Covid: How new drugs are finally taming the virus


The first patients in the NHS are being offered a new drug to help treat Covid-19. As Covid treatments are changing, fewer patients are becoming seriously ill or dying. So does this mean we are finally taming the virus?

At the start of the pandemic there were no drugs for Covid. In April 2020, I stood in a Covid intensive care ward while a doctor, in full PPE, told me they had nothing but oxygen to treat critically ill patients. I watched patient after patient on ventilators being turned on to their fronts to help their lungs take in oxygen.

It’s a deeply troubling memory that will always remain with me.

Now things have changed enormously. At the Royal Victoria Infirmary in Newcastle, the critical care unit looks and feels very different. Firstly, staff are no longer in full PPE, because most wards are Covid-free. At the peak a year ago the hospital trust was caring for 90 critically ill Covid patients. Today there are just three.

It is now the exception, rather than the norm, for patients to go on a ventilator. Hospital stays are much shorter and survival rates have improved significantly.

“Two years ago we had nothing,'” says Dr Matthias Schmid, head of infectious diseases at the RVI, who treated the UK’s first Covid patient at the end of January 2020.

“Now we have a range of treatments available which reduce the severity and prevent death in a huge number of patients.”

The focus now is on keeping patients from ever needing hospital treatment. That’s where antivirals come in.

There are thousands of medicines on the shelves in the Royal Victoria Infirmary’s automated dispensary, which is the size of a couple of shipping containers. When one of the pharmacists types in the name of a drug, the robot arm races down the central aisle, selecting the medicine and dropping the pack down a chute.

The box of pills selected is called Paxlovid – it’s an antiviral which, in trials, cut Covid hospital admissions by 88%. The treatment is being dispatched to high-risk patients across the UK who have just tested positive.

Through the Antivirals Taskforce, the government has procured nearly five million doses of Paxlovid and another antiviral, molnupiravir.

Both are designed to prevent a Covid infection from turning serious and form part of the armoury of treatments we now have against Covid.

Covid will not disappear completely, but even if a new more deadly variant emerges it should be managed by a combination of vaccines and the increasing range of effective drug treatments.

Covid has been the biggest challenge ever faced by the NHS. Two years on, hospitals can begin to plan for a future not completely free of the disease, but one where it no longer dominates healthcare and society.

Scientists identify new gene differences in severe COVID patients


Scientists have pinpointed 16 new genetic variants in people who developed severe COVID-19 in a large study published on Monday that could help researchers develop treatments for very sick patients.

The results suggest that people with severe COVID have genes that predispose them to one of two problems: failure to limit the ability of the virus to make copies of itself, or excessive inflammation and blood clotting.

The scientists said their discoveries, published in the journal Nature, could help prioritise the likely treatments that could work against the disease.

Eventually, the information could even help predict which patients were likely to become severely ill.

“It is potentially possible in future that we will be able to make predictions about patients based on their genome at the point of presenting (for) critical care,” said Kenneth Baillie, consultant in critical care medicine at the University of Edinburgh and one of the study authors, told reporters.

The genetic analysis of nearly 56,000 samples from people in Britain showed differences in 23 genes in COVID-19 patients who became critically ill, when compared with the DNA of other groups included in the study, including 16 differences that had not been previously identified.

The new findings could help guide scientists in their search for existing drugs that might be useful for treating COVID-19.

Arthritis drug could help save Covid patients – study


A drug used to treat rheumatoid arthritis could help to save the lives of patients with severe Covid, researchers have found, and they say its benefits can be seen even when it is used on top of other medications.

Experts involved in the Randomised Evaluation of Covid-19 Therapy (Recovery) trial say baricitinib, an anti-inflammatory drug taken as a tablet, can reduce the risk of death from severe Covid by about a fifth.

However, they add that when the impact of other medications used alongside the drug are also taken into account, the risk of death could be lowered by well over 50% – although the figure will vary from patient to patient.

“What we have now is a suite of drugs which tackle the immune system at different levels, and slightly different ways, which depending on the patient and their circumstances, and their other illnesses and so on, can be used either alone or in combination and further reduce the risk of death,” said Prof Sir Martin Landray, a joint chief investigator of the trial at the University of Oxford. He said the drugs did not appear to pose undue risks.

Writing in a preprint that has yet to be peer-reviewed, the team report how they looked at outcomes for 4,008 patients hospitalised with Covid between February and December 2021 who were given usual care – which included interventions such as oxygen, the steroid dexamethasone, the arthritis drug tocilizumab, which has to be given intravenously, and the anti-viral drug remdesivir.

These outcomes were compared with those for 4,148 patients who were given baricitinib for up to 10 days in addition to usual care.

The results reveal 546 patients given usual care died within 28 days of being admitted to hospitaland 513 patients who were also given baricitinib.

“This result was consistent across the very wide range of people we studied, younger people and older people, men and women,” said Landray.

Landray noted that those given bariacitinib were also more likely to be successfully discharged alive within the first 28 days, although the size of the effect was small, and less likely to require mechanical ventilation.

Antiviral Covid pills to keep us out of hospital


When the second red line appeared, Gill Harrington realised her fears had finally been realised. “You get used to seeing that one line on the lateral flow test,” she said. “But to see the two lines — well, it was terrifying.”

Testing positive for the coronavirus is worrying for anyone. But Harrington, a retired legal secretary, has a rare form of blood cancer that has left her with a weakened immune system. Despite having had three coronavirus vaccines, she knew her compromised immunity meant she was extremely vulnerable.

“I’ve been shielding since February 2020,” she said. “I’ve only seen family in the garden. My grandchildren — two beautiful little girls — live over the road but have never been inside my house.”

But despite her fears, Harrington was protected. There was a new safety net: an antiviral medication called molnupiravir, a pill that studies show halves the risk of hospital admission or death from Covid.

She is one of 10,000 vulnerable people — cancer patients, transplant recipients and those with Down’s syndrome — who have received specialised drugs within days of testing positive for coronavirus.

Professor Stephen Powis, medical director of NHS England, said: “It has been a remarkable achievement for a programme only started a month ago.” By the middle of next month another drug, Pfizer’s paxlovid, is due to be provided for vulnerable people in the UK. The pills have even better trial results, cutting the risk of death or needing hospital treatment by 89 per cent.

As Britain prepares for a post-pandemic world, scientists increasingly regard antivirals as a second line of defence against future coronavirus outbreaks. “The vaccine programme is our main pharmaceutical intervention and obviously will continue to be very important,” Powis said. “But drugs are the second key therapeutic intervention.”

Antivirals are also attractive for another reason. If a catastrophic variant arrived that bypassed our vaccines, scientists are confident antivirals would remain effective.

The Covid wave is receding. Restrictions are being eased. But the virus itself has not gone away. There will be future outbreaks and future waves. Combined with vaccines, however, antivirals promise to help ensure that Covid never again causes the kind of death and disruption we have seen during the past two years.

Britain approves Pfizer’s antiviral Covid-19 pill that shows 90% efficacy in preventing hospitalisation and death


Britain has approved Pfizer’s Covid-19 pill for patients over the age of 18 years who have mild to moderate infection and are at high risk of their illness worsening.

Based on data, the pill, Paxlovid, is most effective when taken during the early stages of Covid-19, Britain’s Medicines and Healthcare products Regulatory Agency (MHRA) said on Friday, recommending it be used within five days of the onset of symptoms.

Pfizer this month said Paxlovid showed near 90% efficacy in preventing hospitalizations and deaths in high-risk patients, and recent lab data suggests the drug retains its effectiveness against the fast spreading omicron variant of the coronavirus.

“We now have a further antiviral medicine for the treatment of Covid-19 that can be taken by mouth rather than administered intravenously. This means it can be administered outside a hospital setting,” MHRA chief June Raine said in a statement.

Paxlovid is made of two active substances which come as two separate pills taken twice a day together for five days. Britain has secured more than 2.75 million courses of the antiviral treatment.

Rival Merck’s Covid-19 pill was approved by Britain last month, but that drug only reduced hospitalizations and deaths in its clinical trial of high-risk patients by around 30%.

First doses of Paxlovid, Pfizer’s new COVID pill, are released to states


A federal agency has released the first allocations of Paxlovid, the new COVID-19 treatment from Pfizer, to states and territories. The federal government has a contract for 10 million courses of the treatment and is providing the medicine free to state and territorial health departments.

The government acknowledges that supplies will be tight to start.

“An initial 65,000 courses of Paxlovid will be made available for shipment to states and territories and will begin arriving at dispensing sites by the end of December,” an HHS website says.

Only California, Florida, New York and Texas are receiving more than 3,000 treatment courses. By contrast, Washington, D.C., Alaska and North Dakota will each get only 120 for now. Federally funded health centers that serve low-income patients around the country will get enough Paxlovid for 9,750 patients.

The Food and Drug Administration authorized Paxlovid for emergency use on Wednesday.


Pfizer’s COVID At Home treatment pill authoriSed by FDA


An at-home treatment for COVID-19 that can prevent serious illness was authorized by the Food and Drug Administration on Wednesday, offering a note of optimism for the future of the pandemic as the world faces the omicron variant.

When taken early, Pfizer’s pill was 89% effective at reducing the risk of severe illness and death from COVID-19, according to the company, and was effective against omicron.

Pfizer CEO Albert Bourla estimated that 1,200 deaths and 6,000 hospitalizations would be prevented for every 100,000 COVID-19 patients who take the pills.

The FDA said the pill, Paxlovid, was authorized for the treatment of mild-to-moderate coronavirus disease in anyone 12 years and older who weighs at least about 88 pounds. Patients must test positive and be at high risk for progression to severe COVID-19, including hospitalization or death.

Pfizer Says Its Covid-19 Pill Likely Works Against Omicron


The company said the pill reduced the risk of hospitalization and death by 89 percent if given within three days of the onset of symptoms. It’s been one year since the first vaccine dose in the U.S.

A highly anticipated study of Pfizer’s Covid pill confirmed that it helps stave off severe disease, the company announced on Tuesday.

Pfizer also said its antiviral pill worked in laboratory studies against the Omicron variant, which is surging in South Africa and Europe and is expected to dominate U.S. cases in the weeks ahead.

“We are confident that, if authorized or approved, this potential treatment could be a critical tool to help quell the pandemic,” Albert Bourla, Pfizer’s chief executive, said in a statement.

Last month, Pfizer asked the Food and Drug Administration to authorize the pill, known as Paxlovid, based on a preliminary batch of data. The new results will undoubtedly strengthen the company’s application, which could mean that Americans infected with the virus may have access to the pill within weeks.

The results, based on an analysis of 2,246 unvaccinated volunteers at high risk of severe disease, largely match the company’s initial, smaller analysis of the clinical trial, released last month.

Glaxo Antibody Treatment Works on Omicron Mutations in Study


GlaxoSmithKline Plc said research shows its Covid-19 antibody treatment is effective against the full combination of mutations in the new omicron variant.

Tests done in-vitro against a pseudo-virus that recreates a synthesized version of omicron showed that sotrovimab, Glaxo’s antibody treatment, stands up to all mutations in the spike protein of the omicron variant and not just the key mutations, the drugmaker said in a statement Tuesday. The tests included all 37 mutations identified to-date in the spike protein.

Glaxo’s observations come amid uncertainty about whether omicron erodes the defenses of existing medicines and vaccines — and by how much. Its many mutations, particularly on the spike protein that’s the target of most treatments, have sparked concern worldwide and spooked financial markets.

Given the less than three-fold drop in neutralization during tests, “we are confident that sotrovimab will continue to provide significant benefit for the early treatment of patients hoping to avoid the most severe consequences of Covid-19,” said Vir Chief Executive Officer George Scangos.

Sotrovimab reduced the risk of hospitalization and death in people with mild to moderate Covid by 79% in trials. The drug won clearance from U.K. regulators this month.

Covid antiviral pill molnupiravir/Lagevrio set for UK at-home trials


The first at-home treatment for Covid-19 could reportedly be offered to UK patients before Christmas as an attempt to protect the most vulnerable from the Omicron variant.

The Sunday Telegraph reported that Sajid Javid is set to launch a national pilot of the Molnupiravir antiviral pill, marketed as Lagevrio.

The newspaper said that under the plans, the NHS was expected to deliver courses of the tablet to clinically vulnerable and immunosuppressed patients within as little as 48 hours of them testing positive for Covid.

It said hospitals and GPs had been told a series of Covid medicines delivery units were being established to ensure the treatment gets to patients as quickly as possible once it is confirmed they have the virus.

Last month, the UK became the first country in the world to license its use – a move described as a “gamechanger” by Javid, the health secretary.

But just over a week ago, England’s chief medical officer, Prof Chris Whitty, warned its use may have to be reconsidered in the light of the emergence of Omicron. “I think we probably need to do a rethink of it just to make sure with the new variant, we’re targeting in the right direction.”

A Department of Health and Social Care spokesman said: “The UK has proven itself to be a world leader in identifying and rolling out effective treatments for Covid-19, including through government-backed national trials.

“The government’s antivirals taskforce was launched to identify treatments for UK patients who have been exposed to Covid-19 to take at home, stopping the infection spreading and speeding up recovery time.

“There are a number of exciting opportunities in the pipeline and we will provide further details in due course.”