How remdesivir became the first and biggest hope for treating COVID-19

Dr. George Diaz was at home in Edmonds, Wash., on Jan. 20 at 8:30 p.m., when his phone rang with news that he was both anticipating and dreading.

On the line was his hospital’s infection-prevention manager, who had just received a call from the U.S. Centers for Disease Control and Prevention (CDC). 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.

“They didn’t force us,” Diaz says. “We never considered saying no.” Because this was the first known patient in the country with the new infection, CDC scientists wanted to admit him for observation, in case his disease worsened.

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 January, little was known about the virus, only that it had originated in China and appeared to be infectious—although it wasn’t clear how infectious—and potentially deadly. There was no treatment and no playbook to help doctors decide how to care for patients. Diaz instructed his team to rely on their training and to use the same safety precautions they would in caring for an Ebola patient: they donned full protective gear, isolated the patient and limited any direct contact.

These decisions proved prescient. The patient, who wishes to protect his privacy and remain anonymous, lives in the Seattle suburbs and had just returned from a visit with family members in Wuhan, China. He seemed relatively healthy when he was admitted to the hospital; he had a cough but no fever. But that quickly changed. Over the next few days, he developed a fever that spiked to 103°F, his cough worsened, and he complained of trouble breathing. Diaz gave him supplemental oxygen, but his condition continued to deteriorate. “We made contingency plans to move him to the ICU if he got worse,” he says.

Before doing that, however, Diaz