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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's stay sixty four.

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Speaker 1: Since coronavirus was declared a global pandemic our main story.

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Speaker 1: Many governments and companies were caught off guard by the

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Speaker 1: devastating spread of the coronavirus. But Gilliad Sciences was different.

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Speaker 1: The company had vials of its experimental COVID nineteen drug

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Speaker 1: from Desevere ready to put into a clinical trial, and

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Speaker 1: it had everything it needed to spring into production when

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Speaker 1: the drug was approved for emergency use. How did gill

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Speaker 1: Lead anticipate what so many others missed? But first, here's

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Speaker 1: what happened today. For the eighth straight week, the number

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Speaker 1: of Americans seeking unemployment and totaled in the millions as

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Speaker 1: the economy continued to reel from the pandemic. Nearly three

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Speaker 1: million people filed initial jobless claims last week, and while

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Speaker 1: the number was lower than the week before, it was

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Speaker 1: higher than economists had predicted. Economists at Goldman Sachs Group

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Speaker 1: revised their forecast for the peak unemployment rate in the US.

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Speaker 1: They now say unemployment will hit twenty five percent before

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Speaker 1: falling again, when they previously forecast a peak of fifteen percent.

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Speaker 1: A serious but rare inflammatory disease in children, may have

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Speaker 1: jumped thirtyfold because of coronavirus, according to an Italian study.

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Speaker 1: A detailed analysis from Bergamo, the city at the center

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Speaker 1: of the Italian COVID nineteen outbreak, found ten cases of

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Speaker 1: a COVID linked illness that resembles Kawasaki disease. All told,

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Speaker 1: about a hundred such cases have been reported in It'll,

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Speaker 1: New York, and England. The cases are challenging the previous

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Speaker 1: understanding that the disease rarely made children very sick. Finally,

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Speaker 1: Asian countries that were among the first affected by the

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Speaker 1: coronavirus and the most successful in quelling its spread are

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Speaker 1: now fearing second waves. After containing their outbreaks through measures

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Speaker 1: from strict lockdowns to rapid testing regimes, Hong Kong, South Korea,

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Speaker 1: and China face resurgences of the disease even as they

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Speaker 1: pursue aggressive testing and tracing. It's a reminder that untraceable

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Speaker 1: flare ups are likely even after an extended lulling cases.

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Speaker 1: Scientists have warned that the disease may never go away

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Speaker 1: because it lurks in some people without causing any outward

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Speaker 1: signs of sickness and now our main store. The drug

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Speaker 1: um Desevere, manufactured by Gilead Sciences, has offered one of

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Speaker 1: the fewest lovers of hope about the virus to emerge

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Speaker 1: in the last few months. In a clinical trial, ram

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Speaker 1: desevere was shown to reduce the recovery time of patients

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Speaker 1: who were seriously sick with COVID nineteen. Based on that trial,

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Speaker 1: the Federal Food and Drug Administration authorized the drug for

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Speaker 1: emergency use. The promising results suggested the virus may be

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Speaker 1: beatable and even buoyed the volatile stock market for a

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Speaker 1: short while. Gilliad had enough of its drug ready to

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Speaker 1: test and start manufacturing it at a larger scale because

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Speaker 1: it had started stockpiling not just the drug but its

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Speaker 1: ingredients at the first hint there may be a new coronavirus.

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Speaker 1: I talked to Robert Langraff about why the company was

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Speaker 1: able to act early to prepare for a pandemic when

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Speaker 1: so many businesses and institutions did not. So, Bob, how

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Speaker 1: good is this drug? Well, the short inswers, we really

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Speaker 1: don't know yet. Uh. It got an emergency author's use

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Speaker 1: authorization by the Food and Drug Administration based basically on

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Speaker 1: a single trial about a thousand patients conducted by the

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Speaker 1: National Institute's of Health. According to the preliminary data, kind

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Speaker 1: of it helped speed up recovery from the disease on

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Speaker 1: the average by about four days. But none of the

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Speaker 1: data really has been published. We don't really know any

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Speaker 1: of the details of the data. And then there's another

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Speaker 1: study from China, much smaller study from China, you know,

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Speaker 1: that failed to show a clear effect of the drug,

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Speaker 1: also in hospitalized patients. So it's just the data is

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Speaker 1: very very preliminary, preliminary, preliminary. Now, you know, doctors really

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Speaker 1: haven't seen it has been invented or published, you know,

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Speaker 1: in medical journal. It is from you know, the n

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Speaker 1: i H with a very good reputation, Tony Fauci's group.

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Speaker 1: It you know, ni H help sponsor and conduct this, uh,

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Speaker 1: this study. But you know, in terms of the fine

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Speaker 1: details of whether there's a safe lives or not, you know,

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Speaker 1: we just don't know yet. So you wouldn't necessarily call

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Speaker 1: it a cure. No, I definitely would not necessarily call

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Speaker 1: it a cure. And uh, in you know discussing it,

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Speaker 1: you know, early on when they kind of announced the results, Uh,

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Speaker 1: Tony Faucci kind of like in this early trials, early trials,

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Speaker 1: you know, a z T which was one of the uh,

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Speaker 1: the first HIV drug, and that kind of was you know,

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Speaker 1: proved quickly based on early evidence, but then you know,

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Speaker 1: later on was you know, supplanted by you know, much

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Speaker 1: more potent, stronger drug combinations. The way to think about

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Speaker 1: this is kind of, hey, it's a start. You know,

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Speaker 1: it's a first, first drug we can use, and there

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Speaker 1: We're gonna need many more drugs and vaccines in the future.

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Speaker 1: So I'm wondering what are some of the issues with

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Speaker 1: producing this drug in in large quantities. It's been likened to,

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Speaker 1: you know, making you know, these very specialized complex chemicals

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Speaker 1: sort of been liking to bake in a very you know, specialized,

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Speaker 1: fancy type of bread. You have to do, uh, you know,

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Speaker 1: have to have all the right ingredients on hand in

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Speaker 1: large quantities, and if you have to wait for the

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Speaker 1: week to grow, so to speak, then you're you know,

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Speaker 1: out of luck and you may have to wait a while.

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Speaker 1: So you have to have all the ingredients on hand,

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Speaker 1: and then you have to execute all the steps in

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Speaker 1: the proper sequential order. And for this drug, there's more

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Speaker 1: steps chemical steps than usually it's about the twenty five

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Speaker 1: different chemical steps depending on how you count. So basically

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Speaker 1: at the start of the process, Gilly had Gilly had

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Speaker 1: had some supply on hand, but they estimated that to

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Speaker 1: make more of it would take you nine to twelve

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Speaker 1: months from start to finish just to gather all the

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Speaker 1: important raw materials and starting chemicals, then to produce the

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Speaker 1: raw drug supply the raw they call it active pharmactical

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Speaker 1: sudical ingredients that's just like a bulk white powder. And

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Speaker 1: then because this drug is not a pill, it's infused

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Speaker 1: into viles, that there's an additional manufacturing step that's need

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Speaker 1: and that they have to you have to dissolve it

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Speaker 1: and put it into viles under very sterile conditions. H

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Speaker 1: And that adds additional complexity to the process that you know,

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Speaker 1: a separate manufacturing plants. So all told, there's there's are

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Speaker 1: quite a number of steps, and they've been able to

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Speaker 1: get it down to about six months now by improving

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Speaker 1: the process, but you know, it's still a lengthy, complicated

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Speaker 1: process from start to finish. What was the original use

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Speaker 1: case for rem desvier? Why was bill yad developing the drug. Yeah,

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Speaker 1: so it's very interesting. They put a team together back

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Speaker 1: in two thousand and fourteen, you know, looking at some

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Speaker 1: of their drugs for emerging viruses. And you know, one

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Speaker 1: of the reasons they were looking at that is because

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Speaker 1: that was like the big bowler outbreak in West Africa.

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Speaker 1: So they put together a team, you know, fifteen or

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Speaker 1: twenty people looking at that, you know, what drugs might

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Speaker 1: be good for some of these emerging viruses and remdesiviere,

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Speaker 1: which is like in the test to work, we worked

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Speaker 1: against a lot of viruses kind of jumped to the

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Speaker 1: top of the list, but they weren't able to actually

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Speaker 1: test it in people and for easy in a bowler

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Speaker 1: until kind of the next bowl outbreak I was like

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Speaker 1: twos eighteen tousand, nineteen, uh and the congo. Interestingly enough,

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Speaker 1: it didn't work well there. They got those results you know,

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Speaker 1: last year. But in the process of testing it for

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Speaker 1: a ball, I'm looking at it for other things. Some

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Speaker 1: researchers at the head is working with at the University

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Speaker 1: of North Carolina and Vanderbilt University Medical Center, you know,

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Speaker 1: showed that it was really quite effective at least in

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Speaker 1: the lab and the test tube type tests against a

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Speaker 1: whole variety of coronaviruses. When this COVID nineteam came aroung

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Speaker 1: Long deserverre basically immediately became a you know, a prime

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Speaker 1: candidate to test as a drug against COVID nineteen. And

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Speaker 1: currently how much supply is there of M devere So

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Speaker 1: gill Lead is promising to donate the first one point

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Speaker 1: five million vials of the drug, and that's you know,

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Speaker 1: roughly enough to treat close to two hundred patients, you know,

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Speaker 1: under a kind of existing regiments, And the US Department

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Speaker 1: of Health and Humanity Services said that about six hundred

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Speaker 1: thousand uh of those vials are going to earmarks so

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Speaker 1: to speak, for the United States, that maybe that will

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Speaker 1: treat about seventy eight thousand patients here. So, you know,

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Speaker 1: there's already a lot of debate over you know, which

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Speaker 1: hospitals are getting it and why. Now Guilliad is not

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Speaker 1: deciding that. The US government and the state governments are

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Speaker 1: deciding that, but there's been a lot of confusion over

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Speaker 1: you know what what you know, how is it being

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Speaker 1: allocated different hospitals, and why do some parts of the

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Speaker 1: country have a supply of this now and others don't

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Speaker 1: how is that being decided. So Gillian is working very

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Speaker 1: hard to increase the supply. One key decision, you know,

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Speaker 1: it made early on, was very early in January, as

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Speaker 1: soon as it became clearly this thing, you know, it

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Speaker 1: was caused by coronavirus and could potentially be significant, they

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Speaker 1: put out a big, big order, like all the bulk supplies.

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Speaker 1: They need to make a lot more of this drug,

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Speaker 1: sort of like the equivalent of you know, all the

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Speaker 1: specialized flower and all the specialized eggs and all the

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Speaker 1: specialized butter and all the other ingredients that go into

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Speaker 1: your baking. They put a big, big order and because

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Speaker 1: of that, you know, they're now in a position to start,

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Speaker 1: you know, making much bigger supplies of it. And they're

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Speaker 1: talking about having by fall enough to treat five hund

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Speaker 1: thousand patients, but into the year enough to treat at

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Speaker 1: least a million patients. So that's still going to take

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Speaker 1: a number of months to role in. So it's still

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Speaker 1: right now, it's definitely in short supply. Now you mentioned

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Speaker 1: that Gilliat is willing to donate a certain amount of

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Speaker 1: the drug initially, but eventually they are going to have

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Speaker 1: to charge for the drug. Is there any estimate of

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Speaker 1: how much this drug is going to cost? Now Guilliad

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Speaker 1: is not talking about it, and so it's too early

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Speaker 1: to talk about that. But uh, Wall Street, you know,

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Speaker 1: is talking about that, and they're they're figuring, you know,

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Speaker 1: it might be around three or four or five thousand

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Speaker 1: dollars per course of treatment, you know, at least for

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Speaker 1: you know, wealthier countries like the United States and Europe. So,

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Speaker 1: as you mentioned, REM descivite is not a cure for

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Speaker 1: COVID nineteen. And so in your estimate or your recommendation,

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Speaker 1: what are some other drugs or vaccines? What more research

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Speaker 1: is needed to be done to maybe compliment REM decivere

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Speaker 1: or maybe to actually find a cure for COVID nineteen. Well,

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Speaker 1: there's just an immense I call almost a fire hose

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Speaker 1: of drugs and trials and vaccines being tested. Now there's

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Speaker 1: like literally more more than a hundred drugs and hundred

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Speaker 1: vaccine means being either tested and trials are you know,

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Speaker 1: explored in preclinical trials. Um one approach on the drug

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Speaker 1: front that a number of companies are working on is

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Speaker 1: called monocle antibodies. This is antibodies would be directly against

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Speaker 1: COVID nineteen. Companies working on that include every General and

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Speaker 1: Pharmaceuticals which made a successful treatment for a bowl are

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Speaker 1: using the same type of approach, and so monoclon antibodies

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Speaker 1: they be essentially when when you when you get get

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Speaker 1: the virus and the coverent from it, you have antibodies

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Speaker 1: to that virus that basically block the spike protein of

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Speaker 1: the virus, which is how the virus gets into cells.

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Speaker 1: And so what these artificially made monoclon antibodies would be

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Speaker 1: would essentially duplicate the natural process of creating antibodies, and

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Speaker 1: except they pick out some antibodies and make you know,

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Speaker 1: large quantities of them the factory and just inject them

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Speaker 1: directly into you. And you could use these monoclon antibodies

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Speaker 1: two different ways. They could be used as a preventative

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Speaker 1: treatment for people at very high risks, such as like

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Speaker 1: versus doctor's first responders, and they could also be used

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Speaker 1: to treat very sick patients UH with the disease and

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Speaker 1: re General has talked about starting clinical trials with that

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Speaker 1: approach in June, and there are several other drug companies

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Speaker 1: also working on similar approaches. And these antibodes are viewed

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Speaker 1: as one of the most promising treatment approaches or proven nineteen.

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Speaker 1: That was Bloomberg's Robert Langrath. His reporting on gile lead

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Speaker 1: is the cover story of this week's issue of Bloomberg

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Speaker 1: Business Week. And that's our show today. For coverage of

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Speaker 1: the outbreak from bureaus around the world, visit Bloomberg dot

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Speaker 1: or Spotify. It's the best way to help more listeners

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Speaker 1: find our global reporting. The Prognosis Daily edition is of

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Speaker 1: to Me Laura Carlson. The show was produced by Me

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Speaker 1: Topher foreheads, Jordan Gaspore and Magnus Hendrickson. Today's main story

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Speaker 1: was reported by Robert Langrith. Original music by Leo Sidrin.

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Speaker 1: Our editors are Francesca Levi and Rick Shine. Francesca Levi

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Speaker 1: is Bloomberg's head of Podcasts. Thanks for listening.