The coronavirus pandemic that has gripped the world and paused life in an unprecedent manner has infected over millions of people worldwide with well over a million deaths and counting. South Africa has shown a highly positive recovery rate of 90%, and in many ways we feel we have beaten the virus. The global impact of this novel virus has been severe with some European countries experiencing a second wave of infection. Patients that developed serious symptoms & recovered from virus infections are often left with long lasting complications. Accurate testing remains important in controlling the virus & reducing its transmission and currently, the PCR diagnostic test is the best method to test for Covid-19 infection, testing for RNA from Covid-19 and diagnosing that a person is actively infected with the virus. The South African Health Products Regulatory Authority (SAHPRA) has also approved serology tests which test for the presence of antibodies i.e. whether your body has produced antibodies against Covid-19, but not for the presence of the virus itself.
A Covid-19 patient may or may not present symptoms that require treatment. The symptoms have been of a wide range, with patients with particular co-morbidities & elderly patients presenting the most severe symptoms. Scientists are racing to develop vaccines & drug treatments. In light of the urgency of the pandemic, the first approach has been to try drugs that have already been approved for other conditions, which is known as drug repurposing. Identifying new uses for known drugs is vital to accelerating the development of treatments as it speeds up the time it takes to make a treatment available. This is mainly because researchers do not have to repeat the earlier stages of development to show drug safety. A new use of a known drug can be patented if it is novel and inventive.
We have heard a lot about remdesivir. This drug was originally developed to treat Ebola. It was shown to shorten the recovery time for patients hospitalized with COVID-19. Several pharmaceutical companies obtained authorisation from SAHPRA to import the generic of remdesivir under a Section 21 exemption. This allows for the import of medicines that have not been scrutinised by SAHPRA but which have been approved by regulators in other countries. However, in August 2020 the National Department of Health issued treatment guidelines where it decided to not recommend the use of remdesivir due to its high cost & marginal benefit. It has instead only been recommended for clinical trials.
Oxford University is running a RECOVERY trial to test whether existing drugs could be useful in treating Covid-19. It found that the drug dexamethasone reduced mortality among ventilated patients. Dexamethasone is a steroid that has been used since the 1960s to reduce inflammation in a range of conditions. Dexamethasone has been in use in South African hospitals to treat critically ill Covid-19 patients since June where it has reduced fatalities of patients in ICU by 25%.
A key objective in fighting the pandemic is to develop an effective vaccine that protects people from contracting Covid-19 before they are exposed to the virus. There are more than 160 projects globally that are focused on developing such a vaccine. Vaccine development typically takes 10-15 years, however, this has been accelerated with AstraZeneca, Moderna and Pfizer reporting high successes with their respective vaccines which are anticipated to be rolled out within the next few months in some countries.
Researchers succeeded in identifying the structures of the key proteins of the new coronavirus. This would have normally taken months or years to accomplish, but through open collaboration between researchers, it was completed in weeks! Open global cooperation is imperative at this time to arrive at a successful vaccine in an accelerated time frame. Now that international travel has been re-opened and many restrictions have been lifted, we cannot become complacent. Until the wide global spread of the virus has been contained, we still need to rely on key measures such as social distancing, frequent hand washing & monitoring flu-like symptoms. Take care and be safe!