Don't break out the champagne for COVID-19 drug just yet, says doctor

Transcript

An infectious diseases specialist says an antiviral drug being tested on COVID-19 patients shows some early promise, but "we have to temper our enthusiasm enough so that we make sure we get the science right."

The U.S. National Institutes of Health has tested remdesivir against usual care routines for 1,063 coronavirus patients around the world.

On Wednesday, the U.S. NIH's Dr. Anthony Fauci — head of the White House coronavirus task force — said early results in one uncompleted trial show the drug reduced the time it takes patients to recover by 31 per cent.

He called it "a clear-cut, significant, positive effect" and suggested the drug could become "the standard of care" for people who contract COVID-19.

But the study is not yet complete. And another medical trial in China found remdesivir failed to improve patients' condition or reduce the pathogen's presence in the bloodstream. Those results were published Wednesday in the Lancet medical journal 

Dr. Tim Lahey, an infectious disease specialist and ethicist at the University of Vermont Medical Center, spoke to As It Happens host Carol Off about the conflicting results on the drug's potential. Here is part of their conversation. 

From your point of view, how big a deal is this news about this drug remdesivir?

I think it's a big deal. It's the first time that we've really had evidence that something is likely to work against this virus. 

Dr. Fauci called it highly significant. Would you agree with that?

I think he's right on the money. 

Here we have human patients — some got remdesivir, some who got placebo — and clearly, there's a statistically significant difference for the people who got the drug. It's the first time we've had something that looks like it works. 

I do think that there is cause for, you know, opening up, maybe not an expensive bottle of champagne, but perhaps a beer and celebrating this preliminary result.- Dr. Tim Lahey, Vermont Medical Center

This study was not completed.... What questions do you still have about this drug and about this study? 

This raises a really important caveat. This isn't a study that's gone all the way to completion, but instead just an interim check by the people who are monitoring for subject safety. 

You could imagine that over time that difference between placebo and drug recipients could go away, or maybe some safety concern can come up. 

So we really have to let the study complete and really get the full information before we can completely take these results to the bank. 

But I do think that there is cause for, you know, opening up, maybe not an expensive bottle of champagne, but perhaps a beer and celebrating this preliminary result. 

What exactly does this drug do? … This is not a cure for COVID-19.

That's right.

This is a drug that has been given to people who are hospitalized with COVID-19 — so people who are relatively sick. And it's helping them get better faster.

And so certainly this isn't the vaccine that we're really waiting [for] that can protect people from getting sick in the first place.

All we know is that it gives us one tool to help support people who are tenuous and in the hospital and need some treatment. 

I don't need to tell you that any kind of treatment for this disease is of monumental importance, isn't it? So how difficult is it to look objectively, to have a clear scientific eye on something like this, when there's so much pressure to find a cure? 

I think we've all been dismayed by some of the pseudoscience that's been out there in the COVID- 19 epidemic. And I think that's all driven by hope and desperation. 

This study really for me was the first time that we can put our hopes on there actually being a scientific signal of benefit. 

But, you know, we want to make sure that we temper that enthusiasm, even, and recognize that this is a study that's part-way completed. We don't have all of the details of all of the findings that the investigators have. It's good news, but we're all still waiting to get all the details before we completely start jumping up and down and yelling hooray. 

Really we have to temper our enthusiasm enough so that we make sure we get the science right.- Dr. Tim Lahey

There's another study of remdesivir out of China … with a limited group and it was published in The Lancet today. And in that study, it showed no significant value to the drug for treatment of severely ill patients with COVID-19. What does that say to you? 

I think that's a really important finding for us to put next to this one.

There are different ways you can understand why two studies would show slightly different results.

The other way you can explain it is that they may have looked at slightly different endpoints. So maybe the way they measure improvements ...[or] the timing through which they administer the drug is a little bit different. 

So that's why I'm really eager to see the details of the [U.S.] study that have not yet been published and put them right up next to this one in The Lancet and say, "OK, really, what's the answer to this mystery here?"

I was watching Dr. Fauci today in the United States, in Washington, in a room with President Trump. Clearly, so much is riding on this being something that they can put out there as being the beginning of the end. And so will there be the room to actually explore these possibilities and to have the doubt that you're describing? 

We have to. You know, I think the real tragedy would be to add to the death toll of COVID-19, on top of that, a layer of shoddy science.

Really we have to temper our enthusiasm enough so that we make sure we get the science right. And that doesn't mean that we can't do things like expand compassionate access to drugs, or think about how do we enroll more people in more studies of this, if it looks promising. 

But we need to make sure that we don't let our desperation for a quick fix stop our critical thinking or make us not let the scientists do their jobs. 

So I'm excited. But I do want to see the studies be completed, even though we'd all like for them to be done yesterday.

Written by Sheena Goodyear with files from CBC News and The Associated Press. Interview produced by Kate Swoger. Q&A has been edited for length and clarity.