[fasteddie31003]

I'm all for stopping new variants of COVID. Why in the world do we have a treatment for COVID that intentionally creates mutations in COVID https://en.wikipedia.org/wiki/Molnupiravir ? I'm not a doctor but it seems pretty clear to me that Molnupiravir creates a great environment for new variants to arise (along with cancer, but that's another issue).

[WJW]

From the wikipedia page you linked:

> Molnupiravir is indicated for the treatment of mild-to-moderate coronavirus disease (COVID-19) in adults with positive results of direct SARS-CoV-2 viral testing, and who are at high risk for progression to severe COVID-19.[1][5]

So after the risk of creating mutations in the Covid virus has been assessed and weighed against the chances of patients just outright dying due to not having this medicine available, the board full of medical professionals trained in this matter voted 13 to 10 that they thought the risk was acceptable.

[nerdponx]

Is the risk different from the risks of antibiotics and antifungals with respect to creating resistant strains?

[WJW]

Well, first off "normal" antibiotics don't kill viruses so that kinda makes it different from the start. But even then, most antibiotics kill bacteria etc through disrupting their cellular processes and leaves the DNA mostly alone. Resistance against antibiotics is created through natural evolution; those bacteria that can survive better in an environment where antibiotics will reproduce more than their cousins which can't.

OTOH, Molnupiravir works by: (quoting from Wikipedia again)

> [it] exerts its antiviral action through introduction of copying errors during viral RNA replication.

So it deliberately stops virus reproduction by introducing errors in RNA copying. The vast majority of time this just makes the virus nonfunctional, but it is technically not impossible that it creates a viable mutated strain. This mutated strain may or may not be worse than the original virus. It is not unsimilar to how `cat /dev/urandom | bash` just MIGHT start off with `rm -rf /` and delete everything, but usually it will just create a crash because the random bytes don't parse into a valid bash command.

[kerneloftruth]

"I'm all for stopping new variants of COVID"

That's very likely not even possible[1]; and, it not being realistic, would be a waste of time, effort, and money. There are lots of corona viruses that we have never stopped, and we live with via herd immunity, hygiene, and therapeutics[2].

[1] https://www.acsh.org/news/2020/11/05/covid-why-we-will-never...

[2] https://www.cdc.gov/coronavirus/general-information.html

[aftbit]

Because it helps keep people alive and the risks are judged to be worth the cost in high-risk patients. Hopefully Paxlovid will obsolete this one soon enough though.

[snet0]

How does it seem clear to you? What's the mechanism through with Molnupiravir creates new CoV mutations?

[rmellow]

GP explicitly referenced the drug's Wikipedia page:

> "The emergency use authorization was only narrowly approved (13-10) because of questions regarding efficacy and concerns that molnupiravir's mutagenic effects could create new variants that evade immunity and prolong the COVID-19 pandemic."

The quote above has its own citations in the Wikipedia page posted by GP.

[cinntaile]

He linked to a source that contains that claim, it includes several sources for that specific claim.

It's unclear why that is relevant in this thread though.

[newsclues]

Because it’s possible to justify the risk with saving lives.

Because creating mutations and prolonged pandemics are more profitable.

[jdavis703]

The government looses money from pandemics, so there’s no profit motive for FDA regulators to prolong the pandemic. There’s both direct costs of coronavirus response, and then there’s indirect costs (lower tax revenue from empty downtowns, less travel, more workers on taking from disability insurance instead of paying in to it, etc).

[newsclues]

Pharma companies are making profits and there is a revolving door between regulators and industry, so your dismissal of profit motive is a joke.