New antiviral drugs could help prevent COVID-19, boosting the efficacy of vaccines and reducing the severity of the infection. They could be handed out to people exposed to the virus or as soon as someone tests positive, potentially stopping them from passing the virus on to other people — which, if currently available, would have been a huge help to the people of Melbourne.
But given Australians’ reported wariness on getting the AstraZeneca vaccine, would people be happy necking government-sanctioned pills to help stop the spread?
What do the drugs do?
Previous antiviral drugs have worked on severe cases of COVID-19 but not much else: remdesivir shortens recovery time and the steroid dexamethasone reduces mortality for those with severe COVID-19 who also received respiratory support.
Two new peptide-based drugs, however, have been specifically designed for SARS-CoV-2. Developed by researchers at Queensland’s QIMR Berghofer Medical Research Institute, the first drug cloaks a cell’s ACE2 receptor, meaning the virus latches to the cloaking peptide — not the cell.
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The second drug deactivates the virus if it manages to get through before it can reach the nucleus of the cell and replicate. The drugs are being tested on hamsters in France.
The second peptide-drug can interrupt the virus’s usual method of replicating within the host cell, even if it the virus does manage to get inside. It also boosts the immune system’s ability to recognise the virus.
Antivirals are nothing new — they’ve been used to treat influenza for decades, and they’re no substitute for a vaccine. But it could bolster the efficacy of vaccines and work as a stop-gap for those who haven’t been vaccinated or are unable to be.
The UK government is planning to develop and distribute similar antivirals among its population by September.
How would they be doled out?
UNSW infectious disease social scientist associate professor Holly Seale told Crikey similar initiatives have been considered before but were abandoned.
“There was a lot of discussion about this even before the 2009 [swine flu] pandemic that … wouldn’t it be wonderful for every member of the community to have some just in case their stockpile of medicine,” she said.
But economically and logistically it didn’t look like it would work, she said. Drugs could expire, causing wastage, people could take wrong doses or mix them with medication they shouldn’t be mixed with, give them to family members, or even stockpile them to sell on the black market.
Logistics aside, even during bad flu seasons the government hasn’t pushed antiviral medications instead or alongside a flu vaccine — the major reason being vaccines are a lot more effective and last a lot longer.
“I don’t think the regulations would allow there to be a massive surge in people taking drugs [over a vaccine].”
Would people take them?
Hypothetically if such drugs were available now, would people take them? While needle phobia is real, member of the World Health Organization’s Technical Advisory Board on Behavioural Insights and Sciences for Health Professor Ross Gordon told Crikey most people’s hesitancy isn’t borne out of a fear of vaccines — but of risk-benefit analysis.
“Health is a very personal and emotional issue so I don’t necessarily think there’s always a huge difference between vaccines and other drugs when it comes to hesitancy,” he said.
“There’s a bit of complacency, as well as a failure of communication because of the assumption that we don’t have local cases and no community transmission and there’s no imperative [to get a COVID-19 vaccine].”
Despite prominent anti-vaxxers using their platform to promote their views, Australia isn’t a particularly vaccine-hesitant nation: 95% of all five-year-olds are fully immunised, while it’s estimated 75% of Australians aged 65 and over were vaccinated against influenza in 2009.
One survey found people hesitant toward the COVID-19 vaccine were nervous about side effects, don’t know enough about the vaccine, wanted to wait until more people have been vaccinated, and didn’t feel there was any rush given Australia’s closed borders.
This, Gordon said, could be addressed with proper communication: “We need to feature people from the community who have had the vaccine and remind them why they’re getting vaccinated — for health benefits, social benefits of protecting others in the community … that it’s the right thing to do.”