Coronavirus/COVID-19 (No Politics)

[Mr._Clark]

Given that the discussion on the existing thread seems to be dominated by politics, I'm attempting to start a thread that separates medical from political aspects.

I noticed that testing for antibodies is getting started by the CDC and the Mayo Clinic:

CDC launches studies to get more precise count of undetected Covid-19 cases

The CDC has begun preliminary studies to try to flesh out the portion of #Covid19 cases that have evaded detection.

www.statnews.com

Science Saturday: The importance of antibody testing in addressing COVID-19 - Mayo Clinic News Network

If there's one thing the world has learned so far in the course of the COVID-19 pandemic, it's the important role of testing for the disease. The ability to know who has the virus and who doesn't provides critical information for people and entire regions. Early testing involved collecting cells...

newsnetwork.mayoclinic.org

 

[lovinthehd]

Might want to exchange the dash before "politics" for the word without....I thought at first it was specifically for the politics

 

[Mr._Clark]

Might want to exchange the dash before "politics" for the word without....I thought at first it was specifically for the politics

Good point! I inadvertently went into google search mode

 

[Mr._Clark]

A report dated 4/3/20 indicates that another widely available drug may be effective against the coronavirus:

https://www.sciencedirect.com/science/article/pii/S0166354220302011

 

[Swerd]

Given that the discussion on the existing thread seems to be dominated by politics, I'm attempting to start a thread that separates medical from political aspects.

Thank you!

 

[Mr._Clark]

I'm hoping remdesivir proves to be effective:

>>>In fact, remdesivir is one of only two highly effective compounds to come out of six years of screening against coronaviruses, says Mark Denison, a coronavirus expert and director of the Division of Infectious Diseases at Vanderbilt University Medical Center. Denison has collaborated with labs at the University of North Carolina and elsewhere to find small molecules that keep coronaviruses from replicating—and still work if the virus mutates. The other effective compound, EIDD-2801, was discovered by Emory University chemists and recently licensed to Ridgeback Biotherapeutics.

One reason so many compounds failed is that coronaviruses are a little smarter than other RNA viruses. They’re the only ones with a polymerase that can fix errors in their genomes, meaning they can spot and ignore the mimics that drug hunters typically design. Denison’s lab found that remdesivir, like EIDD-2801, can bypass that proofreading function.<<<

What can initial remdesivir data tell us about tackling COVID-19?

Gilead Sciences’ antiviral is in multiple late-stage trials to treat coronavirus infections. Don’t expect a home run, say infectious disease experts

cen.acs.org

 

[Mr._Clark]

Thank you!

Swerd, you are on of the people I'm hoping will provide insight on the science side of this. My background is engineering, not biology or medicine, and my ability to sort through some of the published papers is limited.

 

[Mr._Clark]

Hopefully this works and they can find a way to get the monoclonal antibodies in production sooner than September.

>>>'Pandemic' scientist says his team has discovered potential cure for COVID-19

Dr. Jacob Glanville's team took antibodies used to neutralize SARS and used technology in their lab to adapt them to recognize COVID-19. . . "We are happy to announce we have completed the engineering and we have some very potent antibodies that can be effective against the virus," said Dr. Glanville. . .

We are sending [the antibodies] to the military for confirmation testing and to Charles River Laboratories for safety and tox characterization. We’ve partnered with two different companies that will help us scale up large batches of the antibody for production. We're in discussions to start humane phase one/two trials that would happen at the end of the summer.

Pending good results - [if] we see the drug is safe and helpful means we could start releasing it for compassionate use in September.<<<

'Pandemic' scientist says his team has discovered potential cure for COVID-19

Dr. Jacob Glanville's team took antibodies used to neutralize SARS and used technology in their lab to adapt them to recognize COVID-19.

www.cbs8.com

 

[Mr._Clark]

DARPA is also working on producing antibodies, but they are also not predicting these will be available any time soon:

>>>The more immediate goal for the COVID-19 outbreak is to discover the antibodies that are relevant to the illness and then produce those in a traditional bioreactor, hopefully quickly. They could then go to frontline medical workers, deployed troops, or even to sick patients to treat the infection. The hope is “to have something by late summer” she said, but that’s if everything goes perfectly.<<<

US Military Scientists Hope To Have Coronavirus Therapeutic By Summer

A new approach would use RNA or DNA to help the body develop antibodies to the rapidly spreading illness.

www.defenseone.com

 

[Swerd]

A report dated 4/3/20 indicates that another widely available drug may be effective against the coronavirus:

https://www.sciencedirect.com/science/article/pii/S0166354220302011

A very brief report, on a drug I knew nothing about, Ivermectin. It is already approved by the FDA to treat parasite infestations. It does show anti-viral activity, but the tests were done on cells growing in culture, infected with SARS-CoV-2. It required concentrations of at least 2 to 3 µM (micromolar) to be effective. (See EDIT below)

It would have been interesting to see Ivermectin's anti-viral activity directly compared, using the same lab model, to that of other drugs, such as remdesivir or hydroxychloroquine.

Can those 2-3 µM concentrations be achieved, safely, in an animal model of Covid-19 or in human patients? Because this drug is already used in humans, I suspect that answer may be known, but I didn't find it with a quick & dirty search.

It appears to be a systemic oral drug. As an anti-parasite drug, it's given as a single dose, with a possible repeat dose every 3 to 12 months. What dose & schedule would be needed for patients with Covid-19?

Does the drug get to the affected respiratory tract tissues at the needed concentration?

Is it effective in severely ill hospitalized patients who already need ventilator? Covid-19 patients and patients with a parasitic disease are a very different patient population. A clinical trial might be needed to test this drug in patients with Covid-19.

EDIT: It looks like concentrations of 2 to 3 µM cannot be achieved in humans. With an Ivermectin molecular wt of 875.1 g/mol, 2 µM becomes about 1750 ng/mL. The highest plasma concentration after a single oral dose in a phase 1 clinical trial was 81 ng/mL, more than 20-fold lower. Ivermectin is highly soluble in lipids, and as a result, it may be available at higher concentrations in cell membranes that what was measured in patient plasma (cell-free blood). This has to be worked out before this drug can be considered. I don't know if other ways are available to give this drug to get >20-fold higher concentrations in the blood. But with this data, it doesn't look good for Ivermectin to treat Covid-19.

 

[Swerd]

Hopefully this works and they can find a way to get the monoclonal antibodies in production sooner than September.

>>>'Pandemic' scientist says his team has discovered potential cure for COVID-19

Dr. Jacob Glanville's team took antibodies used to neutralize SARS and used technology in their lab to adapt them to recognize COVID-19. . . "We are happy to announce we have completed the engineering and we have some very potent antibodies that can be effective against the virus," said Dr. Glanville. . .

We are sending [the antibodies] to the military for confirmation testing and to Charles River Laboratories for safety and tox characterization. We’ve partnered with two different companies that will help us scale up large batches of the antibody for production. We're in discussions to start humane phase one/two trials that would happen at the end of the summer.

Pending good results - [if] we see the drug is safe and helpful means we could start releasing it for compassionate use in September.<<<

'Pandemic' scientist says his team has discovered potential cure for COVID-19

Dr. Jacob Glanville's team took antibodies used to neutralize SARS and used technology in their lab to adapt them to recognize COVID-19.

www.cbs8.com

This looks more like an optimistic press release, than a scientific report. Take it with a grain of salt. The concept is scientifically accepted, but…

 

[Out-Of-Phase]

Remdesivir

https://www.nejm.org/doi/full/10.1056/NEJMoa2001191

 

[Out-Of-Phase]

Remdesivir

Ailing Everett couple gambles on drug trial for COVID-19 cure

Josie and George Taylor of Everett are two of the first people in the U.S. to recover from novel coronavirus infections after joining a clinical trial for the antiviral drug remdesivir.

www.seattletimes.com

 

[KEW]

I am embarrassed to admit that I don't remember who was the authority being interviewed, but they made an interesting statement ( not verbatim)

We have three means to fight an epidemic - testing, tracking, and vaccine"

Obviously this is from an epidemiologist, not a doctor/care provider.
As I understand it tracking just began using a variation of a system used for tracking the flu.
Once the new higher quantities of tests that are faster get out, the tracking will be much more effective, but for now, they are using inferences from doctor visits.
I hope we see a vaccine soon as that is really what it will take to put this pandemic to rest.
Kudos to Bill and Melinda Gates for their philanthropy - they donated the money to finance 7 companies to pursue a vaccine independently (they are welcome to share ideas, but the Gates Foundation recognized that the normal process of choosing which company to back is out the window when it is this critical and it makes sense to have multiple routes to a solution!
Also in an interview with B Gates, he made the point that this vaccine needs to be global/universal if it is to truly eliminate the virus. I don't know how that works as if an animal can carry it, and it can then jump to humans, it seems like an animal could carry it until out immunity wains. Maybe he means with booster shots and everyone getting one like we do with measles, mumps, and rubella!?

 

[Swerd]

A vaccine is the only really effective way to counter a viral infection. Only recently are there anti-viral drugs that slow down or inhibit viral replication.

Also in an interview with B Gates, he made the point that this vaccine needs to be global/universal if it is to truly eliminate the virus. I don't know how that works as if an animal can carry it, and it can then jump to humans, it seems like an animal could carry it until out immunity wains.

You might be over thinking this. By a global vaccine, I think Gates means a vaccine must be given to as many humans as possible no matter where on earth they live. It has to be inexpensive, be capable of being stored as a dry powder without refrigeration, and all those taboos against vaccinations have to be overcome.

Maybe he means with booster shots and everyone getting one like we do with measles, mumps, and rubella!?

Yes.

 

[Swerd]

Earlier today, I was talking with a family member whose brother is a general practice MD in southeastern Virginia. About 4 weeks ago, he tested all of his staff for SARS-CoV-2 virus, including himself, some 30 people. There were 9 positives. At the time, none of them showed any symptoms.

As a result, those 9 were quarantined, and his staff of 30 was cut by 30%. He was negative, but now is over-worked, routinely putting 12+ hours daily. At least those 9 people could not infect any of the patients who, at the time, were still visiting their doctor's office.

Yes, there can easily be that many infected people who don't yet have symptoms. That's probably why this virus is spreading so quickly.

 

[mtrycrafts]

...

Dr. Jacob Glanville's team took antibodies used to neutralize SARS and used technology in their lab to adapt them to recognize COVID-19. . . "We are happy to announce we have completed the engineering ...

His team seems to be engineers. They understand. You should too.

 

[Mr._Clark]

Earlier today, I was talking with a family member whose brother is a general practice MD in southeastern Virginia. About 4 weeks ago, he tested all of his staff for SARS-CoV-2 virus, including himself, some 30 people. There were 9 positives. At the time, none of them showed any symptoms.

As a result, those 9 were quarantined, and his staff of 30 was cut by 30%. He was negative, but now is over-worked, routinely putting 12+ hours daily. At least those 9 people could not infect any of the patients who, at the time, were still visiting their doctor's office.

Yes, there can easily be that many infected people who don't yet have symptoms. That's probably why this virus is spreading so quickly.

Hopefully the people who tested positive are doing okay?

Captain obvious, but testing is obviously a good idea.

 

[Mr._Clark]

This looks more like an optimistic press release, than a scientific report. Take it with a grain of salt. The concept is scientifically accepted, but…

That was my initial impression, but I have to admit I am looking for any potentially positive news.

My sister in law has cancer and she has been treated with a monoclonal antibody-based drug (not sure if it's actually considered to be a drug)(I think it might be trastuzumab, but I'm not sure) and it seems to be working.

Some of these new treatments are amazing. I may be naively optimistic, but I do think we are likely to make significant progress on cancer in the next few years.

 

[Mr._Clark]

His team seems to be engineers. They understand. You should too.

Hahaha! They are just engineering wanna-bees!

Biology is where the interesting science is right now (that and cosmology, perhaps).