The key problem to solve in the quest for coronavirus treatments

Happy Thursday, readers.

It’s been a week since our first edition of The Capsule, formerly known as Brainstorm Health Daily. That’s if you believe the calendar—it feels more like a few years.

Our collective heads are spinning during a coronavirus pandemic that has wrought catastrophic human suffering. It’s become all the more imperative to keep a close watch on the science underlying COVID-19 drug development.

That science is pretty complicated given some basic facts we still don’t fully understand.

The key unknown: What is it about this particular coronavirus strain that makes it so deadly for certain people? It’s a question that will determine exactly which kinds of treatments—whether they be antivirals, antibodies, or other drugs—will be most effective in healing sick patients.

Viruses have many opportunities to wreak havoc on the human body. They can break down our cellular machinery; they can also turn our own biological defense mechanisms against us.

“Immune response may be what’s causing the severe disease,” Geoff Porges, director of therapeutics at SVB Leerink, told Fortune.

If that’s the case, then a drug that attacks the virus directly could have diminished effect since it doesn’t address the immune response issue; other types of treatments may actually make the disease worse by galvanizing an even more extreme immune response.

Again, all of this research is still in its nascent stages. Creating a new therapy is tricky in even the most stable of times. Getting from an experimental molecule to an approved treatment on the market can take more than a decade.

With a crisis raising the stakes considerably, regulators have been expediting the process by cutting down on red tape and drug makers have had to get creative, scouring their existing treatment libraries to see which therapeutics may best aid in the fight.

Initial data on which drugs could prove most effective are due in the coming months. We’ll be keeping an eye out.

Read on for the week’s news, and see you again next week.

Sy Mukherjee
sayak.mukherjee@fortune.com
@the_sy_guy

DIGITAL HEALTH

PBS's extraordinary documentary on the history of the gene. I encourage anyone who's interested in the history of the human genome (and I imagine a fair number of you readers are) to check out the amazing Ken Burns-produced PBS documentary The Gene: An Intimate History. The first part premiered on Tuesday, exploring the early stages of medical knowledge about genetics (and it's available to watch for free); ensuing parts will examine how this rich and complicated history has led to an era of gene therapies. (PBS)

INDICATIONS

Sage Therapeutics is nixing half its workforce after a failed trial. Sage Therapeutics, which won a pioneering Food and Drug Administration (FDA) approval for the first ever post-partum depression drug in the U.S. last year, has hit a serious clinical setback. The biotech's experimental depression treatment failed to hit its main endpoint in a late-stage study for major depressive disorder (MDD), leading to a massive restructuring that will axe more than half its workforce (primarily in its commercial unit). The company says it will refocus on its pipeline and continue to focus on the notoriously tricky neurological drug development space.

Pfizer paid $185 million upfront for COVID-19 collaboration with BioNTech. Pfizer has revealed more details about its coronavirus vaccine collaboration with BioNTech—including a hefty $185 million upfront cash-and-equity deal that could spur hundreds of millions for the biotech down the line. The firms are working on a slew of vaccine candidates. That's on top of Pfizer's efforts to create a COVID-19 treatment that it believes can begin clinical testing within months. (MarketWatch)

THE BIG PICTURE

A flattening curve isn't a reason to ease social distancing. Here's the good news: Hospitalizations for coronavirus seem to be, for the moment, slowing. Here's the bad news: That doesn't mean social distancing measures should be relaxed any time soon. Multiple public health authorities and New York Gov. Andrew Cuomo emphasized that an initial flattening of the curve in coronavirus cases indicates that social distancing has been working so far—but that distancing needs to continue to mitigate the risk of a renewed wave of hospitalizations. Case in point: While hospitalization were down, deaths in the state, the epicenter of the pandemic in the U.S., spiked yet again this week. (Reuters)