News Brief: Antiviral Drug, Coronavirus Test, Civilians Mariners Restricted
RACHEL MARTIN, HOST:
Researchers are moving ahead to try and develop a vaccine for the coronavirus. But they are also making progress with treatments to fight the disease right now.
STEVE INSKEEP, HOST:
One experimental antiviral drug is showing promise. The optimism comes after a study showed faster recovery times for those given the drug. Dr. Anthony Fauci spoke of the study yesterday.
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ANTHONY FAUCI: It is a very important proof of concept because what it has proven is that a drug can block this virus.
MARTIN: All right. To explain this, we have got NPR's Joe Palca with us. Hi, Joe.
JOE PALCA, BYLINE: Good morning.
MARTIN: Good morning. So what exactly is this drug?
PALCA: Well, it's an experimental antiviral drug called Remdesivir. And the reason it's called an antiviral is it's designed - or it works by mucking up the machinery, the molecular machinery, the virus uses to make copies of itself. It's made by a company called Gilead Sciences. And people may have heard of it because Remdesivir was tried as an experimental treatment for Ebola. But other drugs proved more effective. This drug trial that we're talking about today began in February - February 21. And it was sponsored by Dr. Fauci's institute, the National Institute of Allergy and Infectious Diseases.
MARTIN: Yeah. I remember reporting on that. So people have been, at least, talking about this drug in the context of the coronavirus for months. Now it's been tested. Explain the study and what it found.
PALCA: Well, it's what's known as a randomized, placebo-controlled study, which is considered to be the gold standard among researchers. And what you do there is you give some patients the drug and some an inert placebo. And the way it's set up is the doctors don't know what they're giving to the patients. And the patients don't know what they're getting. So there's no chance of implicit bias or somebody trying to get the right answer from the drug.
PALCA: They did 68 sites all around the world, mostly in this country but several others. And strictly speaking, the trial isn't over. But all the patients who were enrolled - have been enrolled. But there's something called an independent monitoring board. And they were taking a peek. They're a completely separate group.
And they were taking a peek at how the first 400 or so patients did. And they found that the drug was shortening the hospital stays from 15 days to 11 days. And there was also in the data at least a hint that patients getting the drug were less likely to die from COVID-19 than those who weren't.
MARTIN: Well, if true, I mean, that would be huge, right? We heard Dr. Fauci calling this a proof of concept. What does that mean? What does it mean for what happens with the drug now?
PALCA: Well, what it means is that there's something that's proven by the gold standard to work. It's not great. It's not a homerun. It's not the silver bullet that's going to, you know, you take it and you dance out of the room. No, not at all.
PALCA: But it is a start in terms of getting a therapy. And now what happens is interesting. Remdesivir becomes the standard of care. You can't use a placebo anymore. It's going to be more ethically controversial to use a placebo...
PALCA: ...Because you've shown something works.
PALCA: But they have already set up this same study to begin to look into other drugs that they can combine with Remdesivir to see if, together, they can block the virus and also do something about the damage to the lungs that the virus causes.
MARTIN: You will keep us up to date on all of them. We appreciate it. NPR's Joe Palca. Thank you.
PALCA: You bet.
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MARTIN: All right. It's good news Thursday, apparently, because we're going to move from good news on the treatment front to some good developments on testing.
INSKEEP: A shortage of testing, of course, has constantly frustrated efforts to contain the pandemic up to now. A different kind of test called an antigen test may offer a simpler way to identify cases if these tests are accurate enough. So are they?
MARTIN: Let's ask NPR health correspondent Rob Stein. Hi, Rob.
ROB STEIN, BYLINE: Good morning, Rachel.
MARTIN: What is this new test?
STEIN: So it's called an antigen test because instead of looking for the genetic material from the virus, like the tests that we currently use do, it looks for pieces of the virus, pieces of protein called antigens. They stick out like spikes from the surface of the virus and can be found on cells of people who were infected. Antigen tests have been used for a long time to do things like, you know, test people for the flu and strep. And they're also the kinds of tests that people use as home pregnancy tests.
MARTIN: So what makes this a better strategy for identifying the virus than the current tests?
STEIN: Yeah. Yeah. The big thing about antigen tests that could be a game-changer is that they're really fast and cheap and easy to make and use - a lot cheaper and less complicated than those fancy genetic tests. So it would be a lot easier to make and use millions of them to screen millions of people a day. You know, that's crucial if we're going to try to reopen the country safely. You know, if we're going to...
STEIN: ...Do things like - say, you know, a company wants to test workers every day to see who's infected and so needs to stay home and who's in the clear, can safely come back to work and to, you know, spot people who have just gotten infected to keep them from spreading and sparking new outbreaks.
And this may not be too far off. I've been in touch with several companies that say they've already developed antigen tests to spot the virus really quickly and easily in saliva, you know, just from a sample of their spit. Lee Gehrke is a scientist I talked to about this at MIT and Harvard who's involved with one of these companies.
LEE GEHRKE: Looks very much like a pregnancy test. And they're very simple. They don't require special chemicals or training to use them. And they can give you a readout within about 15 minutes or so. And so it could be a very good way of solving the testing problem that we're having in the U.S. right now.
MARTIN: Fascinating. I mean, a pregnancy test, that's something you could just do, yourself, at home, which is, it sounds like, where this is heading. But, I mean, there must be concerns about these tests.
STEIN: Yeah. Yeah. Some of the experts I've talked to about this are skeptical. And that's because, you know, when antigen tests have been used to do things like test people for the flu and for strep, it misses more infected people than the genetic tests do - maybe, you know, 15 or 20 out of every hundred people tested. So there's a lot of false negatives there. And they worry about relying on an antigen test to keep the virus from spreading for that reason. So you know, if you're using it to screen people, you may end up sending people who are infected back into the population who think they're free of the virus.
MARTIN: I mean, it's a trade-off - right? - getting these tests out there. What do companies say about that critique?
STEIN: Yeah. So they say they're doing the studies to prove their test would be reliable and could match those fancy genetic tests. Or maybe the test could be used to screen people and then get confirmed by other tests. So you know, they're going to do a lot more research and hopefully show just how well these tests work and how reliable they are.
MARTIN: NPR health correspondent Rob Stein. Thank you, Rob.
STEIN: You bet.
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MARTIN: The Navy's aircraft carrier the USS Theodore Roosevelt has nearly 1,000 coronavirus cases. And the Navy wants to stop outbreaks like that from happening on other vessels.
INSKEEP: The Navy has imposed strict rules - though, only on a small group of civilian Navy employees. These are mariners who bring supplies like food and fuel to Navy ships around the world. And they are, essentially, locked down and confined to their ships. NPR's learned they're not happy about it.
MARTIN: NPR Investigations correspondent Joseph Shapiro has been digging into the story and joins us now. Hey, Joe.
JOSEPH SHAPIRO, BYLINE: Good morning, Rachel.
MARTIN: OK. Explain what's going on here.
SHAPIRO: So on March 21, the Navy admiral who runs the Military Sealift Command - the MSE - issued a gangway up order. The civilian mariners, they've been locked down on their ships ever since. And this wasn't a two-week quarantine, the people who'd been exposed to the coronavirus. It was a move to stop the - an outbreak from starting by keeping CIVMARS - that's the name for civilian mariners - locked down on their ships. It's been more than five weeks now. And it's actually worked pretty well at stopping sickness.
MARTIN: So if it's working, where's the controversy?
MARTIN: I mean, why are these people so upset?
SHAPIRO: Right. Well, even when a ship is docked and on a Navy base, the mariners, they can't leave. Even if their house is just minutes away, they can't see family. They said they can't go to medical appointments. And there's another reason the civilian mariners are very upset. The lockdown applies only to them. So while they're confined to their ships, other people - Navy personnel, contractors - come and go.
UNIDENTIFIED PERSON: They restrict our liberty on the name of protecting us from coronavirus. But we are still exposed to the military personnel that goes home and come back to work. And the contractors that have some jobs to do on the ship, they go home, they come back.
SHAPIRO: That's a civilian mariner. He asked that we not name him because of fear of retaliation. He's among the more than 20 civilian mariners that we heard from ships around the world. And he says, the Navy personnel and contractors, they don't always wear those N95 masks. Everyone's screened before they get on a ship. Their temperature is taken. They're asked questions about symptoms, about whether they've been exposed to someone who's sick.
The Military Sealift Command confirmed to us that in the last few days, two civilian mariners tested positive for COVID-19 at a Massachusetts shipyard. And it's thought they may have been exposed to infected outside contractors. The MSE says that any shortages of protective gear are sporadic. And many civilian mariners that we spoke to told us that they do have access to the N95 masks, at least in the last few weeks. But others said they still can't get the proper protective gear, like Tom. He works on a ship that's being repaired. And he says until he can get the proper mask, he's not going to wear any mask at all.
TOM: I figured that if I got to wear a cloth over my face like a bandit from the Old West, it's not really worth it, because a piece of cloth is not going to stop a microorganism that's airborne.
MARTIN: Of course, we don't know if it's airborne at this point, we should just say.
SHAPIRO: Right. Right. Right. So the unions are asking for proper gear and also, in their legal grievance, for bonus pay for those who are confined to their ships. But there haven't been large outbreaks.
MARTIN: All right. NPR investigative correspondent Joe Shapiro. Thank you.
SHAPIRO: Thank you.
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