No one wants to go back to a nationwide coronavirus lockdown. French Emmanuel Macron and Spaniard Pedro Sanchez rule out general stay-at-home restrictions, even as cases of Covid-19 rise. Their motives are clear: Another round of widespread lockdowns would result in a reservoir of the economy and a division of society, and would also be an admission of defeat on the part of politicians and public health officials who – like Sanchez – insist about the fact that we are “better prepared” to control the epidemic than we were in the dark days of spring.
The less drastic strategy of combining preventive measures while waiting for a vaccine to emerge is laudable. But there are also limits here. Mask policies becomeharder and more complicated, risking confusion and hostility. International travel restrictions, which have not always been effective or easy to enforce, areaccumulates again. And while testing and tracing are essential to improving our ability to detect cases, resource gaps remain. Spain commits thethe military to aid its efforts.
The tangle of rules will become more and more difficult to apply over time. History suggests that citizens end up resenting epidemic decrees, the mask ” lazy people ”from the Spanish Flu of 1918-19 to 19th-century Naples residents who, as historian Frank Snowden recounts, protested the anti-cholera rules by eating large quantities of fruit that authorities might confiscate. There is a lifespan for such measurements.
A new emphasis must be placed on the curative above the purely preventive. While vaccines occupy an important place in the collective imagination, finding a treatment against the virus would be the real thinggame changer. It would likely be cheaper and faster to manufacture than a vaccine and reduce risks such as low take-up or a fight over doses. Stopping infections or deaths would rob Covid-19 of its most terrifying traits.
Unfortunately, seven months after the start of this pandemic, little progress has been made. We treat severe cases better, but not by many. An article published last month by the French government’s scientific advisory committee cited the low-cost anti-inflammatory drug dexamethasone – which reduces the number of deaths in patients requiring respiratory support – and the arthritis drug tocilizumab as being effective.
This is no ordinary virus, withseveral possible points of attack, including eliciting an uncontrollable immune response. Finding a cure takes resources. The Milken Institute has 316 treatments currently under study around the world, as well as 203 vaccines.
Yet time was wasted. Rushed clinical trials, intended to produce results faster, have only confused and fueledinfatuation. So far there have been more disappointments, like the fight against malariadrug hydroxychloroquine orHIV therapies, including lopinavir, are successful.
The result is that hospitals are still at the mercy of the virus. A predominance of milder symptoms and greater experience in treating Covid-19 has dropped the estimated overall case fatality rate to 3.5%, but suggestions that the virus has mutated to a much less virulent form are not still inconclusive. Hospitalizations and deaths, while increasing much more slowly than cases, are starting to accelerate again in countries like France and Spain. Julien Carvelli, intensive care doctor at La Timone hospital in Marseille, tells me that his concern is the mixture of Covid-19 patients with other patients as winter approaches.
The price to pay for the development of Covid-19 drugs, such as the reuse of generics,could reach $ 200 million per treatment (a fraction of the $ 1 billion it can cost to produce a single vaccine). It is all the more attractive that Covid-19 may end up requiring a cocktail of different therapies. Jeffrey Aronson, clinical pharmacologist at the Center for Evidence-Based Medicine at the University of Oxford, last monthlikened the use of a mixture of drugs to a siege strategy attacking all sides of the virus castle: preventing the virus from entering cells, preventing it from reproducing once it gets inside and alter the body’s immune response by stimulating or suppressing it at relevant times.
None of this means that more immediate prophylactics such as masks and social distancing should be abandoned. But scientific research must be supported and coordinated as part of the plan. If we expect another peak in cases this fall, patient trials should be ready.
Instead of getting caught up in a binary debate about stupid or smart locks, the focus should be on finding a cure that makes all kinds of locks obsolete. And it could be right under our masked noses.
This column does not necessarily reflect the opinion of the Editorial Board or of Bloomberg LP and its owners.
To contact the editor responsible for this story:
Melissa Pozsgay at [email protected]