Dissecting the progress made on COVID-19 treatments and charting epidemiology
There are two key components of epidemiology that should be considered, according to the specialist. First, “there really is a very thin margin between being in a situation where the effective reproductive number is less than one”, and therefore a comprehensive public health approach is imperative. Second, the overdispersion of R0 means that “the majority of people who get this infection actually don’t infect anybody”, with a minority responsible for many more infections. This makes mapping outbreaks more difficult for public health departments.
In clinical trials, regarding therapeutics, the response has been “disjointed and not thoughtful”. The associate professor detailed the low share of randomised, double-blind, placebo-controlled trials and the fact that most research is being conducted on hospitalised patients rather than at an earlier stage.
Numerous factors impede clinical trials. There is a three-day window to recruit people for these studies, and the patients may be in areas lacking the requisite healthcare infrastructure. However, David Boulware’s study of post-exposure prophylaxis and early treatment with hydroxychloroquine is one example of how to overcome these obstacles. It “was done entirely over the internet with electronic consent and delivery of [the] drug to people’s doorstep.”
The conversation turned to therapeutics that could be promising, and one noted in the Interview was Merck’s EIDD-2801. A “clear advantage” with this drug, the specialist expressed, is that this is an oral agent, which could make it easier to deliver across the population.
The specialist also commented on vaccine development, including how different levels of efficacy could affect transmission and which demographics should be targeted first. They also explored whether there has been any conflict in reaching the dual targets of vaccines and therapeutics.
To access all the human insights from Third Bridge Forum’s COVID-19 Epidemiology Projections, Therapeutics & Vaccine Implementation Interview, click here to view the full transcript.
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