Europe’s Vaccine Delays Highlight Continued Importance of COVID-19 Treatments
In both economic and public health terms, the European Union’s vaccination campaign has been one of the costliest failures in the bloc’s history. As of April 7th, less than 13% of the total population of the EU had received at least one dose of vaccine, compared to over 31% of Americans and fully 46.5% of people in the UK.
While European officials boast that new and existing manufacturing facilities in Germany, France, Switzerland, and elsewhere will allow the EU to reach an annual production rate of up to three billion doses by the end of this year, the crush of COVID-19 patients currently overwhelming ICUs across Europe underscore the human cost the bloc faces in the interim. In France alone, over 30,000 patients are currently hospitalised with COVID, with over 5,600 of them in the ICU – the highest rate since the peak of the first wave last April.
Those numbers, together with the constant threat of new variants which throw the effectiveness of currently available vaccines into doubt, make the pursuit of effective treatments for COVID-19 patients an indispensable part of any strategy to ultimately overcome this virus. While the past year has brought a number of promising developments for European COVID patients, the EU’s current laser focus on vaccine production and deployment has largely shunted the policy discussion surrounding treatments to the sidelines.
Finding novel applications for existing remedies
While EU policymakers may have little bandwidth to dedicate to the issue of treatments, European researchers and medical institutions have nonetheless kept up the search for effective tools in treating COVID patients, particularly among existing drugs. Across the Channel, the UK is also a year into its Randomised Evaluation of COVID-19 Therapy (RECOVERY) trials, with nearly 40,000 patients from 181 facilities taking part.
The RECOVERY programme, which is currently evaluating the effectiveness of remedies such as the Regeneron monoclonal antibody cocktail, the arthritis drug Baricitinib, and the psoriasis and multiple sclerosis treatment Dimethyl fumarate, previously explored the utility of the malaria drug hydroxychloroquine and the steroid dexamethasone for COVID-19 patients. Trials such as RECOVERY have found that steroids such as dexamethasone and hydrocortisone make a significant difference for intubated patients, and that these steroids could be combined with anti-inflammatory drugs such as tocilizumab to reduce rates of death.
Parallel trials inside the EU have delivered similarly promising results. In Belgium, a study conducted by Ghent University Hospital in collaboration with the Flemish Institute for Biotechnology Research (VIB) tested the effectiveness of sargramostim (commercialized as Leukine by US-based Partner Therapeutics) in treating patients facing acute respiratory failure. Covering five Belgian hospitals and 81 patients, the trial found that Leukine improved the oxygenation of hospitalised patients and validated what researcher Dr. Bart Lambrecht called “sargramostim’s critical role in the repair and healthy functioning of the lung.”
Of the 81 patients who took part in Dr. Lambrecht’s study, more than half of those who received inhaled sargramostim (Leukine) in addition to the standard regimen of care saw their levels of oxygenation improved by 33% from the baseline, together with other improvements in lung function. Importantly, the Leukine treatment also produced a “statistically significant increase in activation of CD8+ anti-viral T cells,” indicating a boost in immune system responses to COVID-19, all while reducing signs of the inflammation that is so dangerous for COVID patients.
Given Leukine is already approved for use in treating acute respiratory distress syndrome by the US Food and Drug Administration (FDA), the Flemish study’s findings seem to offer yet more confirmation that existing treatment regimens can prove lifesaving for COVID-19 patients – even if no individual drug has thus far proven itself to be a cure.
Saving lives while vaccines catch up
Given the many thousands of new COVID cases EU governments and public health authorities will need to handle in the remaining months until a critical mass of Europeans can be vaccinated, the need for effective treatment regimens – whether composed of one or, as is more likely, several drugs – is readily apparent. As temperatures rise and political leaders come under increasing pressure to re-open bars, restaurants, and other businesses currently shuttered across much of Europe, public health experts are already warning that this summer will not be like that of 2020.
Instead of enjoying open and unrestricted travel to holiday destinations within Schengen, a hard-earned reward for enduring months of strict confinement that dramatically cut into viral transmission rates, EU citizens cannot count on warm summer weather alone to counter the saturation of hospital beds. Instead, as a group of over 40 Paris-area urgent care doctors warned last month, hospitals in and around the French capital still face the prospect of triage for patients in the weeks ahead – reviving some of the most horrific memories of last year’s first wave.
With so many European ICU beds currently full and likely to remain so for months to come, any and all treatment options that improve health outcomes for hospitalised patients – and reduce the time they need to spend on ventilators or receiving urgent care – merit not only attention from policymakers but also funding for research, development, and deployment alongside vaccines. Between the lethargy of the vaccination campaign and the emergence of new variants both inside and outside Europe, these treatments could ultimately come to play a critical role in the EU’s post-pandemic exit strategy.
Additionally, as the recent history of respiratory illnesses such as COVID, SARS, and MERS makes clear, more viruses in this mould are certain to appear in the years to come. By identifying and investing in effective treatments now, the EU can ensure it will be better prepared for the next pandemic before it arises.
Photograph: Hospital Diakovere Henriettenstift in Hannover during COVID-19 pandemic. Photograph by Michał Beim (Wikimedia Commons), Creative Commons License BY-SA 4.0.