DAVID GREENE, HOST:
So to stop the coronavirus pandemic, a vaccine is almost certainly necessary. But what about drugs for treatment? Though it's likely no single drug will be as effective as a good vaccine, there is a huge effort underway to develop effective medications. NPR science correspondent Richard Harris reports.
RICHARD HARRIS, BYLINE: So far, scientists have only identified one kind of drug that is shown to save lives. Steroids help a bit. They somewhat reduce the risk of death among seriously ill patients. It's a start. The drug remdesivir apparently shortens hospital stays. And this week, Eli Lilly said it is making progress on two more drugs, including one that is designed to block infection. Dr. Dan Skovronsky, Lilly's chief scientific officer, says the drug is derived from an individual COVID survivor's natural immunity.
DAN SKOVRONSKY: We found the one antibody in their body that was the most potent. We engineered it in our laboratories, turned it into a medicine, made it in our factories and started testing in patients.
HARRIS: This proof-of-concept study suggests that this strategy of blocking virus with antibodies holds promise, at least. Inma Hernandez at the University of Pittsburgh School of Pharmacy is hopeful, but she doubts that these drugs will be a game-changer.
INMA HERNANDEZ: These drugs are so complex to produce, probably we will not have antibodies available for treating everybody that gets coronavirus. They're probably also going to be considerably expensive.
HARRIS: Antibodies, as a class, are among the highest-priced drugs. And Derek Lowe, a drug developer and industry blogger, notes that Lilly used hefty doses of these expensive drugs - grams of the stuff. Imagine making enough to treat the tens of thousands of Americans who get sick every day.
DEREK LOWE: Those are truckloads of antibody.
HARRIS: Lots of drug companies are trying another approach to treating coronavirus. They're trying to find drugs that help tamp down the body's overactive immune system, since that reaction, inflammation, is dangerous and potentially deadly.
LOWE: Problem is inflammation and the immune system are so just ridiculously complicated that you have to be empirical. You have to say, well, that's - looks like a good idea. Let's go find out if it's real. And a lot of the times, it's not.
HARRIS: That eats up time and money. Now, there are a few actual cures for viral diseases, including hepatitis C. Lowe says the secret there was to find just the right combination of drugs.
LOWE: If you wanted to do that for the coronavirus, you would still be looking at quite a few years.
HARRIS: The reality is that most ideas that look great on paper actually fail somewhere along the way. They are either too toxic, or they simply don't work. Dr. Vinay Prasad, a cancer doctor at UC San Francisco, says most of the time, when a drug does work, it is rarely revolutionary.
VINAY PRASAD: Most of our effect sizes are modest benefits - 5% benefits, 2% benefits, 1% benefits.
HARRIS: When those drugs are combined, the benefits can add up, sometimes to quite effective therapies. But that takes years of trial and error. Prasad uses a baseball analogy for how he thinks coronavirus drug development might play out.
PRASAD: It's possible that we're going to get sort of singles and doubles. We might not get the home run, and we might have to rely on the core things that we know control viral spread.
HARRIS: Masks and social distancing are, in the short run, at least, more potent than pills. Skovronsky at Lilly isn't discouraged, though. He says a cure usually doesn't require any medicine.
SKOVRONSKY: The truth is that for most people who get COVID-19, probably they cure themselves.
HARRIS: That's why his company is focusing on drugs that will help the 5 or 10% who get really sick. True, a lot of those drugs, like the antibodies, are expensive, but Skovronsky doesn't see that as an impediment.
SKOVRONSKY: We're confident that this will be an affordable drug for society, for governments. Of course, our expectation is that governments would not pass any expenses along to patients.
HARRIS: That's a big assumption. But with coronavirus, it seems all bets are off.
Richard Harris, NPR News.
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