WEBVTT - The Promise of a New Treatment 0:00:03.640 --> 0:00:08.760 Welcome to Prognosis. I'm Laura Carlson. It's day one forty 0:00:08.800 --> 0:00:14.120 five since coronavirus was declared a global pandemic. Today's main story. 0:00:14.800 --> 0:00:18.520 Once a vaccine is developed, there's a chance it won't 0:00:18.560 --> 0:00:23.000 help the most vulnerable, elderly people and those with compromised 0:00:23.040 --> 0:00:28.280 immune systems. So drug companies are working on new ways 0:00:28.400 --> 0:00:32.760 to treat COVID and hoping to protect the very people 0:00:33.280 --> 0:00:39.080 vaccines may not. But first, here's what happened in virus 0:00:39.120 --> 0:00:47.520 news today. Tokyo confirmed two hundred and fifty eight new 0:00:47.600 --> 0:00:52.280 cases of the virus. Japan is facing a resurgence of 0:00:52.360 --> 0:00:56.920 COVID nineteen. The country had contained its initial wave of 0:00:56.920 --> 0:01:01.520 COVID nineteen earlier this year, but now infections that were 0:01:01.600 --> 0:01:06.040 first concentrated in the capital have spread to other urban areas. 0:01:06.880 --> 0:01:11.880 Regions that went for months without cases have become new hotspots. 0:01:12.720 --> 0:01:16.399 The patient demographic in this new wave has changed, too. 0:01:17.080 --> 0:01:20.920 The virus was first spreading among younger people who were 0:01:21.000 --> 0:01:25.360 less likely to get seriously ill. Now it's expanding to 0:01:25.440 --> 0:01:29.720 the elderly. That's a major concern in the country with 0:01:29.800 --> 0:01:36.360 the world's oldest population. In the US, talks to break 0:01:36.360 --> 0:01:39.679 an impass over a new virus relief package have become 0:01:39.800 --> 0:01:45.199 increasingly urgent. Millions of jobless Americans were left without additional 0:01:45.240 --> 0:01:49.680 aid after Republicans and Democrats failed to reach a deal 0:01:49.720 --> 0:01:53.920 on a new stimulus package. The Senate is scheduled to 0:01:54.000 --> 0:01:59.200 leave for an extended break on Friday. The parties remain 0:01:59.400 --> 0:02:02.280 far apart art on some of the biggest sticking points, 0:02:02.600 --> 0:02:07.080 including extending the supplemental six hundred dollars a week that 0:02:07.280 --> 0:02:13.360 has kept many unemployed people from falling into poverty. Meanwhile, 0:02:13.840 --> 0:02:17.600 the White House is exploring whether President Donald Trump can 0:02:17.760 --> 0:02:22.200 act on his own to extend the benefits and eviction protection, 0:02:22.639 --> 0:02:27.960 according to people familiar with the matter. Finally, the World 0:02:28.040 --> 0:02:32.360 Health Organization says the US can still fight the spread 0:02:32.360 --> 0:02:37.919 of the disease. Maria van Kirkhove, the who's chief epidemiologist 0:02:37.960 --> 0:02:41.600 on COVID, said that by staying home and wearing masks, 0:02:42.000 --> 0:02:53.560 the country can still change its catastrophic infection trend. And 0:02:53.680 --> 0:02:59.200 now for today's main story, The drug company Eli Lily 0:02:59.600 --> 0:03:03.600 is about out to start testing it's COVID nineteen antibody 0:03:03.680 --> 0:03:08.280 drug in nursing homes. Vaccines may not work as well 0:03:08.400 --> 0:03:13.840 on elderly people or those with compromised immune systems. Since 0:03:13.960 --> 0:03:17.200 these are the very groups most at risk for severe 0:03:17.240 --> 0:03:21.960 disease or death if they contract the coronavirus, a successful 0:03:22.040 --> 0:03:26.760 antibody treatment could have a marked effect on lowering the 0:03:26.800 --> 0:03:32.160 pandemic's death. Toll I talked to reporter Riley Griffin about 0:03:32.200 --> 0:03:42.680 the new drug and the promise of antibody treatments. Tell 0:03:42.760 --> 0:03:45.800 us a little bit about Eli Lillian companies. So called 0:03:45.880 --> 0:03:50.280 antibody therapy. It's a little of a lesser known approach 0:03:50.320 --> 0:03:52.600 to counturing COVID nineteen. So I was hoping you could 0:03:52.640 --> 0:03:56.160 walk us through it. Yes, So Lily is co developing 0:03:56.200 --> 0:04:01.040 what's known as a monoclonal antibody with a Canadian startup, 0:04:01.400 --> 0:04:06.040 Absilera Biologics, and these neutralizing antibodies you may have heard 0:04:06.080 --> 0:04:11.520 that term before. They're tailored to mimic immune responses to 0:04:11.600 --> 0:04:15.160 the virus. Other companies racing to come up with similar 0:04:15.200 --> 0:04:20.000 treatments include Astra Zenica and VERB Biotechnology in partnership with 0:04:20.040 --> 0:04:24.159 Glaxo Smith Klein. The best known treatment of this kind 0:04:24.360 --> 0:04:29.320 is a to antibody cocktail from Regeneraan, which actually received 0:04:29.400 --> 0:04:32.520 a whopping four fifty million dollar award from the U. S. 0:04:32.560 --> 0:04:38.360 Government's Operation Warp Speed project to that very end, and 0:04:38.400 --> 0:04:42.240 so maybe you could talk us through where Lily stands 0:04:42.440 --> 0:04:47.120 right now in terms of their clinical trials. Lily's antibody, 0:04:47.200 --> 0:04:50.040 which was isolated from one of the very first COVID 0:04:50.120 --> 0:04:54.720 nineteen patients, is now actually going into phase three clinical trials. 0:04:54.760 --> 0:04:58.240 That's the latest stage of development, and Lily is taking 0:04:58.240 --> 0:05:01.960 a single antibody approach. It's hoping that this therapy will 0:05:02.000 --> 0:05:04.560 work both as a treatment for those with COVID nineteen 0:05:04.800 --> 0:05:09.080 the disease, and as a prophylaxis which can prevent those 0:05:09.120 --> 0:05:13.159 from contracting the illness. To that end, Lily is actually 0:05:13.200 --> 0:05:16.640 studying the drug in nursing homes where the elderly are 0:05:16.720 --> 0:05:19.840 at risk of exposure. So in a lot of clinical 0:05:19.880 --> 0:05:22.840 studies that have launched in a similar setting, and there 0:05:22.880 --> 0:05:26.160 aren't many, but in those that have, the point is, 0:05:26.200 --> 0:05:28.640 if you notice that there's an outbreak in a nursing home, 0:05:28.760 --> 0:05:31.960 what do you do next? And these studies would ultimately 0:05:32.120 --> 0:05:36.040 enroll the population on the therapy and you could see 0:05:36.080 --> 0:05:39.839 who then contracted it thereafter. Given its a population that 0:05:39.960 --> 0:05:43.839 is so very much at risk, So how does this 0:05:44.160 --> 0:05:50.880 antibody approach fit into the overall larger landscape of therapeutics 0:05:50.920 --> 0:05:55.920 and vaccines. Antibody treatments are seen as a compliment to vaccines, 0:05:56.600 --> 0:06:00.960 which may not elicit the necessary immune response when administered 0:06:00.960 --> 0:06:04.760 to elderly patients or those with compromised immune systems. And 0:06:04.920 --> 0:06:07.480 that's a that's a lingering question that we all have, 0:06:07.720 --> 0:06:11.360 is how is any vaccine going to work um in 0:06:11.400 --> 0:06:15.039 the elderly, in the immunocompromised, not just among the young 0:06:15.279 --> 0:06:19.320 the healthy. It's honestly, it's increasingly evident that we're going 0:06:19.400 --> 0:06:22.240 to need effective treatments for COVID nineteen in addition to 0:06:22.279 --> 0:06:27.159 those inoculations that can prevent against contracting the virus. Though 0:06:27.200 --> 0:06:29.960 there are a hundred and sixty vaccines in various stages 0:06:29.960 --> 0:06:32.719 of development, and a handful of course in late stage 0:06:32.760 --> 0:06:37.360 human studies, we don't know how each is going to 0:06:37.480 --> 0:06:41.360 work in every specific population. We're getting closer and closer 0:06:41.400 --> 0:06:43.719 to seeing one of those candidates reached the stage in 0:06:43.760 --> 0:06:46.440 which they could get an emergency use authorization to be 0:06:46.560 --> 0:06:52.119 deployed two populations like healthcare workers. This is a really 0:06:52.160 --> 0:06:55.800 historic feat just thinking about how the industry has mobilized 0:06:55.839 --> 0:06:57.960 to bring a shot across the finish line and under 0:06:57.960 --> 0:07:00.880 a year. It's really never been done before. Are But 0:07:00.920 --> 0:07:03.880 I want to be clear here that no vaccine candidate 0:07:04.080 --> 0:07:07.839 yet looks like it could be a silver bullet for 0:07:07.880 --> 0:07:12.520 squashing the pandemic. There remain these lingering questions about how 0:07:12.560 --> 0:07:16.400 many doses will be needed, how much immunity they will offer, 0:07:16.840 --> 0:07:21.120 how durable that immunity will ultimately be, and what populations 0:07:21.160 --> 0:07:24.559 they will work to protect. And really that's all before 0:07:24.600 --> 0:07:30.320 we get into these other questions of production, distribution, access, 0:07:30.320 --> 0:07:34.280 and price. So some pharmaceutical industry CEOs who have been 0:07:34.280 --> 0:07:37.760 speaking with think that a vaccine may be needed seasonally 0:07:37.840 --> 0:07:42.400 for the indefinite future, if the virus persists, if it mutates, 0:07:42.520 --> 0:07:44.840 or if we're simply not able to get the herd 0:07:44.880 --> 0:07:49.160 immunity needed to really crush COVID nineteen. What does the 0:07:49.240 --> 0:07:54.960 US government and in particular Wall Street think of this approach. Yeah, 0:07:55.040 --> 0:07:58.040 so the the US certainly is deploying capital to that end. 0:07:58.120 --> 0:08:02.679 We saw the award to Regenera on for its dual 0:08:02.800 --> 0:08:05.920 in a body approach. Um, they're making investments here like 0:08:06.000 --> 0:08:08.840 they have with vaccines, and through the same operation warp 0:08:08.840 --> 0:08:12.560 speed effort. We're also seeing the National Institutes of Health 0:08:13.120 --> 0:08:17.480 working with these companies to conduct studies of monoclonal antibodies 0:08:17.800 --> 0:08:21.640 and similar antibody therapies. Meanwhile, you asked about Wall Street 0:08:22.000 --> 0:08:26.600 investors really consider this to be an important quote unquote 0:08:26.600 --> 0:08:30.360 plan b um. If the vaccine approach doesn't pan out 0:08:30.400 --> 0:08:34.840 as it initially hoped, which is quite possible, what challenges 0:08:35.160 --> 0:08:37.920 could Lily or really any of the other producers of 0:08:37.960 --> 0:08:43.280 monoclonal antibodies have in bringing this treatment to market. Well, 0:08:43.320 --> 0:08:50.000 Manufacturing the antibodies will both be challenging and very costly. Um. 0:08:50.160 --> 0:08:52.400 Lily told us just last week that it's likely to 0:08:52.400 --> 0:08:56.120 spend more than million this year loan on COVID related 0:08:56.240 --> 0:09:00.240 R and D and manufacturing. Chief financial off a Sir 0:09:00.400 --> 0:09:03.880 Joshua Smiley actually noted that there's quite a limited amount 0:09:03.880 --> 0:09:06.840 of capacity in this world for this type of manufacturing, 0:09:07.320 --> 0:09:10.720 so they're currently working to build that out and reconfigure 0:09:10.760 --> 0:09:13.000 plants so that they can produce more than one hundred 0:09:13.080 --> 0:09:18.840 thousand doses before year end. A antibody approach is not 0:09:19.080 --> 0:09:22.680 like a pill. It's not like a small molecule. That's 0:09:23.200 --> 0:09:26.800 that's fairly cheap and can be done and mass It's 0:09:26.840 --> 0:09:32.400 a very complex technology that is costly, and they're going 0:09:32.480 --> 0:09:36.120 to be lingering questions about how to price antibody responsibly 0:09:36.120 --> 0:09:38.560 should one come to market, but also how you reach 0:09:38.640 --> 0:09:41.480 that scale and do so quickly if one should prove 0:09:41.520 --> 0:09:46.000 successful in the clinic. You know, it's a historic feat 0:09:46.000 --> 0:09:51.160 that we're seeing vaccines and therapeutics reach late stage trials 0:09:51.280 --> 0:09:54.800 and get closer to securing an emergency use authorization that 0:09:54.840 --> 0:10:00.160 would allow us to move these these important pharmaceutic goal 0:10:00.200 --> 0:10:05.520 products to healthcare workers, to frontline workers, and then beyond um. 0:10:05.520 --> 0:10:09.040 We're seeing the US, the UK, Japan reach deals to 0:10:09.200 --> 0:10:13.360 secure doses of these products should any proof successful in 0:10:13.400 --> 0:10:17.040 the clinic. But ultimately, broader success will mean more than 0:10:17.080 --> 0:10:20.160 crossing a finish line. It will mean we as a 0:10:20.240 --> 0:10:25.480 society have the wherewithal to produce, to provide, to pay, 0:10:25.720 --> 0:10:29.520 to protect ourselves from COVID nineteen and any other viruses 0:10:29.640 --> 0:10:37.840 that could one day come. That was Riley Griffin and 0:10:37.920 --> 0:10:40.160 that's it for our show today. For coverage of the 0:10:40.200 --> 0:10:44.440 outbreak from one bureaus around the world, visit Bloomberg dot 0:10:44.440 --> 0:10:48.760 com slash coronavirus and if you like the show, please 0:10:48.840 --> 0:10:51.760 leave us a review and a rating on Apple Podcasts 0:10:51.840 --> 0:10:55.000 or Spotify. It's the best way to help more listeners 0:10:55.240 --> 0:10:59.559 find our global reporting. The Productnosis Daily edition is produced 0:10:59.559 --> 0:11:05.560 by Topor foreheads Jordan Gospoure, Magnus Hendrickson and me Laura Carlson. 0:11:06.040 --> 0:11:10.240 Today's main story was reported by Riley Griffin. Original music 0:11:10.280 --> 0:11:14.600 by Leo Sidron. Our editors are Francesco Levi and Rick Shine. 0:11:15.160 --> 0:11:19.800 Francesco Levi is Bloomberg's head of podcasts. Thanks for listening.