Ray of Hope

Matters of The Moment

Worldwide tests with anti-viral drug remdesivir show that patients who were treated with it recovered faster and had a shorter time of recovery

By Mrinal Roy

After four months of battling against the deadly Covid-19, there is finally a ray of hope. Research has shown that the anti-viral drug remdesivir is highly effective in inhibiting a key enzyme of coronavirus responsible for the replication mechanism of Covid-19.

A government-run study carried by the US National Institute of Allergy and Infectious Diseases as well as White House immunologist Dr Anthony Fauci revealed that worldwide tests with anti-viral drug remdesivir showed that patients who were treated with it recovered faster and had a shorter time of recovery. Dr Fauci added that ‘it has proved that the world has a drug that can block this virus.’ On 1 May the American biopharmaceutical company Gilead Sciences, Inc which developed remdesivir announced that the US Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for the investigational antiviral remdesivir to treat Covid-19.

Remdesivir will become available to US hospitals in the coming week to treat some 150,000 to 200,000 Covid-19 patients with 1.5 million vials of the drug donated to the US government by Gilead Sciences. It will take some time before the antiviral drug remdesivir is produced to be more widely available hopefully at reasonable cost to treat Covid-19 patients.

Remdesivir provides treatment not a cure. Several companies are thus working on existing antiviral drugs, some of which are already in use against other illnesses to adapt them to treat patients infected with Covid-19. Photo aljazeera.com

Remdesivir provides treatment not a cure. Scientists around the world are working on potential treatments and effective vaccines against Covid-19 to stem the pandemic, minimize its dire impact on the world and save lives. Researchers are exploring diverse pathways to combat the virus. Several companies are thus working on existing antiviral drugs, some of which are already in use against other illnesses to adapt them to treat patients infected with Covid-19.

Treatments such as remdesivir thus help the world buy time until the discovery of a safe and effective vaccine. It is evident that the post Covid-19 normality will be significantly different from the pre-Covid-19 situation. The world would have to reinvent and adapt itself to operate in a sustainable manner in the context of a materially different new world order. We first need to stop the virus. This necessarily means finding an effective vaccine.

Protracted validation process

There are over 120 Covid-19 vaccines candidates in the research pipeline in different stages of development in the world. Their progress is being tracked and monitored by the World Health Organization.

It could take between 9 months to 2 years to develop a vaccine. World leaders have this week pledged $ 8 billion to fund laboratories that have promising leads in developing and producing a vaccine. The US is also investing billions of dollars into its own research efforts. The world desperately needs a vaccine which provides robust immunity against Covid-19. To meet this key goal, the world needs an unflinching solidarity and cooperation among nations. Ideally, we would want a vaccine which is 100 percent effective. However, this is not always the case. A vaccine that is at least 70 percent effective will be enough to stop the outbreak. This year’s flu vaccine is only around 45 percent effective.

The safety and efficacy of a new vaccine will have to be tested and validated though a protracted process where human trials of the vaccine with different doses are effected in stages to increasingly larger groups of volunteers including people from different age groups and health conditions in accordance with a well established protocol. The whole process must be reviewed independently and validated before being submitted to the WHO and various government agencies for approval. The production of some 7 billion doses to be distributed and administered to the world population also needs to be urgently organized. This is intrinsically a long drawn process.

The established protocol and steps for trials, testing and validation are sequential to ensure at every step that all pathological questions and safety norms have been satisfactorily addressed. Investors want to make sure that each step is comprehensively validated before investing into the next step. This is an emergency situation. The world is ready to support whatever it takes to find a vaccine which can stop Covid-19. Bold actions are required. There is therefore a growing urgency to reduce the timeline of finding a safe and effective vaccine by financially supporting scientists and researchers to save time by carrying out under the highest safety precautions required several of the development steps at once.

We know that the vaccine developed by the University of Oxford in the UK has already started human trials. In a bid to save time in the race to swiftly provide an approved vaccine to the world to defeat Covid-19, The Serum Institute of India, the world’s largest vaccine maker has thus taken the initiative and risk to start mass production of the Oxford vaccine and produce 40 million units which will be made available at a nominal cost, even before the vaccine has reached advanced clinical trials, without knowing if it works.

Every day that can be saved in the process of validation and dissemination of a safe and effective vaccine will make a huge difference to the world in terms of saving lives and reducing trillions of dollars in economic damage.

So long as a safe and effective vaccine is not discovered and validated for worldwide use, strict compliance with social distancing and hygiene rules in place as well as the wearing of masks will be part of the new normal. The easing of prevailing lockdown restrictions across the world can only be envisaged in a sustainable, very well-thought-out step by step process when statistics relating to new cases of Covid-19 infection, number of deaths, elimination of hotspots of infection and level of testing for Covid-19 show that the spread of the virus is robustly contained in the country concerned. Any rash or premature lifting of restrictions carries the potent risk of a costly second surge of infection of the virus and of significantly delaying a return to a modicum of normality in the world.

Getting our priorities right

The US situation is a case in point. According to forecasts based on modelling by the US Centers for Disease Control and Prevention and the Federal Emergency Management Agency made public this week, the death toll could rise to 3000 Americans a day by 1 June, up from a current daily toll of about 2000, in the wake of the relaxation of restrictions in a host of States across the US in an attempt to revive the economy and employment in a country with very little social protection. They also forecast about 200,000 new cases of infection each day by the end of the month, up from about 25,000 cases now. Will these chilling forecasts come true?  Are the stakes of the US presidential elections in November 2020 clouding a sensible and safe management of the pandemic?

The future will therefore depend on the strategies adopted by each country to robustly contain and stem the spread of the virus. It will also depend on the manner each country prioritizes its objectives and judiciously arbitrates the cardinal issue of saving lives as opposed to saving the economy bearing in mind that it is those who depend on work to assure their livelihoods who are the principal casualties of a pandemic.

* Published in print edition on 8 May 2020