The data, which were posted online Thursday, have not yet been peer-reviewed or published in a scientific journal.
“This puts the issue to rest — there is certainly no mortality benefit,” said Dr. Ilan Schwartz, an infectious-disease physician at the University of Alberta in Canada.
But Dr. Peter Chin-Hong, an infectious-disease expert at the University of California, San Francisco, was more circumspect.
A huge trial like this one, conducted in various countries with various health care systems, can lead to inconsistent treatment protocols whose effects can be difficult to analyze, he said.
“So much goes into care,” Chin-Hong said. “The drug is only part of it.”
Remdesivir, which was originally developed as a treatment for Ebola and hepatitis C, interferes with the reproduction of viruses by jamming itself into new viral genes.
The drug was granted emergency authorization by the Food and Drug Administration on May 1 following a trial by the National Institutes of Health, which found that remdesivir modestly reduced the time to recovery in severely ill patients.
That study, too, did not find that remdesivir prevented deaths in patients with COVID-19. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, acknowledged at the time that remdesivir was not a “knockout” drug.
A final analysis, published in The New England Journal of Medicine on Oct. 8, suggested “a trend toward reduced mortality” in certain patients receiving remdesivir, according to the drug’s maker, Gilead.
Gilead disputed the conclusions of the WHO study Thursday, noting that a variety of drugs and drug combinations had been evaluated under a wide range of circumstances and that more rigorous studies had found a benefit.
Because of its design, there was “significant heterogeneity” in the way the trial was conducted. “Consequently, it is unclear if any conclusive findings can be drawn from the study results,” the company said in a prepared statement.
The antiviral has become part of the standard of care for COVID-19 patients in the United States and has been administered to thousands of patients since its approval, including President Donald Trump after his diagnosis with COVID-19 this month.
Here’s the opposite story, though. With apologies because I don’t have the book in front of me, so I may get some details wrong, but I read this “Irena’s Children“ by
Tilar J. Mazzeo.
Irena lived in Warsaw during the Nazi occupation, and dedicated her life to rescuing Jewish children from the Ghetto, and her story is complicated in a lot of ways but - well, this story isn’t actually about Irena, per se.
It’s about a bus driver.
It’s about a day when she’s traveling across town by bus with a very young Jewish child, and partway to their destination the child looks up and asks a question - in Yiddish. and the whole bus goes quiet, because everyone knows what that means. And Irena thinks, okay, we’re going to die here today.
And she’s running through her options - all of them bad - and suddenly the bus stops, and the bus driver announces that there’s been a mechanical failure and the bus needs to return to the depot immediately. Everyone off, please.
And she stands and goes to get off the bus and the driver says - not you two. Sit down. So she sits down as everyone else leaves, because, well, what else is she going to do? the options are all still bad, at this point.
and when the bus is empty the bus driver says,
“Where do you need to go?”
And then he drives them as close to their destination as he can, and lets them off, and drives away. And Irena lives, and the kid lives, and they never cross paths again.
So a janitor got three people killed, and a bus driver saved two lives - not to mention all the other lives indirectly saved because Irena was able to continue her work.
I think about that almost every day now, to be honest.
We can’t all be Irena. I couldn’t be Irena. She was in a unique place with very specific skills and connections that let her do what she did. I am just one mentally ill librarian. I can’t be her. But - I can be the bus driver. Or I could be the janitor. Because it doesn’t matter what your job is. It doesn’t matter who you are. In a world like this, every single one of us has the opportunity to do massive harm or massive good. We can save lives or end them.
And that’s scary. but it’s also very comforting? at least for me. Because at the end of the day it means this: no matter of how small and helpless and unimportant you feel, you’re never powerless in the face of great evil.
