The Coronavirus outbreak has crippled the world's economy as people
attempt to slow down the spread of the disease.
What makes the pandemic particularly frightening for many is the lack
of an approved vaccine or treatment of the virus.
So there is no approved therapy for COVID-19.
So physicians in the hospital are generally treating symptoms,
providing supportive care.
That fluids and oxygen and renal replacement therapy is needed.
Really trying to keep the patient alive so the patient has a chance to
recover on their own. One glimmer of hope could be the recent
discovery of a possible treatment Remdesivir.
Manufactured by Gilead sciences.
Data shows that Remdesivir, has it clear cut significant positive
effect in diminishing the time to recovery.
Developing a treatment for COVID-19 is important to help patients that
are critically ill who need either some sort of reduction in side
effects, prevent viral entry into the cells, or in other words, you
know, prevent the disease from progressing.
Knowing how to treat COVID-19 could be a valuable asset in a turning
point in the fight against the pandemic.
So how close are we to developing a treatment?
And why would economic recovery depend on it?
There are several ways to fight a pandemic, but a vaccine that can
help build up immunity against COVID-19 still remains the long term
solution. The vaccine is really the holy grail.
It's the thing that really opens up the possibilities of returning to
a normal way of life.
The problem is it's going to take some time to be approved for mass
use, about 12 to 18 months, according to most experts.
Yet some reports predict that close to half of the global population
will eventually contract the virus while aggressive testing to
contain the spread of the disease still remains a top priority, s
cientists and researchers believe that an effective treatment can
serve as a bridge to a vaccine that will hopefully arrive in the near
future. Developing a treatment for COVID disease is important because
we know that without treatment, there's a high morbidity and
mortality rate. Governments and industries across the world are
combining their efforts in developing a treatment.
U.S. health agencies like the National Institutes of Health have
partnered up with a dozen leading pharmaceutical companies for a
faster collaboration, while more than 70 countries have joined the
WHO to accelerate the research process.
Although President Trump controversially suspended American
contributions to the organization.
They're pooling all of the data that we have about the safety and
efficacy of treatments and making that available to companies to
speed development even faster than its normal.
There are hundreds of treatment options currently under consideration.
On March 24th, the FDA approved the use of convalescent plasma
therapy that uses the blood of recovered patients to treat those in
critical condition. The Mayo Clinic is currently the leading site for
evaluating the efficacy of the therapy.
There's been a lot of news coverage about the plasma therapy, and I
think it's because it should be widely accessible.
It's cheap. And the trials are ongoing right now.
It's a treatment that's actually been around for over 100 years to
combat other diseases like the Spanish flu pandemic of 1918.
So the theory underlying treating somebody with COVID disease with
plasma is that a patient who has previously recovered COVID should
have antibodies and those antibodies should target the virus and
hopefully will neutralize that virus so that the virus stops
replicating. If proven to be effective, plasma therapies can also be
used to protect healthcare workers who are treating patients on the
frontlines. Further testing is still needed to prove its efficacy and
safety before it can be routinely administered to patients.
Right now, we don't know how effective it's going to be.
And so it's important to do these treatments under control study
circumstances so that we can study, do patients who have recovered
from the virus have antibodies?
Do they neutralize?
And do they help make people better as a consequence.
If proved, the challenge also lies in securing enough plasma to treat
those who are in need, a constraint made even more difficult by FDA's
restriction on donations from gay and bisexual men.
The biggest challenge right now is identifying donors and having
donors work through the system in a manner that allows them to donate
plasma efficiently.
The systems are being developed as a new treatment where we're a
therapy or so, and so there's been some growing pains.
But there is now a national effort to coordinate the blood donation
activities. Convalescent plasma therapy is just one of many
therapeutic treatments currently under consideration.
As of April 19th, the FDA revealed that there are 72 treatments
currently going under trial, with an additional 211 alternative
treatments in their planning stages.
Yes, there's a lot of therapies and what individual institutions are
doing and Mayo is one of them, is evaluating those therapies.
Which ones can we access?
Which ones do we think have the most favorable benefit to to
potential side effect ratio and trying to decide which trials we want
to start here. Another possible treatment option that regulators are
heavily leaning towards is repurposing existing medications.
It is very common to use recycled drugs to treat new diseases.
In many cases, we don't have effective therapy, so we use what we
have. Repurposed medications have two unique advantages over working
on a treatment from scratch, time and supply.
They're already available and approved for a different disease in most
markets in the world. So in a perfect world, the fastest way for us
to get a treatment is to use an existing drug and find out through
clinical trials that it works in COVID-19 as well.
Drugs that are normally used to treat other conditions like HIV,
malaria, Ebola and rheumatoid arthritis are currently under trial as
possible candidates to treat COVID-19.
Kevzara a rheumatoid arthritis drug made by Regeneron and Sanofi show
promising results for the sickest of coronavirus patients.
The immune response that you see in rheumatoid arthritis may be very
similar to the immune response that you see in COVID-19.
So you're trying to apply the same concept to a different disease.
There's still an immune response.
Immune response is our immune responses within body.
And so you're trying to affect that immune response with a similar
mechanism.
Even if they are proven safe for human consumption, repurposed drugs
must still go through rigorous additional trials to ensure their
safety and efficacy against COVID-19.
It takes a lot of trial and error in many cases to come up with the
either treatment or preventive vaccine that is going to be used in
the public. And a lot of these really hinge on not only is it
effective, but is it safe?
You can give something to a patient that will stop or treat the
disease or prevent it from going to another person.
However, it could be at such a high level that it is toxic to that
patient. Hydroxychloroquine is a recent example of the importance of
rigorous clinical trials.
The anti-malaria drug is available in a generic form, and is also
produced under the brand name Plaquenil by French pharmaceutical
company Sanofi.
The malaria drug was once touted by President Trump as a game changer
in the fight against COVID-19 After showing promising results in a
small scale study in France.
I think it could be a game changer and maybe not and maybe not.
But I think it could be based on what I see, it could be a game
changer. However, a recent nationwide study revealed it might result
in more deaths without any real benefits, prompting the National
Institutes of Health as well as the FDA to warn against its use due
to the risk regarding its toxicity.
There is a lot of confusion about what really is evidence for
effectiveness and safety.
A lot of things that we see are anecdotal use of drugs like
hydroxychloroquine and chloroquine in patients who have been sick.
It's very difficult, statistically speaking, to point out whether or
not this is actually effective or the patient just coincidentally got
better, which happens
Frankly treatment development is very, very difficult business.
Four out of five drugs fail in development.
And that exact same failure rate should be expected in developing a
treatment for COVID-19.
On April 24th, White House health advisor Dr.
Anthony Fauci revealed promising results from Gilead Sciences
remdesivir. And it is a very important proof of concept because what
it is proven is that a drug can block this virus.
Sparking hope for the development of an effective treatment against
COVID-19. I think because there's so much research into experimental
therapies for COVID and there's so many good drug candidates out
there. I think it is likely that we will be able to identify a
therapy that has some success within a period of several months to
maybe a year. Fortunately, the development of a treatment for a novel
disease like COVID-19, is likely to be faster than ever thanks to
recent rapid advancements in technology.
You are seeing now an explosion of technology and new and new startup
companies who are becoming adept at pooling massive amounts of data
to inform how to best target a new drug in a novel in a novel target
for a particular disease.
So AI and ML is becoming a real hot spot through a technology lens
for drug discovery,
Microsoft recently announced, the launch of chat bots known as plasma
bots that can help recruit recover patients to donate their blood for
plasma therapies.
While IBM has partnered up with the White House to launch the COVID-19
High Performance Computing Consortium.
That will make supercomputing power, available for researchers and
scientists working on developing a treatment.
We have these unique scientific instruments which are supercomputers
that have been designed historically to accelerate the rate of
discovery, to be able to perform calculations and simulations that
would be costly to do experimentally.
Next generation supercomputers like IBM's Summit, the world's fastest
supercomputer, or helping researchers study the virus and narrow down
which drugs can be effective against it using complex simulations.
Let's say we want to model the virus itself.
We can represent the structure of the virus and we can use these
computers to model its behavior and its interactions.
Now, that process of doing all those experiments is normally
something that would take many, many, many months if you were to do
it on a normal computer.
But you could do it under two days because you're using a
supercomputer. Computing power that was once thought to be impossible
could entirely change how we respond to future pandemics.
Right now we are learning and creating new ways to collaborate on new
institutions and new ways to mobilize the tech sector to respond to
the current crisis. Out of this we will definitely not only have
lessons learned, but we will create new mechanisms for coordination
to better prepare for future crises.
On March 31st, first the FDA announced its Coronavirus Treatment
Acceleration Program designed to help accelerate the approval process
for any potential treatments for COVID-19.
I am aware of individual protocols that had been approved within
twelve hours. I'm aware of many protocols that have been approved
within 24 hours.
So the red tape has absolutely been cut.
I don't believe this has been done at the expense of safety or
quality. The fast track approval process will also have an impact on
the stock market. On April twenty ninth, the White House's
announcement on Gilead's remdesivir led to a two point seven percent
gain for the S&P, and shares of Gilead's Sciences also jumped by five
point seven percent in a single day.
It is clear that the stock market will respond to the availability of
COVID-19 treatments and in a positive way.
And this is true both for the stock performance of pharmaceutical
companies but also for other critical aspects of our economy and the
industries that are engaging within them.
Because, again, getting treatments that are safe and effective to
treat COVID-19 are critical to reopening our economy.