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Remdesivir Will Not Be Enough to Curb COVID-19, Study Finds

By Robin Foster and E.J. Mundell
HealthDay Reporters

SATURDAY, May 23, 2020 (HealthDay News) — There have been high hopes that the antiviral drug remdesivir might be an answer to the pandemic of COVID-19. But a major, new study finds the drug on its own won’t be enough to significantly curb cases and deaths.

The study, published May 22 in the New England Journal of Medicine, found that, “given high mortality [of patients] despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient.”

It’s sobering news as Americans embark on a holiday weekend in the shadow of more than 1.6 million cases of COVID-19 and nearly 96,000 deaths.

The study of 1,063 COVID-19 patients was led by Dr. John Beigel and Dr. Clifford Lane at the National Institute of Allergy and Infectious Diseases (NIAID). The researchers found that remdesivir, delivered by infusion, did help ease the illness: Patients who got the antiviral recovered after an average of 11 days versus 15 days for those who hadn’t received it.

Patients who were so sick they required supplemental oxygen, but did not need a ventilator to breathe, appeared to benefit most from remdesivir.

But the difference in the overall death rate — 7.1% of patients on the drug vs. 11.9% of those who didn’t get it — did not reach statistical significance, the researchers said.

The study does suggest that early treatment works best. “Our findings highlight the need to identify COVID-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation,” the researchers said.

Early evidence had suggested that remdesivir might help fight coronavirus illness, so the U.S. Food and Drug Administration gave it “emergency use authorization.” The new trial is significant because it is the first double-blind, placebo-controlled trial to test the drug in patients. Double blind means that neither doctors nor patients knew whether remdesivir or a placebo was being used in a particular case.

Already, combinations of remdesivir and other drugs are being tried, to see if dual-drug treatments might boost outcomes even more. For example, one federally funded clinical trial is combing remdesivir with a potent anti-inflammatory drug called baricitinib, while a trial from biotech firm CytoDyn is pairing it with an antiviral called leronlimab.

Vaccine efforts continue

Meanwhile, the search for an effective vaccine goes on. The U.S. Department of Health and Human Services (HHS) said Thursday it would provide up to $1.2 billion to the drug company AstraZeneca to develop a potential coronavirus vaccine from Oxford University, in England.

The fourth, and largest, vaccine research agreement funds a clinical trial of the potential vaccine in the United States this summer with about 30,000 volunteers, The New York Times reported.

The goal? To make at least 300 million doses that could be available as early as October, the HHS said in a statement.

However, many experts have said that the earliest an effective, mass-produced vaccine would be available won’t be until sometime next year, and billions of doses would be needed worldwide.

The United States has already agreed to provide up to $483 million to the biotech company Moderna and $500 million to Johnson & Johnson for their vaccine efforts. It is also providing $30 million to a virus vaccine effort led by the French company Sanofi, the Times reported.

Meanwhile, all 50 states have started reopening their economies ahead of the Memorial Day weekend, more than two months after the new coronavirus first forced America into lockdown.

States in the Northeast and on the West Coast, as well as Democratic-led states in the Midwest, have moved more slowly toward reopening, the Times reported. But a number of states in the South opened earlier and more expansively, albeit with social distancing restrictions in place, the newspaper said.

Luckily, new data shows the number of new coronavirus cases in the country has begun to drop.

According to the Times, in New York state case counts have dropped over the last month, and they have also plunged in hard-hit Massachusetts and Rhode Island. Some states, including Vermont, Hawaii and Alaska, are seeing hardly any new cases at all, the newspaper said.

According to a Times tally, the top five states in coronavirus cases as of Saturday are: New York with almost 363,000; New Jersey with nearly 153,000; Illinois with nearly 106,000; and Massachusetts and California with nearly 91,000 each.

Testing issues continue

Of course, testing will be key to further efforts to control the spread of the new coronavirus. But only about 3% of the population has been tested.

Meanwhile, a survey from the Washington Post reveals another dilemma: Though tests for the virus are finally becoming widely available, too few people are lining up to get them.

The poll of governors’ offices and state health departments found at least a dozen states where testing capacity outstrips the supply of patients.

Why aren’t more people getting tested? “Well, that’s the million-dollar question,” Utah Health Department spokesman Tom Hudachko told the Post. “It could be simply that people don’t want to be tested. It could be that people feel like they don’t need to be tested. It could be that people are so mildly symptomatic that they’re just not concerned that having a positive lab result would actually change their course in any meaningful way.”

And a new report finds that millions more Americans are venturing out in public.

From March 20, when states began urging people to stay home, to April 30, when many states started easing those restrictions, 43.8% of U.S. residents stayed home, a Times analysis showed.

But last week, only 36.1% of Americans stayed home.

What is the Wuhan coronavirus?
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Serious illness in kids

Meanwhile, troubling news has emerged from New York City: A total of 89 children have contracted a new, serious inflammatory syndrome that seems to be linked to COVID-19 infection, the city’s health department reported on Thursday. Forty-three other suspected cases are still under investigation.

The CDC has confirmed the link, New York City Mayor Bill de Blasio said this week, adding that the city will work under the CDC’s latest definition of what it now calls multi-system inflammatory syndrome in children.

“The CDC has confirmed a link to COVID-19. This is important, we assumed it, but they have done additional research to 100 percent confirm it and released a national standard definition,” de Blasio told NBC New York.

The syndrome affects blood vessels and organs, and has symptoms similar to Kawasaki disease and toxic shock.

A small number of cases have been reported in other states, including New Jersey, California, Louisiana and Mississippi, the Times reported. At least 50 cases have been reported in European countries.

As New York City officials grappled with how to track and treat this new condition, an Italian study published in The Lancet medical journal described similar cases that cropped up in that country.

Between Feb. 18 and April 20, there were 10 cases of young children hospitalized with the inflammatory condition in the Lombardy region of northern Italy. In the five years leading up to the middle of February, only 19 children in that region had ever been diagnosed with the condition.

All 10 children survived, but they had more severe symptoms than those diagnosed with Kawasaki disease in the previous five years.

Americans still nervous about reopening

Across the country, reopening plans proceed, with all states relaxing social distancing measures this Memorial Day weekend, CNN reported. But polling shows that most Americans fear that reopening will trigger a second wave of infections.

Of the 1,056 adults surveyed between May 14 and May 18, 83% said they’re at least somewhat concerned that easing restrictions will result in a new surge of infections, with 54% saying they’re very or extremely concerned, according to the Associated Press-NORAC Center for Public Affairs Research poll.

With reopening, it’s essential for people to return to self-quarantine if they are exposed to the virus, about 80% of respondents said.

About 6 in 10 said widespread testing for the coronavirus is necessary to resume public activities, along with requiring people to stay six feet apart in most places and to wear face masks when they’re near others outside their homes.

Nearly half of the respondents said it’s crucial for a vaccine to be available before public life resumes, while another third said that’s important, but not essential.

Nations grapple with pandemic

In Asia, where the coronavirus first struck, several countries are finally returning to a new normal.

In China, public officials are testing all 11 million residents in the city of Wuhan this week in the hopes they can extinguish any remaining cases of coronavirus in the pandemic’s original epicenter, the Post reported.

But a small cluster of cases in the northeastern province of Jilin has prompted officials to employ many of the strict lockdown measures that were used in Wuhan, the Times reported.

Meanwhile, South Korea began a phased reopening of schools this week, starting with the oldest students. Some 450,000 third-year students returned to their high schools under a set of strict social distancing guidelines, the Post reported.

Elsewhere, the situation remains challenging. On Saturday, the United Kingdom’s coronavirus death count passed 36,000, the second highest in the world, according to a Johns Hopkins University tally. Britain has now surpassed Italy, Spain and France for COVID-19 deaths in Europe.

Brazil looks like it might become the next hotspot in the coronavirus pandemic. By Saturday, the South American country had reported over 21,000 deaths and over 330,000 confirmed infections, according to the Hopkins tally.

Cases are also spiking wildly in Russia: As of Saturday, that country reported the world’s second-highest number of COVID-19 cases, the Hopkins tally showed. Russia now has nearly 336,000 cases. Only the United States has more cases.

Worldwide, the number of reported infections passed 5.2 million on Saturday, with almost 339,000 deaths, according to the Hopkins tally.

Copyright © 2020 HealthDay. All rights reserved.


SOURCES: New England Journal of Medicine, May 22, 2020; Associated Press; The New York Times; Washington Post; CBS News; NBC News, The LancetNew York City Dept. of Health and Mental Hygeine

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