Over two million people around the world have become infected with the SARS-CoV-2 coronavirus, and so far, over one hundred thousand of those have died. The COVID-19 disease has been so devastating because it is easily transmitted, and a carrier of the disease may initially show no symptoms, leading to exponential spread.
This situation has led to a tremendous effort to find a way to prevent the disease from spreading further, and, if prevention cannot be achieved soon, to find a safe and effective treatment for those who are already infected.
What are the most promising possibilities for prevention and treatment that we can see right now, and when might they become widely available to those who need them?
For prevention, the only solution is to somehow give people immunity to SARS-CoV-2, so that if they are exposed to it, they will not become infected. There are a couple of approaches to generating that immunity, convalescent plasma and a vaccine. For treatment, several drug candidates are being investigated.
Plasma is the component of blood that contains the factors that provide immunity to infectious agents such as the SARS-CoV-2 virus. Convalescent plasma is plasma isolated from the blood of a person who has survived an infection by an infectious agent, who no longer has active disease. A clinical trial at the University of Texas Health Science Center at Houston is currently taking place to test whether plasma taken from COVID-19 survivors is safe and provides effective immunity to the SARS-CoV-2 pathogen. If the trials conclude that convalescent plasma is both safe and effective, it can be deployed to save lives. At present, how effective this treatment will be is unknown. If, for example, a person is infected with the virus that causes chicken pox, after surviving that disease, they are protected from ever getting chicken pox again. However, a tetanus infection raises an immune response that does not last for a lifetime. A person who survives a tetanus infection is not protected from subsequent infections. Where COVID-19 fits on this continuum is unknown and must be determined by clinical trials such as the one in Houston.
The silver bullet of COVID-19 prevention would be a vaccine against the disease. Several organizations are working on this, but it takes time and cannot be hurried beyond a certain point. The consensus is that widespread deployment cannot occur in less that twelve to eighteen months. That is going to be too late for a lot of people. In the meantime, a safe and effective treatment for people who already have the disease is needed. For them, it is already too late to prevent the disease.
Researchers have been looking at drugs that are already approved for use against other pathogens, to see if they might also be effective against the SARS-CoV-2 virus. If such a drug can be shown to be effective against SARS-CoV-2, it can be fast-tracked into widespread use because it has already been shown to be safe in a different context.
Several treatments based on existing drugs have been proposed and are being investigated. One of them is remdesivir. Remdesivir is an investigational nucleotide analog that has been shown to have antiviral activity against several viruses, including those that cause Ebola, Marburg, MERS, and SARS-CoV-1. A small study conducted by Gilead Sciences, Inc, the manufacturer of remdesivir, seemed to show effectiveness against COVID-19. This is promising, but the trial must be duplicated on a larger scale, with a double-blind placebo-controlled protocol.
Another candidate treatment involves the drugs hydroxychloroquine and azithromycin. Hydroxychloroquine is currently prescribed as a treatment for malaria and for some autoimmune diseases. Azithromycin is an antibiotic that is currently used for sinusitis and pneumonia. Both drugs have potential side-effects, so for it to make sense to use them, their benefits must outweigh any problems that they might cause. Until properly controlled clinical trials are performed, it is impossible to know whether either of these drugs, either separately or in combination, have a place in the treatment of COVID-19.
Other drugs entering trials include Genentech’s tocilizumab, Incyte’s ruxolitinib, and CytoDyn’s Leronlimab.
What can we conclude from this?
Deployment of an effective preventative against COVID-19 is probably at least 18 months away. Come to terms with what that will mean for you, for your job, and for your family.
Treatment of people with COVID-19 will improve in the meantime, but at present there is no truly effective treatment on the horizon that will be widely available for at least several months.
Become accustomed to meeting people virtually, and with practicing social distancing in live encounters. This is the new normal, and it will be in effect for quite a while to come.
BIO:
Allen G. Taylor is a 40-year veteran of the computer industry and the author of over 40 books, including Develop Microsoft HoloLens Apps Now, Get Fit with Apple Watch, Cruise for Free, SQL For Dummies, 9th Edition, Crystal Reports 2008 For Dummies, Database Development For Dummies, Access Power Programming with VBA, and SQL All-In-One For Dummies, Third Edition. He lectures internationally on astronomy, databases, innovation, and entrepreneurship. He also teaches database development and Crystal Reports through a leading online education provider. For the latest news on Allen’s activities, check out his blog at wwwallengtaylor.com or contact him at allen.taylor@ieee.org.