[The Global Outbreak] New comment on Simeon Courtie Says Coronavirus Vaccine Could Be R....

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Plan B

If the same fate befalls a Covid-19 vaccine, the virus could remain with us for many years. But the medical response to HIV/AIDS still provides a framework for living with a disease we can't stamp out.
"In HIV, we've been able to make that a chronic disease with antivirals. We've done what we've always hoped to do with cancer," Offit says. "It's not the death sentence it was in the 1980s."
The groundbreaking development of a daily preventative pill -- pre-exposure prophylaxis, or PrEP -- has since led to hundreds of thousands of people at risk of contracting HIV being protected from the disease.
A number of treatments are likewise being tested for Covid-19, as scientists hunt for a Plan B in parallel to the ongoing vaccine trials, but all of those trials are in very early stages. Scientists are looking at experimental anti-Ebola drug remdesivir, while blood plasma treatments are also being explored. Hydroxychloroquine, touted as a potential "game changer" by US President Donald Trump, has so found been found not to work on very sick patients.
"The drugs they've chosen are the best candidates," says Keith Neal, Emeritus Professor in the Epidemiology of Infectious Diseases at the University of Nottingham. The problem, he says, has been the "piecemeal approach" to testing them.

"We have to do randomized controlled trials. It's ridiculous that only recently have we managed to get that off the ground," Neal, who reviews such tests for inclusion in medical journals, tells CNN. "The papers that I'm getting to look at -- I'm just rejecting them on the grounds that they're not properly done."
Now those fuller trials are off the ground, and if one of those drugs works for Covid-19 the signs should emerge "within weeks," says Neal. The first may already have arrived; the US Food and Drug Administration told CNN it is in talks to make remdesivir available to patients after positive signs it could speed up recovery from the coronavirus.
The knock-on effects of a successful treatment would be felt widely; if a drug can decrease a patient's average time spent in ICU even by by a few days, it would free up hospital capacity and could therefore greatly increase the willingness of governments to open up society.
But how effective a treatment is would depend on which one works -- remdesivir is not in high supply internationally and scaling up its production would cause problems.
And crucially, any treatment won't prevent infections occurring in society -- meaning the coronavirus would be easier to manage and the pandemic would subside, but the disease could be with us many years into the future.

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Posted by Erin Burnett to The Global Outbreak at 3 May 2020 at 08:10