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Tywin et al.

COVID-19 #13 or: How I Learned to Stop Worrying and Love the Disease

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It's Wednesday morning? Jeez. Anyways, continue. 

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Just watching CNBC - apparently positive data on remdesivir as an effective antiviral treatment in a double-blind test. Sounds like it could be good news!

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South Korean doctors have concluded that people re-testing positive for COVID-19 after apparently recovering seems to be down to "dead" fragments of the virus that have not cleared their system. This refutes the idea of re-infection of people who've already had symptoms.

Good news, although it raises the prospect that a lot of people could test for false positives when the virus is no longer infectious or dangerous and they're actually fine.

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1 hour ago, Jeor said:

Just watching CNBC - apparently positive data on remdesivir as an effective antiviral treatment in a double-blind test. Sounds like it could be good news!

Hopefully, but this is very preliminary data from a study conducted by the company that makes the drug.

I'd like to see replications by independent researchers before I get too excited here.

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36 minutes ago, Ormond said:

I'd like to see replications by independent researchers before I get too excited here.

True enough, we do have to wait and see but it could be the best news in a while. The good thing about an antiviral is that it should be much faster to mass produce than a vaccine, so can be used earlier than the 12-18 months people are quoting for a vaccine.

I'm actually surprised the markets aren't reacting to it more, but maybe that's because they're already way up over what they should be anyway.

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Posted (edited)
1 hour ago, Ormond said:

Hopefully, but this is very preliminary data from a study conducted by the company that makes the drug.

I'd like to see replications by independent researchers before I get too excited here.

Just to note, there are two studies going on here. One is the one you mention, run by the manufacturer, but that has no control arm, so it is essentially of very little use to measure the effectiveness of the drug vs standard care - They've released the results for that one.

Secondly, it's the larger study *AND* one that has a control arm run by the National Institute of Allergy and infectious disease ( NIAID), that we need to look at the results for - apparently they're going to have a briefing soon about that so we'll have to wait and see.

Edited by Raja

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Posted (edited)
1 hour ago, Jeor said:

I'm actually surprised the markets aren't reacting to it more, but maybe that's because they're already way up over what they should be anyway.

I'm actually pleased that markets aren't reacting to a non-randomised trial...let's see what the NIAID trial says. 

The leaked WHO trial was randomised and showed no statistically significant benefit. But I understand that one suffered from low enrollment. 

Edited by Paxter

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The UK has changed it's daily covid 19 statistics update to include deaths in care homes and the community. It's still only those who have actually tested positive in these numbers though with the weekly ONS report covering the rest.

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As much as I want Remdesivir to be a tool in the toolkit I can't help but feel as I watch this press conference that it's all being coerced somehow.  

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There is potentially a lot of money to be made, and the drug companies have a long track record of putting their thumb on the scales when it comes to testing. They are also well used to marketing drugs that give only minor improvements - the cynic in me can see them doing just that here.

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Posted (edited)

It does seem to have outperformed HC at least.  High bar there.  

 

ETA:  Gilead stock jumped like 7% on the news.  Actually kind surprised it's not more.  Not cause I think the findings look so robust so far.  Just that I figure that since the findings suggests probably better than placebo and everyone so desperate for anything  that orders and use could skyrocket.

Edited by Triskele

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~~~~~~~~~

The NY State Health Commissioner thinks the so-called random testing NYC has been doing indicates that it's likely over 45% of the residents of the Bronx have been infected to some degree or other (they also provided the most fatalities, along with the Hassids, allowing de Blasio to shoot himself in both feet yet again -- politicians! stay off twitter! unless you are AOC, and even she blows it sometimes:

https://www.nytimes.com/2020/04/28/nyregion/hasidic-funeral-coronavirus-de-blasio.html?   ).

So. The damage is out there no matter what? he asks? may as well re-open the city since it can't be contained? 

Today's news cycle informs NYers  new hospitalizations for NYC have increased since the day before -- not by much, but still an increase, not a decrease, from the day before, not fulfilling the stated requirement that there be a 14 day straight decrease every day to as close to zero as possible.
 

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Bah, I can't blame the mayor for getting angry. A group of Hasidic Jews from Montreal decided to spend the holidays in NYC in March, and likely are responsible for a big chunk of the Montreal area Covid-19 cases. It's not a bloody joke.

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The US governent is going to issue an emergency use order for Remdesivir, allowing it to be used imediately

"It has a clear-cut positive effect in reducing the effects of Covid-19", says Dr. Fauci.

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Posted (edited)
5 hours ago, Raja said:

Just to note, there are two studies going on here. One is the one you mention, run by the manufacturer, but that has no control arm, so it is essentially of very little use to measure the effectiveness of the drug vs standard care - They've released the results for that one.

Secondly, it's the larger study *AND* one that has a control arm run by the National Institute of Allergy and infectious disease ( NIAID), that we need to look at the results for - apparently they're going to have a briefing soon about that so we'll have to wait and see.

Is the second study this one:

https://www.theguardian.com/world/2020/apr/29/remdesivir-coronavirus-drug-experimental

It doesn't look like a game changer but still useful.

Edited by williamjm

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15 minutes ago, williamjm said:

Is the second study this one:

https://www.theguardian.com/world/2020/apr/29/remdesivir-coronavirus-drug-experimental

It doesn't look like a game changer but still useful.

Could have been a good, early positive message from Trump if he hadn't already torched his credibility* and good will* with HQ, UV, and injecting disinfectant into the lungs.

*Such that it existed in 2020

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32 minutes ago, williamjm said:

Is the second study this one:

https://www.theguardian.com/world/2020/apr/29/remdesivir-coronavirus-drug-experimental

It doesn't look like a game changer but still useful.

It does appear to be the one Raja linked to.  

Dr. Fauci's institute, known as NIAID, is a sub office of NIH.  Your article mentions NIH.  They're sort of one and the same.  NIAID is the allergy and infectious disease wing of NIH.

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5 hours ago, Triskele said:

ETA:  Gilead stock jumped like 7% on the news.  Actually kind surprised it's not more.  Not cause I think the findings look so robust so far.  Just that I figure that since the findings suggests probably better than placebo and everyone so desperate for anything  that orders and use could skyrocket.

IIRC, Gilead's stock has already been inflated on the expectation that the drug would work out. They're up over 30% from end of January. I also remember seeing an investment memo, I think from Goldman Sachs, suggesting that Gilead likely won't make too much money from all this, even if the drug works. Too great a chance for similar competitors and generics to quickly get on the market if there's any evidence of success.

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Posted (edited)
2 hours ago, williamjm said:

Indeed :) We haven't actually seen the paper, so I'm waiting to read that when it's published, not enough data at the moment & the effect seems marginal ( big caveat is that we need to actually see the paper, the data they've released is not much)

Edited by Raja

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I assume remdesivir is already registered in the USA, so it's just and adjustment to prescribing guidelines. A 31% reduction in recovery time and a 27% reduction in deaths among hospital patients is very good. But it doesn't suggest there should be a substantial relaxation of control measured aimed at limiting spread. In areas where hospitals aren't overrun this would be a tool to help establish more head room in bed availability if there is a surge in cases. IN areas where there is already plenty of spare capacity the availability of the drug could allow a faster pace in relaxing any lockdowns. In areas where hospitals are overrun this will help to get hospitals back to only operating at maximum capacity or just below, but will do nothing to allow faster relaxation of lock-down measures.

Also until the drug is able to be ubiquitously supplied prescribing will probably have to be limited to hospital cases only, which means in-home cases that may also benefit in reducing severity of disease and reduce hospitalisation rates may be some time away. The problem is the study only looked at severely ill patients, so the study won't provide any information on whether it can reduce hospitalistion rates if used on people showing moderate symptoms before they get bad enough to need hospital care.

There may need to be some patent busting to allow manufacturers of generics to produce in order to ramp up production. 

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