“I Want A New Drug” — One To Treat Coronavirus

Not that any of them have time to be singing right now, but health care professionals are certain to embrace “I Want A New Drug” as their current anthem. This 1984 hit by Huey Lewis and the News was a love song, but medical workers today are taking the title literally. Everyone is clamoring for a drug–“one that does what it should,” i.e., take on the dread coronavirus. Why is that? Well, duh, none exists at this point. 

Doctors are worried about the coronavirus pandemic because there is no specific medicine available to prevent or even treat coronavirus. What this lack means is that if a patient contracts coronavirus, all a doctor can do is to monitor him and provide supportive treatments. It’s not like having strep throat where the doctor prescribes an antibiotic, and you take a pill that very quickly makes you feel better.  

So, there’s no medicine to prevent someone from getting coronavirus. Why don’t we just have our crack scientists and medical personnel come up with one lickety-split? After all, necessity is the mother of invention. By golly we need that medicine yesterday as thousands around the world are dropping like flies during this pandemic. Nope. Doesn’t work like that.

Development of a vaccine usually takes 10 to 15 years. After that amount of time, the 2020 coronavirus pandemic will hopefully be nothing but a bad memory. Timing is everything as they (whoever “they” are) say.  Developing a coronavirus vaccine that won’t be available for a decade or so is of absolutely no help now. A fast food mentality is incompatible with the vaccine development process. 

OK, then, why don’t we just whip up a new drug to use in treating patients with coronavirus since we don’t have a vaccine to prevent them from getting it?  Nope. That won’t work either. Why? Because developing a new drug treatment also takes time–time that patients in the ICU don’t have. How much time is needed? Typically it is a decade from the discovery of a new drug treatment until it is on the market. 

Because it is impractical to timely develop a new drug, pharmaceutical companies throughout the world are working 24/7 to develop an effective drug treatment with existing medications. Unfortunately, there have been no clear breakthroughs yet. But there are some good possibilities. 

This past weekend the Food and Drug Administration (“FDA”) gave emergency use authorization to treat coronavirus patients with two anti-malarial drugs–chloroquine and hdroxycholorquine. These medications have produced positive results in small, early tests, but no controlled clinical trials have been completed yet. And, of course, controlled clinical trials take–you guessed it–time.

I don’t know about you, but if I’m on my deathbed with coronavirus, I think I’d take the gamble to try something that has given promise in test tube form even if hasn’t been vetted through painstaking and lengthy clinical trials. The worst that will happen is that it doesn’t work I’d die, which I’m likely to do anyway if I take no medicine.

But how does an anti-malarial medicine used to treat a disease caused by a mosquito bite help a patient with coronavirus? According to the experts (of which I am clearly not one), chloroquine and hydroxychloroquine are effective in two ways. First, they block the virus; second, they reduce the inflammation which occurs when the body reacts to the presence of the coronavirus.

Understanding what the virus does is key to combating it medically. You need to know your enemy as they (whoever “they” are) would say during the Cold War. A coronavirus typically attacks one’s respiratory system. So if you are wondering why there’s such a clamor for ventilators for coronavirus patients, now you know. Yesterday, it was toilet paper; today, it is ventilators in huge demand.

Infected patients may develop pneumonia, but the virus isn’t what’s causing the pneumonia–it’s the patient’s strong immune response to the coronavirus. An overprotective immune response can be fatal. You’ve heard of too much of a good thing? Well, that’s what’s happening to some coronavirus patients whose immune systems are compromised by age and/or underlying health conditions. The normal immune response doesn’t cut off when it should. Immune cells flood the infection site causing surrounding tissue to become inflamed. The inflammation causes severe respiratory distress and the subsequent shutdown of multiple organs. 

If inflammation can be reduced, the patient might be kept from being put on a ventilator or could be taken off of one–assuming there was one available to put him on. Therefore, medications with anti-inflammatory benefits are being considered. Chloroquine and hydroxychloroquine are oral prescriptions drugs which have been used since the 1940’s for the treatment of malaria and some inflammatory conditions. President Trump’s plan to deliver large amounts of these anti-malaria drugs to hospitals was given emergency approval by the FDA while clinical trials are ongoing. Hopefully, the supply of such drugs is larger than the apparently woefully short stockpile of ventilators.

An experimental drug named leronlimab is also being considered for use against the coronavirus. Although typically used to treat breast cancer and HIV, it is deemed a promising treatment for coronavirus. This IND (Investigational New Drug) calms the immune system’s overly aggressive response to the virus which can lead to pneumonia or death. If trials prove  leronlimab is not effective against coronavirus, it is still most certainly effective in twisting your tongue when you try to pronounce the drug’s name–especially if you say the name quickly three times.

It’s going to take time to develop a vaccine to prevent and new medications to treat coronavirus. Nevertheless,it takes no time at all for everyone to simply engage their brains and act with common sense. Stay home if at all possible. If you must go out, practice social distancing. Wash your hands frequently. It doesn’t take a decade long controlled clinical trial to establish that these are prudent ways the average citizen can protect himself against contracting the coronavirus. After all, as they say (whoever “they” are), an ounce of prevention is worth a pound of cure. 

Just WONDER-ing:

Were you aware that it took so long to develop vaccines and new drugs? What’s less expensive to do–practice social distancing or formulate a new drug? What’s easier for you to do–stay home or develop a coronavirus vaccine? If you were in ICU, would you consider using an experimental drug which showed promise even if it hadn’t passed controlled clinical trials yet?

 

 

 

 

 

 

 

 

 

 

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