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COVID-19: THE CASE FOR THERAPEUTICS

Artesia Mayor Ali Sajjad Taj

 

By Artesia Mayor Ali Sajjad Taj • May 13, 2020

 

Winston Churchill once said, “You can always count on the Americans to do the right thing after they have tried everything else.”

While it is true that we were caught flat-footed with testing at the start of this Pandemic, American science is catching up.

Remdesivir by Gilead,a Californian pharmaceutical company, is the first drug that has scientifically been proven to be effective against COVID-19. The treatment is a repurposed drug that was originally developed for other diseases.

Results showed a 31% faster time to recovery in patients treated with Gilead’s drug versus a placebo. The median time to recovery was 11 days versus 15 days, respectively.

NIH also noted a survival benefit, where the Remdesivir group had an 8% mortality rate compared to 11.6% with placebo.

This is preliminary data on very sick patients. I have faith in American doctors that they will find even smarter ways to administer this treatment in less severe patients and stop them from becoming more severe. In other words, it is reasonable to expect better numbers with clinical experience.

This drug is not a knockout punch but is a significant first step and has public health policy implications.

The hospital capacity increases by about 30 percent since people are spending 30 percent less time in the hospital; that means the hospital is now treating 30 percent more people.

This is especially important because we could have higher fatalities if hospitals are overwhelmed. Survival rates would decline if the hospital is not able to provide care for the sick.

In other words, this scientific breakthrough, in effect, has added at least 30 percent more beds for COVID-19 patients; and quite possibly more as American doctors will learn to use the drug more effectively.

A vaccine is an ultimate solution and everyone is doing their best to get a vaccine out by the end of this year or January 2021.

We should keep in perspective that a vaccine has to be given to 7 billion people in the world, 320 million in the United States. This is a huge logistical and production undertaking. It will take time to get the entire population vaccinated even if we were to be able to meet this ambitious goal.

We should, of course, work for the vaccines and do our best. However, we should also consider that the virus may not infect the entire population.
It certainly does not make everyone sick; most infected people don’t even know they were infected.

Therefore, developing an effective treatment may be just what we need. Remdesivir may be the foundation and it could be married up with other treatments. There are dozens in the works and I am optimistic that we will have something like Rengeron’s Antibody platform by the summer. 

There are many other promising candidates which could, in combination with Remdesivir, independently reduce mortality by 80 percent. This could bring COVID-19 mortality to flu levels by mid-summer.

There are so many promising treatments that I do believe American science will solve this very soon. From a public policy standpoint, it is much easier to treat people who need treatment. Those in need of treatment will be between 2-3 million if the entire country were exposed and infected.
Treating 2-3 million would be easier versus vaccinating 300 million people, who may be hesitant about getting injected with a very rushed vaccine.

Additionally, it may take a long time to develop a vaccine that is effective. While it is all hands-on deck and resources are being thrown at dozens of potential vaccines, we must note that the quickest we have ever developed a vaccine in the past is 4 years.

Therefore, we must plan with what we have. This would be therapeutics coupled with targeted testing and contact tracing. This is the only way forward, i.e., to open with some variant of the Swedish model, where we keep the virus at a manageable level. This will ensure that our hospitals are not overwhelmed while we continue to work on better therapeutics.

Once we have a vaccine that works, we require smart strategies and the cooperation of the population so that we can keep adding to the arsenal of therapeutics.

 

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