Coronavirus/COVID-19 (No Politics)

[Mr._Clark]

Remdesivir

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

I realize this is just one patient and he may have recovered anyway, but it is interesting that he was going downhill right up until they started the remdesivir on day 7, and he started to improve the very next day:

>>>Treatment with intravenous remdesivir (a novel nucleotide analogue prodrug in development10,11) was initiated on the evening of day 7, and no adverse events were observed in association with the infusion. . .

On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea.<<<

Gilead is ramping up production of remdesivir and making it available at no charge:

>>>The drug maker now has 1.5 million individual dosages that could be used for more than 140,000 patients and is supplying the medicine, which is being made available through clinical trials and special access programs, at no charge.<<<

Gilead ramps up production of experimental Covid-19 treatment amid criticism over access

In response to intensifying demand, Gilead has been ramping up production of its experimental remdesivir treatment that is being tested to combat the novel #coronavirus.

www.statnews.com

 

[Mr._Clark]

Here's another drug that appears to have some potential:

>>>On March 28—last Saturday—Prime Minister Shinzo Abe told reporters that his government had begun the formal process for designating Avigan as Japan’s standard treatment for Covid-19. . . .Unlike most other influenza treatments, which inhibit the spread of the virus across cells by blocking the enzyme neuraminidase, Favipiravir works by inhibiting the replication of viral genes within infected cells, thereby mitigating the virus’s ability to spread from one cell to another.

What this means, in practical terms, is that patients who take the drug while their viral load is low or moderate may prevent it from making them any sicker. And there is some evidence that Favipiravir can achieve these same effects in viruses other than influenza. Prime Minister Abe seems to be among the believers, and last weekend announced that Japan will “start to boost production and proceed with clinical research in cooperation with those countries that wish to join us.” He also said that many countries had already expressed an interest in the drug.

Though Abe did not mention any of those countries by name, one of them seems to be the United States. According to a recent report in Politico, Fujifilm has discussed with the FDA and the US Department of Health and Human Services the possibility of Avigan trials in the US, and it is seeking research funding from the US government. After Abe spoke to President Trump by phone about Avigan, the report says, the White House National Security Council began pressuring the government to accept a donation of Avigan from Japan, and asking the FDA to authorize its use on an emergency basis.<<<

Japan Is Racing to Test a Drug to Treat Covid-19

Based on a compound discovered in 1998, the antiviral favipiravir is already being used in Japan and Turkey. Its maker? A subsidiary of Fujifilm.

www.wired.com

 

[Swerd]

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.

Trastuzumab, a monoclonal antibody directed against HER2 (also known as HER2/neu) a member of the human epithelial growth factor receptor family. It's considered a biological drug, and it has an interesting mechanism of action. In about 20-30% of early stage breast cancers, HER2 is amplified, causing its over-expression. This leads to strong & constant signals for cell proliferation, leading to tumor formation. Over-expressed HER2 also deactivates of cell division checkpoint proteins, which slow down and regulate several important steps in DNA replication and cell division that normally need proof-reading and repair, allowing for even faster and unregulated proliferation. Trastuzumab binds to HER2 on the surface of tumor cells and induces an immune-mediated response that causes internalization and decreased expression of the HER2 gene.

Does your sister-in-law have breast cancer? I'm glad to hear it seems to be working. She's probably getting other anti-cancer drugs at the same time.

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.

Yes, without any doubt. And many of these new drugs are monoclonal antibodies, such as trastuzumab. If you read those Wikipedia links for trastuzumab and for HER2/neu, you'll realize how much basic research was needed before any of those proteins could be developed as targets for monoclonal antibody treatment. It probably spanned two decades.

 

[Swerd]

I realize this is just one patient and he may have recovered anyway, but it is interesting that he was going downhill right up until they started the remdesivir on day 7, and he started to improve the very next day:

That's why the FDA requires results from controlled clinical trials where more than one patient was treated. And yes, the FDA does understand that an emergency exists.

Gilead is ramping up production of remdesivir and making it available at no charge:

The drug maker now has 1.5 million individual dosages that could be used for more than 140,000 patients and is supplying the medicine, which is being made available through clinical trials and special access programs, at no charge.

It does seem like Gilead is anticipating approval of remdesivir.

Please note that all drugs must be made available free of charge while they are being tested in clinical trials. Only after FDA approval, can a drug company sell a product commercially.

 

[Trell]

Coughing tiger at the Bronx Zoo tests positive for coronavirus, ‘first case of its kind’ in U.S.:

"A tiger at the Bronx Zoo has tested positive for the novel coronavirus, becoming the first known animal in the United States to contract the virus, the zoo and federal officials revealed Sunday.​

​

The 4-year-old Malayan tiger named Nadia was tested for the virus after she and several other lions and tigers came down with a dry cough starting March 27, the U.S. Department of Agriculture said in a statement. Officials believe that an asymptomatic zookeeper carrying the virus somehow transmitted the disease to the tiger while caring for the animals.​

​

The Wildlife Conservation Society, which runs the Bronx Zoo, said it wanted to test Nadia “out of an abundance of caution,” hoping to ensure “any knowledge we gain about COVID-19 will contribute to the world’s continuing understanding of this novel coronavirus.”​

Her test was confirmed positive at the USDA’s National Veterinary Services Laboratories, in what the agency described as “the first case of its kind.” "​

 

[Mikado463]

I realize this is just one patient and he may have recovered anyway, but it is interesting that he was going downhill right up until they started the remdesivir on day 7, and he started to improve the very next day:

>>>Treatment with intravenous remdesivir (a novel nucleotide analogue prodrug in development10,11) was initiated on the evening of day 7, and no adverse events were observed in association with the infusion. . .

On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea.<<<

Gilead is ramping up production of remdesivir and making it available at no charge:

>>>The drug maker now has 1.5 million individual dosages that could be used for more than 140,000 patients and is supplying the medicine, which is being made available through clinical trials and special access programs, at no charge.<<<

Gilead ramps up production of experimental Covid-19 treatment amid criticism over access

In response to intensifying demand, Gilead has been ramping up production of its experimental remdesivir treatment that is being tested to combat the novel #coronavirus.

www.statnews.com

a feel good story that hopefully proves beneficial to others.

 

[Mr._Clark]

Here's another med (EIDD-2801) that seems to have some potential. I realize many drugs with potential ultimately don't prove effective, but some drugs with potential is better than nothing.

"An orally bioavailable broad-spectrum antiviral inhibits SARS-CoV-2 in human airway epithelial cell cultures and multiple coronaviruses in mice"

Promising Drug On The Horizon For COVID-19

A drug that's been tested against the coronaviruses that cause MERS and SARS and shown to have valuable antiviral properties appears to be potent against the COVID-19 virus as well.

www.npr.org

Science | AAAS

stm.sciencemag.org

 

[Gmoney]

Here where I live in Louisiana we have 5 reported dead and 83 who are infested with the Covid-19 Virus.

 

[Mikado463]

what do they attribute to such a high death ratio in Louisiana ?

 

[herbu]

What is expected when all the segregation is ended due to a low number of new cases? If widespread quarantine is at least partly responsible for the decrease in viral transmissions, where is the point at which we can stop the quarantine without restarting the virus spread? Do we wait for a proven treatment to be available? A vaccine?

And how do we balance lives with the economy? Let's say we reach a point where we can send everybody back to work, but it will cost an estimated 10 lives. Is that worth it? How about 1,000? 10,000? How many lives are lost or destroyed during our country shutdown? Again, how do we balance?

I'm not sure there is a "right" answer to either question above. ANY decision will be hotly debated.

 

[Mikado463]

another view ...........

 

[Old Onkyo]

what do they attribute to such a high death ratio in Louisiana ?

Not from Louisiana huh?

 

[Kvn_Walker]

What is expected when all the segregation is ended due to a low number of new cases? If widespread quarantine is at least partly responsible for the decrease in viral transmissions, where is the point at which we can stop the quarantine without restarting the virus spread? Do we wait for a proven treatment to be available? A vaccine?

And how do we balance lives with the economy? Let's say we reach a point where we can send everybody back to work, but it will cost an estimated 10 lives. Is that worth it? How about 1,000? 10,000? How many lives are lost or destroyed during our country shutdown? Again, how do we balance?

I'm not sure there is a "right" answer to either question above. ANY decision will be hotly debated.

What part of "NO EFFIN POLITICS" did you miss? There's a thread for that already.

 

[Kvn_Walker]

This is uncomfortably close to home... one of those nightmare scenarios you hope wouldn't play out.

Death toll at Canterbury facility in Henrico reaches 32

Canterbury, a long-term care facility in western Henrico, has experienced one of the worst clusters of the coronavirus in the country that has now killed at least 32 residents and sickened hundreds…

www.wavy.com

 

[Gmoney]

what do they attribute to such a high death ratio in Louisiana ?

Mike, from what I have been reading the Mardi Gras that was in New Orleans had a lot to do with it. It’s like a huge block party for a week people coming in from all over the Country. I live about 125 miles from New Orleans . Plus on top of that New Iberia, Lafayette and other city’s had their own little Mardi Gras parades. I’m sure that had a lot to do with it.

 

[Gmoney]

Not from Louisiana huh?

Hey bro! You doing ok? hope you are well Sir! I moved back to New Iberia last Monday. Got a nice two bedroom apartment has a nice front porch plus a much bigger living room.

 

[Mr._Clark]

That's why the FDA requires results from controlled clinical trials where more than one patient was treated. And yes, the FDA does understand that an emergency exists.
It does seem like Gilead is anticipating approval of remdesivir.

Please note that all drugs must be made available free of charge while they are being tested in clinical trials. Only after FDA approval, can a drug company sell a product commercially.

Interesting, I didn't know that a company must provide drugs for free for clinical trials.

My sister in law has breast cancer but I do not know a lot of the details about her treatment. Also, to be honest, I'd prefer not to get into it too much in a public forum, even though it is in theory anonymous (I debated mentioning it all but it seemed potentially relevent to the topic of monoclonal antibodies).

 

[Mr._Clark]

This article discusses the problem of cytokine storms in COVID-19 patients. Knowing how and when to slow down the immune system during an infection strikes me as being an especially difficult problem.

It's too bad this blasted virus is spreading so fast.


>>>Although there's limited data on how the release of too many of these molecules (the cytokine storm) affects COVID-19 patients, some doctors are already treating people who have the disease with powerful anti-inflammatory drugs to try and slow or stop the process. Anecdotally, they say that the approach appears to be helping.

"The impact was dramatic," says Dr. Daniel Griffin, chief of infectious disease for ProHEALTH Care Associates, a group of physicians that serves the New York City area. The first six patients he treated all appear to be improving, at least for now, he says. "Yesterday was a good day."

But other researchers caution that the untested treatments carry significant risks. Suppressing the body's immune system at the exact moment it's trying to fight off the deadly coronavirus could have all sorts of unintended consequences, warns Dr. Tobias Hohl, the chief of infectious disease at Memorial Sloan Kettering Cancer Center in New York City. "The infection could get worse," Hohl says.

Nevertheless, Hohl and others believe that controlling cytokine storms will turn out to be a critical way to help at least some of the sickest COVID-19 patients. And clinical trials already underway in New York and elsewhere could soon provide data about how existing drugs should be used.<<<

Why Some COVID-19 Patients Crash: The Body's Immune System Might Be To Blame

An overblown immune response could be killing a portion of the sick, and some doctors think that new treatments being tested could help at least some of those patients.

www.npr.org

 

[mtrycrafts]

... It’s like a huge block party for a week people coming in from all over the Country. ....

If not from other parts of the world as well.

 

[mtrycrafts]

...
It's too bad this blasted virus is spreading so fast.
...

Yes, very inconsiderate of it not letting us study it first to give us a fighting chance at least.