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How President Trump Is Treating COVID-19

SCOTT SIMON, HOST:

As you've just heard, the president's been given Remdesivir. That's an intravenous antiviral medication. He's also had an infusion of an experimental drug made by Regeneron which has shown some promise in trials. NPR science correspondent Joe Palca joins us now. Joe, thanks for being with us.

JOE PALCA, BYLINE: You bet.

SIMON: First, what can you tell us about Remdesivir?

PALCA: Well, Remdesivir is a new antiviral drug. It's made by Gilead Sciences. It was used to treat patients with Ebola. Right now, it's been shown scientifically to reduce hospital stays by a few days for patients who need hospitalization. And it typically is given as a course of five to 10 days of treatment. And the treatment guidelines that - from a panel for the National Institutes of Health say there's insufficient evidence to recommend for or against Remdesivir for patients with mild or moderate disease.

SIMON: Well, to be blunt about it, does this mean the president is much sicker than we're being led to believe?

PALCA: Well, the short answer is, we don't know.

SIMON: What about the other drug the president was given yesterday?

PALCA: It's a drug from Regeneron, as you said. It's what's known as a monoclonal antibody cocktail. So an antibody is one of these immune molecules that fights off disease. A monoclonal antibody is a synthetic form of that antibody. And the cocktail is, there's more than one in this drug - actually, there are two - and the idea is that the two combination will make it less likely that the virus will form resistance against the drug.

SIMON: Do we know why the president got these drugs now when reportedly his symptoms are not severe?

PALCA: Well, it's been a - sort of a dogma that a lot of these antiviral drugs will work best when the viral load isn't so great, when you're not having that much virus circulating in your system. And so, at least in theory, there's been some reason to think that you would give these earlier on. But, of course, when you're first testing a drug, you want to start it off with the sickest patients, so that's where it's been shown to work.

SIMON: You and I couldn't take it. The drug hasn't been authorized by the Food and Drug Administration. How did the president get it?

PALCA: Well, according to the company, the president got it under what the FDA calls the expanded access program, or sometimes that's called compassionate use. And according to the FDA website, this program is a way for patients with, quote, "an immediately life-threatening condition or serious disease or condition to gain access to an investigational medical product, drug, biologic or medical device for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available," close quote.

Now, clearly, there's some wiggle room in there because it has been given for people with less than immediately life-threatening illnesses. But it's kind of interesting, and it certainly is at odds with the way the president's physician described his condition.

SIMON: And what would be any potential downside to giving the president an experimental drug?

PALCA: Well, I mean, you have to remember what the word experimental means. It means it might work, and it might not work. And actually, there's, I mean, little or no experience of giving this cocktail along with Remdesivir, so, you know, it's just hard to tell. And Andre Kalil from the University of Nebraska is a scientist who's been studying these. He says Regeneron drug is one of several promising drugs that are currently being tested in clinical trials. But Kalil says the way you learn whether a drug actually works and is safe is to give it to someone in a clinical trial.

ANDRE KALIL: At this point, because we do not have any proven therapy, this is not a time to give patients, the president or anyone unproven therapies outside a controlled trial.

PALCA: Because if the president gets better, you don't know whether the drug helped or whether he might have gotten better without any intervention.

SIMON: NPR science correspondent Joe Palca, thanks so much.

PALCA: You're welcome. Transcript provided by NPR, Copyright NPR.

Joe Palca is a science correspondent for NPR. Since joining NPR in 1992, Palca has covered a range of science topics — everything from biomedical research to astronomy. He is currently focused on the eponymous series, "Joe's Big Idea." Stories in the series explore the minds and motivations of scientists and inventors. Palca is also the founder of NPR Scicommers – A science communication collective.
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