Are we turning the corner on Covid-19 treatments?
Covid-19 treatments are key to living with the virus. Here’s where we’re at.
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there’s another new development on the horizon that, in combination with vaccines, might really be a game changer.
In recent months, researchers have made some advances in figuring out how to treat Covid-19 once you’ve contracted it. Of particular promise are medications available in a form that should be especially useful in the fight against the virus: pills. Pills are easy to store and ship, making them a more feasible option for worldwide distribution, and they don’t tax already overloaded hospital resources during a surge.
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The lack of good early treatments for Covid-19 has led to high demand for drugs that have gained adherents but probably don’t help all that much, from hydroxychloroquine to metformin to ivermectin. The effort to figure out how and whether those treatments work has been marred by widespread fraud in published research investigating them.
But there’s finally been some real progress on identifying Covid-19 treatments that not only are highly effective but also available for Covid-19 sufferers to take at home.
Fighting Covid-19 with a pill
One pill that’s been shown to be effective against the disease wasn’t even made to fight Covid-19.
Fluvoxamine is a cheap, generic antidepressant that’s been around since the 1990s. It also appears to reduce hospitalizations and deaths by Covid-19 by up to 30 percent, according to the results of a randomized, controlled trial, the initial findings of which I reported on back in August. Results from the so-called TOGETHER study, which tested fluvoxamine and some other treatments, were recently published in The Lancet medical journal.
How does fluvoxamine work in the case of Covid-19? Researchers’ best guess is that it modulates the body’s inflammatory response and reduces lung damage as the immune system fights off the coronavirus.
A 30 percent reduction in hospitalizations and deaths may not strike you as particularly high, but the drug is cheap (only $4 per dose) and has a demonstrated track record of safety (it’s FDA approved), which should strengthen the case for adding it to the global arsenal in the fight against the pandemic.
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An even more promising pill is Merck’s molnupiravir. Unlike fluvoxamine, it’s not already FDA approved, but it’s also repurposed after a fashion: Merck began developing the antiviral as an influenza treatment. It’s taken as a batch of up to four pills, twice a day for five days.
In Merck’s studies, molnupiravir reduced Covid-19 hospitalizations and deaths by about half. The UK granted the drug “conditional authorization” last week; the FDA has been reviewing the data since mid-October and will hold a hearing to discuss the data on November 30.
The US government has committed to purchasing 1.7 million courses of the drug for about $700 apiece once it’s approved or authorized for emergency use. Merck has licensed the generic manufacturing of molnupiravir at a much, much cheaper price in more than 100 developing countries, and the success of that program will be key for molnupiravir to make a difference worldwide.
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Pfizer’s Paxlovid is a little farther away from widespread availability, but recent research suggests it might be poised to make a huge difference. Paxlovid is an antiviral developed to target Covid-19 specifically by blocking a specific enzyme the virus needs to reproduce itself.
An interim analysis of an ongoing trial published by Pfizer last week noted that Paxlovid reduced the risk of hospitalization or death by 89 percent for adults at risk of severe Covid-19. That’s a huge effect size, and it’s always wise to be a little skeptical of results that good.
