Antibodies for the coronavirus sometimes show up in the blood of people who've had COVID-19, but it's possible they could also be given to patients therapeutically to help fight the virus.
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Bill Gates is hopeful that eventually there will be an effective coronavirus vaccine, but "we may need a second-generation" vaccine, he said, which could take a while.
In the near term, treatments could "cut the death rate quite dramatically, which would be a very big deal," he said.
Gates said antiviral drugs, monoclonal antibodies, and steroids are all promising treatments that could be ready to go much sooner than vaccines, possibly in a matter of months.
Bill Gates isn't expecting a highly protective coronavirus vaccine to be ready anytime soon.
"The very first vaccine won't be like a lot of vaccines, where it's a 100% transmission-blocking and 100% avoids the person who gets the vaccine getting sick," the billionaire philanthropist told Insider.
Vaccine trials take months, they don't have to create completely effective inoculations, and they won't help protect people who are already sick.
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That's why Gates is more excited, in the immediate term, about coronavirus therapeutics.
"It's much easier to test a therapeutic than it is a vaccine," he said during a wide-ranging chat earlier this week.
His best guess is that there are three types of therapeutic treatments that could be available for coronavirus patients in just a "few months."
It's not quite a reason to herald the end of the pandemic, but it's a start.
"It doesn't let you go to sporting events or hang out at the bars," he said. "You gotta get herd immunity [through vaccination] before you really do that."
But these treatments, if shown effective at helping people recover faster and better from the virus, could be a game changer for the mounting coronavirus death toll. Already, more than 150,000 people are dead from the coronavirus in the US. Several estimates suggest about 40% of those deaths are linked to nursing homes.
"These things where nursing homes get infected, and very high death rates, the therapeutics will make a big difference there," he said.
Here's a breakdown of the three kinds of treatments Gates is most excited about.
Vials of Remdesivir.
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Antivirals (as the name suggests) aim to act against a virus. They do this by preventing the virus from multiplying and reproducing. (The antiviral Tamiflu, for example, can help make flu infections shorter and less severe, if taken early on.)
One antiviral drug being used right now to treat the coronavirus is Remdesivir, a broad-spectrum antiviral and once failed Ebola treatment. Studies suggest it helps shorten coronavirus recovery time in patients who are very ill. In the US, Remdesivir is recommended only for emergency use in hospitals (it's approved in Japan). It is delivered intravenously.
Remdesivir maker Gilead announced on July 10 that its early trial results suggest the drug may cut hospitalized patients' risk of death by 62%, when compared with the standard of care, calling it "an important finding that requires confirmation."
More research on the drug is being conducted on thousands more hospitalized coronavirus patients, with results expected "in the coming months," the company said in a release.
Gates said he envisioned "reformulating Remdesivir to be easier to give," as well as getting other antiviral drugs tested for the coronavirus.
Corticosteroids are drugs that are similar to our natural human hormone cortisol. These steroids can help reduce inflammation and suppress the immune system, curbing a body's reaction to the coronavirus and helping prevent organ failure.
One steroid Gates is excited about for treating the coronavirus is dexamethasone, which some early studies suggest may reduce the risk of death in severely ill coronavirus patients. The cheap drug is not recommended for patients with milder infections, as it could prevent the immune system, in those cases, from "doing its job," Dr. Nina Shah, a blood-cancer physician and associate professor of medicine at UCSF Health, previously told Insider.
"Our foundation funded the UK trial that found dexamethasone," Gates said. "Trials have been pretty uncoordinated in the US, so things haven't gone as quickly as we expected."
The dexamethasone Recovery trial in the UK started in March, and by June, investigators announced their preliminary finding that "dexamethasone reduced deaths by one-third in ventilated patients."
"Given the public health importance of these results, we are now working to publish the full details as soon as possible," they said in a press release.
A coronavirus-antibody rapid serological test.
Robyn Beck / AFP via Getty Images
Monoclonal antibodies are a manufactured kind of protection cloned from the most potent natural protective antibodies that people who have had the virus have developed.
"There's three or four, including Regeneron, Eli Lilly, AstraZeneca, and others, that we'll have data on before the end of the year," Gates said of the lab-created antibody treatments. "That, in combination with the antivirals, could cut the death rate quite dramatically, which would be a very big deal."
The fact that these three kinds of coronavirus treatment trials might yield results "within a few months" is why Gates said the field of therapeutics was "getting less attention than maybe it deserves," as opposed to vaccines.
"At least some of those are likely to work before the end of the year," he said. "We're trying to make sure that the ease of giving them, and the cost, and the availability, takes care of the entire world."
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