Opinion: Notwithstanding the seemingly amazing results both companies boast, their new anti-viral drugs should not be viewed as the ultimate treatment, but rather an additional powerful tool in the world’s arsenal against the pandemic
Sheba Medical Center’s coronavirus ward(Photo: Reuters)-Nadav Eyal
With the past two years filled to the brim with bad and grim news, it is refreshing to finally hear something positive: if Pfizer and Merck’s claims regarding their coronavirus medications turn out to be true, most especially Pfizer’s, we are truly looking at a possible end to the pandemic.
The anti-viral pills will not make the disease go away. The virus will most likely remain among us for a long time and also remain a leading cause of death among the global population.
But what these medications can do is end the crisis that had so severely derailed our lives, end fears that mass infections will lead to the collapse of the health system and end any calls for drastic restrictions to prevent or fend it off.
Both medications come as simple pills and should be ingested soon after the onset of symptoms. Both are trying to disrupt the virus’ replication using vastly different mechanisms. Both show good results, although while Merck’s data is good, Pfizer’s are fantastic. In both cases, people who suffer from underlying health conditions such as heart disease, obesity or diabetes will be asked to take between 30–40 pills over the span of about a week.
Merck’s drug hit the market first and has already been approved by the desperate British regulator, where there is a disturbing rise in cases, hospitalizations and mortality.
It is 50% effective in preventing hospitalization and death. Clinical trials only tested people who were not vaccinated.
Merck’s drug was originally designed for the flu, disrupting the virus’ replication by introducing genetic errors. One of the immediate questions that have arisen in this regard is whether mutations in the virus could also affect the immune system or other cells.
According to Pfizer, its pill has shown better efficacy rates (89%) and unlike Merck’s, it was originally designed for COVID-19.
The results were so good that the experiment was cut short for reasons of medical ethics: those who received the placebo could not be allowed to continue to be hospitalized and die for the sake of comparison when there was an immediate drug available. The company is currently seeking emergency approval from the U.S. Food and Drug Administration (FDA).
The history of Pfizer’s pill actually begins as early as the original SARS epidemic in the early aughts and the company simply had to make some adjustments for COVID-19.
It should be taken alongside another known anti-viral drug, which is part of the anti-AIDS drug cocktail; the second drug is taken to slow down the metabolic rate and allow the substance to work more effectively.
In Pfizer’s case, the drug does not mutate the virus’ replication processes, but rather inhibits the activity of an essential enzyme that allows the virus to replicate itself within the body’s cells.
Clearly, Pfizer’s drug is preferable; so on Friday, its stock skyrocketed, while Merck’s stock plummeted significantly. In both cases, no deaths were recorded among those who received the drug, compared to 15 deaths in the test group. The drugs, according to the companies, are effective against all existing coronavirus strains.
It is important to note that these are two publicly traded companies. Lying in reports about such experiments is a very dangerous thing for them. The costs of both drugs are expected to be very high, in the hundreds of dollars per treatment. This is very disappointing, and with good implications for their balance sheets, and bad for public health around the globe — but also for the prospect of new coronavirus strains cropping up. The earlier the disease is treated, whether either through an immune response elicited by a vaccine or through one of these drugs, the smaller the chance of a dangerous mutation coming about.
It should also be noted that the world is not totally desperate for these drugs.
We have a variety of vaccines that work and even children are now eligible to get them. We have a drug protocol that significantly lowers mortality with relatively conservative treatment (steroids). There are monoclonal antibodies — the same former U.S. president Donald Trump received — that are now also available in Israel. PSR and quick tests are widely available, as well as N95 face masks that are largely capable of reducing infections. In a few months, drugs that lower hospitalization and death will be offered to those who are already infected.
But all these combined create a new reality, but with some important caveats.
First, this allows mass infections, which always was and remains a very bad idea because it can result in the emergence of vaccine-resistant strains.
Since we do not know what the long-term effects of COVID-19 are for those who have recovered, and since none of these tools is 100% effective, more infections mean higher chances some will fall victim to statistics.
Those who were vaccinated with a second dose and subsequently received a booster shot now enjoy a higher level of protection from the virus than any of these drugs could offer. It is not advisable to wait or rely on just one of these means, but utilize all options at our disposable.