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COVID Treatment and Vaccine – Remdesivir? 

By  Dr. Mike Hansen

According to Alex Azar, secretary of Health and Human Services and chair of President Trump’s Covid Task Force,
“Although the virus represents a potentially very serious public health threat, and we expect to continue seeing more cases here, the immediate risk to the American public is low at this time,”

I agree. Especially when you look at the influenza virus, which is causing many morbidity and mortality in Americans right now, it’s going around like crazy.

Remdesivir

Mr. Azar also said. “We are working as quickly as possible on the many unanswered questions about this virus. That includes exactly how it spreads, how deadly it is, whether it’s commonly transmitted by patients who are not yet displaying symptoms, and other issues.”

Meanwhile, there might be an adequate drug on the horizon to treat the covid.

There is currently a randomized, controlled clinical trial for a new antiviral drug for the novel covid. The drug is called remdesivir and is currently being given in China to some patients with the novel covid.

According to reports, on Jan 26, a 35-year-old patient in the U.S. with 2019-nCoV received remdesivir a week after he was admitted to the hospital.

Five days after being treated with remdesivir, all of his symptoms resolving except for his cough, which had improved.

Remdesivir is a novel nucleotide analog prodrug, originally developed by the biopharmaceutical company Gilead Sciences to treat Ebola and Marburg virus. However, it has also shown reasonable antiviral activity against related viruses like respiratory syncytial and covid viruses.

Remdesivir is yet to be approved anywhere globally, and although it appears to be safe, it still has not been proven safe or effective for any use.

However, the encouraging result prompted Gilead and the Chinese authorities to move the phase III trial ahead and expand it to a lot more patients who need treatment desperately.

The clinical trial is expected to be completed in April.

So, the standard of care for covid consists of supportive treatment only, meaning there is no specific treatment.

Besides this drug to potentially treat covid, several organizations and investigators are developing a vaccine for the 2019-nCoV.

Also, the NIH is working with Moderna Inc. to develop a vaccine built on a messenger RNA platform.

According to Dr. Fauci, “One of the first steps is to successfully get that novel covid gene and insert it into the messenger RNA platform successfully and allow it to express proteins. We’ve succeeded in that.

The next step is to put it in a mouse animal model to induce immunogenicity and make the company make gold nanoparticle products. All of those have been successfully implemented”.

Also, as of February 7th – more action is being taken to protect Americans from a potential covid epidemic.

Now let’s talk about testing for covid.

The test is real-time PCR testing.
Because this is a new virus with new testing, the exact accuracy of the test, meaning sensitivity and specificity of the test, is still not known.
A positive test becomes more accurate when there is a high positive predictive value.

For example, if someone comes into contact with Wuhan, China, they develop symptoms and have secretions coming from their nose. Those secretions are swabbed, a positive test result is more likely to be accurate.

In contrast, if someone does not have symptoms and has a positive test result, the test is more likely to be a false positive.

Now let’s look at another situation. What if someone comes into contact with someone who has covid and develops symptoms but has a negative test result? In that case, the test would have a low negative predictive value, meaning the test is more likely to have a false negative.

So, false-negative tests are most likely to occur when tested at the onset of infection before becoming more symptomatic.

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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