One of the reasons COVID-19 presents such a significant global medical challenge is that there are few effective therapies for it so far. As cases fill hospital beds across many parts of the country, doctors and scientists are coming up with inventive ways to treat the disease, if not to cure it. PBS NewsHour science correspondent Miles O’Brien reports.
As the COVID summer surge climbs, before there is a cure, Miles O’Brien explores the push to find ways to treat the virus.
It’s part of our Leading Edge series on science and innovation.
And a note:
Some of the video Miles used here was shot as part of an earlier collaboration with PBS’ “Frontline.”
Emergency room physician Ryan Padgett is back home with his family, on the mend after a near-death experience, a Hail Mary pass, and a stunning victory over COVID-19.
It all began in late February, when he and the team at Merchant Logo EvergreenHealth Kirkland began treating some very sick nursing home residents with the symptoms of viral pneumonia.
You’re used to dealing with patients with illness, but to realize that you’re going to potentially have 60 patients from one place with this novel illness was kind of scary
Still, with only a handful of sick days in 19 years on the job, Dr. Padgett wasn’t too concerned about his own health. In fact, he was the picture of it.
A starting offensive lineman for Northwestern University in the 1996 Rose Bowl, he has always stayed in great shape. Then the telltale symptoms of COVID-19 came rushing through his body’s defensive line.
And I was like, wow, something is different here.
And, pretty quickly, I came to kind of think, timing wise, that I was probably infected. They call it the beast, and you realize why. It’s like getting hit by a truck.
Things went downhill fast. He ended up in the intensive care unit at Seattle’s Swedish Medical Center on a ventilator and a heart lung machine.
Sure, the virus had done plenty of damage, but inside his body, something else was at play. Dr. Padgett’s immune system had mounted a counteroffensive that had run amok. This overreaction is called a cytokine storm.
My immune system had caught a wildfire. My body overreacted and was putting me into kidney failure, respiratory failure. My heart and even my liver started going downhill.
It was not a surprise. There were numerous reports from China of COVID patients who succumbed to a cytokine storm.
A similar thing sometimes happens to cancer patients receiving immunotherapy. So, the medical team reached out to the oncology department.
Dr. Krish Patel.
We were all really learning day to day how to try to manage this illness, and I think that’s where kind of borrowing from other disease processes or other specialties seemed to make sense.
He recommended an antibody called tocilizumab. In addition to helping cancer patients, it is used to treat people with rheumatoid arthritis as well.
Doctors in China had some success with it, so the team here saw no reason not to try it on Ryan Padgett. Within days, they had weaned him off the machines.
We were very encouraged by what we saw in his experience, since that time have had — developed continued experience with the medicine.
Dr. Patel says the team at Swedish has now treated more than 65 COVID patients with tocilizumab, with encouraging results.
He is participating in a big randomized study, results due later this summer.
But Ryan Padgett needs no convincing.
It saved my life.
Absolutely. This isn’t the time for a yearlong randomized control trial. This is a time of, put your finger where it’s bleeding and hold it there, and let’s hope it stops.
Understandable in a pandemic, but it can often lead to false hope.
People want hope, but false hope is not just neutral. False hope is worse than no hope at all.
Chemist Derek Lowe has done early stage drug discovery for 30 years. He also writes the well-respected blog “In the Pipeline.”
People are scared and looking for a silver bullet.
They sure are. And I don’t blame them for a minute.
And we haven’t had a situation like this. People are used to saying, OK, I have got this disease. Where’s the drug? I guess everyone is starting to learn a little bit more about what drug discovery is like.
We are all learning the hard way.
President Donald Trump:
And a lot of good things have come out about the hydroxy. A lot of good things have come out.
President Trump frequently promoted the antimalarial drug hydroxychloroquine as a COVID-19 therapeutic before there was scientific data to support the claims.
When that data came in, it showed hydroxychloroquine offers no benefit, but also great harm, causing potentially fatal heart arrhythmias in some patients.
On June 15, the Food and Drug Administration revoked the emergency use authorization for hydroxychloroquine as a COVID-19 treatment.
Dr. George Diaz treated the first U.S. COVID-19 patient at Providence Regional Medical Center in Everett. He was failing fast, when Dr. Diaz got permission from the FDA and the patient to try the antiviral drug remdesivir.
He was still having very high fevers and still was requiring oxygen the day that we gave it to him.
By the next day, his fevers resolved, and they stayed gone. And he was able to come off of oxygen one day after receiving treatment. So — and he felt much better. He felt like he had started beating the virus.
Dr. Diaz is participating in a big randomized study of remdesivir, and, in the meantime, continues to see lots of encouraging signs among the patients he treats.
I sent two people home today.
Oh, that’s fantastic.
A separate study released at the end of May shows remdesivir slightly reduces the length of hospital stays for COVID-19 patients.
So, that tells you about where the drug is, helpful, but not a cure, because there’s no way that one single drug can shut down a viral infection. That’s one thing that we have sort of proven over the years.
Doctors on the front lines all over the world have tried hundreds of drugs for off-label use on COVID patients.
The most promising? A steroid called dexamethasone. One study shows it reduces the mortality rate for COVID patients on ventilators. But perhaps the most proven way to beat back a virus is found in the blood of the survivors.
After all, the antibodies it contains have proven their mettle by defeating the virus. But so-called convalescent plasma has limits. One survivor may only be able to help no more than three others.
The solution to that may lie in immune cells which are cloned and grown in large batches. They produce so called monoclonal antibodies, and scientists are now identifying the most effective of them.
Dr. Robert Garry is a professor of microbiology and immunology at Tulane Medical School.
These have worked very well IN other serious diseases, like the Ebola virus. So, I’m waiting for the SARS-CoV-2 human monoclonal antibodies. I think that those are very likely to have a major impact on the course of this illness.
Monoclonal antibodies are like a temporary vaccine for those who are sick, their families, and for health care workers.
And while it likely won’t take as long to bring them to the market as a vaccine, scaling up production to meet global demand will take time, and maybe more patience than we have.
For the “PBS NewsHour,” I’m Miles O’Brien in Seattle.
Banner image credit: PBS NewsHour.