Remdesivir: “50/50 chance of success”
“GileadAnalyst Sees Only 50% Chance That Coronavirus Drug Works.” – Bloomberg.
https://www.bloomberg.com/news/articles/2020-03-05/gilead-analyst-sees-only-50-chance-that-coronavirus-drug-works
This seems a dire prediction from a top Gilead stock analyst, when it is being stated by other headlines as the best thing going to cure COVID-19. Obviously Mr. Abrahams knows something that journalists don’t. Is he close to the Gilead scientists and hears insider stuff, or has he just read the science and put two and two together?
Regardless, it hasn’t prevented Gilead’s stock price from going vertical. Traders are like Aussie toilet paper panic buyers: the thought that they won’t be able to wipe their backsides results in a strong buy sentiment!
But I’ll let you read the full story above before we continue.
So what did you think of that? Actually, there’s not much to go on regarding the essential details necessary to make an informed decision about Remdesivir’s potential for success. I suppose we’ll have to wait and see onApril 27. (You may recall that this time period has previously been stated on these threads).
Without having much information about why Brian A. is not very optimistic on COVID-19 being conquered by Remdesivir, let’s look into the science ourselves to see what may come. Remember though, that in doing science we must remain neutral to any preconceived notions of outcomes, something that traders are not generally very disciplined at.
Remdesiviris a broad spectrum antiviral presently being tested in China and the US onCOVID-19. It was initially created by Gilead primarily to fight Ebola, but waswithdrawn due to poor results after extensive studies. In short, about 49.7%fatality rate in the Remdesivir cohort part way through the testing in WestAfrica, resulting in the drug being withdrawn from the study. Mind you, theother cohorts didn’t fare much better. Ebola lives on ferociously. https://www.nejm.org/doi/full/10.1056/NEJMoa1910993).
Let’s hopeit does better in treating COVID-19.
So, what broughtit back from the dead to treat the new corona virus. Apparently, during its earliertesting, it did show better results in rhesus macaque monkeys infected by MERS
https://www.pnas.org/content/early/2020/02/12/1922083117).Species selection is critical for testing against human invading pathogens, andeven though rhesus macaques belong to the old world order of nonhuman apes, asopposed to the new order, they are still closer to us on the evolutionary treethan mice are. Apart from the few rats among us. Genetically though, MERS-CoVis more distant to SARS-CoV-2 than SARS-CoV is. You can read about theimportance of using nonhuman apes for drug development here, since there is apush in the USA to stop using chimpanzees: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145602/
Moresignificantly, Remdesivir has been trialled in vitro against SARS-CoVand MERS-CoV, and using human lung cells as required, with statistically meaningfulresults, as well as in vivo mouse tests. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5567817/
Here is a listof tests being conducted, or about to be conducted using Remdesivir as a cure (orpartial) for COVID-19.
https://www.biocentury.com/article/304529
As you can see, first results can’t be far away. Wouldn’t it be wonderful if it achieves its purpose!
But let’s not let hope become our focal emotive in case it clouds our judgement of the science. To begin our research, let’s review the article that was provided on the last thread that contains a review of small molecule drugs under development to fight COVID-19: “In the Pipeline.”https://blogs.sciencemag.org/pipeline/archives/2020/03/06/covid-19-small-molecule-therapies-reviewed.
To be honest, my first red flag went up quite soon in this article when the author first described the history of Remdesivir, but never mentioned something quite important within that history: that the Ebola tests failed. Not knowing anything about that history, a reader may be inclined that its success on COVID-19 may be a sure thing.
“This has been in development for a few years as an RNAvirus therapy – it was originally developed for Ebola, and has been tried outagainst a whole list of single-strand RNA viruses. That includes the relatedcoronaviruses SARS and MERS, so Covid-19 was an obvious fit.”
If I didn’t know anything about Remdesivir, after reading that, I’d be buying shares in Gilead too. I wonder if Mr. Lowe is trading it? His disclaimer doesn’t mention it, but only that “he does not speak in any way for his employer.” I wish my boss was so easy going. I can’t even wash the bat mobile without being scrutinized. Maybe it’s just a family thing.
Anyway, moving on. There is one thing you’ll pick up if you’re reading journalists about the present pandemic. There is a general consensus from the numerous professionals that they quote, that antivirals developed for other diseases will not be a panacea for COVID-19. This is because they are mostly highly specific towards one aspect of a virus, and as no two viruses are the same, then such specificity may work against being a cure for any new virus. Here is one such article: https://www.scientificamerican.com/article/a-promising-antiviral-is-being-tested-for-the-coronavirus-but-results-are-not-yet-out/
This is not very encouraging. Remdesivir however is unique in that it is quite broad spectrum, so we’ll all just have to wait until late April to see what the controlled tests come up with.
The second important thing about antivirals is that they are most effective when used early in infected patients, as acute lung damage can’t be repaired so easily. This is not only important for therapeutic usage (after a person is infected), but also for prophylactic usage (before a person is infected), in the case for frontline health workers. Why, because in this pandemic, a vaccine is still a long way from ‘rapid’ development, whereas an antiviral that shows efficacy WILL be utilized almost immediately, not only on infected patients (as is already being done), but on the most vulnerable health professionals. But to believe this later point you will need to appreciate the ethical argument better than the science, which for many, is even more difficult. But that is a topic for a another day.
We’ve hardly began on the science behind Remdesivir, but this post is already too long, and my work week is about to begin;very late today. Less demand has resulted in the ferries running infrequently. Howdo 17 hour days sound? I do get a decent siesta though, when the cave goes intoquiet time. 
(20min delay)