While the world has been focused on the the rollout of COVID-19 vaccines, more drug trials to treat the virus are still underway, with at-home access to those drugs already available to the most high-risk and immunocompromised.
Dr. Robert Shafer specializes in the treatment of infectious disease, for which is he a professor at Stanford University. He runs the Coronavirus Antiviral and Resistance Database, and told KCBS Radio on Tuesday’s “Ask an Expert” that when researchers began learning about new variants, they realized it was complicated and important to dive in and get a granulated picture.
“I think clarity is emerging from the multiple labs that are producing this data in large numbers making it publicly available,” he said. “It’s not just being presented in papers, but making the data available in many formats, so it’s been possible to create this database.”
Dr. Shafer added that what makes studying COVID-19 so fascinating is the amount of genomes that have been sequenced for it since then.
“There have been nearly one million SARS-CoV-2 genomes that have been sequenced since the pandemic began and there’s nothing like that for any other virus,” he said. “And it could be argued that we need to do even more sequencing to get a better distribution of the variants, but already the work being done is impressive.”
When it comes to treatment, Dr. Shafer said the monoclonal antibodies are the main advance.
“They have been the most effective treatments, and are most effective when they have been used for outpatients with rare, early disease,” he said, adding that they are also impactful when they have been used to prevent infection in high-risk areas like nursing homes and in the households of people that have been infected with the virus
The setback with Remdesivir, he said, is that because it is an intravenous drug, it is only given to hospitalized patients and has the greatest impact the earlier the patient is treated.
But there are a few agents Dr. Shafer said have been studied in clinical trials even though they are not widely available.
“They may become available in the next few weeks,” he said. “And that’s another nucleoside analog acting by the same mechanism as Remdesevir, but it’s given orally and we’re gonna learn about that pretty soon.”
Inhaled interferon is another option that he said is being looked at in a very large clinical trial because it showed some promise in a smaller clinical trial of about 100-200 people, along with a handful of other drugs that are being investigated into clinal trial.
Dr. Shafer did say that he was disappointed there would be more at-home therapies available right now, and was surprised at how quickly highly effective vaccines were made available compared to drugs to treat the virus. But he said we have been “extremely lucky” with the mRNA vaccines, considering how low the rate of serious side effects are.
At-home therapy is, however, approved for older and high-risk people, but Dr. Shafer recommends getting tested first and foremost if you think you have been exposed so that you can become eligible for treatment.
“For prophylaxis, I believe that any day now, there will be an emergency use authorization to still receive one or more of the monoclonal antibody formulations, but not yet,” he said, adding that there is an oral drug that we’ll “hear about any day now” manufactured by Merck, as well as an inhaled Interferon.