How remdesivir moved from back shelf to best hope for treating COVID-19

Dr. George Diaz received a call from the U.S. Centers for Disease Control and Prevention (CDC) on January 20, 2020. The agency wanted Providence Regional Medical Center to admit a patient who was infected with the novel coronavirus, which at that point had been reported only in China (where the first reported cases had emerged in December), Thailand, Japan and South Korea. The patient was the first confirmed case of COVID-19 in the U.S.

Back in 2015, Providence Regional had been designated to receive people with Ebola infections, so administrators were prepared to convert hospital space into physical isolation units as well as deploy a team, led by Diaz, trained to manage highly infectious patients. Still, they were essentially flying blind when it came to the new coronavirus.

In lab studies, the 11-year-old experimental drug had shown promise in fighting SARS and MERS, two illnesses caused by coronaviruses in the same family as SARS-CoV-2, which causes COVID-19. But there was no reason to believe it would work against this new coronavirus. “We really had no idea what to expect,” says Diaz. “There was no evidence, zero experience in humans with this [disease].” But, given the circumstances, Diaz was willing to try anything with even a glimmer of scientific grounding.

Remdesivir’s journey from idea to treatment is unprecedented. That path, by necessity, has taken advantage of innovative regulatory pathways to–and is telescoping–the normal drug-development time-line, to meet urgent medical needs while producing a safe, effective drug. Diaz, local public-health officials and the CDC scientists who advised him published an account of their experience, and word quickly spread in the medical community about the potential promise of remdesivir.