We keep comparing our current situation with the 1918 (“American”) Pandemic, but of course, “we’ve come a long way, baby.” We know what a virus is. We know that it spreads in the air. We know that masks arrest transmission. And, of course, in those days, they didn’t even have antibiotics!
There are now two vaccines that are racing to trials, and it shouldn’t be long before at least one of them proves effective. Dr. Anthony Fauci says it would be great if we had at least two effective vaccines, for several reasons. But in the meantime, we have some good news in an old drug that looks like it’s saving lives.
No, it’s not hydroxychloroquine. It’s Dexamethasone, according to the Center for Infectious Disease Research and Policy (CIDRAP), at the University of Minnesota.
Data from a large randomized controlled trial in the United Kingdom showing a benefit from use of the steroid dexamethasone in hospitalized COVID-19 patients was released today in the New England Journal of Medicine (NEJM), while two more studies show no benefit for the malaria drug hydroxychloroquine. . .
The NEJM [the New England Journal of Medicine] data. . .show that in patients needing mechanical ventilation, dexamethasone reduced deaths by 36% compared with usual care. In patients receiving oxygen, the incidence of death was 18% lower for patients on dexamethasone. . .
While the results from the RECOVERY trial indicate that dexamethasone can help some severely ill COVID-19 patients, two trials investigating the efficacy of hydroxychloroquine found it provided no benefit for patients with mild COVID-19.
In a study published yesterday in the Annals of Internal Medicine, researchers from the University of Minnesota, the University of Manitoba, and McGill University. . .showed that. . .hydroxychloroquine failed to cause a statistically significant difference in symptom severity or prevalence over the 14-day period. . .[And] Adverse effects occurred in 43% of patients taking hydroxychloroquine versus 22% of those receiving placebo. . .
In the other study, a multicenter trial conducted in Spain. . . “The results of this randomized controlled trial convincingly rule out any meaningful virological or clinical benefit of [hydroxychloroquine] in outpatients with mild COVID-19,” the authors wrote in Clinical Infectious Diseases.
The results of the Dexamethasone studies are exciting, because it has been an almost sure death sentence once someone needed mechanical ventilation.
Meanwhile, we are awaiting the results of trials of a new vaccine by the Massachusetts company, Moderna. This is from the National Institutes of Health (NIH):
A Phase 3 clinical trial designed to evaluate if an investigational vaccine can prevent symptomatic coronavirus disease 2019 (COVID-19) in adults has begun. The vaccine, known as mRNA-1273, was co-developed by the Cambridge, Massachusetts-based biotechnology company Moderna, Inc., and the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. The trial, which will be conducted at U.S. clinical research sites, is expected to enroll approximately 30,000 adult volunteers who do not have COVID-19.
“Although face coverings, physical distancing and proper isolation and quarantine of infected individuals and contacts can help us mitigate SARS-CoV-2 spread, we urgently need a safe and effective preventive vaccine to ultimately control this pandemic,” said NIAID Director Anthony S. Fauci, M.D. “Results from early-stage clinical testing indicate the investigational mRNA-1273 vaccine is safe and immunogenic, supporting the initiation of a Phase 3 clinical trial. This scientifically rigorous, randomized, placebo-controlled trial is designed to determine if the vaccine can prevent COVID-19 and for how long such protection may last.”
Meanwhile, The Hill reports that New York’s Pfizer is also in the race, in partnership with German biotech company BioNTech.
Drugmaker Pfizer on Monday became the second drugmaker to announce it had begun phase 3 testing of a vaccine to prevent the spread of coronavirus. . .
The two companies received nearly $2 billion in funding from the U.S. government for the vaccine’s development and production under Operation Warp Speed, a partnership between a number of top health authorities in the U.S. including the Department of Health and Human Services (HHS). . .
About 25 vaccines for the coronavirus are in the clinical testing phase around the world, according to the World Health Organization. The coronavirus pandemic has so far infected more than 4.2 million Americans and more than 16 million globally.
CNN says praise for the companies is merited, but it will also be a brave act for individuals who volunteer to be “guinea pigs.”
As scientists race to develop a Covid-19 vaccine, thousands of people have expressed their interest in participating in clinical trials that would expose them to the virus. Many of these people are eager to help in the name of saving lives and willing to take on any potential risks. . .
Because doctors have an ethical duty to minimize harm, they generally avoid purposely infecting people with a virus. But the usual process of waiting to see how many of the participants are naturally infected takes a long time. . .
If a controlled infection trial of a vaccine fails after all the participants have been infected, some will likely get very sick and die. According to the US Centers for Disease Control and Prevention data from mid-February to mid-March, as many as 20.8% of 20- to 44-year-olds infected with Covid required hospitalization. . .
It’s important to remember that in 1976, a swine flu vaccine was approved and eventually administered to about 45 million Americans, more than 450 of whom developed Guillain-Barre syndrome — a rare neurological disorder in which the body’s immune system mistakenly attacks the nervous system. The incident has helped fuel the anti-vaxxer movement ever since.
Vaccines usually take more than a decade to develop, so it’s clear that we are on a very accelerated timetable. The World Health Organization (WHO) estimates that there are more than 165 vaccines in development around the world (including the 25 mentioned above, which are already in the testing phase).
While companies study, hospitals test, and volunteers risk their health for your benefit, you can do your part by wearing a mask and observing physical distancing.