Coronavirus: Treatments and Vaccines

Recently a science teacher said that treatment for covid with remdesivir or hydroxychloroquine is better than a vaccine. I said, treatment like that is good but a vaccine is better. She said, “no. since many people get adverse reactions from vaccines, a treatment is better”. So I decided to write this blog post. First, let us consider what are drug treatments and how they are different from vaccines.

Drug treatments: Currently over 70 companies are working on various drug treatments for novel coronavirus. Although this virus is novel, not all drugs being considered are entirely novel. For instance, like the previously considered malaria drug, hydroxychloroquine, Gilead’s drug, Remdesivir, that is in the news, is not a novel drug. Remdesivir is a broad spectrum antiviral drug that has been found to successfully prevent MERS coronavirus in rhesus monkeys. Besides antiviral drugs, there are other anti-inflammatory drugs. Scientists believe that in the end, what might work may be a sort of a cocktail or some combination of antiviral and anti-inflammatory drugs.

Drug treatments do not prevent Covid-19. These drugs are offered to patients who are already suffering from coronavirus. On the other hand, vaccines prevent people from contracting the disease in the first place.  

Drug treatments are not cures. 1) there isn’t a 100% response rate among people treated with remdesivir or any other treatment. So despite many drugs showing promise, there are a few people who will respond to a drug; many still die. 2) many who suffer from the disease but go on to recover, they still utilize huge amounts of hospital resources during their illness phase. 3) during the illness phase, these sick people also spread the virus with the possibility of making others (including healthcare professionals) sick. 4) even people who may recover with the help of these drugs from covid, may have suffered substantial damage to their lungs and that may reduce their lifespan or affect them in other ways.

Vaccines:  Vaccines prevent people from getting sick. So when people don’t get sick, they don’t spread the virus, don’t utilize healthcare resources, don’t infect healthcare professionals or others in the community, and don’t get any kind of long lasting damage to their lungs. Clearly, vaccine is a far superior way to deal with coronavirus.

Why are vaccines taking much longer than drugs for covid?

As I mentioned above, many of the drugs considered currently for treatment of covid are already in existence for some other illnesses or diseases. So there are existing drugs considered for either preventing covid deaths or preventing people from becoming sicker and helping them recover faster and ending hospital stays earlier.

Vaccines on the other hand, have to be developed. There are considerable challenges at each stage of vaccine research, development and manufacturing. First of all, pharmaceutical companies have decreased vaccine research and development in the last several years, because vaccine development and manufacturing is expensive, time consuming and offers smaller payback in terms of revenues. For each new virus and for all mutations, the vaccine has to be developed and then when the virus is not active then the vaccine is not useful. Clinical studies take place during the research and development phase. Only if the studies show the vaccine to be safe and effective then the vaccine proceeds to the next phase where it has to be manufactured in large quantities required.

During a pandemic like this one, not only do we need a vaccine quickly but the world will also need  hundreds of millions of doses for the entire world population.  Fortunately, pharma companies, scientists from all over the world, billionaires like Bill Gates and Governments and countries have stepped up to tackle this challenge, with an unprecedented spirit of collaboration.  There are measured expectations for an effective vaccine to be available within 12 to 18 months. That is an unprecedented and highly aggressive timeline. Bill Gates has offered to support manufacturing of top 7 candidates during the research and development phase. That means, even without the proof of effectiveness of any of them, he will foot the bill for manufacturing all of them, in the hope that at least a couple of them will prove to be safe and effective and the world will get required doses speedily. Meanwhile, countries like India are getting ready for manufacturing of vaccines. India has proven capability and expertise to ramp up production of vaccines, while keeping costs down. Regulatory hurdles are likely to be less severe as US FDA and other regulatory bodies have promised EUA (emergency use authorization) for drugs and vaccines that may help contain covid.

If drugs like Remdesivir work then that will help some people recover and recover faster; so let us hope that any one of these drugs alone or in combination with other drugs will reduce mortality, shorten hospital stays, and help reduce spread of covid. But ultimately we need a vaccine for covid-19 and the way in which entire world is coming together, gives much hope for availability of a speedy vaccine.