Ebola drugs for COVID-19Approx Read Time: 6 minutes
Context: What are the medicines being considered for the novel coronavirus pandemic?
Background: Ebola drugs for COVID-19
- Globally unknown till under 200 days ago, the virus, SARS-CoV2, has today, according to the WHO, caused the world’s largest pandemic.
- Over half a million people are under lockdown, over six lakh are infected and more than 30,000 dead globally.
- In India, the numbers stand at a shade below 1,000 cases and 24 deaths (as on March 28, 9 p.m.). The number of cases is growing despite the unprecedented measures put in place by the Central and State governments.
- With the rise in cases, India has now joined the world in the search for drugs to treat COVID19.
- Earlier this week, India approved the use of the antimalarial drug, hydroxychloroquine, as a preventive medication for people at high risk, such as health workers and immediate contacts of a person who has tested positive for COVID19.
Vaccine under process:
- Vaccination has been ruled out as an immediate solution
- WHO noting that even if the vaccine development process is fast-tracked, a vaccine would take over 18 months to be ready for use.
- The discovery and licensed use of a drug comes with a long gestation period.
- As an immediate solution against pandemic, WHO and other health agencies are relooking the efficacy of known therapies and drugs this time to treat COVID19
- A giant multinational trial for testing therapies that researchers have suggested may be effective against COVID19. It is launched to generate robust, high quality evidence as fast as possible.
- India like the rest of the world, does not have the luxury of time to look for new treatment or vaccines right now, Our best bet right now is looking at repurposed drugs
- India, on Friday, aligned with the study after having so far stayed away due to its small sample size. This is now is an all-out, coordinated push to collect robust scientific data from across the world.
- To counter any shortage of the drug supplies, the authorities have banned the export of the finished drug and its component ingredients.
What is causing death in COVID19 patients?
- In India, COVID19 deaths have been seen in mostly the elderly population with other health issues including diabetes.
- COVID19 patients have severe blood clotting disorders that lead to respiratory failure and death.
- 15% of COVID19 Needs hospitalized care and of these 5% need ICU care.
Therapeutic measures taken:
- The most promising therapies including a combination of two HIV drugs, lopinavir and ritonavir (used in India also for an Italian patient in Rajasthan),
- Antimalaria medications, chloroquine and hydroxychloroquine, not to be used without doctor’s prescription.
- An experimental antiviral compound called remdesivir.
- Now with time running out rapidly for the entire world, repurposed drugs are being aimed at to contain the problem, reducing hospital load, freeing critical hospital beds and allowing people to swiftly return to normal work.
- Agencies are also looking at unapproved drugs that have performed well in animal studies with the other two deadly coronaviruses, which cause Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).”
About the research so far:
- The drug, remdesivir, developed to treat Ebola and related viruses, is being tested to find out whether it can be used on COVID19 patients. It works by shutting down the viral replication.
- This was first tested in a COVID19 patient diagnosed in the United States, when his condition started worsening. The condition of the patient improved.
- The international health community has maintained that of the drugs in the Solidarity trial, remdesivir has the best potential — the drug shows that it can be used in high doses without causing toxicities.
- The novel coronavirus hails from a family on which work has already been done worldwide after SARS and MERS.
- This really helps in research in the sense that we don’t have to start from scratch. This is vital in our hunt for drugs to contain this virus.
About the usage of antimalaria drugs?
- Chloroquine and hydroxychloroquine are decades old Antimalarial drugs.
- Hydroxychloroquine is being looked at in India and the ICMR is currently studying the drug action in the Indian population with respect to COVID19.
- The two drugs were brought back for consideration when some countries showed interest in its potential.
- A study on 20 COVID19 patients in France who were given hydroxychloroquine showed a significant reduced viral load in nasal swabs.
- Hydroxychloroquine, is known to have a variety of side effects, and can in some cases harm the heart. People with heart conditions are at higher risk of severe COVID19
- The combination drug, ritonavir/lopinavir, was introduced two decades ago to treat HIV infections.
- Doctors in Wuhan, China, gave 199 patients two pills of lopinavir/ritonavir twice a day plus standard care, or standard care alone. There was no significant difference between the groups as per reports submitted on March 15.
- Although the drug is generally safe it may interact with drugs usually given to severely ill patients, and could cause significant liver damage.
- Another combination under testing is interferon beta, which WHO has cautioned might be risky.
About Plasma therapy:
- Plasma or antibody therapy for COVID19 with China using it recently on its patients.
- WHO had recommended its use against Ebola, and issued protocols for its use to treat MERS but its clear-cut benefit to treat COVID19 cases is still under investigation.
Why is the lockdown necessary?
- It will give us time delay, maybe push back any surge towards community transmission of COVID19.
- It is also helping us to redraw our strategy to cope with this very strong and infectious virus.
- India has asked all State governments to be prepared in terms of manpower, hospital facilities and care for patients.
- India is now readying its health infrastructure to cope with a virus that has tested the most resilient healthcare systems in the world, bringing them to their knees.