Blind flight: brief history of Covid treatments, hopes and snake-oil cures

As the coronavirus pandemic roiled across the globe and people began to get very ill and die, the search for a viable cure kicked into high gear.

It has been a now two-year quest during which scientists, doctors and medical researchers, as well as a number of con artists, rolled out already available drugs in an attempt to cure people of the disease.

“We faced a new virus which didn’t have a treatment, and when that happens you look at what antivirals are available off the shelf that perhaps didn’t work elsewhere,” Stavros Nicolaou, Aspen Pharmacare’s group senior executive for strategic trade said. “Very often with a new virus it does respond to a product developed for a different virus. You also look at drugs that are not antivirals but that you could repurpose.”

Some existing drugs showed early promise but ultimately failed, while others helped turn the tide in the battle against the Covid-19.

Here are some of the high and low flyers.

Remdesivir

Within weeks of the pandemic hitting Europe, injections of this drug, developed to cure Ebola, appeared to speed up patient recovery times, helping boost maker Gilead’s share price along the way. But later controlled studies, one published in The Lancet medical journal, showed there was, in fact, little clinical benefit for patients. 

Hydroxychloroquine

This antimalaria drug received a significant boost after it was touted by former US president Donald Trump as a cure. Subsequent studies showed the drug offered no benefit to coronavirus patients and might even in fact increase the risk of death, leading the US health authorities to withdraw approval for its use as an emergency treatment. Trump later tested positive for Covid-19.

Lopinavir-Ritonavir

This common combination of drugs used to treat HIV failed to produce significantly improved outcome for very ill coronavirus patients despite high hopes. Results of a study published in the Lancet showed that 23% of those given the drugs died within 28 days of the start of treatment compared with 22% under usual care.

Monoclonal antibodies

The name “Regenron” was on the world’s lips when it emerged that Trump had received the “antibody cocktail” on being admitted to hospital for treatment. However, the US Food and Drug Administration (FDA) later revised its emergency approval for the Regenron, as well as for a similar drug produced by Eli Lilly, saying they were unlikely to work against the Omicron variant.

Dexamethasone

This cheap steroid proved to be something of a silver bullet in the fight against Covid-19. While at the beginning of the pandemic, 60-80% of the patients on ventilators were dying, dexamethasone dramatically reduced those numbers, said Nicolaou.

“Dexamethasone was a real breakthrough,” he said. “For the first time we were starting to see a 30-35% reduction in mortality. It gave the clinicians a lot of hope that they were not completely alone in this.” 

Paxlovid

The new kid on the block is this oral antiviral treatment developed by Pfizer that came to market in November. The drug, which contains ritonavir, a protease inhibitor used in the HIV treatment, was found to be nearly 90% effective in preventing hospitalisations and deaths among patients who had a high risk of developing severe illness.

Nicolaou said it was likely that the development of Covid-19 cures and therapies would continue.

“There will be ongoing interest in it because we don’t quite know if we have reached the endemic stage of the illness,” he said. “We don’t know if there’s another mutation that is less pathogenic than we’ve seen with Omicron but is still highly transmissible and which might not respond to the current crop of vaccines.”

But if the virus becomes endemic like the seasonal flu, drugs such as the Pfizer antiviral, along with vaccines, will be the way to manage patients.

Ivermectin

The outlier of all the drugs — medication originally developed to kill parasites in animals — was not actually touted as a treatment for Covid-19 but as a sort of cheap vaccine.

However, despite polarising social media and leading some healthcare professionals to immolate their careers by taking a stand for ivermectin’s efficacy in preventing Covid-19, numerous studies could not prove that the medication offered any benefit at all.