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ANALYSIS: Antiviral pills will change the pandemic, but they can’t end it alone

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Tue, 2021-11-23 11:59 — mike kraft
Treatments will change the pandemic, but they can’t end it alone A year after coronavirus vaccines dangled visions of an end to the pandemic, science has delivered inspiring results again: two antiviral pills that dramatically reduce the risk of hospitalization and death. Carolyn Y. Johnson Washington Post

A year after coronavirus vaccines dangled visions of an end to the pandemic, science has delivered inspiring results again: two antiviral pills that dramatically reduce the risk of hospitalization and death.

The notion that a fearsome infection could soon be treatable with a handful of pills is an exhilarating idea nearly two years into a pandemic that has killed more than 5 million people, at least 770,000 in the United States. But experts — who are thrilled about the prospect of two powerful new medicines — worry that enthusiasm for the idea of treatments may distract from their limitations and the necessity of preventing illness in the first place.

If regulators deem the five-day treatment courses from Pfizer and Merck and its partner Ridgeback Biotherapeutics safe and effective in coming weeks, as most people expect, the drugs could make getting sick far less scary. The United States has already prepurchased millions of treatments. The good news arrives like an echo of last year, when two remarkably effective vaccines were authorized in the middle of the holiday season as a winter surge in new cases loomed.

But these treatments alone aren’t likely to close the book on the coronavirus. Instead, they will be a valuable addition to an armamentarium that the world is going to have to keep building and maintaining in the long run: vaccines, booster shots, more antiviral pills, virus-fighting antibodies engineered to stick around in people’s bodies and fast-turnaround testing linked to treatment options. ...

The drugs are good, but not perfect: Merck and Ridgeback’s molnupiravir slashed hospitalization and death by half in a clinical trial, but that means some people still ended up in the hospital. Pfizer’s Paxlovid reduced hospitalization and death rates by an impressive 89 percent, but it must be taken within days of symptoms.

And scientists have learned not to underestimate the virus. As soon as treatments become widespread, scientists will be watching for signs of resistance.

“There’s always a sense of optimism with a new strategy that comes along, and I’m optimistic, too, that this is one additional thing that is going to help in our fight against this disease,” said Erica Johnson, chair of the Infectious Disease Board of the American Board of Internal Medicine and a physician at the Johns Hopkins Bayview Medical Center. “But I’m also cautious that it is just a single strategy, and it really only works if all the other strategies are healthy and working, too.” ...

 

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Tue, 2021-11-23 12:10 — mike kraft

The FDA will soon decide on Merck's Covid-19 antiviral pill. It shows promise, but there are also concerns In the fall of 2015, Dr. Mark Denison was preparing for a long drive home from Alabama after making a presentation at a scientific meeting when a colleague asked him to stick around for lunch and check out some data on a potential new drug. Elizabeth Cohen, CNN Senior Medical Correspondent CNN

... "We should worry about the dangers to pregnant women and the dangers of developing resistance. But if we have a drug that works, we want that drug. We just have to figure out how best to use it given its limitations," said Dr. Eric Rubin, an infectious disease expert at the Harvard T.H. Chan School of Public Health and editor in chief of the New England Journal of Medicine. ...

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