COVID UPDATES MAY 13TH 2020WHERE DO WE GO FROM HERE?

FRED GROVER JR. M.D, REVOLUTIONARYMD

THE ROAD AHEAD

WORLD STATS TODAY

CURRENT DENSITY OF CASES IN US

DEATHS IN US MARCH-MAY

COLORADO DAILY DEATHS

Current Vaccines in Clinical Trials

• Phase I clinical trials are small-scale trials to assess whether the vaccine is safe in humans and what immune response it evokes.

• Phase II clinical trials are larger and look mainly to assess the efficacy of the vaccine against artificial infection and clinical disease. Vaccine safety, side-effects and the immune response are also studied.

• Phase III clinical trials are studied on a large scale of many hundreds of subjects across several sites to evaluate efficacy under natural disease conditions. If the vaccine retains safety and efficacy over a defined period, the manufacturer is able to apply to the regulatory authorities for a license to market the product for human use.

• The final Phase IV happens after the vaccine has been licensed and introduced into use. Also called post-marketing surveillance, this stage aims to detect rare adverse effects as well as to assess long term efficacy.

Clinical phases of vaccine development

• Time needed to develop it safely.• Encouraging international collaboration• Regulatory hurdles• Supplies such as vials and syringes to dispense millions of doses.• Misinformation from anti-vaccine groups• Politics blocking funding or deployment of vaccines.• Pharma wanting big return on investment vs making it reasonably priced for the masses.• Worrisome adverse side effects such as Antibody dependent enhancement (AED), a

dangerous phenomenon which paradoxically leaves the body more vulnerable to severe illness after inoculation.

Vaccine challenges

• Vaccine available for front line workers Fall of 2020.• Vaccine demonstates safety and efficacy amongst health

care workers and other volunteers. • Available to high risk individual in US in Spring or Summer

of 2021 and then to others at lower risk.• Unlike many are saying on social media, I don’t see a

mandate to get the vaccine, but it could be required byemployers in future, just like the flu shot is required for docs working in a hospital.

Best case scenario for an effective vaccine by 2021

An oral drug called EIDD-2801 has shown promise in test-tube experiments with human lung and airway cells, scientists reported online April 6 in the journal Science Translational Medicine. The drug might even be more efficient at blocking the novel coronavirus, SARS-CoV-2, than remdesivir, a drug being tested against COVID-19 in clinical trials that began in March. While remdesivir stops the novel coronavirus from replicating entirely, EIDD-2801 introduces genetic mutations into the virus’s RNA. As the RNA makes its copies, so many damaging mutations accumulate that the virus is no longer able to infect cells, Scientific American reported. The drug also seems to work against several RNA viruses, and as such, the researchers said it could be a multipurpose antiviral.

Hope for new drug therapies

• Recent trial showed that patients who received a shorter, 5-day course of remdesivir experienced similar clinical improvement as patients who received a 10-day treatment course.

• Results showed that those on remdesiver were more likely to be discharged earlier, but no reduction in deaths seen yet. At day 14, 62 percent of patients treated early were able to be discharged from the hospital, compared with 49 percent of patients who were treated late.

“Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial” Lancet, 4/29/20

Remdesivir Trial updates

Reassuring signs so far in the fight against this pandemic• Death rates are dropping in most states including Colorado, thanks to most following the stay

at home orders, and wearing masks.

• Now relaxing “stay at home” to “safer at home”

• We are “wrapping our head” around this crisis to some degree now.

• Improved testing, but still have a long ways to go.

• Freedom to travel by car, but limit air travel.

• Remdesivir showing potential, especially as they research it in combo with other drugs.

• Businesses beginning to reopen cautiously, and intelligently in most cases.

• We have a greater understanding of the transmissibility, pathology of virus, treatment, and progress towards vaccine development.

How can we maintain happiness in this new normal for now?

• Get outside and enjoy nature. Take a hike and follow social distancing.

• Stay as social as you can with safe social distancing, meet outside with others this summer, use video over phone when possible. Be nice and friendly to neighbors.

• Be careful with the toxic environment growing in social media. Limit time spent and only post verifiable facts, not conspiracy theories when it comes to Covid.

• Find creative outlets to maintain balance such as painting, pottery, music, writing etc.

• Give back to the community by volunteering

• Create a garden in your yard, in pots, or in a community garden

• Keep up with Mindful based activities

• Exercise to increase your endorphins, and maintain a healthy diet to keep yourself out of the hospital if you get this.

Questions?