Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent • Hacker News Board

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#51

Post by zdragnar » Fri, Oct 01, 2021, 5:39 PM UTC

LurkingPenguin wrote: post #32

loeg wrote: post #23

Earlier quoted context omitted.

We have vaccine mandates because infected healthcare workers spreading COVID reduce capacity even more. We haven't actually fired many workers, because the vast majority just get the vaccine (mostly before the mandates).

1. You need to account for the fact that some percentage (perhaps large) of healthcare workers already survived COVID and have natural immunity. Since the science is demonstrating that natural immunity is as durable and robust as vaccine immunity (if not more durable and robust), one would have to ask what the rationale is for firing workers who have natural immunity (as verified by a past COVID diagnosis or presence…

Healthcare workers have been on the front line, unvaccinated, for going on two years. To mandate it or risk being fired has absolutely pissed off quite a few that I know of... My wife has gotten it, and even she is offended.

The hyperbole around this very serious situation just makes all the policies seem even more like theater.

To your second point, there was just a new report I saw yesterday that there is no difference in viral load between asymptomatic vaccinated and unvaccinated individuals.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#52

Post by sudosysgen » Fri, Oct 01, 2021, 5:40 PM UTC

carbocation wrote: post #37

I think it's disappointing that this thread has devolved into a political discussion that is hardly related to the topic. The scientific/medical achievement here seems significant. As an MD, the difference between calling in a script for a pill and arranging for outpatient infusion therapies is vast.

Indeed. The opportunity for prophylaxis with an oral antiviral is also amazing.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#53

Post by crooked-v » Fri, Oct 01, 2021, 5:41 PM UTC

logicalmonster wrote: post #40

mmastrac wrote: post #7

Earlier quoted context omitted.

If it halves hospitalizations, it'll have a pretty drastic effect on overwhelmed ICUs but there's probably still a ways to go before ICU levels return to normal and we can skip mandates.

What are normal ICU levels and is this a goalpost that can ever be achieved? Long before Covid, it was well-known that hospital ICUs were designed to run fairly close to 100% capacity because it wasn't profitable to pay for staff that weren't truly needed at any given time. Is there any hospital that is going to pay for far more staff than they need and somehow manufacture many ICU beds out of nowhere? I feel like th…

> and is this a goalpost that can ever be achieved?

It could absolutely be achieved. Literally the only thing keeping things from going back to more-or-less normal conditions right now is that there are many unvaccinated people getting extremely ill from COVID and filling up ICUs.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#54

Post by dougmwne » Fri, Oct 01, 2021, 5:41 PM UTC

carbocation wrote: post #37

I think it's disappointing that this thread has devolved into a political discussion that is hardly related to the topic. The scientific/medical achievement here seems significant. As an MD, the difference between calling in a script for a pill and arranging for outpatient infusion therapies is vast.

Thank you for weighing in. I am hugely excited about this and immediately sent a message to all my family. I know people who died because they didn't know that antibody treatments were available and effective when given early enough. I very likely saved my own father's life by helping him to get an antibody treatment when he and his own doctor knew nothing about it at the time. When we're talking about pre-hospitalization, this knowledge is everything. This pill is hugely promising and I will be following it closely.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#55

Post by photochemsyn » Fri, Oct 01, 2021, 5:41 PM UTC

Some interesting points on the nature of our pharmaceutical patent system... (and while the cohort in this study does seem a bit small, the conclusions appear to be fairly valid):

> "Molnupiravir was invented at Drug Innovations at Emory (DRIVE), LLC, a not-for-profit biotechnology company wholly owned by Emory University, and is being developed by Merck & Co., Inc. in collaboration with Ridgeback Biotherapeutics."

> "In fiscal year 2019, more than half of Emory's total $689.1 million in research funding came from the federal government, the university's largest sponsor."

Clearly, this patent should be assigned to the federal government, not to Merck, and anyone who wants to manufacture and distribute it should be able to do so under an non-exclusive federal licensing program. The transfer of intellectual property created by the public funds to private entities is simply a criminal ripoff of the taxpayer.

[edit] Wait, was this a three-week clinical phase III trial? Seems massively expedited relative to other phase III trials?

> "Phase 3: Just 33% of drugs make it past Phase 2 and into Phase 3, which tests the potential treatment in the largest number of people. This phase measures both safety and effectiveness with many volunteers, sometimes thousands. Phase 3 trials last from one to four years."

Trial began on Sept 2 2021 apparently?

1. https://www.clinicaltrialsarena.com/news/merck-ridgeback-mol...

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#56

Post by WaitWaitWha » Fri, Oct 01, 2021, 5:42 PM UTC

This is not my field. But if there is a pill that can reduce death by 50% from the virus, I would like to know more about it.

> Bright's concerns that similar drugs in its class have mutagenic properties

As a layperson, this instantly raises a red flag in my mind. Should I be concerned? Why, or why not? More importantly, where can I find research that elucidates this for me?

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#57

Post by twofornone » Fri, Oct 01, 2021, 5:43 PM UTC

mmastrac wrote: post #24

mrfusion wrote: post #15

Earlier quoted context omitted.

If we’re worried about hospital capacity why are we firing healthcare workers?

I'm no policy or health care expert, but maybe because front-line and hospital workers are exposed to extremely large viral loads which seem to be related to the severity of the disease, and taking one HCW off the front-lines and adding them to the sick in the ICUs is worse than one less HCW and the same ICU level? This seems like you are trying to start a flamewar about vaccine mandates, BTW.

Something extremely frustrating about virtually all reporting to date is that I haven't seen any statistics as to infection and reinfection rates among front line workers. The implication is that immunity post exposure/infection doesn't exist, but I suspect that this data is being deliberately withheld because it would suggest that frontline workers don't need vaccines, or at the very least don't need a mandate.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#58

Post by DominikPeters » Fri, Oct 01, 2021, 5:44 PM UTC

I enjoyed this article explaining in more detail how the drug works, though much of it goes over my head: https://www.nature.com/articles/s41594-021-00657-8

Briefly, it causes the copying process of viral RNA to go wrong by increasing the number of G-to-A and C-to-U mutations. A potential worry is that such mutations will also increase in places where we don't want them, such as in host DNA, but apparently at least for mitochondrial RNA things look good.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#59

Post by tiahura » Fri, Oct 01, 2021, 5:44 PM UTC

elliekelly wrote: post #44

tiahura wrote: post #18

The Ridgeback founders were on CNBC this morning in a very encouraging interview. A few takeaways: 1. They are testing now as a prophylactic and anticipate positive results. 2. The mechanism of action is different from the upcoming Pfizer pill, so it’s reasonable to expect they can be taken together as a cocktail for even better outcomes. 3. It is showing positive results with other viruses in animals. Cool stuff!

> The Ridgeback founders were on CNBC this morning in a very encouraging interview. This just feels wrong and makes me uncomfortable for reasons I’m not quite able to articulate.

Why? It’s my understanding that this flows from work done years ago at Emory University. With the exciting news, why shouldn’t they take a bit of a victory lap? Good for them.

Re: Antiviral Molnupiravir Reduces Risk of Hospitalization/Death by ~50 Percent

#60

Post by sudosysgen » Fri, Oct 01, 2021, 5:45 PM UTC

dibujante wrote: post #21

mmastrac wrote: post #5

If I understand things correctly, this only helps _before_ hospitalization.

My understanding as well. By the time people are hospitalized, the disease isn't necessarily still prolific in their body; the post-infection damage kills them.

It is possible that it could allow for more aggressive immune modulation and immune suppression in people where post-infection and immune damage is the main issue.