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The situation with COVID-19 has been a fluid one from the beginning. The coronavirus emerged rapidly, introducing the world to its first global pandemic in decades. Hundreds of thousands have since died from the virus, despite efforts in quarantining, mask-wearing, and social distancing. COVID vaccines then appeared and offered significant protection against COVID-19 infection and spread. But these appear to require ongoing boosters over time. And the new delta variant of the coronavirus seems to have reduced its overall effectiveness to a degree.

Understanding this, it’s clear that our battle with COVID-19 is far from over. This realization has prompted researchers to forge ahead in their efforts to develop new treatment methods. One of these endeavors involves finding an oral tablet for COVID-19 that can be used alongside other therapies. Thus, COVID treatment pills are being tested by a number of pharmaceutical companies. An oral tablet for COVID-19 could not only increase access to management for millions. It could also offer new ways to reduce virus spread and impact. Many therefore hope that COVID treatment pills could be a step closer in getting the world back to normal.

“There is an increasing realization that we will not be able to fully vaccinate the global population as fast as we would like to or should.” – Sam Fazeli, Head of EMEA Research, Bloomberg Intelligence; Non-executive Director at Arecor Limited

COVID Treatment Pills Versus Vaccines

Several vaccines are currently on the market that are designed to prevent infection of the coronavirus and its spread. Pfizer, Moderna, and Johnson & Johnson are among the major ones available for many nations. These vaccines work by different mechanisms, but in essence, they attempt to prevent infection by the virus from the start. By developing specific antibodies against the virus or its machinery, COVID-19 is unable to effectively infect human cells. But while this is ideal, personal resistance to vaccination and limited access have reduced the potential for success. An oral table for COVID-19 could solve some of these issues.

Unlike vaccines, an oral tablet for COVID-19 would not likely introduce an antibody attack against the virus. Instead, the COVID treatment pills being developed today take a different approach to interrupts the virus’ life cycle. Some target enzymes needed to help the virus reproduce itself within human cells. Others insert false RNA messages into the virus’ genome that also prevents normal replication. Thus, while vaccines offer upfront protection, an oral tablet for COVID-19 limits its potency afterwards. These are key distinctions between the two forms of medical biotechnology treatments. (Medical biotechnology is the future–read why in this Bold story.) And its why using one will not deter the use of the other.

“We learned very quickly in HIV that if you don’t pay attention to [ongoing viral resistance], you develop molecules that quickly become obsolete.” – Daria Hazuda, Chief Scientific Officer, Merck Research Center

Developing an Oral Tablet for COVID-19 with Lasting Effects

Coronavirus is not the first virus where researchers have attempted to develop oral therapy. Such efforts have certainly taken place in fighting HIV as well as other viruses like Ebola. In these efforts, researchers have learned a great deal in addition to spending billions of dollars. In fact, many of the effective HIV treatments today came from this research, which is guiding current work with COVID. (Dive deeper into the innovations in HIV treatments with this Bold story.) Researchers are much more aware of how quickly a virus can adapt and change as a result. Therefore, their efforts in developing COVID treatment pills strives to interfere with the virus in ways that aren’t easily avoided.

Currently, scientists hope the leading COVID treatment pills being developed will have lasting effectiveness. Those that inhibit enzymes that help the virus reproduce use a major common pathway that would be hard to work around. Others that insert false genetic material limit viral resistance because of the major changes they make in viral activities. Whether this proves to be true or not is yet to be known. But researchers recognize that any oral tablet for COVID-19 must be effective despite efforts of the coronavirus to continually adapt.

“…It is relatively easier to make these drugs than it is to produce vaccines and biologics, and the wherewithal to do so exists across the world…And easier manufacturing should lead to lower pricing that can help speed distribution to the most vulnerable populations.” – Sam Fazeli

Leading Pharmaceutical Manufacturers for Oral Therapies

At the current time, there are three major pharmaceutical companies actively pursuing an oral tablet for COVID-19. These include Pfizer, Merck, and Japan-based Shionogi. All are either actively involved in experimental trials for their drugs or will be soon. Any or all of these COVID treatment pills may therefore be available within months.

  • Pfizer – The oral tablet for COVID-19 being developed by Pfizer works by blocking a protease enzyme. This enzyme is needed by the coronavirus to replicate itself within cells. If the tablet is taken within 5 days of infection, it should limit the virus’ ability to spread through the body. As a result, infections would be less indurated and less severe. Pfizer’s current COVID treatment pills would be taken twice daily.
  • Merck – The name of Merck’s oral tablet for COVID-19 is molnupiravir, and it works by a different mechanism. This drug inserts false RNA genetic material into the coronavirus’s genome, causing errors in replication. Merck, which is working with Ridgeback Biotherapeutics, has a contract with the FDA in place. It will provide 1.7 million treatments for $1.2 billion, which is roughly $700 per patient.
  • Shionogi – This pharmaceutical firm is small but well known. It developed the now popular cholesterol drug, Crestor. Now, it is pursuing an oral tablet for COVID-19 that can be taken only once daily. This drug will work similar to the one being developed by Pfizer as it also disrupts cellular protease activity. Shionogi may also partner with a larger company, like Astra-Zeneca, for global distribution once ready for market.
An old dude trying to open a child-proof pill bottle
An oral tablet for COVID-19 treatment? There may be some soon available.

A New Therapy Against COVID Needed

In addition to opposition against vaccinations and new COVID variants, additional barriers to effective treatment exist. Many developing countries have limited access to vaccines. Cost of development of vaccines and other hospital-based therapies are additional obstacles. The addition of COVID treatment pills to these therapy options would therefore be welcomed. This is especially true if they were less expensive, easy to administer, and limited in duration. Hopefully, drug trials will demonstrate that oral COVID treatment pills will be both safe and effective. If so, an oral tablet for COVID-19 may soon be part of routine course of care.

 

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