COVID-19 research points to repurposed drugs

This Sunday, 60 Minutes reports on how a 40-year-old obsessive-compulsive disorder drug, Fluvoxamine, is being tested in the U.S. and Canada to be repurposed and possibly used in the fight against COVID-19. A trial organized by the Washington University School of Medicine in St. Louis is testing the efficacy of this inexpensive pill in preventing severe lung damage in COVID patients.

60 Minutes correspondent Sharyn Alfonsi spoke with the director of the U.S. National Institutes of Health, Dr. Francis Collins, about the job of therapeutics and drugs in this pandemic, and what role they play now that there are vaccines available.

"I'm as enthusiastic about vaccines as anybody you've ever met. But at the same time, I'm a realist," Collins said. "We know that vaccines are not going to reach everybody across the entire planet in the next couple of weeks. People are going to continue to get sick in the meantime... we need treatments for those people."

Collins explained that although he is a proponent of the vaccine, it's "not the whole answer," and as the virus transforms and continues to mutate into different variants, potentially rendering the original vaccine ineffective, "you want something that has a broad efficacy against the whole family of coronavirus."

Currently available therapeutics in U.S. hospitals are remdesivir, dexamethasone and monoclonal antibodies. So why are physicians intrigued by fluvoxamine? If approved, patients would be able to take a pill.

"A big need right now is for a drug that you could take by mouth, that you could be offered as soon as you had a positive test, and that would reduce the likelihood that the virus is going to make you really sick," Collins told 60 Minutes. "If you're somebody at high risk, that is, over 65 with a chronic illness and you've just been diagnosed... you have to basically go somewhere for two or three hours and have an intravenous line placed."

• Finding a possible early treatment for COVID-19 in a 40-year-old antidepressant
  
• Washington University clinical trial

With hospitals already taxed with sick patients, the need for an oral drug would "reduce the likelihood of the drug making [people] really sick," according to the NIH's Collins.

Though fluvoxamine was already approved in 2007 for the treatment of OCD, the FDA needs to evaluate the benefits and risks of the drug for off-label use against COVID-19.  The risks may be negligible because fluvoxamine has been widely used and monitored for side effects for over a decade.

"Fluvoxamine could certainly be something you want to put in the tool chest... it looks as if it has the promise to reduce the likelihood of severe illness," Collins explained. "It's not going to be the complete answer... but if it is a way of getting us further towards that goal of having fewer and fewer people really sick from this disease, then we want to pursue it as vigorously as we can."

Dr. Francis Collins, Director of the National Institutes of Health told 60 Minutes that misinformation about hydroxychloroquine, a drug used to treat malaria, had a detrimental impact on looking for existing drugs that could also be used to to treat COVID patients.

"Basically it was a bust... maybe it got in the way of trying other kinds of repurposed drugs. All the enthusiasm about hydroxychloroquine was basically dependent on anecdotal reports," Collins said. "And that did leave everybody with kind of a sour taste in their mouths... we had to get over that. I think we're over it now."

Though ultimately, we want something "designed specifically" for this virus, Collins told 60 Minutes Correspondent Sharyn Alfonsi that there is a way for everyone to play a part in finding a solution to this pandemic: by participating as volunteers in clinical trials.

 "If you've just been diagnosed with COVID, you might be a great person to take part in a trial for one of these new drugs we're talking about," Collins said. "If you're not diagnosed with COVID, you've actually just got a test and you're fine, you might be a great person to partake in a vaccine trial... and if you are somebody who's survived COVID-19 and you're fine, you might want to donate your plasma. Because that could also be beneficial. You can be part of the solution to this terrible pandemic."