Remdesivir, a drug that has shown early promise as a treatment for COVID-19, should be used “carefully and wisely”, rather than as an excuse to flout the social distancing requirements, the first doctor in US ever administered the medicine warned on Monday.
“It appears that we do have an agent in our armamentarium against COVID, but we have to use it very wisely,” said Dr George Diaz, section chief of infectious diseases at Providence Regional Medical Center in Everett, Washington.
“This should not be used as a crutch to – for patients to say, well – or people to say, ‘I can now do whatever I want because we have a treatment.’ ” Diaz told reporters in a Foreign Press Center briefing via video Monday.
Diaz treated a patient diagnosed with the novel coronavirus, who was also the first US patient to be treated with remdesivir, an antiviral drug developed by the California-based Gilead Sciences.
In a major study run by the US National Institute of Allergy and Infectious Diseases, researchers found remdesivir reduced patients’ recovery time by 31 percent, from 15 days to 11 on average and may have also an improved or reduced mortality.
On Friday, US President Donald Trump announced remdesivir has been authorized by US regulators for emergency use against COVID-19. On Sunday, Trump said the US government is putting its “full power and might” behind the experimental drug.
At least 100 million Americans were in states making assertive moves to reopen, or had no stay-home orders to begin with, according to an Associated Press tally. States home to more than 210 million people were taking more gradual steps or didn’t appear close to reopening.
“The people of the world need to continue to follow the guidance of the infection control and public health people that are advising them about social distancing,” Diaz said.
The doctor said that any medication for treatment of an infection, whether it be to treat bacteria or viruses, should be used appropriately, because widespread inappropriate use of any medicine can result in resistance to that particular medication.
“And so as the FDA has approved this medication on Emergency Use Authorization, it’ll be really important that we try to use this medication as appropriately as possible. And to this point, it’s only been shown to have some effectiveness in people who have severe pneumonia,” he said.
The maker of remdesivir is also studying the drug in patients with less severe COVID-19, but those results are not expected until later this month, according to earlier media reports.
“So I would say that we need to be very careful in how we use this medication and use it very wisely, because widespread inappropriate use could result in potentially the development of resistance to the antiviral, as we’ve seen on occasion to, for example, treatments for influenza,” Diaz said.
The largest side effect has been nausea, but “at my center we did not have to discontinue that medication for that reason”, Diaz said, adding that other side effects include transient rises in the liver function tests of a patient.
At an online briefing in Geneva on Monday, Mike Ryan, top emergencies expert of the World Health Organization, said the WHO welcomed recent clinical trial data for remdesivir, saying there were “signals of hope” for the potential use of the drug in COVID-19 patients.
“We will be engaging in discussions with Gilead and the US government as to how this drug may be made more widely available as further data emerges on its effectiveness,” Ryan said.
However, a study on 237 severe COVID-19 patients in China between Feb 6 and March 12, published in the Lancet on April 29, found that remdesivir was not associated with “statistically significant” clinical benefits.
“Remdesivir use was not associated with a difference in time to clinical improvement. Although not statistically significant, patients receiving remdesivir had a numerically faster time to clinical improvement than those receiving placebo among patients with symptom duration of 10 days or less,” the study said.
On Sunday, Gilead Sciences CEO Daniel O’Day said remdesivir could reach COVID-19 patients within days.
“We intend to get that to patients in the early part of this next week … beginning to work with the government, which will determine which cities are most vulnerable and where the patients are that need this medicine,” O’Day told CBS.
Remdesivir previously failed as a treatment for the Ebola virus. It is being tried against COVID-19 because it is designed to disable the mechanism by which certain viruses make copies of themselves and potentially overwhelm their host’s immune system, Reuters reported on April 29.
