the U.S. National Institutes of Health tested remdesivir against usual care routines for 1,063 coronavirus patients worldwide.
On Wednesday, US NIH Dr. Anthony Fauci – head of the White House coronavirus task force – said initial results from an unfinished trial show the drug has reduced patient recovery time by 31%.
He called it “a clear and significant positive effect” and suggested that the drug could become “the standard of care” for people who get COVID-19.
But the study is not yet finished. And another medical trial in China found that remdesivir did not improve the condition of the patients or reduce the presence of the pathogen in the bloodstream. These results were published Wednesday in the Lancet medical journal
Dr. Tim Lahey, infectious disease specialist and ethicist at the University of Vermont Medical Center, spoke with As it happens animate Carol Off on the conflicting results on the drug’s potential. Here is part of their conversation.
From your point of view, how important is this news regarding this remdesivir?
I think this is a big problem. This is the first time that we have really had any evidence that something is likely to work against this virus.
Dr. Fauci called it very important. Would you agree with that?
I think he’s right about the money.
Here we have human patients – some received remdesivir, others received a placebo – and it is clear that there is a statistically significant difference for the people who received the drug. It’s the first time we’ve had something that seems to work.
I think there is a need, you know, to open up, maybe not an expensive bottle of champagne, but maybe a beer and celebrate this preliminary result.– Dr. Tim Lahey, Vermont Medical Center
This study is not finished … What questions do you still have about this medicine and about this study?
This raises a very important caveat. This is not a study that has been completed, but rather an intermediate check by the people who monitor the safety of the subject.
You might imagine that over time this difference between the placebo and the drug recipients might go away, or maybe some safety issues might appear.
So we really have to let the study finish and really get all the information before we can bring these results to the bank.
But I think there is a need, you know, to open up, maybe not an expensive bottle of champagne, but maybe a beer and celebrate that preliminary result.
What exactly does this medication do? … This is not a cure for COVID-19.
It is true.
It is a drug that has been administered to people hospitalized with COVID-19 – therefore to relatively sick people. And it helps them improve faster.
And so it’s certainly not the vaccine we’re really looking for [for] which can protect people from getting sick in the first place.
All we know is that it gives us a tool to help people who are frail, hospitalized and in need of treatment.
I don’t need to tell you that any kind of treatment for this disease is of monumental importance, is it? So how hard is it to look objectively, to have a clear scientific eye on something like that, when there is so much pressure to find a cure?
I think we have all been dismayed by some of the pseudoscience that plagued the COVID-19 epidemic. And I think it’s all motivated by hope and despair.
This study was really for me the first time that we can put our hopes on the fact that this is really a beneficial scientific signal.
But, you know, we want to make sure to temper that enthusiasm, even, and recognize that this study is half finished. We do not have all the details of all of the investigators’ findings. This is good news, but we are waiting for all the details before we start jumping up and down and shouting hurray.
Really, we need to temper our enthusiasm enough to make sure we get the right science.– Dr Tim Lahey
There is another study on remdesivir outside of China … with a limited group and it was published in The Lancet today. And in this study, it did not show any significant value for the drug for the treatment of critically ill patients with COVID-19. What does that tell you?
I think this is a really important conclusion for us to put aside from this.
There are different ways to understand why two studies would show slightly different results.
The other way you can explain it is that they may have looked at slightly different endpoints. So maybe the way they measure the improvements …[or] when they administer the drug is a little different.
That’s why i’m really looking forward to seeing the details of the [U.S.] study that has not yet been published and put them right next to it in The Lancet and say, “OK, really, what’s the answer to this mystery here? “
I was watching Dr. Fauci today in the United States, in Washington, in a room with President Trump. Obviously, there is so much to do about it that they can say it’s the beginning of the end. And will there be room to really explore these possibilities and have the doubt you describe?
We must. You know, I think the real tragedy would be to add to the death toll of COVID-19, on top of that, a layer of poor quality science.
Really, we need to temper our enthusiasm enough to make sure we get the right science. And that doesn’t mean we can’t do things like expanding compassionate access to medicines, or thinking about how to recruit more people into more studies, if that sounds promising.
But we need to make sure that we don’t let our desperation for a quick fix stop our critical thinking or stop us from letting scientists do their job.
So I’m excited. But I want the studies to be finished, even if we all would like to have them done yesterday.
Written by Sheena Goodyear with files from CBC News and the Associated Press. Interview by Kate Swoger. The questions and answers have been edited for clarity and length.