Dr. David Seftel, the physician for the 500 employees and their families at the East Bay racetrack Golden Gate Fields, recently played a role in the early study of a common psychiatric drug, fluvoxamine, that has shown promising results in keeping COVID patients out of the hospital. And he was featured on Sunday night's episode of 60 Minutes, talking about the success he had in treating employees during a COVID outbreak at the track last year.
The outbreak at Golden Gate Fields was a scary one, quickly infecting around 200 people — 95 percent of whom were not showing any symptoms. Seftel tells 60 Minutes that he sprang into action because he knew the disease could be disastrous for many in the community.
"It was really across the entire spectrum," Seftel said of the infections, which impacted stable workers as well as family members. "And what's interesting about our community is that it really is a mirror image of the community that is most affected by COVID, predominantly Latino... incredibly hardworking. They don't have the luxury of working from home or working on Zoom. They have to be out there every single day."
Seftel said he saw a "disaster in the making."
"When I looked at this community, I said I know the numbers, I know the stats. There are gonna be deaths and there's gonna be disability unless I take action," Seftel said in the interview.
He decided to act on a tip that he had heard during a webinar with other healthcare professionals — prescribing fluvoxamine to anyone who wanted to take it. The drug, created 40 years ago and used commonly to treat obsessive-compulsive disorder, had already been put to a small-scale trial at Washington University in St. Louis, after researchers at the University of Virginia found that it was able to prevent sepsis in mice.
Sepsis, part of the runaway immune response that ends up killing some COVID patients, causes severe inflammation throughout the body, and fluvoxamine seemed to stop it in its tracks. In the St. Louis trial, 100% of COVID-positive patients who got the drug stayed out of the hospital, while 8% of those who got a placebo saw deterioration that required hospitalization.
Seftel ended up seeing a parallel result among Golden Gate Fields employees and family members who were infected. He offered prescriptions — known as an "off-label" use of a drug, which is medically accepted when the drug is known to have few side effects and the patients consent to try it — to anyone who wanted them. He had 65 patients who elected to take fluvoxamine and 48 who declined. Among the 65 who took it, none needed hospitalization, while among the group who didn't take it, 12.5% of cases deteriorated — which is about the figure that epidemiologists have been citing as the common likelihood of severe COVID cases.
Seftel tells 60 Minutes that he doesn't think it's a fluke after these two small trials.
"You cannot influence a virus that is as wily and as wicked as COVID with a fluke," he said.
Other experts say the drug still needs a wider trial.
"I have to be a scientist about this," says Dr. Eric Lenze in the 60 Minutes piece. "We've tested it in one study. But, in my view, it needs to be confirmed in a larger study."
Fluvoxamine joins a handful of other drugs created for other purposes that have shown promise in treating COVID-19 and preventing its worst outcomes. In January we learned that a team led by UCSF systems biologist Nevan Krogan had found that a drug used to treat blood cancers, called Aplidin, also appeared to be an effective treatment — and was potentially 30 times more effective at preventing severe COVID than the much touted remdesivir.
Photo by Justin Sullivan/Getty Images