Vaccine for virus just part of battle
As with HIV, researchers focus on array of drugs
A vaccine may not be enough to end the coronavirus pandemic and restore society to some semblance of normalcy, according to doctors and researchers who say effective treatments for COVID19 are equally important.
While many parts of public life, from crowded stadiums to San Francisco’s beloved cable cars, are on hold until the threat posed by the virus abates, a vaccine alone will likely not allow those functions to resume. And even if scientists find a vaccine that works and is safe, it may take a long time to reach everyone who needs it.
In the meantime, millions of people will continue to become ill with the coronavirus. So researchers across the globe are racing to find drugs that can keep more people alive and out of the hospital — and any one of those treatments
may ultimately work just as well as a vaccine.
“I’d much rather put my money on the drugs rather than the vaccine for now,” said Dr. Lee Riley, an infectiousdisease expert at UC Berkeley’s School of Public Health.
A drug could function similarly to a vaccine if it can prevent people from transmitting the virus in addition to improving their symptoms, Riley said. For example, people can protect themselves from being infected with HIV by regularly taking a preexposure prophylaxis, or PrEP, a pill sold under the brandname Truvada and made by Foster City’s Gilead Sciences.
To accomplish something similar for the coronavirus, drug makers would need to develop a pill that people could take as soon as they begin having symptoms or even as a preventative measure akin to Truvada, Riley said. If a drug along those lines works to prevent people from falling ill with COVID19, people can start going back to work and school much more easily, he said.
None of that is to say that the nearly 200 potential vaccines under investigation worldwide are unnecessary.
“We have to focus on both,” Riley said. “It’s not just the vaccine becoming available.”
So far, the highestprofile and most advanced drug used to treat COVID19 is remdesivir, an antiviral medicine that is also made by Gilead. Clinical trials have shown that hospitalized patients who received the drug through intravenous injections recovered faster than those who did not get the treatment, and Gilead revealed data on Friday indicating that remdesivir can help people survive, too. In a recent study of hundreds of coronavirus patients, remdesivir reduced mortality risk by 62%, the company said.
Gilead now is studying an inhalable form of remdesivir. If proved safe, the inhalable version of the drug could be given to patients who are not hospitalized, potentially slowing the spread of the virus.
But remdesivir’s ultimate role is still not clear, and it’s far from the only drug under investigation. Researchers worldwide are studying more than 260 possible treatments for COVID19, according to the Milken Institute. One of those drugs is favipiravir, which Stanford University researchers are testing in people who have been recently diagnosed with the virus but not admitted to a hospital.
Eventually, a more effective way of treating COVID19 may be a “cocktail” of multiple antiviral drugs, said Dr. Warner Greene, a senior investigator with the Gladstone Institutes in San Francisco. Such a combination could help “nip this thing in the bud” and prevent many patients from being hospitalized while also reducing the virus’ spread, he said.
“It would be a wonderful bridge to a safe and effective vaccine,” Greene said. “Some of the pressure would be removed and we could move at a more deliberate pace . ... In our need for speed, we cannot cut corners in terms of the safety of a coronavirus vaccine.”
The scale of the pandemic may require several vaccines due to resource constraints that would prevent any one vaccine from getting around the world quickly, he said. And the earliest one that works might not be as effective as the ones that come later.
“I’m not sure I want to take the first vaccine — I want to take the best vaccine,” Greene said.
The need for COVID19 drugs will not evaporate once vaccines are available. That’s why Anixa Biosciences, a Bay Area biotech company, is trying to develop treatments from scratch instead of repurposing drugs developed for other illnesses.
Using artificial intelligence to screen a vast computer database, Anixa has identified four compounds that could become coronavirus drugs. CEO Amit Kumar said he thinks of it as a backup strategy — in case a vaccine proves elusive — or “a transition approach.” Though he wants to see a vaccine become available, he said drugs to treat COVID19 aggressively will remain just as necessary for the foreseeable future.
“A lot of things have to work out right in order to get a vaccine in (a) short period of time,” Kumar said. “Longer term, I think a better solution is a therapeutic — and by therapeutic, I mean something that really is very easy to administer and something that can be administered at home.”
The most effective treatments should not only reduce the percentage of coronavirus patients needing to be hospitalized but also shorten the time they are symptomatic and curb transmission of the virus, said Dr. Annie Luetkemeyer, a UCSF infectiousdisease expert. Widespread testing and easy access to coronavirus drugs are also paramount, she said.
“Even the best medicine in the world, unless we pair it with those pieces, it’s not going to achieve the results that we want to have,” Luetkemeyer said.
Though the country appears to be facing the pandemic “for the long haul,” she said the public already has one invaluable tool to help resume many aspects of daytoday life in a safer way while scientists continue researching effective drugs.
“It sounds like a broken record, but wearing a mask works to reduce people’s risk of getting infected,” Luetkemeyer said. “It’s cheap, everybody can do it and it makes an enormous difference.”