HSNW News:
These four major developments on the coronavirus front in the past week caught our eye:
Difficult reopening. More and more countries are moving to reopen their economies, schools, and other parts of society, and each offers a different mix of measures aiming to balance economic recovery, societal (new) normalcy, and health security, with an eye to avoiding a second wave of infections in the fall.. They all share one thing: Their citizens are becoming restless.
Clinical success. The FDA om Friday allowed emergency use of remdesivir, the first drug that appears to help some COVID-19 patients recover faster, a milestone in the global search for effective therapies against the coronavirus.
Clinical failure. Hydroxychloroquine and azithromycin have been aggressively promoted by President Trump as possibly the biggest game changer in the history of medicine. But in the largest clinal trial yet of the two drugs, they failed to have any benefit for infected patients, while significantly increasing the risk of electrical changes to the heart and cardiac arrhythmias, which could lead to heart attacks, strokes, and death.
The China syndrome. More and more countries are calling for an impartial and credible investigation of Chinas conduct regarding the coronavirus between November 2019 and the end of February 2020.
China syndrome
Pressured by China, EU Softens Report on Covid-19 Disinformation
Bowing to heavy pressure from Beijing, European Union officials softened their criticism of China this week in a report documenting how governments push disinformation about the coronavirus pandemic, according to documents, emails and interviews. European officials, worried about the repercussions, first delayed and then rewrote the document in ways that diluted the focus on China, a vital trading partner taking a very different approach than the confrontational stance adopted by the Trump administration.
Remdesivir
U.S. Allows Use of Remdesivir, 1st Drug Shown to Help Virus Recovery
U.S. regulators on Friday allowed emergency use of remdesivir, the first drug that appears to help some COVID-19 patients recover faster, a milestone in the global search for effective therapies against the coronavirus. Matthew Perrone and Marilynn Marchione write for AP that the Food and Drug Administration cleared Gilead Science’s intravenous drug for hospitalized patients with “severe disease,” such as those experiencing breathing problems requiring supplemental oxygen or ventilators. The FDA acted after preliminary results from a government-sponsored study showed that the drug, remdesivir, shortened the time to recovery by 31%, or about four days on average, for hospitalized COVID-19 patients. Those given the drug were able to leave the hospital in 11 days on average vs. 15 days for the comparison group. The drug may also help avert deaths, but that effect is not yet large enough for scientists to know for sure. The National Institutes of Health’s Dr. Anthony Fauci said Wednesday the drug would become a new standard of care for severely ill COVID-19 patients. Remdesivir, which blocks an enzyme the virus uses to copy its genetic material, has not been tested on people with milder illness. The FDA previously allowed narrow use of a malaria drug, hydroxychloroquine, for hospitalized patients who were unable to take part in ongoing studies of the medication. President Trump touted the drug as a game changer and repeatedly promoted it as a possible COVID-19 treatment, but no large high-quality studies have shown the drug works for that and it has significant safety concerns.
Hydroxychloroquine
Hydroxychloroquine for Treatment of COVID-19 Linked to Increased Risk of Cardiac Arrhythmias
In a brief report published today in JAMA Cardiology, a team of pharmacists and clinicians at Beth Israel Deaconess Medical Center (BIDMC) found evidence suggesting that patients who received hydroxychloroquine for COVID-19 were at increased risk of electrical changes to the heart and cardiac arrhythmias. The combination of hydroxychloroquine with azithromycin was linked to even greater changes compared to hydroxychloroquine alone. Hydroxychloroquine and azithromycin each can cause an electrical disturbance in the heart known as a QTc prolongation, indicated by a longer space between specific peaks on an electrocardiogram. QTc prolongation denotes that the heart muscle is taking milliseconds longer than normal to recharge between beats. The researchers note that the delay can cause cardiac arrhythmias, which in turn increases the likelihood of cardiac arrest, stroke, or death. While hydroxychloroquine and azithromycin are generally well-tolerated medications, increased usage in the context of COVID-19 will likely increase the frequency of adverse drug events (ADEs), said co-first author Nicholas J. Mercuro, PharmD, a pharmacy specialist in infectious diseases at BIDMC. Senior author Howard S. Gold, MD, an infectious disease specialist at BIDMC and an assistant professor of medicine at Harvard Medical School, said: Based on our current knowledge, hydroxychloroquine for the treatment of COVID-19 should probably be limited to clinical trials.
Tests
Virologists Show that Sample Pooling Can Massively Increase Coronavirus Testing Capacity
A new procedure will help to meet the high demand for testing in mass coronavirus screening programs needed in the early identification and isolation of asymptomatic individuals. The pooling of samples before testing is a safe and well-established procedure in blood banking. The team from the Institute of Virology has adapted and tested this method for use in coronavirus diagnostics. Saarland University says that samples from several individuals are pooled and tested together in a single tube using sensitive molecular biological detection methods. Only if the pool result is positive do the samples need to be tested individually. When the infection rate is low and only a few people are infected, pool testing can significantly expand the testing capacity of the existing laboratory infrastructure. The team has been using the new procedure at Saarland University Hospital in Homburg since mid-March to protect vulnerable patients from infection by asymptomatic SARS-CoV-2 carriers. The success of the pool testing procedure has now led to its use in screening residents and staff at nursing and residential care homes in Saarland.
