With all the protests, looting, curfews, and presidential Bible thumping, you may have missed the words of Dr. Anthony Fauci. He is the nation’s top infectious disease expert. Along with others in his field, he has confidence that a vaccine may be the best hope of stopping or at least slowing the pandemic. But much is still unknown about the disease and how it attacks the body.
Various age groups are affected differently. For some, COVID-19 embattles the immune system. For many, it’s the lungs. Others present clotting disorders, strokes, and disorientation. Asymptomatic and pre-symptomatic individuals can spread the disease.
Rapidly disseminating a vaccine with such diverse symptoms and methods of transmission may not adequately protect the masses. And we still do not know if the novel coronavirus will be a mutating seasonal illness. Do patients develop life-long antibodies or can they catch it again, like shingles?
Remdesivir Is Not Long-Term Cure
There may be some confusion between the current approved treatment remdesivir and a vaccine. Remdesivir, sold under the brand name Veklury® by Gilead Sciences, received emergency use authorization by the FDA. This was bases on three peer-reviewed, random controlled, blind studies. It is administered after a patient contracts COVID-19.
A typical five-day treatment course includes six vials. This drug claims to reduce the length of your hospital stay by a third. On October 22, 2020, the FDA granted formal approval of Veklury® as a treatment for hospitalized COVID-19 patients age 12 and up, according to the manufacturer, Gilead.
The WHO conducted its own study of remdesivir and other repurposed drugs. It followed more than 11,000 coronavirus patients in 30 countries. “For each drug in the study, the effect on mortality was disappointingly unpromising,” WHO said in a statement. Gilead challenges the WHO findings.
Coronavirus Vaccine Development
A vaccine is supposed to prevent people from contracting the virus. No vaccine is 100 percent effective. The annual flu vaccine teeters between 40 to 60 percent. We can only hope vaccines for COVID-19 will be more effective.
In an interview on the Today Show, the director of the National Institute of Allergy and Infectious Diseases said that a vaccine candidate is in the first phase of a clinical trial. If the second phase shows it is safe and effective, “we’re going to start up ramping up production with the companies involved,” Fauci said. “You do that at risk. In other words, you don’t wait until you get an answer before you start manufacturing, you at-risk, proactively, start making it, assuming it’s going to work.”
If projections are correct, the United States should have 100 million doses of one coronavirus vaccine candidate by the end of the year. “Then, by the beginning of 2021, we hope to have a couple hundred million doses,” Fauci said during a live Q&A with the Journal of the American Medical Association. By the end of 2021, we should see a billion doses.
A drug goes into phase 3 clinical trials in July with 30,000 participants. “I’m cautiously optimistic that with the multiple candidates we have with different platforms, that we are going to have a vaccine that will make it deployable,” Fauci said.
Many things can hinder the prediction. Recently, scientists discovered that antibodies developed after recovering from COVID-19 have limited duration. Fauci admits, in addition to a lack of consistency among testing methods, individuals do not have “a uniformly robust antibody response.”
This fact may make it difficult to develop a vaccine that works equally well for all people. Yet, his big concern is that too many people may refuse the vaccine. Until there is a resolution, the best prevention is social distancing and mask wearing with optimism.
Arthur L. Caplan, PhD in the Division of Medical Ethics at NYU’s Grossman School of Medicine presents a counter argument. The fastest vaccines in the past that have ever made it to FDA approval—not manufacturing, but just to approval—have taken upwards of 5 or 6 years.
“When the [U.S.] President, Tony Fauci, or others say they hope to have a vaccine by the end of the year or early next year, I think to myself, not only is that next to impossible to achieve because research may not deliver and manufacturing is difficult, but we don't want to cut corners in any way.”
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Article updated on October 16, 2020 with study on repurposed drugs, and on October 22 with news of first FDA approved drug for treatment of COVID-19.
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