The Wuhan coronavirus (2019-nCoV) outbreak continues to spread with a 60% overnight increase in cases. On Tuesday, China authorities said there were 4,633 reported infected individuals and 106 deaths from the infection. In China, face masks and hazmat suits are in short supply, and hospitals restrict the use of test kits to only the sickest patients. Scoring a test kit is like winning the lottery, according to one source, although being tested means you have a severe case, so it isn't a lottery that anyone particularly wants to win. Meanwhile, at least two biopharmas hope to repurpose existing anti-virals to treat patients who have the coronavirus infection, and the Coalition for Epidemic Preparedness Innovations (CEPI) funded two early-stage coronavirus vaccine programs.

In an unusual move, China officials have recommended using an AbbVie fixed-dose HIV drug known as Kaletra (also Aluvia) as an unapproved treatment for 2019-nCoV. Kaletra has two components, lopinavir and ritonavir, both of which are protease inhibitors that are designed to block HIV viral replication. Although neither is approved to treat a coronavirus, the combination seemed to be effective in one very high-profile case. Guangfa Wang, the leader of Peking University First Hospital’s pulmonary and critical care medicine department, contracted the disease while serving as a member of a national expert team in Wuhan. He was treated with Kaletra and recovered. Needless to say, his story gives Kaletra a lot of credibility.

In response, AbbVie China agreed to donate $1.5 million of Kaletra to Wuhan to treat infected patients.

Similarly, Gilead Sciences is considering testing its Ebola drug, remdesivir, for 2019-nCoV. In a clinical trial during the Ebola epidemic, remdesivir was less effective than two other candidates for Ebola. Subsequently, remdesivir was shown to inhibit murine hepatitis virus and Middle East respiratory syndrome, both of them coronaviruses, without causing the rise dangerous drug-resistant strains. Gilead thinks its candidate may be effective against the new virus strain as well.

In a response that will not have immediate consequences, the Coalition for Epidemic Preparedness Innovations, a public-private group that has raised hundreds of millions of dollars to fight infectious disease outbreaks, made two grants to companies to develop new vaccines for the Wuhan coronavirus.
CEPI will support Moderna Therapeutics's work with the US-based NIH National Institute of Allergy and Infectious Diseases on the development of an mRNA vaccine. The researchers at the NIAID will conduct preclinical tests and a Phase 1 clinical trial.

And Inovio will use its CEPI grant to cover development costs through Phase 1 for INO-4800. The vaccine is based on Inovio’s DNA medicine platform that the company says enables rapid development of a vaccine against emerging threats. In 2018, CEPI awarded Inovio up to $56 million over five years for its work on Middle East respiratory syndrome (MERS) and Lassa fever vaccine candidates.

In addition, Roche, AstraZeneca, Pfizer, Eli Lilly, Sanofi, Novo Nordisk, J&J, Allergan, GlaxoSmithKline, Boehringer Ingelheim, Bristol-Myers Squibb, Fresenius Kabi and Takeda have all announced plans to donate money or products in the million-yuan range each to support the cause. Bayer said it would donate CNY 6.5 million worth of medicines to Wuhan and another CNY 4.5 million in cash to help purchase medical protection products for Wuhan.

Disclosure: none.