Vaccines are great, and you should get yours. But for almost two years now, alongside the showy and ultimately successful hunt for vaccines that fight COVID-19, scientists have also been looking for drugs to treat people who were already sick. That hasn't gone quite as well: a scientific quest tangled up in hundreds of studies too small to give real answers, then sidetracked by hype over the antimalarial hydroxychloroquine and then the antiparasitic ivermectin. Those didn't work. But the research continued—and in the past few weeks, it seems to have paid off.
First, in early October, the transnational pharmaceutical company Merck and a biotech company called Ridgeback announced that molnupiravir, a decades-old antiviral drug invented at Emory University, reduced the risk of hospitalizations and deaths in people with COVID-19 by a respectable 50 percent. Then, in early November, the equally transnational pharmaceutical company Pfizer (you might remember it from its mRNA-based COVID vaccine) announced that its purpose-built antiviral Paxlovid likewise reduced the hospital-and-death risk in high-risk COVID patients by a whopping 89 percent.
That's a win, right? COVID vaccines are finicky, hard to manufacture, and hard to distribute because of, in the case of the ones based on mRNA, a snowflake-like need for ultracold freezers. The steroid dexamethasone is for the severely ill. Monoclonal antibodies have to be administered early to work, and, like the antiviral drug remdesivir, they’re expensive, and both require hospital visits for intravenous infusion. But molnupiravir and Paxlovid are “small-molecule” drugs, easier to make, more stable in storage and distribution, and—this is the big one—they’re just pills. You pop ’em. On a planet ravaged by a pandemic virus, with effective vaccines unavailable in most places, easy-to-use, relatively cheap drugs could help beat the disease. “They’re game-changing in the sense that they’re both pills and therefore relatively easy to take,” said Charles Gore, executive director of the Medicines Patent Pool, a UN-supported organization that sets up international licensing agreements for drugs. "You don't have to lie down to get an infusion, or walk 150 miles to get to a hospital."
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