Remdesivir was initally investigated as a treatment for another lethal viral disease, Ebola
Australia Lifts Pandemic Travel Restrictions to Allow New Zealand Woman and Her Dying Sister's Reunion
By the time Diaz’s patient flew from Wuhan to Seattle on Jan. 15, the virus had penetrated deep into most parts of China. Other countries, including the U.S., were bracing for COVID-19 to breach their borders but were still unsure how dangerous a threat it posed. While the patient felt fine during the trans-oceanic flight, he felt feverish the next day, and after trying to recover at home he went to an urgent-care center on Jan. 19.
His room wasn’t exactly inviting either. He was admitted to a separate unit with filtered, pressurized air that flowed into but not out of the room in order to reduce the chance of any virus circulating into the rest of the hospital. The medical team could see and communicate with him through a large window, but to further protect themselves from infection, the staff relied on a robot–a computer screen on wheels equipped with devices for measuring vital signs, as well as a microphone.
Back at Gilead’s headquarters in Foster City, Calif., there was only a limited supply of remdesivir on hand. Diaz had to request that the company provide the drug on a “compassionate use” basis, which allows drugmakers to release unapproved drugs like remdesivir on a case-by-case basis to doctors who ask for them, as long as the FDA sanctions it. That federal agency “wanted a bunch of clinical information, which we provided,” says Diaz.
Doctors around the world began asking for the drug to treat COVID-19 patients on a compassionate-use basis. “We got inundated with a large number of requests,” says Gilead’s Parsey, and because each case needed to be reviewed individually, “it got to the point where we were unable to ethically keep going because it was taking so long to process each patient and we had a backlog of patients,” he says.
One of those patients was Bill Clark, a retired attorney from Atlanta, who began feeling sick with fever, chills, coughing and lethargy on April 6. A little over a week later, worried he might have COVID-19 and at the suggestion of his personal physician, he went to the emergency room at Emory St. Joseph’s Hospital, where doctors decided to admit him even before his COVID-19 test results were complete. Chest X-rays showed early signs of pneumonia.
That afternoon, Clark received his first infusion–he has no way to know if it was remdesivir or a placebo. “I’m pretty sure I never prayed so hard over a medical procedure in my life as I watched that fluid going into my arm,” he says. “I was awfully hopeful that whatever was going in was going to be the treatment for what I was dealing with.”
That optimism is still tempered with a sizable amount of caution, since researchers have outstanding and important questions about which patients might benefit most, and when in the course of a COVID-19 illness the drug will work best. The study begun in China, for example, did not find the same positive results among severely ill patients. In that study, people taking the drug did no better than those given a placebo.
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