Bob WachterVerified account

15/ We’re still waiting for better studies of Remdesivir, incl. to tell us if it’s useful in patients w/ milder disease, & if using it in combo w/ other drugs is helpful. Unfortunately, it’s IV only, which thwarts possibility of giving it earlier in course of illness (@ 41:06).

18/ Next, @ 46:42, vaccines w/ Joel Ernst. I had chatted w/ Joel on Mon https://bit.ly/3c0ba0V  re @moderna_tx's early results. His new insights today: @ 48:50, while 8 out of 45 pts had neutralizing antibodies, he clarifies that others weren’t neg; they haven’t been reported yet

19/ @ 52:20: The @moderna_tx is RNA vaccine: there’s no RNA vaccine in use today (it’s based on v. modern technology). This increases risk that there'll be a surprise problem. @ 53:10, next step in testing Moderna vaccine is expanding safety trial to 600 pts, incl. pts >age 55

20/ @ 56:00, Joel gives more details on the two ways of testing vaccine efficacy: a population-based study vs. a human challenge. He also notes that some vaccines block infections; other effective vaccines just attenuate the illness rather than completely blocking infection.

21/ @ 1:01;05: even if everything goes perfectly in further tests of @moderna_tx vaccine, Ernst thinks we’re still at least a year away from routine availability for high-risk populations. And, to produce billions of doses for everybody, add some time on time on top of that.

22/ Final topic, @ 1:03:00, Andy Leavitt on thromboembolic complications (aka “Covid-Associated Coagulopathy”). It’s the real deal, and “we don’t understand it mechanistically.” It’s not just a form of DIC (a fairly common bleeding/clotting abnormality in very sick patients).