I know about living in times of medical insecurity, waking up to days full of uncertainty and walking roads steeped in darkness. For twenty months, I was my husband’s caregiver as he fought against a disease with dismal survival rates. In those twenty months, I armed myself with knowledge. I read every article and study I could find, and attempted to make sense of every journal entry to which I was allowed access. I knew the harsh truth about his disease, and I wasn’t delusional. But I had hope. Because in those articles and studies and impossible to understand journal entries, there were promising treatments and clinical trials, stories of miraculous recoveries and case studies of patients who never should have recovered, but did. There was a glimmer of light and hope.
I am once again living in a time of medical insecurity, although this time, the world is living that same turmoil beside me as we fight a disease that has never been seen before. And my heart is breaking for all those grieving, all those suffering and hurting and dying alone. But old habits die hard, I guess, because I am once again spending my days reading everything I can find and finding reasons to hope we’re nearing the light at the end of this dark road.
I know the facts about this disease, this virus that targets the elderly and vulnerable populations, but also can strike a healthy person with seemingly no risk factors. I am too aware that we won’t be back to “normal” for a long time, if ever. And, I very much understand how far away an effective treatment might be, let alone a vaccine. I have first hand experience with clinical trials and I know they can fail. I know clinical trials can promise a miracle and fail, anyway.
But I can’t help but hope, anyway. Because it’s how I handle times of medical uncertainty. It’s how I find a little light on a dark day.
In my husband’s battle, I found the very brightest reasons to hope and clung to them. I’ve done the same here.
I was nearly euphoric when news of Remdesivir, an antiviral medicine originally tested for Ebola, came from a Chicago hospital treating severe COVID-19 patients. The hospital was seeing speedy recoveries, with nearly all patients discharged within a week. Nearly all patients. A week. If that was true on a widespread basis, it could be a game-changer.
Then on Wednesday, researchers released equally-promising early results of the drug’s federal trial, sponsored by the National Institute of Health. “The data shows that Remdesivir has a clear-cut, significant, positive effect in diminishing the time to recovery,” Dr. Anthony Fauci said during a meeting at the White House. A senior administration official told the New York Times that the FDA would likely grant an emergency approval of Remdesivir’s use.
Gilead Sciences, the manufacturer of the drug, never promised it would be a magic bullet; just a “modestly helpful” treatment. But at this point, when our arsenal seems woefully empty, something even modestly helpful feels like a bright star against an ink black sky.
It’s a drug already FDA approved to treat asthma and has been used for off-label purposes to treat COVID-19 patients—with some success. Dr. Tom Braciale, of the University of Virginia, noted that Singulair reduces inflammation in lungs but may “also work by preventing infection of the cells in the lungs that are involved in oxygen exchange. So, if those cells are not infected by COVID-19 the immune system won’t destroy them and they will be able to function normally.”
The drug needs more study before it can become a widespread treatment, but there’s enough promise in it as a treatment that I’m here for it.
Tissue Plasminogen Activator (tPA)
The Massachusetts Institute of Technology is studying the potential benefits of repurposing a commonly found blood-thinning drug known as tPA.
The report from MIT, published in The Journal of Trauma and Acute Care Surgery, explains that a significant problem doctors are finding is that critically ill patients are clotting, and suffering from kidney and heart failure from the blood clots. Drugs like tPA could be used to treat that problem, thereby reducing deaths. Thereby, giving hope.
Favipiravir, or Avigan, is a Japanese flu drug that has been approved for study by the FDA. The drug works by preventing certain viruses from replicating and potentially shortening the duration of illness and improving lung function. The research hasn’t been peer reviewed yet, but it’s shown a high degree of safety and effectiveness in a clinical trial of 340 people in China. Words like high degree of safety and effectiveness make the day feel a little lighter.
Researchers are finding promise in convalescent plasma. The plasma—and resultant protective antibodies from patients who have recovered from COVID-19—is infused into currently infected and ill patients. The hope is the protective antibodies from the donor also protect the recipient.
Promising trials are also underway for repurposing HIV drugs and first-line treatments against multiple sclerosis, as well as repurposing blood pressure drugs and immunosuppressant drugs and an antiviral known as EIDD-2801.
I know vaccines take time—developing them, ensuring their safety, and bring them to market. Realistically, we’re looking at 12 to 18 months before a vaccine. But…that what if glimmer of hope remains whenever I read studies of the progress on a vaccine in Israel, where scientists had been developing a vaccine against infection bronchitis virus (IBV) and have reason to believe COVID-19 has a high genetic similarity to IBV and uses the same infection mechanism. If true, an effective human vaccine could be available sooner than we think.
And this, from the National Institute of Allergy and Infectious Diseases (NIAID), which has been studying the coronavirus family of viruses ever since MERS and SARS alerted them to the fact that coronaviruses would be a threat. A vaccine known as mRNA-1273 is in a phase 1 clinical trial. The science is more complicated than I can begin to break down, but researchers are hopeful that “mRNA vaccines can be more potent than older approaches and lead to rapid, cheaper manufacturing. And because they don’t use live viruses, they’re potentially safer, too.
And definitely this, from Oxford University, which is working on a vaccine that could potentially be available by September (this September!). The Jenner Institute at Oxford University had a head start due to their work on MERS, a respiratory virus closely related to COVID-19 and, assuming regulators approve, is preparing to test the vaccine in 6,000 people.
As of this writing, COVID-19 has caused more than 60,000 deaths nationally and over 200,000 deaths globally. There is so much grief and heartache, and so many reasons to be afraid. There won’t be a miracle cure or treatment tomorrow. But the pandemic has brought the global scientific community together in a way that feels hopeful. Scientists are making incredible discoveries every day. The treatments and vaccine hopefuls listed here are only a handful of potential treatments and cures being developed, and more are coming every day.
Walking the line between hope and reality is a balance, and I tend to lean toward hope over reality. That mindset has failed me once before and I’m well aware of the risks of leaning too far into hope without holding onto a tether of reality. And yet, the brightest minds are making the brightest discoveries, and for that reason, I cannot help but hold onto the brightest hopes.