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jyl jyl is online now
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Join Date: Jan 2002
Location: Nor California & Pac NW
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You're asking is there a treatment suitable to give someone who's been diagnosed with Covid but whose symptoms are just starting and mild (not hospitalized, not on supplemental oxygen)?

AFAIK, right now the only pharmaceutical treatment shown to be effective in that situation is Regeneron's antibody cocktail REGN-COV. See summary of phase 3 data https://investor.regeneron.com/news-releases/news-release-details/phase-3-trial-shows-regen-covtm-casirivimab-imdevimab-antibody

"Effective" means that it substantially reduced the risk of hospitalization or death (by 70% or so), not that it is a silver bullet. I don't know of data for REGN-COV in the Delta variant but I think it is likely to retain effectiveness there as well. Lilly's antibody drug was withdrawn because it isn't effective against some variants. New antibody cocktails are being developed.

REGN-COV is currently available under EUA as an infusion. It hasn't been used all that much (I think several million persons in the US have received it so far) because it isn't that practical to administer a 30-60 minute infusion to 66,000 new Covid patients persons per day. There are around 3,600 infusion centers in the US, very roughly 20 chairs/beds per, so do the math on how infusion capacity. It is even more limited because infusion is typically used for cancer patients, who you really don't want exposed to Covid patients. There are home infusion services but there manpower is the capacity limiting factor.

Of course, if you're Donald Trump, Chris Christie, or other VIP you'll get REGN-COV, and if you're assertive and educated patient able to advocate for yourself, you can likely get it, especially if you're at higher risk.

REGN-COV is being developed in a subcutaneous administration form, which could really relieve the capacity limitations. Watch for that.

Other treatments shown effective so far are for severe Covid (hospitalized), they can somewhat reduce your risk of death, reduce your risk of requiring ventilation, and/or shorten your hospitalization, to varying degrees. Remedsivir, toclizumab, and dexamethasone. I think (am betting money on) that lenlizumab will be added to that list. These are not silver bullets, the improvement shown in clinical trials is generally around 20-30%.

Many pharma companies, large and small, are working on treatments, including for oral and nasal (spray) administration. As just one example, from a tiny UK company (and I'm not suggesting this one is or isn't likely to succeed) https://www.synairgen.com/covid-19/

It is frustrating that therapeutic development hasn't advanced nearly as fast as vaccine development. Frustrating, but understandable. Simplistically, the best time to stop the disease is when the virus has just entered the body, and the most highly-developed, flexible and effective disease-fighter is the body's own immune system, so priming the immune system to quickly recognize and attack the virus (vaccine) or supplementing the immune reaction with man-made antibodies (REGN-COV, etc) is the most effective response so far developed. Once the virus has replicated widely and the patient is sick enough to be hospitalized, it is much harder.

It is also frustrating that the extraordinarily effective vaccines developed in record time aren't being used effectively. We're like the Afghan army or something, even given US weapons and money and air support, many of us abandon our weapons and defect and/or join the Taliban.

Anyway, the development effort being directed at this is immense, and I think effective and practical treatments will be developed. Given that a third of Americans would apparently rather get Covid than take the vaccines that most of the world would die to have access to (sick pun there), therapeutics should remain a big market.
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Last edited by jyl; 07-30-2021 at 08:41 AM..
Old 07-30-2021, 08:36 AM
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