On May 1, the US Food and Drug Administration (FDA) gave emergency use authorisation for antiviral drug remdesivir in patients with COVID-19.
This followed promising preliminary results from a trial conducted by the US National Institutes of Health (NIH) which showed some benefits of remdesivir when compared with a placebo.
Naturally, there are still multiple studies in progress to further determine its safety and efficacy. This is particularly challenging, as attempting to investigate an agent alongside an evolving global pandemic is not the same as your traditional “everyday” drug development.
But, for a disease that has infected more than four and a half million people and killed over three hundred thousand worldwide, this may be seen as encouraging, although it is still very early days.
Despite being grateful as always to the hard-working researchers who are desperately trying to find ways to manage or prevent this disease, I can’t help but feel such regret that any treatment developed now, any new drug or even any vaccine, will tragically be too late for the many that have lost their lives to COVID-19.
When you consider the many medical breakthroughs in history, you immediately think of those whose lives have been saved or improved by these advances, but having recently lost a family member to the novel coronavirus, it is difficult not to dwell on what could have been.
While remdesivir is far from being considered a breakthrough, the very idea that there will one day be treatment for this disease shows just how personal loss can skew your thinking, when the reality is, that is indeed the nature of medicine.
There will always be those that will benefit from a therapy and those for whom it will be all too late. In fact, the many lives lost from disease and sickness historically have propelled the development of medicine today and provided the information needed to further research.
Nowadays, we sometimes take these for granted. Canadian scientists Sir Frederick G Banting and Charles H Best are credited with the discovery of insulin in 1921. This milestone truly revolutionised both the treatment and the prognosis of diabetes, one of the most studied diseases in the history of medicine. During the “pre-insulin era” though, anyone with this disease died in childhood or early adulthood, and the life expectancy was thought to be less than 3 years from the time of diagnosis.
Around the same time, Scottish bacteriologist, Alexander Fleming was in the process of sterilising his bacterial culture plates that had mould growing on them when he noticed that there were clear zones encircling the mould colony. This mould toxin responsible for killing the bacteria on his plates turned out to be penicillin, which was later isolated and purified to produce what has become arguably the world’s most effective life-saving antibiotic.
It is thought that without penicillin, 75 per cent of the population would not be alive because their parents or grandparents would have succumbed to infections.
Even practices now considered routine such as the use of sterile and antiseptic measures in hospitals to combat infection, washing hands and using clean equipment were only deemed crucial after observing high maternal mortality rates. In the 1800s, it is thought up to 40 per cent of pregnant women did not survive childbirth prior to starting these simple measures.
So, even with dramatic improvements and staggering medical breakthroughs, there will always be those who missed out. Moreover, many of these advances are unintentionally made at their expense. This is neither tragic nor unfortunate but the reality of medical progress. Ideas and innovations that change the very core of medical practice have a responsibility to all the untold millions of lives lost in the past, by saving many more in the future.