“All lives are important and matter”
Dr. Norbert Bischofberger, the inventor of Remdesivir, explains the anti-viral U.S. President Trump was immediately administered to treat his COVID-19 infection. “If we can save the life of a poor black person in Harlem, that's as important as saving Trump's life,” the native Austrian tells Die Weltwoche.
Norbert Bischofberger has racked up a record 28 drugs approvals in his prolific career. The biochemist invented Tamiflu and medicines for a range of serious conditions. He has transformed the treatment of diseases such as HIV/Aids, HCV, lymphoma, and recently COVID-19. This Spring, as the first wave of the coronavirus was cresting, Die Weltwoche spoke with the medical pioneer.
We turn to Bischofberger, once again, to explain how Remdesivir can help COVID-19 patients such as the recently diagnosed, 74-year-old American president.
Weltwoche: In an effusive statement from Walter Reed Hospital, President Trump credited therapeutics for tackling his symptoms, calling the treatments "miracles." He said: "We have things happening that look like they're miracles coming down from God." I thought to myself, "Well, in that case, I know the god of whom he speaks, the distinguished Austrian biochemist who invented Remdesivir: You.” Dr. Bischofberger, please explain how your invention can help patients at an early stage of infection.
Bischofberger: This is very simple, and it's intuitive. With an antiviral, the sooner you take it after infection, the better it works. The way it goes with corona, initially, you get infected by the virus. The virus starts to replicate in the lungs. It damages the lungs, and then it goes into the blood and damages other organs.
Once you are far along in the disease, and you get hospitalized, then it's less of a viral disease and more of an immunological disease. The symptoms that you see are caused by the response of the immune system to the damage that the virus has done. For instance, with influenza, it's well known. We have studied this, we and others. You get infected on day one with the virus. Then, essentially, the virus is gone at day seven or day eight, but you can still feel sick for two or three weeks, and that's because of so-called cytokines. It's an immune response, the body reacts to the damage.
Weltwoche: How can it help in Trump’s case?
Bischofberger: If it's early in the disease, soon after symptom onset, then he has a really good chance that Remdesivir provides a good benefit. It inhibits the virus, then the body has a chance to take over and mount an immune response before much of the damage has been done.
Weltwoche: We are told by Trump’s doctors that, along with a five-day course of Remdesivir, he is being treated with an experimental drug cocktail; it's described as a single eight gram dose of Regeneron's antibody cocktail. What is that exactly?
Bischofberger: It's an antibody against the spike protein. If you look at the virus, at the outside of the virus there's the so-called “spike protein.” By the way, it looks like a crown. That's why the virus is called “corona.” This antibody is actually similar to the antibodies your immune system will generate, antibodies to the spike protein. Regeneron's compound is not a single antibody but a mixture of antibodies that bind to the spike protein. This approach should also work. I haven't seen any data, yet. It's also an antiviral, and it would essentially bind to the virus and eliminate the virus with the antibody.
Weltwoche: It is called an experimental drug and is still undergoing a clinical trial. Is it safe?
Bischofberger: Yes, antibodies are typically fairly safe. I don't know about Regeneron. I haven't seen any data yet that are published, but antibodies should be relatively safe. By the way, the word "experimental" is used for compounds that are not approved yet by the FDA (the U.S. Food and Drug Administration). It's still being evaluated in clinical studies.
If this was me, I would say, "Give me Remdesivir." That's approved and has been shown to be relatively safe. Also, "Give me the Regeneron antibody." I don't have any concerns about that. I think they're doing the right thing.
Weltwoche: Among the drugs Trump was given is zinc, vitamin D, famotidine (the medication in Pepcid, for heartburn or acid reflux), melatonin, and a daily aspirin. What are these for?
Bischofberger: Vitamin D, there's no evidence that that does anything. What I can say is it doesn't do any harm either. So, vitamin D is fine, same for Zinc. Famotidine alleviates symptoms of heart burn.
Weltwoche: Some doctors see the administration of the powerful steroid dexamethasone as a sign that President Trump is seriously unwell. Others believe that he is being over-medicated because of the number of treatments that he has received while at Walter Reed hospital. What is your opinion on this?
Bischofberger: I believe dexa will have a place later in the disease when COVID is more of an immune disease. If you give it early in infection you could do harm because you suppress the immune response to the virus.
Weltwoche: From what we hear from the president’s doctors, he seems to be doing fairly well regarding the circumstances. He left Walter Reed Hospital Monday night. How can it be that he recovered so quickly?
Bischofberger: The symptoms vary enormously. They range from completely asymptomatic, to mild symptoms, to hospitalizations, to death, and anything in between. I think by Monday they should know where on the scale Trump’s Corona infection lies. If he doesn't get worse, and it looks like he is getting better, and if there's no decrease in blood oxygen saturation, then, that would be good news. Under those circumstances, I would say he's doing relatively well. The treatment has helped, and he can go home.
Weltwoche: If the president, the most powerful leader in the world, is getting back to normal and survives with the help of new drugs, that must be an enormous boost for medical producers such as yourself.
Bischofberger: Yes, but I look at the human side of this, and I wish Trump all the best, but I wish everybody else all the best. I don't feel like that one life is more important than another. All lives are important and matter. If we can save the life of a poor black person in Harlem, that's as important as saving Trump's life. The problem with Remdesivir is that it has to be given by intravenous infusion, and that cannot be done on a large scale. It's reserved right now for hospital use. If you had something orally, a pill or something that you could just pop, everybody can take a pill. For IV administration, you need a medically trained person to do that. You can't just inject yourself intravenously. It's an excellent drug for hospital use, right now. Gilead is working on an inhaled version, but it's not available yet.