New coronavirus anti-viral med is “welcome, but not a miracle cure”: Virologist

Pharmaceutical company Merck announced last week that its antiviral medicine Molnupiravir could prevent 50 percent of coronavirus-related hospital admissions and deaths in high-risk groups if administered in time. According to virologists, this new treatment is a "welcome addition," but not a "miracle cure," they said to NOS.

Molnupiravir is a pill and will be the first oral drug against the coronavirus if approved by the medicines authorities. According to Merck, the antiviral lowers the chance of coronavirus hospital admission or death if the patient starts taking it within five days of the onset of symptoms. The patient will have to take four pills twice a day for five days. Molnupiravir causes errors in the virus's genetic code, preventing it from making copies of itself. Once a patient needs hospital treatment, the drug has no measurable effect.

Virologist Eric Snijder of LUMC called the clinical results for Molnupiravir encouraging. According to him, especially oral administration is "a welcome addition" to the treatment options for the coronavirus. The only other antiviral commonly used against the coronavirus, Remdesivir, has to be given by IV. "That almost only happens in a hospital, and therefore only after someone has been admitted," Snijder said to the broadcaster.

Belgian virologist Marc Van Ranst also called Molnupiravir promising. "A caveat is that, like all antivirals, it should be taken as early as possible. Antivirals will not be miracle cures," he said to NOS. Getting an antiviral into a patient in time is "often not easy in practice," he said.

Another potential downside is, like bacteria treated with antibiotics, there is a risk of the virus becoming resistant to antivirals. "You have to be selective in its use to keep resistance problems as small as possible," Snijder said. If Molnupiravir comes on the market, both virologists suggest only giving it to high-risk groups: the elderly, people with underlying diseases, and people for whom the vaccine is ineffective.

Molnupiravir could also be an extra treatment option for people who refuse to get vaccinated. Still, Van Ranst warned not to present it as such because it entails a "moral dilemma." The vaccines also protect people from becoming infected to some extent and are therefore much more cost-effective. Molnupiravir is also expensive. Merck charges 700 dollars per Molnupiravir treatment in the United States, including 40 pills. The vaccine only costs a few euros.

Snijder also doesn't think virus inhibitors can be an alternative to a vaccine, but they can be valuable additions. "It may be that there will be a variant of SARS-CoV-2 that the vaccines no longer work against or a completely new coronavirus," he said. Pharmaceutical companies can adapt vaccines reasonably quickly, but it can still take six months before they can be used. "Then it's nice to have these kinds of resources to bridge that period."