> Frameshifting almost never happens in our cells. It would lead to dysfunctional cellular proteins.
So the drug would disable an aberrant behavior that coronaviruses depend upon to replicate. This doesn’t sound like a bad thing. It’s also why trials exist.
New technologies are all very well, but this is not the sort of approach that should be rolled out in an emergency. If someone has 10 years of safety data from some trial and can put their hand on their heart to swear there are no suspicions of a problem then that is one thing, but otherwise there is no way this approach is safe for an emergency mass deployment. It probably won't be relevant for the current pandemic.
You've skipped one of the usual phases, which is Phase IV trials. Cell lines -> Phases III trials aren't enough to catch long term side effects, because they are all done quickly.
An experimental mechanism passing Phase III trials is insufficient to prove it is safe. It proves that any negative events aren't evident quickly. The drug will probably prove to be safe in time, and I don't mind if people want to take that risk, I'm pretty free market. But it is, nevertheless, risky. We can't be confident that the body isn't using the same trick somewhere or somehow for something delicate that breaks quickly and shows symptoms slowly - biology is complex.
If the mechanism is novel then it wouldn't be suitable for a mass rollout to deal with this pandemic.
But this assumes there is no risk to not doing it, which is false. Getting sick, suffering long term damage to your body, or dying are all very real risks of covid-19 that we already know about. We also have no idea what all the long term less evident negative effects are from covid-19. We have no idea if an asymptomatic covid infection does some sort of long term damage. So we are weighing the risk of treatment against the risk of the disease. People are naturally biased against active risk when compared to passive risk, so it is natural allow a high passive risk while worrying about a low active risk, but they are both just as real.
We need people to be confident in the long-term, as well as to have a solution quickly in the short-term.
[0] hence, for example, the use of the word “obscure” in the headline “The obscure maths theorem that governs the reliability of Covid testing”: https://www.theguardian.com/world/2021/apr/18/obscure-maths-...
So I’m skeptical of folks using 2nd order arguments about why going beyond rational approaches to risk is a good idea. People see overly risk-averse behavior by the FDA as evidence that the risk is actually high (relative to other stuff in their lives).
You can demonstrate a high degree of safety.
But demands to prove it can always ask for more more more.
But, let's imagine we find, by the usual trial and error, a chemical compound whose effects are that of curing patients from the coronavirus. Trials show that it has some rare side effects, like many other drugs.
How much do we need to "understand" its first, second and third (and fourth) order effects before deciding to use it?
No one argues we should stop breaking those ribs as that’s a fairly easy balance to strike versus a vaccine that you give prophylactically to healthy people. Far more caution is warranted there. (This article is about a therapeutic drug concept, meaning it’s the former case, but I’d still argue caution and where traditional supportive and therapeutic measures are working, I’d not rush to use this mechanism on mild cases.)
Just because someone survives 12 months and feels fine doesn't tell us anything about the safety of that mechanism. We could literally be injecting people with HIV and it'd only be showing "rare side effects" for the first 12 months as far as symptoms go.
But we're using empirically discovered drugs since forever, where we had no idea on how the thing even supposed to act, let alone the consequence of this action.
You have to do better than the alternatives, and it was easier at a time when alternatives had 60% mortality.
That said, this could be a good alternative than straight up dying for those in critical conditions. It would however tell us nothing about its safety, as people in critical condition have some deal of damage taken by the coronavirus itself and it'll be hard to control for each secondary effects.
There is reason to be optimistic, because if for it to be really bad then there'd need to be:
* Permanent change
* Causing negative symptoms
* Which took a long time to be symptomatic
(which, coincidentally, HIV/AIDS exposure is a great example of)
Now if frameskipping supressing drugs are something we expose people to as a matter of course then very well, probably would work out great. But if this is new then it is absolutely not safe to do a mass rollout in the next decade. There are obvious risks.
Thank you for saying this, there is a great deal of over confidence bias in the approach to this virus.