The FDA announced yesterday that hydroxychloroquine had a negative drug interaction with remdesivir, the only antiviral drug that showed activity with the SARS-CoV-2 virus. The reaction was severe enough that it negated the benefit of remdesivir for treating COVID-19.
This finding helped clarify why the FDA removed the emergency use authorization for hydroxychloroquine, since taking the drug without guidance could alter the benefit of remdesivir. The FDA should allow trials to proceed where the two drugs are not used concomitantly. Thus, we should get the final results on the antimalarial drug treatment.
Mike Osterholm, director of the Center for Infectious Disease Research and Prevention at the University of Minnesota, was interviewed by Chris Wallace on Fox news Sunday. I recommend you watch the segment. Mike is a well-known and experienced observer of communicable diseases and often blunt in his assessments. He is much appreciated for his insights and candor.
He made three important points, which I think bear repeating. First, we do not have an absolute insight into the progression of COVID-19 and just don’t know what will happen. Reinforcing that point he argued that more states are dropping or stabilizing infection rates than increasing. Finally, he was reassured that not having a severe drop off this summer might indicate that there won’t be a seasonal recurrence/uptick in the fall.
He also stated that he does not believe that the virus will continue to spread until the population is 60% immune and herd immunity happens. I think this is generally true, but I disagree that this will need to be determined by antibody. Given that immunity to the virus may be present by cellular immunity without antibody, we likely won’t need 60% of the population to be antibody positive before herd immunity is present.
Finally, the Rt numbers for coronavirus in the different states show no increases this week and no significant overall change. If anything, a few states (SC, AZ and OK) show significant drops from two weeks ago. The overall numbers from University of Washington also show no increase in the rates of deaths or hospitalizations.
Therefore, while there is no new spike or second wave of COVID-19 there continues to be steady, ongoing new infections.