Does the recent and rapid development of Pfizer’s SARS-CoV-2 protease inhibitor (discussed today by Derek Lowe) affect your conclusions here at all?
Reasons I think this might affect your conclusions:
The antiviral is very effective. In fact, the trial was stopped due to efficacy, after it showed 89% reduction in hospitalization when given to high-risk patients within 3 days of symptom onset, and 85% reduction when given within 5 days.
The antiviral was created quickly. While it took more than 100 days, it has been less than 2 years after the emergence of SARS-CoV-2 (so this is definitely a speed record for a bespoke antiviral). This speed record suggests to me that we may also get faster at producing new antivirals (e.g. through ).
Yeah, it certainly shifts my view slightly, but it still seems like these are slower than vaccines, and less useful than prevention. I’d still put them last on my list of what we should be prioritizing, but as I said elsewhere, I ideally think they should get a non-zero level of funding. (But given relatively large pressure from other actors, I’m happy ignoring them and only pushing for the things we think are better investments.)
I was about to post this. There are now two effective antivirals for COVID-19, developed relatively quickly, which makes me update towards antiviral development being a little easier and more promising than I thought.
In addition, the historic antivirals with great success are against HIV and Hepatitis C and are targeted against a chronic disease. Herpes and CMV have antiviral treatments and are somewhat more acute (though Herpes is a chronic disease with acute flare-ups), but COVID-19 is more acute than those two.
So my skepticism towards effective antivirals for acute illnesses is lower than before.
Thanks—yes, I have updated towards antivirals being more tractable, but it still seems clear that any such approach is not quick enough to matter for the most worrying existential /​ global catastrophic biorisks. So I’d still argue that it’s not the right focus for the (still frustratingly and unfortunately) limited pandemic preparedness dollars, even if it’s a useful investment overall.
Does the recent and rapid development of Pfizer’s SARS-CoV-2 protease inhibitor (discussed today by Derek Lowe) affect your conclusions here at all?
Reasons I think this might affect your conclusions:
The antiviral is very effective. In fact, the trial was stopped due to efficacy, after it showed 89% reduction in hospitalization when given to high-risk patients within 3 days of symptom onset, and 85% reduction when given within 5 days.
The antiviral was created quickly. While it took more than 100 days, it has been less than 2 years after the emergence of SARS-CoV-2 (so this is definitely a speed record for a bespoke antiviral). This speed record suggests to me that we may also get faster at producing new antivirals (e.g. through ).
The antiviral was created at a time when global vaccine access is still limited (e.g. most African countries are not on track to have 40% of their population vaccinated by the end of 2021). We still have limited mRNA vaccine production capacity, whereas it should be possible to rapidly scale global production of this, especially if this is put into the UN Medicines Patent Pool.
Yeah, it certainly shifts my view slightly, but it still seems like these are slower than vaccines, and less useful than prevention. I’d still put them last on my list of what we should be prioritizing, but as I said elsewhere, I ideally think they should get a non-zero level of funding. (But given relatively large pressure from other actors, I’m happy ignoring them and only pushing for the things we think are better investments.)
I was about to post this. There are now two effective antivirals for COVID-19, developed relatively quickly, which makes me update towards antiviral development being a little easier and more promising than I thought.
In addition, the historic antivirals with great success are against HIV and Hepatitis C and are targeted against a chronic disease. Herpes and CMV have antiviral treatments and are somewhat more acute (though Herpes is a chronic disease with acute flare-ups), but COVID-19 is more acute than those two.
So my skepticism towards effective antivirals for acute illnesses is lower than before.
Thanks—yes, I have updated towards antivirals being more tractable, but it still seems clear that any such approach is not quick enough to matter for the most worrying existential /​ global catastrophic biorisks. So I’d still argue that it’s not the right focus for the (still frustratingly and unfortunately) limited pandemic preparedness dollars, even if it’s a useful investment overall.