Every single person participating in the protests against police violence is risking their lives, not just because those standing on the other side of the line might decide to employ deadly force, but because the coronavirus pandemic is still raging. In fact, that pandemic has affected the Black community at a much higher rate. The people taking to the streets of America’s cities are in many cases those who are most aware of what’s at stake, and most likely to have suffered personal loss because of COVID-19. It just happens that they also know that at this moment, the risk does not diminish the need to protest injustice.
In most cities, the vast majority of protesters have been careful to wear masks, and to stay as safe as possible under the far from ideal circumstances. But the possibility that Black communities will face a resurgence of COVID-19 in the wake of what’s happening now is very real. With any effective vaccine still months away, the best option for reducing the effects of COVID-19 through the summer and fall might be the emergence of an effective treatment. So, despite everything else that’s dominating the headlines on Tuesday, here’s a look at four treatments—not vaccines—that may be available for those battling COVID-19.
Remdesivir
First up, a look at a treatment that has already been in the news several times and which has become something of a standard treatment, to the limits of its highly restricted availability: broad-spectrum antiviral Remdesivir from pharmaceutical company Gilead Sciences.
After some early trials gave apparently good results and suggested that a daily injection improved the outcome and shortened the recovery time of COVID-19 patients, Remdesivir was given approval for emergency use in the United States and Japan. The drug also gained at least a tacit endorsement from Dr. Anthony Fauci, who pointed out both the apparent benefits and relative safety of the drug.
However, even as a medium-scale U.S. trial was indicating an improved outcome for patients taking the anti-viral, British medical journal The Lancet published a smaller Chinese trial finding no evident benefit. And now the The New England Journal of Medicine has published the results of a phase 3 trial, and those results are … puzzling at best.
In this trial, all of the 397 patients had COVID-19 severe enough to cause pneumonia and low blood oxygen levels. All those who participated received Remdesivir, with some getting a five-day course of treatment, and others having treatment extended to ten days. Two weeks in, 64% of patients getting five days of treatment had significantly improved. However, for the group treated for ten days, the rate of improvement was just 54%. So, at the very best, taking Remdesivir for an extended period was no better than taking it for a short period, and since there was no control group in this study that didn’t receive the drug at all, it’s unclear just how much improvement, if any, there was above standard care without the anti-viral.
At the very least, these results have cast a cloud over the effectiveness of Remdesivir, and analysts at Barron’s suggest that these results, along with the marginal improvement reported in the first study, may prevent the drug from being more widely used. It certainly doesn’t appear to be the kind of highly effective “silver bullet” that everyone would like to see.
LY-CoV555
One of the approaches that genuinely appears to be successful at this stage is treatment of COVID-19 patients with serum or concentrated antibodies collected from those who have recovered from the disease. This treatment has proven to provide limited, short-term immunity to other coronaviruses, and it’s no surprise that plasma from survivors has become a hot commodity.
It’s also no surprise that several companies are working on treatments that are essentially synthesized forms of these antibody proteins. This kind of monoclonal antibody therapy has proven effective against a number of diseases, including Ebola. Unlike a broad spectrum antibiotic like Remdesivir, or a drug for a wholly different purpose like Trump’s beloved hydroxychloroquine, this would be a treatment aimed solidly at the SARS-COV-2 virus, making it a high priority in many labs. That includes pharmaceutical giant Eli Lilly, which announced on Monday that it has begun human trials of a monoclonal antibody therapy which (for the moment at least) has the ungainly moniker of LY-CoV555.
The drug is based on work by biotech firm AbCellera, which identified antibodies to COVID-19 from one of the first U.S. patients to recover. There’s a potential that it could either treat people who have COVID-19, or provide immunity lasting for weeks or months for those who have not been infected. The potential is such that Eli Lilly announced it is moving to full-scale production in advance of trials, making this one of several significant monetary gambles going on in Big Pharma connected to COVID-19.
This is a phase one trial, meaning that it’s only concerned with the drug’s safety, rather than how effective it is in either preventing or treating COVID-19. However, the results of this test are expected to be available later in June, and assuming the drug is well tolerated, Eli Lilly will immediately move to phase two trials to determine effectiveness. And if that goes well, the drug could theoretically be available “by autumn.” Take with two massive grains of salt and call me in the morning.
But if everything goes right … hang on a second … IF everything goes right, this treatment could help those already infected, and be a bridge until an actual vaccine arrives.
Leronlimab
Just mentioning this because it was in the list from three weeks ago when maker CytoDyn indicated that this treatment, originally aimed at HIV, showed promise in an early trial. CytoDyn has promised more trial results this month concerning an emergency investigation approved by the FDA (including a Tuesday call to which I am not privy), so there should be more to say about the drug soon. Like Remdesivir, early results had indicated improvements, but not a “cure.”
Avifavir
Ever notice how Russia manages to be near the top of the COVID-19 charts in terms of confirmed cases, but reports a rate of deaths far below that of other nations, including the United States? The suspected reason for this is the high rate of defenestration among doctors who might be tempted to give an accurate count. But even if Putin is doing a DeSantis-writ-large, it’s still possible they have found a means to reduce the deadliness of the disease. And part of that miracle could be Avifavir.
This is another anti-viral, based on an existing medication for flu and produced in conjunction with a firm in Japan, where the new product is known as Avigan. Russian officials and news agencies have been praising the drug, saying that it is a “major step forward” and that it has shown “high efficacy” in treatment of COVID-19 during trials in Russia.
According to Russian news agency TASS, a ten-day trial of Avifavir produced no safety concerns or side effects while having a “efficacy above 80%.” Whether that means that 80% of patients recovered, or that 80% recovered more quickly, or that they … nope, honestly, I don’t know what that means.
To be clear, Russia isn’t actually claiming that Avifavir is responsible for the relatively low rate of death in Russia (I believe the actual official line is … leadership), but they are planning to make the drug available this month for possible trials outside Russia.