Are Cases Really Increasing in the U.S.?
In April, the U.S. saw about 20,000 to 30,000 cases of COVID-19 per day, but now the number has reached 40,000 nationally as of June 29th. While a majority of cases were seen in cities such as New York and Boston earlier in the year, COVID-19 cases have now spread throughout the country, rising in both the number of cases and deaths in states that previously had relatively low numbers, including Florida, Louisiana, Texas, and Arizona. Florida, for example, reported 43,784 new cases the week of June 29th, having only reported 21,723 cases the week before, according to National Geographic.
While many hospitals in New York and other earlier overwhelmed cities have learned from their initial wave of COVID-19 cases, hospitals in places such as Texas are just beginning to face saturation issues that they weren’t completely prepared for. Hospitals are working with research centers, such as the Harvard Global Health Institute, to use models to predict their needs. In this way, they’re becoming more adept at adding beds when needed, stockpiling essentials like masks and anesthesia, moving personnel, and finding ways to keep visitors and non-COVID patients safe when inside.
Moderna’s Vaccine Update
As Moderna continues to enroll patients in Phases 1 and 2 of its mRNA-1273 clinical trials, it finalized a design for Phase 3 with the FDA to begin in July. Thirty-thousand randomized people will be enrolled in Phase 3 to receive either 100 µg of mRNA-1273 or a placebo. The primary objective of the trial will be to test how well mRNA-1273 can prevent symptomatic COVID-19 disease. Secondarily, it will assess how well the vaccine can prevent hospitalization and infection with the disease.
The world hopes for a vaccine that will both stop people from becoming infected as well as spreading COVID-19, but this may not be possible with Moderna’s first vaccine. While Moderna’s vaccine, as well as other vaccines in R&D at AstraZeneca, Inovio, Sanofi, and others, may not be able to stymie the spread of the disease, promising evidence shows it can prevent and stop its devastating effects in infected individuals.
Moderna is still holding onto hope of rolling out a vaccine by January of 2021. However, a company spokesperson says they can only produce one billion doses a year with the help of a contract manufacturer. In addition, trials currently point to patients needing two doses, meaning only 500 million patients could be vaccinated a year globally with their supply.
Remdesivir Gets Priced
Gilead has finally priced its repurposed drug that is cutting the hospital stays of many COVID-19 patients. For private insurances, the list price is $520 per vial. Most patients will need a six-vial course, which would be $3,120. For governments of developed countries, including the U.S., the price will be $390 per vial or $2,340 per course. NIH trials found the death rate of all severity levels of COVID-19 to drop from 11.9% in placebo patients to 7.1% for those on remdesivir.
The study also found the drug cut the length of hospital stays for 1,000 patients by an average of four days. In light of this, ICER determined that remdesivir would be cost-effective at around $4,580 to $5,080 per patient. Should the promising and low-cost steroid dexamethasone prove effective in treating severely ill patients, the price of remdesivir could fall. Dexamethasone is being studied in the U.K., which so far reports a 35% reduction in death rate among seriously ill, mechanically ventilated patients.
