Expert Explainer: Remdesivir, Vaccine Odds, and NYC Herd Immunity

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“The thing I’m really holding out for is a whole other class of drugs,” says Dr. Nahid Bhadelia of Boston University

Photo: Jeff Pachoud/AFP via Getty Images Japan’s Prime Minister Shinzo Abe is reportedly considering fast-tracking antiviral remdesivir for use on COVID-19, despite the treatment’s failure to show that it works in clinical trials. Should Abe go through with it, Japan would become the first country to approve remdesivir for use. Experimental vaccines as well may be approved for emergency use in the near future, which is not unprecedented.

Contact tracing seems like it could have been critical in early February. Why is it important now, when New York City is on the other side of the curve? It needs to be both. States need to plan according to the capacity of their health-care systems. We should learn from the experiences of New York and Boston and other cities. Things are pretty dire still. Our CEO at the Boston Medical Center mentioned that more than 70 percent of our cases are COVID patients. Thankfully, no Massachusetts hospital has reached a crisis standard of care — they didn’t have to make hard decisions about resource utilization and distribution.

That’s still not the number we need. There’s an equation one goes by to figure out what herd immunity is for a particular disease. That’s the function of the R0 and other variables that I won’t get into. Hearing [infectious-disease epidemiologist] Michael Osterholm talk about it, 60 to 70 percent is the kind of number we need to actually say that we have herd immunity. So whatever this opening looks like, whenever it happens, it needs to happen with caution.

It looks as if Japan is considering deploying remdesivir before the U.S. has approved it. Could that provide the sort of human data that moves it closer to use in the U.S.?

 

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