Why is There so Little News about Drugs to Treat Covid-19?
[Thursday, August 13, 2020]
While coronavirus vaccines have constantly been in the news, there is little noise about treatments. Vaccines cannot help those who are already infected and seriously ill, so, it should be surprising that there is so little news about treatments. In fact, there are about 10 times as many Phase 2 and 3 treatment clinical trials for Covid currently ongoing than there are for vaccines. But a close review of the treatment trials shows that almost all are evaluating standard of care symptom relief therapies rather than novel state-of-the-art treatments that generally attract popular media. Unlike coronavirus vaccine trials which present a very organized evaluation of less than 10 different vaccine types, the treatment trials are highly diverse, ranging from various combinations of anti-virals, antibiotics, and other drugs. Most of these trials are based on poorly supported rationale making them seem like broad stroke approaches hoping for something to stick. Such trials are inherently designed to exploit the opportunity rather than test a well-supported hypothesis. Viral treatments are anyway hard to develop. It requires years of work to understand the biology of the virus to find specific blockers of steps in its life cycle. Coronavirus was, somewhat incorrectly, compared to flu from the beginning leading to a focused effort in developing a vaccine rather than treatments, just like flu. While there are several effective vaccines to flu, there are very few treatments for it. Another factor that probably worked against a coronavirus treatment is that the fatality rates for the infection are around 1-5% by the best estimates making the drugs to treat a much smaller market than a vaccine, again just like flu. Any financial returns from developing treatments to the coronavirus were probably in the early phases of the pandemic when there wasn’t much news on the vaccines, and it was estimated that vaccines may take more than a year to develop. With vaccines getting ready for mass use soon, that business opportunity is greatly diminished, if not totally gone. Once vaccines for the coronavirus are available, which could be soon, there would be scant interest in any efforts to find treatments. While the US government alone has committed billions of dollars to various vaccines, even pre-purchased hundreds of millions of doses of still to be approved vaccines, there will not be similar interest in treatments for the coronavirus. In fact, the three treatments available for the coronavirus - remdesevir, dexamethzone, and convalescent plasma – were developed with very little public money.  The different fates of vaccine and drugs for coronavirus highlight the key factor is any product development – financial returns to developers. Only products with significant financial returns get developed, and that’s how it is.