Montefiore Health System Albert Einstein College of Medicine have begun the next stage of the Adaptive COVID-19 Treatment Trial (ACTT), to evaluate treatment options for people hospitalized with severe COVID-19 infection. The new iteration of the trial, known as ACTT 2, is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
In March, Montefiore was the first New York location to join the multicenter trial, which evaluated remdesivir, a broad-spectrum antiviral drug given intravenously. Preliminary results from the trial, announced last month and published on Friday in the New England Journal of Medicine, show that patients with COVID-19 who received remdesivir recovered in 11 days on average compared to 15 days for patients in the placebo group — a statistically significant improvement. Of the 1,063 clinical trial participants, 91 of them, nearly 10%, were from Montefiore and Einstein.Following up on remdesivir’s promising results, the trial is now studying remdesivir in combination with baricitinib or placebo in a double-blind, randomized trial. Baricitinib is marketed for reducing inflammation associated with rheumatoid arthritis. Researchers want to know if baricitinib combined with remdesivir can prevent or reduce the hyper-inflammatory “cytokine storm” that can fatally overwhelm the lungs and other parts of the body in people with COVID-19 when their immune system reacts to coronavirus infection.
40% Utilization Needed to Achieve Herd Immunity
Former FDA Commissioner Scott Gottlieb has a rough estimate for the number of vaccinated people to reach herd immunity for COVID-19.Because about 20% of people may have already been infected by the time a COVID-19 vaccine is launched, “we’d need to get perhaps 40% utilization to achieve herd immunity,” he tweeted Tuesday.
How does that stand up to adoption of vaccines we’re all familiar with? It’s about on par with seasonal flu shots, which are administered to around 45.4% of the eligible U.S. population each year. Shingles vaccine, though, has around 34.9% utilization in the U.S. Gottlieb’s herd immunity total of 60% comes roughly close to the 70% overall immunity suggested by two epidemiologists at the Johns Hopkins Bloomberg School of Public Health.For herd immunity to work, a large number of people need to be immune to an infectious disease, ideally through vaccination, thereby providing indirect protection to those not immune.