Some reason for hope in the fight against COVID-19

Some reason for hope in the fight against COVID-19, via the tremendously thoughtful (and plugged-in) Safi Bahcall, who is also the author of the superb book, Loonshots.

Safi sent this e-mail to a group of us, and said it would be fine for us to share it more widely. Here it is:

"I mentioned briefly why I have a bit more optimism about Covid-19 than you see in the media (based on my 20 or so years in drug development).

Much of the media attention is on a vaccine. Progress on a vaccine will be important. It's also likely to be faster than the 12-18 mo timeline typically quoted (the leading contender, typically quite conservative, guided to the fall for limited roll-out to healthcare workers).

Vaccines however are for preventing infection. What's often missed is the sheer volume of therapies now in development for treating the infection. Of the 114 in development, roughly four dozen will have data in the next 8 weeks. Those are drugs that could transform the course of the disease: reducing fatality rates + hospital stays.

Drug discovery is a shots-on-goal game, not an anecdote or magic-bullet game. And we have more shots on goal, moving faster, against this disease than any of us in the industry have ever seen in our lifetimes, including infections we've succeeded in curing or controlling: HIV, TB, Hep C, even Ebola.

In any case - on our last call I mentioned one of the drugs that those in biotech are most excited about, with imminent data, is Gilead's antiviral remdesivir.

Yesterday evening they published their first results. It's a small study, with the most important data still to come (from the first of the many clinical trials) -- but they are encouraging (read the NEJM article here). Of those who received the drug:

68% (36 of 53 patients) had improvement in oxygen support; only 15% worsened

57% (17 of 30) on ventilators improved enough to be taken off ventilators

3 of 4 on ECMO improved enough to be taken off the machine (ECMO is for the most severe cases - the machine that pumps + oxygenates blood outside the body)

When we succeed against treating bad bugs this is how it starts. Early signs of clinical activity from one mechanism of action (one way of attacking the bug). Then you combine with another drug, with a different mechanism. Then a third. Army, navy, air force - and it's done. Cocktail therapy. That's how it worked with TB, HIV, Hepatitis C, etc.

More context (+ short story of Judah Folkman, one of my heroes) in my post here - Counting the Arrows in Your Ass

Hope this is helpful. The data last night certainly made my weekend brighter.

Safi"