Sunday, May 24, 2020

It's Not a Magic Bullet But Who Says No to The Next Best Thing.

At a time when medical experts are questioning whether there will ever be a vaccine to defeat the Covid-19 virus there's good news on the anti-viral front.

Anti-virals alleviate some of the damage caused by the novel coronavirus. They can improve the chances of survival, speed up recovery times, and sometimes moderate some of the damage even survivors sustain.  People will still die, just not so many.

One of the most promising is Remdesivir.  Now, finally, the test results have been released.
The long-awaited study, sponsored by the National Institute of Allergy and Infectious Diseases, appeared on The New England Journal of Medicine website on Friday evening. It confirms the essence of the government’s assertions: Remdesivir shortened recovery time from 15 days to 11 days in hospitalized patients. The study defined recovery as “either discharge from the hospital or hospitalization.”

The trial was rigorous, randomly assigning 1,063 seriously ill patients to receive either remdesivir or a placebo. Those who received the drug not only recovered faster but also did not have serious adverse events more often than those who were given the placebo.

It was an international trial, although most sites were in the United States. Patients were assessed daily, and those administering the evaluations did not know whether a patient had been given remdesivir or the placebo.

A monitoring board reviewed the data at specified intervals and called for a halt to the study when there was clear evidence that the drug was effective.

On April 29, N.I.A.I.D. issued a news release stating as much. But infectious disease doctors were frustrated, because they did not have access to the findings, which might have affected how patients were treated.

“For God’s sake, this is a pandemic — we need some data,” said Dr. Judith Feinberg, vice chair of research at West Virginia University School of Medicine.

Publication of the paper has brought some relief. Doctors had been wondering, for instance, whether they should give remdesivir to patients with the most serious Covid-19 cases or to those who weren’t as sick, especially if there were not enough to go around.

Dr. Andre Kalil of the University of Nebraska, a principal investigator of the study, noted that not only do sicker patients fare as well on remdesivir, but their average time to recovery is also slightly faster.

He added that Hispanics, black people and white patients all derived equal benefit from the drug, as did men and women as well as adults in every age group.
The results were the same for patients regardless of whether they had received the drug treatment before or after 10 days of symptoms, said Dr. Helen Chu, of the University of Washington, who was also an investigator of the study.
Are anti-virals the answer to Covid-19? Of course not. They can, however, make the disease more survivable and reduce the lasting damage sustained by those survivors. They don't eliminate the need for precautionary measures either. Think of them more like airbags and seatbelts. If you're old enough to remember driving around with drum brakes and bias-ply tires, you'll understand what I'm getting at.


Update:  Japan has been using Remdesivir in its hospitals since May 11th.
Japan has begun treating severely ill Covid-19 patients with Gilead Sciences Inc's Covid-19 remdesivir drug, a health ministry official said, just days after giving the drug emergency approval as it seeks to curb the coronavirus outbreak.

With no other approved treatments for COVID-19, interest in the drug is growing around the world. Administered by intravenous infusion, it was granted authorisation on May 1 by the US Food and Drug Administration for emergency use.
While the drug, first developed to treat ebola, appears promising there remains some controversy whether it improves survival rates. There is also concern about potential side effects for those with already compromised liver or kidney function.

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