Why I’m an optimist on Covid

Because I’m an optimist on everything– that’s just my wiring :-).  But, I truly believe a fair assessment of what we know currently know about the state of the virus and the state of biotechnology/biopharmacology research gives plenty of reason for optimism.  Brilliant people around the world are now supremely dedicated to finding an effective treatment and with the tremendous breakthroughs in our understandings of human biology and diseases in recent years, I think it more likely than not that we will– well before the 18 month till vaccine scenario– have a variety of treatments good enough that we can prevent bad cases from going severe and severe case from going critical/fatal.  

Sarah Zhang has a nice piece in the Atlantic summarizing all the potential lines of treatment and the various progress being made.  Her conclusion is modest, but, I think undersells the potential:

Much of the early research into drugs against COVID-19 has focused on repurposing existing drugs because they are the fastest way to get something to a patient in a hospital bed. Doctors already know their side effects, and companies already know how to manufacture them. Unless researchers get very lucky, though, these repurposed drugs are unlikely to be a cure-all for COVID-19. Still, they might just work well enough to keep a mildly ill person from becoming severely ill, which is enough to free up a ventilator. “We can do better probably as time goes by,” says García-Sastre, “but right now we need something to start.”

But, of course, keeping mild from becoming severe and keeping people off ventilators is actually a really big deal.  Again, we’re not there, but there’s so many different strands of encouraging research and drug development.

The New Yorker profiles David Ho and his quest for a “pandemic pill.”  No, he’s not going to save us now, but and many other super-smart people he’s working with have made great progress and learned so much about defeating viruses in the process.  The article talks a lot about how we dropped the ball after after SARS and the problematic economics behind properly funding this research.  But, I’m also optimistic that we’ll now actually clearly value and properly fund this area of research going forward.

And, no, a Tuberculosis vaccine is not going to be our magical savior, but there really is some interesting data that suggests it really could help as it seems to be at least somewhat effective for an array of respiratory infections.  

Likewise, will this new pill invented at UNC save us?  Probably not.  It’s intriguing and promising, but a lot of “if”s:

The paper has yet to undergo peer-review, which means there might be undiscovered flaws that undercut the findings. The medicine, EIDD-2801, still needs to be tested on humans. But if it performs in human trials as it has both in animals and in test tubes—and if there are no dangerous side effects—it might be a game-changing treatment for not just COVID-19 but other diseases caused by closely related coronaviruses. 

Though, I just googled again and it’s already FDA approved for a human trial.  

[And, just after posting, I also saw this Scientific American article on it.  This sentence really caught my attention: 

In addition to planning clinical trials in the U.S., Ridgeback has also asked U.K. authorities to start tests there as well. “We’ve done three to four years of development work in just the past three to four weeks in response to the new pandemic,” Holman says.

Exactly.  All over the world, researchers under this amazing pressure are doing years worth of work in weeks.  I can’t help but believe that will pay off]

So, chances are EIDD-2801 will not be our savior, or that the Tuberculosis vaccine will not, or that Remdesivir will not, or that cytokine inhibitors will not, but, it really does strike me that with the intense and comprehensive global effort to find effective treatments, and the very clear progress that science has made in this type of research, there’s every reason to believe we could have a number of effective Covid-19 treatments by sometime this summer.  And, if that’s the case, we’ll still have a pandemic on our hands, but one that is suddenly much less fatal, much less likely to overwhelm localized medical resources, and therefore one that actually lets us get back to our lives.

And, given that obvious difficulty we’ve had in scaling up testing in any meaningful way.  Not to mention the difficulty in containing a disease with a disturbingly high percentage of asymtopmatic and presymptomatic transmitters, effective treatments strike me as our most likely way out of this.

Or, maybe the pessimists are right and life totally sucks for 18 months (the longer range given for a new vaccine, which, unsurprisingly, I find pessimistically long given the unprecedented efforts).  But, damn it, I’m being an optimist and betting on human ingenuity.  

About Steve Greene
Professor of Political Science at NC State http://faculty.chass.ncsu.edu/shgreene

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