Early COVID-19 treatments could be ‘bridge’ to vaccine, Fauci says

Todd Prussman

Cloned antibodies that stop the coronavirus from spreading in the body are among promising strategies for averting severe illness from COVID-19 before vaccines arrive, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Antibody-based medications, other blood products from recovered patients and antivirals are being investigated as early treatments, Fauci said. The aim is to prevent patients from developing the serious lung damage for which Gilead Sciences Inc.’s remdesivir and the anti-inflammatory drug dexamethasone are administered.

“We are focusing very heavily now on treatment of early infection and/or prevention of infection,” Fauci told the Journal of the American Medical Association in an an interview. “And that’s the bridge to the vaccine.”

Immunization against SARS-CoV-2 could begin in the U.S. in November or December, Fauci said, though it will probably take until at least the third quarter of 2021 for enough Americans to be protected against the pandemic virus to significantly diminish its threat.

Fauci said 100 million doses of vaccine may be produced by December, with all six companies supplying the U.S. slated to have made 700 million doses by next April.

“Optimally, we’d have an oral antiviral drug you can give to more people earlier in the course of the illness,”  said Robert “Chip” Schooley, a professor of medicine at the University of California, San Diego, who is studying more potent versions of an existing antiviral treatment.

Vaccines might not be 100% effective, he said, “which is better than nothing, but we’re still going to have to rely on drugs and behavioral modifications for a long time to come.”

Blockbuster studies published by the journal Science on Thursday showed about 14% of critical COVID-19 patients have impaired levels of a substance called interferon that helps orchestrate the body’s defense against viral pathogens.

The finding opens up new strategies for identifying high-risk patients and treating them with interferon infusions or, in some cases, removing interferon-blocking antibodies from their blood in a procedure called plasmapheresis.

Monoclonal antibodies, a product made by cloning an antibody captured from the blood of a patient who recovered from COVID-19, could also be given to high-risk patients in nursing homes as a preventative treatment, Fauci said.

Ely Lilly & Co.’s experimental antibody LY-CoV555 showed some hopeful signs in a trial among out-patients, the company said on Sept. 16.

“We have some cautious optimism that monoclonal antibodies may be an important therapeutic for early disease,” Fauci said Sept. 10 in an online briefing for Massachusetts General Hospital staff. “We need something to keep people out of the hospital.”

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