Monoclonals antibodies (mAbs) have been quietly built and tested for months now. IMO mAbs have some of the best chances of offering powerful treatments for #COVID19
Lilly is now posting positive results from a relatively small trial
Monoclonal antibodies are manufactured antibodies that are built, in part, based on looking at recovered people’s cells and asking “What antibodies naturally formed in these people” and then recreating the “successful” or protective antibodies as a treatment.
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Many different antibodies are tried in the lab and in animal studies and the most potent are eventually manufactured - and in the case of Lilly and Regeneron are now being trialed, with early but positive looking results
Why do I think monoclonal antibodies are promising?...
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mAbs are promising because we are literally taking proteins (antibodies) that our bodies normally make to defend us from pathogens, we are choosing the best ones, producing them and simply giving them as treatments...
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So biologically, our bodies are built to be OK with these types of molecules.
Also, we have a tremendous amount of experience with mAbs. Different mAbs are produced for all different conditions. Some to defeat viruses like RSV and some to help defeat cancers...
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Point is, we know how to build them, know they can be given to people safely (caveat that each needs to be assessed on its own), we have examples where they work for similar-ish viruses, and we know that the body can break them down safely.
Also, a great aspect of mAbs...
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Is that they could even be given prophylactically. mAbs can even potentially be produced and given to people as a preventative measure - almost like a temporary vaccine - but instead of your body developing immune memory, you give the immune products and they last temporarily
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Some mAbs can be produced to stick around in the blood for months. So there is a potential, particularly for elderly people who may not take to a vaccine very well, to provide a shot of mAbs each winter, for example...
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But mAbs aren’t here quite yet. But I’ve been banking on them (metaphorically - I have no investments) as one of the most promising class of drugs to help us out of this mess. Perhaps moreso even then vaccines - at least for the short term...
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If mAbs (plus other therapies and medical innovations) can help people stay alive and out of the hospital, it can change the overall risk equation and perhaps increase our tolerance for outbreaks, helping the economy to stay open more safely.
But we aren’t there yet.
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mAbs may come to market at very high price points and very limited distribution
Like vaccines, they’re unlikely to be widely available soon. But maybe for ex for compassionate use in hospitalized patients.
So, I’m not holding my breath, but I will remain optimistic.
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People are asking my take on the lack of a dose response.
It’s a small sample - so tough to make much out of it. If the lack of dose response holds, it will be peculiar.
The Lilly mAb may not end up as the winning ticket, but IMO mAbs have best chances of a potent treatment.
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Joseph Hibbeln MD has long researched and advocated for optimizing nutrition, including studying things like seafood consumption in pregnancy and role of mercury consumption and whether it is linked to autism. Generally he’s come out saying it’s not.
Summary: No evidence of anti science or anti vaccine. Likely very balanced and nuanced rigorous scientist to serve on ACIP.
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Cody Meissner MD
Is a pediatric infectious disease expert at my Alma mater - Dartmouth. He is a rigorous scientist and has defended vaccines while formally recognizing underlying issues that are causing people to turn away from them - such as vaccine success driving down disease - affording people the luxury of focusing on very rare side effects while forgetting the real impacts of the diseases.
One of the most common tropes is that measles is fine & doesn’t cause damage…
This is highly inaccurate
Measles literally grows by infecting and killing memory immune cells. It causes loss to existing immunity creating vulnerabilities & acute damage that is often severe
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To discover the massive-stealth-impact measles has on immune protection against infections not associated w measles, we looked at what happened in populations after measles outbreaks swept through, decade after decade across nations…