UC Davis doctors and researchers are rushing to develop treatments that will stop the new coronavirus, building on breakthroughs that helped them save the life of a Solano County woman who made headlines as the first U.S. citizen to contract COVID-19 through community spread.
That patient is now recovering at home, five weeks after she was rushed, clinging to life on a ventilator, to UC Davis Medical Center in Sacramento.
UC Davis doctors were able to acquire the experimental antiviral drug, Remdesivir, and administer it to the Solano County resident with the emergency approval of the U.S. Food and Drug Administration. Now, the university is one of 75 select sites worldwide evaluating the drug’s benefits for patients with severe cases of COVID-19. Remdesivir has not yet been proven to improve everyone’s health outcomes, say UC Davis Health leaders.
Dr. Angela Haczku, a respiratory immunologist at UCD Health, said: “I’m hoping some of these clinical trials will yield beneficial results for patients and we won’t have to be so scared of this virus one day,” she said.
Cases of COVID-19 have exploded in California and across the nation in the weeks since the Solano County patient was diagnosed. The U.S. now leads the world in confirmed coronavirus cases, topping 82,400 Thursday and outpacing China and Italy, according to Johns Hopkins University. More than 1,110 people in the U.S have died from the virus.
UCD researchers told The Bee that antivirals, antibody therapies and vaccines are the triad that hold the most promise to combat the spread, and the university is uniquely poised for this moment.
They were able to quickly assemble a multidisciplinary coronavirus research team from the ranks of the California National Primate Research Center, the School of Medicine, the Center for Immunology and Infectious Diseases and the renowned School of Veterinary Medicine.
All the researchers have experience in the area of infectious diseases, and they have secure research facilities where they could not only grow and study cultures of the Solano County patient’s virus but also to observe the virus’ effects on primates.
Over the years, the primate center has been enlisted to study the Zika virus, HIV/AIDS and other infectious diseases. And UCD’s veterinary school has led the charge globally in guiding other nations in identifying hundreds of animal-borne disease that can spill into human populations.
Primate studies already have been effective in learning much about the new coronavirus, including that it is likely not possible to be re-infected with the same strain, at least in the short term, said Dr. Chris Miller, who works in the primate center at the University of California, Davis.
Diagnostic tests being developed
While he works on that aspect, other researchers are developing various diagnostic tests. Already, they have created and are using their own FDA-approved test to evaluate whether their sickest patients have COVID-19.
They also are working on a diagnostic test that will indicate whether people who unwittingly carried the virus already have recovered and gained the antibodies to ward off the respiratory disease, said Nam Tran, director of Clinical Pathology at UC Davis Health.
Such findings could affect people’s ability to return to work or school amid a foundering economy.
Haczku and her team have worked with breakneck speed to get clinical trials of Remdesivir and immunotherapies such as Sarilumab going. Remdesivir and other antiviral drugs kill viruses or suppress their ability to replicate.
Although Remdesivir is in clinical trial, its success in treating the Solano County patient builds on earlier gains proved in studies on monkeys in China and in UC Davis’ own research to cure a strain of coronavirus deadly to cats, the UC Davis researchers said.
Sarilumab, on the other hand, is a serum packed with human antibodies that can prevent the immune system from triggering a cascade of fever and acute inflammation. It was developed for treatment of rheumatoid arthritis but has shown promise in some people with COVID-19. UC Davis is one of up to 50 sites in the U.S. studying its effectiveness in clinical trials.
Dr. Dennis Hartigan-O’Connor, a scientist at the Primate Research Center, said the antibody treatments are so effective that it makes him hopeful.
“We know that the convalescent plasma seems to be protective,” Hartigan-O’Connor said. “That’s not always true for every virus, so it’s a very good sign.”
That also is potentially good news for developing a vaccine, he said, and that would allow the global population to gain “herd immunity.” UC Davis has begun vaccine trials in monkeys — a three- to six-month process that will typically move to phase one clinical trials in humans, meaning they will test the safety of the vaccine on groups of up to 200 people.
Vaccines can’t be rushed into use
Vaccines, however, can take a year to 18 months to move through clinical trials before they are ready to use on the general population, Hartigan-O’Connor said, adding that is necessary time “to make sure the vaccine is safe and doesn’t do more harm than good.” The FDA, however, can fast-track a drug that works well.
Still, challenges abound from the time needed to cycle through clinical trials to the lack of testing capability in California and across the country to the surge anticipated by hospitals and first responders in the coming days and weeks as the numbers of new patients begin their crest.
The crisis right now lies on the front line, in hospital emergency rooms, Miller said.
“Right now, clinicians are going to be up to their ears in people who can’t breathe,” Miller said. “That’s the real challenge.”
This is why doctors at UC Davis are urging Californians to stay home to flatten the curve and buy them time to develop these treatments for the disease before the state’s health care system is overwhelmed.
“Challenges for us are the same challenges in the broader community,” said Dr. Alexander Borowsky, a pathologist and physician at UCD’s Center for Immunology and Infectious Diseases. “How do we get testing and then, hopefully soon, treatment to the point where we can round the corner on this?”
Editor’s note: This story was updated Friday to correct the first name of Dr. Alexander Borowsky.