type virus. Vaccinated children are also less likely to be infected with the wild-type virus, which is more likely to reactivate as shingles as compared to the weakened vaccine virus.
While scientists have yet to discover the reasons behind the increased incidence of shingles, it is clear that zoster vaccination can prevent many cases of shingles, both in adults and in children.


Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.


Tdap Lead to Increased Trend in HPV Vaccines

Requiring Tdap May Increase HPV Vaccination in Adolescent Girls

About 9 in 10 people will get a human papillomavirus (HPV) infection at some point in their lives, according to the Centers for Disease Control and Prevention (CDC). HPV infections are associated with health problems, including several types of cancer in men and women, which means HPV infection is an urgent health problem. A new study shows that teenage girls were more likely to start the HPV vaccine series in states where schools required the meningococcal vaccine and/or the tetanus, diphtheria, and pertussis (Tdap) booster prior to admission.
frankmagliochetti_tdap-vaccineNationwide, 63 percent of girls have received at least one dose of the vaccine, and half of all boys have started the series. Low HPV vaccination coverage is an urgent public health problem and improving HPV vaccination rates will save lives. The nation’s high Tdap vaccination rate of 86 percent shows that high HPV vaccination coverage is possible.
Most cervical cancers, anal carcinomas, and oropharyngeal cancers are the result of infection with high-risk HPV strains. While vaccines capable of preventing HPV related cancers are available, low usage limits their utility.
Previous attempts at improving HPV vaccination included state laws requiring the vaccine, but many of these laws allowed for exemptions for any reason. Because parents could opt out for nearly any reason, these state laws have been largely ineffective at increasing HPV vaccination coverage.
Improving HPV Vaccination Coverage by Vaccinating Against Other Diseases
To identify policies that could improve suboptimal HPV vaccination rates, the authors of the study sought to evaluate the relationship between adolescent vaccination and states’ school entry requirements. In the study, published in the medical journal Pediatrics, researchers compared HPV vaccination coverage in teenage girls aged 13 to 17 years across states with different vaccination requirements for school entry.
The authors gathered information from published data regarding school entry requirements from the Immunization Action Coalition (2007-2012) and vaccination rates from the National Immunization Survey-Teen (NIS-Teen, 2008-2012). They analyzed Tdap booster and meningococcal vaccination rates and evaluated the possibility of increasing HPV vaccination rates by “spillover effect,” meaning schools that require vaccinations as a condition of attendance could have higher rates of HPV vaccination.

The Results

The researchers found that requiring vaccination for admission to school did indeed improve vaccination rates for HPV. Vaccination requirements also boostedfrankmagliochettireport__hpv_vaccine coverage for Tdap and meningococcal vaccinations.
Compared with other states, those states with Tdap booster and meningococcal vaccination had a 22 and 24 percentage point increases in coverage for these vaccines, respectively. States with HPV vaccination requirements had less than 1 percentage point increase in coverage. Requiring Tdap booster and meningococcal vaccinations caused an 8 and 4 percentage point spillover increases for HPV vaccination coverage.
The study was limited in that it failed to account for confounding variables, such as religion, ethnicity, and parental education. Furthermore, the study did not account for the types of school attended, as homeschooled adolescents and teens attending private schools may not be subject to the same vaccination requirements. Despite these limitations and considering the controversy surrounding HPV legislation, utilizing the spillover effect from meningococcal and Tdap vaccination may be an effective approach to improving HPV vaccination coverage.


Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.


Smart Tech: Wearable Medical Devices

Smart Tech:  Wearable Medical Devices 2017 – 2020

Smart technologies will continue to drive the ever-growing medical wearable device market in 2017 and well into the future.
The global medical wearable devices market topped $3.2 billion in revenue in 2015, according to Mordor Intelligence, which expects the market to surpass $7.9 billion in 2020 as the industry continues to grow at a healthy CAGR of 19.8 percent during that period.
wearablemedicaldevices_frank-magliochetti-reportWearable medical devices, known simply as “wearables,” are small pieces of equipment featuring sensors that attach to the body. These sensors detect and monitor changes in specific body signatures produced by various body systems and organs. Early wearable technology allowed consumers to monitor vital signs. Today’s wearables allow users to monitor food intake, activity, and sleep levels. Tomorrow’s devices may provide continuous monitoring of glucose levels, smart clothing for infants, and smart EKG necklaces for those with heart problems.
Wearables have the potential to fill a number of applications in remote patient monitoring, sports and fitness monitoring, and home healthcare. Simplified usage of these devices, coupled with the ability to synchronize with smartphones and tables, assisted growth in this segment.
Global Wearable Devices Market- Market Dynamics

There are immense potential socio-economics of wearable medical devices for multiple sectors. Fitness devices that encourage the users to exercise can significantly reduce healthcare costs, for example.

Investors are focusing on a wide variety of projects, ranging from downloadable apps to improving the size, cost and sensitivity of sensors.wearablemedicaldevices_frankmagliochettireport

Several factors propel the growth of the global wearable market. Technological innovation is perhaps the most important factor, as these advancements lead to the introduction of new products.
Diabetes and other chronic diseases are rising at a seemingly uncontrollable rate. Wearable devices will play an increasingly important role in helping doctors and patients manage chronic diseases.

Developers make wearable devices easier to use and simplify interpretation of the data collected. Simplicity encourages use.
Market penetration of smartphones, smart watches and other wearable devices will promote the use of wearable medical technology. These devices have already penetrated the market deeply, with the worldwide smart watch shipments reaching about 25 million in 2015.

Some factors, such as reimbursement issues and high device cost, will restrain the medical wearables market somewhat but the effect should be minimal, as demand should remain high.
Several companies are already exploiting the growing interest in medical wearable technology by creating affordable products that offer high value to users and their healthcare partners.

Some of the key players already operating in the medical wearable device market include:
• Dräger
• Fitbit Inc.
• Intelesens Ltd.
• Lifewatch AG
• Omron Corporation
• Polar Electro
• Philips Electronics
• Withings SAS
These wearable manufacturers will likely improve hardware in existing products and create sturdier devices within the next few years. Hardware and device ifrankmagliochettireport_wearable-medical-devicesnnovations may include larger and easier to read displays, extended battery life, waterproof hardware, and compatibility with GPS and other sensors included in a standard smart phone. Software innovations may include advanced monitoring systems and improved patient care software, such as breathing exercises and on-demand nutrition counseling.
The wearable market is expanding because the devices are autonomous, which makes them easy to use, and non-invasive. It is also growing because of its ability to help prevent and manage chronic diseases.


Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.


Innovative Developments in Medical History

Preventative Vaccines:  Bexsero & Trumenba

Frank Magliochetti Report

One of the biggest public health epidemics occurred back in 2014; Ebola and Meningococcal B were responsible. These two diseases took 10,000 people in Sierra Leone, Guinea and Liberia. These three countries have weak health systems, which is the reason why they were unable to treat their people.

In order to fight this disease, which made its first appearance in 1976,  WHO (World Health Organization) had been trying to find a cure for many years. On August 8, 2015, WHO declared that Ebola and Meningococcal B is a disease of international concern and thus began the search for its vaccine. By late October, 2015 WHO had finally come up with two vaccines that were guaranteed to prevent Meningococcal B. Sadly; the cure for Ebola has not yet been found however, its vaccines trials are currently being conducted in Sierra Leone.who_frankmagliochettireport

Meningococcal B is caused by bacteria called “Neisseria Meningitidis”. Neisseria Meningitidis has five serogroups: B, C, Y, W and A. The most common serogroups that affect people in the US is B, C and Y.

Meningococcal B disease is not caught through the air. In fact, it is a diseasewhich is transmitted from one person to another in close physical contact. The disease commonly spreads faster in the family due to the exchange of fluids from daily contact. The disease is found at the back of the throat and later causes sepsis. Sepsis is transferred to the blood that infects the blood stream, which causes damage to the brain and spinal column. Meningococcal B often results in liver failure, vision loss, amputation of limbs and death.

bexsero-frankmagliochettireportThe two vaccines Bexsero and Trumenba specifically treat Meningococcal B and were approved by the FDA in October 2015. The trials for Bexsero were conducted in UK, Chile, Australia and Canada amongst 2,600 young adults and adolescents. The results were that the three infectious strains that cause Meningococcal were destroyed.

Another 5,000 participants in the trials conducted in the USA experienced headache, muscle and joint pain, chills, fatigue and diarrhea after receiving the vaccine. Whereas, 15,000 participants experienced less side effects. All in all, the FDA approved the vaccines because the side effects were not viewed aslong term or fatal.

An accelerated approval was used by the FDA to make this vaccine go public claiming that Meningococcal B is a life-threatening disease. The effectiveness of Bexsero was approved two months prior to the trials being conducted.

FDA recommends that the vaccine should be given to infants, children from the ages of ten till twenty three and people who have a weak immune system. It is recommended that more than one dosage should be given to people having serogroup B Meningococcal.

Anna Jaques, a non-profit Hospital in Newburyport, Massachusetts has taken extra measures and brought more doctors and experts on anna_jaques_hospitaltheir team to prepare themselves if a patient with Ebola or Meningococcal B comes to their door.

Anna Jaques is a remarkable medical facility housed with some of the top health care professionals North of Boston.

Frank Magliochetti

With 2016 being the year of medical innovations, the vaccine for Meningococcal B has come as a godsend that will save millions of lives in rural areas where this disease is commonly found. The vaccines are set to be released worldwide by the end of the year.

Other News and information on Trumenba and Bexsero

Trumenba Offical Website:

Important Safety Information

  • Trumenba should not be given to anyone with a history of a severe allergic reaction after a previous dose of Trumenba
  • Individuals with weakened immune systems may have a reduced immune response
  • The most common adverse reactions were pain at the injection site, fatigue, headache, muscle pain, and chills
  • Data is not available on the safety and effectiveness of using Trumenba and other meningococcal group B vaccines interchangeably to complete the vaccination series
  • Tell your healthcare provider prior to the vaccination if you are pregnant, or plan to become pregnant
  • Ask your healthcare provider about the risks and benefits of Trumenba. Only a healthcare provider can decide if Trumenba is right for you or your child



  • Trumenba is a vaccine indicated for individuals 10 through 25 years of age for active immunization to prevent invasive disease caused by Neisseria meningitidisgroup B
  • Trumenba is approved based upon demonstrated immune response against four group B strains representative of prevalent strains in the US. The effectiveness of Trumenba against diverse group B strains has not been confirmed


Official Site

Important Safety Information


BEXSERO is a vaccine indicated for active immunization to prevent invasive disease caused by Neisseria meningitidis serogroup B. BEXSERO is approved for use in individuals 10 through 25 years of age.

Approval of BEXSERO is based on demonstration of immune response, as measured by serum bactericidal activity against three serogroup B strains representative of prevalent strains in the United States. The effectiveness of BEXSERO against diverse serogroup B strains has not been confirmed.Bexsero_logo_4C_temp_norDNA_bigger

  • BEXSERO is contraindicated in cases of hypersensitivity, including severe allergic reaction, to any component of the vaccine, or after a previous dose of BEXSERO
  • Appropriate observation and medical treatment should always be readily available in case of an anaphylactic event following the administration of the vaccine
  • The tip caps of the prefilled syringes contain natural rubber latex, which may cause allergic reactions in latex-sensitive individuals
  • Syncope (fainting) can occur in association with administration of BEXSERO. Ensure procedures are in place to avoid injury from falling associated with syncope
  • The most common solicited adverse reactions observed in clinical trials were pain at the injection site (≥83%), myalgia (≥48%), erythema (≥45%), fatigue (≥35%), headache (≥33%), induration (≥28%), nausea (≥18%), and arthralgia (≥13%)
  • Vaccination with BEXSERO may not provide protection against all meningococcal serogroup B strains
  • Vaccination with BEXSERO may not result in protection in all vaccine recipients

AAP issues meningococcal B vaccine ( Trumenba & Bexsero)  guidelines for adolescents
Trumenba and Bexsero have both been approved for the prevention of serogroup B meningococcal disease in individuals aged 10 through 25 years by the American Academy of Pediatrics Committee on Infectious Diseases.

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Pfizer heads back to school with Trumenba vaccination campaign

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Teaching kids to share is usually a parental goal, but a new ad from Pfizer may have some parents rethinking the parameters.

The first campaign for meningococcal group B vaccine Trumenba highlights the dangers of MenB, which can be spread through habits common among teens–including kissing and sharing drinks and food.

The TV ad shows a mother in the hospital with her stricken son, asking “how did we get here?” The ad then goes back through events earlier in evening showing the son sharing food and drinks with several different friends at a party and kissing a girl.

“The campaign was designed to reach parents of teens and young adults during the summer and back-to-school season, when many parents are thinking about steps they can take to help protect their child’s health, including vaccination,” she said.

Trumenba is one of two vaccinations to protect against MenB, along with GlaxoSmithKline’s Bexsero. But last year, the CDC’s Advisory Committee for Immunization Practices (ACIP) stopped short of granting the pair universal recommendation. The vaccines are recommended for young adults ages 16 to 23, with a preferred age of 16 to 18, which means that doctors decide on an individual basis whether to vaccinate their patients against MenB.

watch the ad on

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.