The Medical Futurist | 11 min | 31 October 2019

A leap from bits to qubits: this two-letter change could mean entirely new horizons for healthcare. Quantum computing might bring supersonic drug design, in silico clinical trials with virtual humans simulated ‘live’, full-speed whole genome sequencing and analytics, the movement of hospitals to the cloud, the achievement of predictive health, or the security of medical data via quantum uncertainty. Jaw-dropping, isn’t it?

Quantum supremacy, light bulbs, and 42

If you want annoying people to stay away from your birthday party or scare off unwanted relatives from visiting, just start to talk about quantum computing or how Google reached ‘quantum supremacy’ a couple of days ago. Some maybe ask back whether Deep Thought, the highly intelligent computer from The Hitchhiker’s Guide To The Galaxy counts as a quantum computer, but most of them will leave without a word and with a bottle of overpriced rum you brought from the Caribbeans. However, for a few interested folks, you should actually tell the story of how Google’s 54-qubit computer was able to complete a task in 200 seconds that Google estimated would take over 10,000 years on non-quantum, traditional computers. It is leaping into the future by lighting speed. But for all the fanfare, critics, such as Christopher Monroe, a physicist at the University of Maryland and co-founder of the quantum computing startup IonQ, say that Google’s paper might be a milestone in quantum computing, but it was an academic one. We are still far from practical applications.

Still, how does quantum computing differ from regular computing? While we don’t really want to go down the rabbit hole of technicalities as the team is rather far off from quantum physics, as far as we understand it this is not just a better and faster way of computing – it has a fundamentally different basis. Just as with the candle and the light bulb: while both throw out light, you know that the latter is definitely not an upgraded version of the former. But okay, let’s see quantum computing in a tiny bit more detailed manner.

As Shohini Gose quantum physicist says in her TED talk, quantum physics describes the behavior of atoms and fundamental particles, like electrons or photons. A quantum computer operates by controlling the behavior of these particles, which is very different from the way our traditional computers work. It isn’t by chance that quantum computers don’t measure their performance in bits, but qubits – while the former resembles either ones or zeros, and thus the mathematical description of problems, the latter signifies states, which can simultaneously take up ones and zeros, or anything in-between. This means qubits have fluid identities or signify certain percentages and probabilities between two endpoints.

As phenomena in nature are not necessarily describable by ones and zeros, quantum computing could open up better ways to simulate nature. As Richard Feynman, Nobel-prize winner theoretical physicist said in his inimitable way, ‘nature isn’t classical, dammit, and if you want to make a simulation of nature, you’d better make it quantum mechanical’. And as the previously mentioned light bulb had the potential to completely transform society, quantum computers have a truly revolutionary way to impact many parts of our lives – including medicine, pharma, and healthcare. Here, we collected all the fields where quantum computing could have a transformative effect.

1) Supersonic drug design

Developing pharmaceuticals through lengthy and costly clinical trials is definitely passé: scientists and pharma companies started to experiment with alternative ways, such as using artificial intelligencehuman organs-on-chips or in silico trials, to speed up the process and make drug discovery and development more cost-effective.

For example, Atomwise uses supercomputers that root out therapies from a database of molecular structures. Its deep convolutional neural network, AtomNet, screens more than 100 million compounds each day. In 2015, Atomwise launched a virtual search for safe, existing medicines that could be redesigned to treat the Ebola virus. They found two drug candidates in less than one day – shortening a months-long searching process. In another example, InSilico Medicine made headlines with the announcement that the process of developing a new drug candidate lasted just 46 days with the help of its smart algorithm.

And what if these smart algorithms would be leveled up as never seen before? Running searches on quantum computers could unfold looking through all possible molecules with unimaginable speed, drug target tests conducted in every potential cell model or in silico human tissues and networks in the shortest amount of time possible. This would open the gates to find the antidote to diseases we never dreamt about before: Alzheimer’s? Various types of cancer? The possibilities seem to become endless.

2) Reaching the age of in silico clinical trials

In silico clinical trials mean that no humans, no animals, not even a single cell is required for testing a particular therapy, treatment option, or drug, yet its impact can be perfectly charted. It means an individualized computer simulation used in the development or regulatory evaluation of a medicinal product, device, or intervention.

Completely simulated clinical trials are not feasible with current technology and understanding of biology – yet, but their development would be expected to have major benefits over current in vivo trials. Quantum computing could greatly advance the building of ‘virtual humans’ and complete simulations such as the HumMod, which features more than 1,500 equations and 6,500 variables such as body fluids, circulation, electrolytes, hormones, metabolism, and skin temperature. It would even open the door to ‘live’ clinical trials with as many virtual patients as possible and with components of the liking of the testersIt would not only massively shorten the time necessary for such trials but also their quality and completeness. Prepare yourself, the age when new drugs reach the market within weeks of the first discovery of their drug candidacy is coming.

3) Sequencing and analyzing DNA full speed

The last two decades saw radical changes in genetics and genomics. It took more than 15 years to crack the code of the human DNA: the Human Genome Project started in 1990, cost billions of dollars and could present its final results in 2006. As a contrast, by now, there are more than 2,000 genetic tests for human conditions – and direct-to-consumer genetic testing companies make it even possible to order them online. These tests enable patients to learn their genetic risks for disease and also help healthcare professionals to diagnose illness. Even whole-genome sequencing is possible for less than a thousand dollars – I also let my genome sequenced by Dante Labs and detailed my experiences here.

Although the technical conditions, the time and the cost of sequencing genomes were reduced by a factor of 1 million in less than 10 years, the revolution lags behind. We believe that quantum computing could give a significant push to the area: faster sequencing, as well as a more comprehensive and faster analysis of the entire genome, will be possiblePlus, predictions will be more reliable as quantum computers could take into account even more information as traditional computers, and they could even build every piece of genomic data into health records. Quantum computing could take out the guesswork from genomics and genetics for ensuring better health for everyone.

4) Making patients truly the point of care

Currently, we are able to measure a gazillion of health data about ourselves – but we know that it’s still not that widespread. In the future, health sensors, wearables, and tiny medical gadgets could send zettabytes of data about patients into the cloud. Just as a comparison: while in 2013, the amount of digital data encompassed 4.4 zettabytes, by 2020 the digital universe – the information we create and copy annually – will reach 44 zettabytes, or 44 trillion gigabytes (!). Quantum computers will be able to make sense of these huge amounts of data, including bits and pieces of health information. Moreover, surveillance of patients through connected sensory systems might render physical hospitals useless – and truly make patients the point of care. Quantum computing could ensure the ‘home front’ for smoothly running these systems.

Yet another possibility of this groundbreaking emerging technology connected to measurements is raising lifestyle prediction to a whole new level. There are already attempts to move from preventive to predictive health, but these are rather sporadic and in their infancy. For example, there is an ophthalmology app that shows the patient how their vision would change with cataract keeping the same lifestyle they have 5 years from now. Using quantum computers, fed by huge amounts of health parameters, genetic information, sensory data, and other personal health information, might be able to give a comprehensive prediction about a given person’s future health. That’s what we could really call predictive health.

5) Arriving at the perfect decision support system

We have long surpassed the era when the accumulated knowledge of medical professionals could ‘reside’ in one professor’s head. It’s just too much. On Pubmed, there are 31 million papers. If a single doctor could read 3-4 studies of their field of interest per week, they could not finish it in a lifetime and meanwhile millions of new studies would come out. That has already been a problem for a while, thus IBM created a supercomputer and its algorithm, IBM Watson, to sift through millions of studies in a second.

Quantum computing would take that to a whole new level and even augment it with special skills. What if such computers could offer perfect decision support for doctors? They could skim through all the studies at once, they could find correlations and causations that the human eye would never find, and it might stumble upon diagnoses or treatment options that the human doctor could have never figured out by themselves. At the very endpoint of this development, quantum computers could create an elevated version of PubMed, where information would reside in the system but not in the traditional written form, but in qubits of data as no one except the computer would ‘read’ the studies anymore.

6) Creating the safest medical data systems ever

In her TED talk, Shohini Ghose mentioned the use of quantum uncertainty for encryption as one of the most probable applications of quantum computing. She believes it could be used for creating private keys for encrypting messages sent from one location to another – so that hackers could not copy the key perfectly due to quantum uncertainty. They would have to break the laws of quantum physics to hack such keys. Imagine that level of security with regards to sensitive medical information: electronic health records, genetic and genomic data, or any other private information that the health system generates about our bodies.

There are already some examples. In January 2018, a joint China-Austria team showed that communication between continents with quantum encryption was possible. The latest breakthrough achieved by this group consists of combining quantum communication from the Micius satellite with the fiber-optic network in Beijing. It is the first practical proof of the technology that allows networks to use quantum encryption is already available. How long will it be before we see a commercial application? We probably won’t have to wait for long.

I bet your jaw dropped. Quantum computing has indeed amazing potential – in theory. However, we still have to wait a lot until any of this can be applied in real life, so this is rather science fiction at the moment. Plus, another problem with quantum computing is that very few people know what it means and understand its workings completely.

What if we apply it to practical solutions, and we won’t be able to grasp anything from it? You could say that you are using hairdryers without understanding their operation, but would you be that relaxed if your doctor didn’t understand the prediction or recommended treatment that came from a quantum computer? How far should we go in relying on technology?

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