Remdesivir ‘is not a knock out punch’ but it does help patients ‘recover quicker’: doctor
Dr. Amesh Adalja, Johns Hopkins Center for Health Security, joins The Final Round to discuss his thoughts on the rising numbers of cases across the globe and the most recent developments in the vaccine race.
Video Transcript
SEANA SMITH: Welcome back to The Final Round here on Yahoo Finance. The daily coronavirus case count hitting the highest number that we have seen since July, six states recording their highest totals ever. So for more on this, we want to bring in Dr. Amesh Adalja. He is a senior scholar at the Johns Hopkins University Center for Health Security.
And Dr. Adalja, great to have you back on the program. This case count continues to climb. I’m just curious, just, as we try to gauge where we are in this pandemic, what does this tell you just about where we stand? Are the worst days still ahead of us?
AMESH ADALJA: I do think that some of the worst days may be ahead of us. Because we know that this virus is only going to intensify its transmission as it gets colder. It’s less sunny, less humid, people can do more things, only indoors versus outdoors. And the virus will intensify its transmission.
Couple that with pandemic fatigue and people wanting to get back to some semblance of their life. We have to be prepared to see more cases and hear about hospitals getting into trouble again, like we’re hearing about in Wisconsin and Utah, North Dakota.
SEANA SMITH: Yeah, speaking of hospitals getting into trouble, because usually those upticks in hospitalizations lag behind the rise that we see in the number of cases. And like you said, we already are seeing some hospitals, at least at this point, at or near capacity. Some are having to turn patients away.
How prepared are hospitals to deal with the surge that we’re seeing right now? Or better prepared, I should say, the second time around? Because some of them are already near capacity.
AMESH ADALJA: It’s a hodgepodge across the country. So if you’re looking at a metropolitan area like New York or where I’m talking to you from in Pittsburgh, they’re fairly well prepared and can deal with it when they’ve got big academic medical centers that have been thinking about this problem. But if you’re talking about a rural place in North Dakota, the hospital preparedness is probably very spotty. Hospital preparedness is something that is not well prioritized by hospitals, by funding agencies.
So this is something that really is going to be challenging for many hospitals. And I do think that many places didn’t do the work during the time that we had, this lull, or where they weren’t inundated, they weren’t building up their hospital capacity. They weren’t thinking about how they’re going to deal with a surge.
I think there was a lot of magical thinking going on that this wasn’t going to happen or somehow that our worst days were ahead. This is a long pandemic, and it is a marathon, not some kind of a sprint. So we’re going to have to continue to make sure that our hospitals are in a good position, or we will run into problems with mortality rates going up, not just for COVID, but for other conditions as well, as hospitals are stressed and can’t deliver care in a good way.
AKIKO FUJITA: Doctor, we saw the FDA approve Gilead’s remdesivir as treatment for the coronavirus. This is, of course, one that President Trump has touted very highly, given that he was given that when he was treated for the virus. But we also have heard from the WHO talk about how this drug has had little to no real effect on the death rate.
And so I’m curious how you view the effectiveness of the drug and how this gives those first responders, you know, one more tool to be able to respond to this uptick.
AMESH ADALJA: Remdesivir is a tool, but it’s not, what we would say is a knockout punch, it’s not a curative type of therapy. It doesn’t seem to impact a person’s chance of dying. But what it does have a benefit in is getting people out of the hospital faster, making them recover quicker. And that can be a value, especially as we’re talking about hospitals that are worried about capacity.
If you can get people out of the ICU a day earlier or out of the hospital a day earlier, that is something that’s valuable. So I do think that there is– this is something that we’re going to use as a tool, and the approval is a good thing. However, this isn’t game-changing or anything of that sort. Maybe some of the monoclonal antibodies that the president and former Governor Christie got.
When those get approved, I think that’s something where we might see a benefit on mortality rate, the way we have with dexamethasone, a steroid that we give people.
RICK NEWMAN: Hey, Dr. Adalja, Rick Newman here. So those different types of treatments that have been developed that you’re describing, have those improved treatment of COVID to the point that mortality rates have gone down? And I’m not asking that to understate the seriousness of the disease, but just to measure whether the medical community is making progress in learning how to treat this.
AMESH ADALJA: We certainly have been making progress. It’s much better to be in a hospital with COVID now in October of 2020 than it would have been in March of 2020. Not only do we have dexamethasone and remdesivir, and dexamethasone is something that does decrease mortality, we know a lot more about this disease.
We diagnose it quicker, we get people on the correct treatment path quicker, we’re much better at managing their oxygen needs, not reflexively putting people on mechanical ventilators, for example, using– keeping people prone on the bed. We also know the complications, know how to recognize them, prevent them, and treat them when they occur. So we are seeing a decrease in mortality rate of people who are admitted now versus back in March.
Again, this is still a deadly disease. But it is something that medical science has been able to somewhat decrease the virulence of. And I think there’s still a long way to go, and we need more tools desperately to be able to turn this into something that’s manageable and not a public health emergency any longer.
[INTERPOSING VOICES]RICK NEWMAN: –follow up to that, if I may. So, you know, we’ve seen VIPs, like the president and Chris Christie, the former New Jersey governor, get treatment that other people cannot necessarily get. Is that OK? Does that– does that help our understanding of the virus, or does that perhaps public– sort of add to the public health risk? Because it makes it seem like ordinary people will have a better time with this if they do.
AMESH ADALJA: Certainly, the optics of the president and former Governor Christie getting monoclonal antibodies, which are only available to the general public through a clinical trial does kind of send the wrong message. But I do think that the use of these monoclonal antibodies is something that we all have to celebrate because it might be something that will change the way we deal with this virus. It may be a bridge to a vaccine.
Because this could possibly keep people from dying or keep people from needing to be hospitalized. So hopefully, what we’ll see is emergency use authorizations for these drugs if the data seems to be robust. It looks, so far, promising in the clinical trials. Although, the Eli Lilly trial is now on hold.
It is something that, I think, we want to have in our tool belt when we’re taking care of these patients. And it may be something that will really impact the way we deal with this disease in the future.
SEANA SMITH: Dr. Adalja, when we talk about potentially getting a vaccine, we heard that California earlier this week, they won’t approve or won’t allow virus vaccines without state approval. And we heard this from California Governor Gavin Newsom. He was just talking about the fact that he wants a panel of experts to review any federally-approved vaccines before they’re administered in this state.
I’m curious just what this would do for a potential timeline just in terms of distribution, how much further out something like this could potentially push that.
AMESH ADALJA: I do think that states that are doing this, I understand why they’re doing it, but I don’t think the solution to worries about politicization of the FDA is to have 50 FDAs. That will make it much harder for these vaccines to get into the arms of Americans, and it’ll be much longer to control this– control this virus. So I think the solution is is to make sure that the FDA is empowered to make decisions based on science, that they’re not having the political pressure that they felt for convalescent plasma or hydroxychloroquine, and looking at experts, like Dr. Fauci, and professional societies, like the Infectious Disease Society of America, to guide the way that we use this vaccine if there is concern about that politicization.
I worry about what that kind of bureaucracy will do because we know that when it comes to vaccine regulation, when it comes to pharmaceutical regulation, that can be a major cost for companies to get through. And it is a major time kill for how long it takes a vaccine to actually go from a phase III clinical trial into the arms of Americans. So I do think it’s probably not the right thing to do, and there’s a lot of politics involved here.
But I understand, based on the track record so far during this pandemic, why some states feel comfortable doing it.
SEANA SMITH: Dr. Amesh Adalja, always great to have you on. The senior scholar at the Johns Hopkins University Center for Health Security we’ll have you back soon. Have a good weekend.
AMESH ADALJA: Thank you.
