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Martin Landry: "People will argue about the need for earlier use (possibly) or that with even more data there may be a benefit (possibly - but where are those t
by ucha 6y ago
Martin Landry: "People will argue about the need for earlier use (possibly) or that with even more data there may be a benefit (possibly - but where are those trials going to come from).
But the effect is modest at best - and so far there is no strong evidence it is there at all."
But it doesn't follow at all that because there is no effect when administered late, the effect, if administered early, is modest as best. In fact, there are many medication that are very effective if administered before the first symptoms appear and are completely useless after. If you get exposed to rabies, you can get a rabies vaccine and have close to no chance of contracting it, whereas if you get a vaccine after you develop symptoms, you're almost certain to die.
Similarly, the flu antivirals are somewhat helpful if taken early but have no effect if taken too late.
- m0zg 6y agoIt's as if they're doing this on purpose. It is quite obviously pointless to administer antiviral drugs _after_ the cytokine storm sets in and the person is already dying.
- vanilla-almond 6y agoLandray says in the same twitter thread: "...Remdesevir is given by intravenous infusion for 5-10 days. It is not cheap. And supplies are limited (not surprising given scale of epidemic)." This means anyone showing early symptoms is likely to require a stay in hospital for early administration of the intravenous infusion. There are questions about how scalable this is. Landray again: "COVID affects millions of people & their families around the world. It is not a rare disease and we need scalable, affordable, and equitable treatment solutions."
- lbeltrame 6y agoGilead was said to be working on an inhaled version (it can't be administered orally, because it is completely destroyed in the liver).