With far too many people ignoring public health advice around social distancing, we’ve come to the unfortunate place that a lot of areas are on lockdown. However, we need to slow this thing down.
At the World Health Organization press briefing on March 23, the W.H.O. Director-General Dr. Tedros Adhanom Ghebreyesus said that it had taken 67 days to reach the first 100,000 confirmed cases of COVID-19, then 11 more days to reach 200,000, then only 4 more days to reach 300,000. As of March 23, 13:51 GMT-7, the W.H.O. reports 334,981 confirmed cases across 190 countries, with 14,652 deaths.
The Director-General went on to say:
“Asking people to stay at home and other physical distancing measures are an important way of slowing down the spread of the virus and buying time but they are defensive measures that will not help us to win. To win we need to attack the virus with aggressive and targeted tactics, testing every suspected case, isolating and caring for every confirmed case and tracing and quarantining every close contact.”
At this time the W.H.O.’s clinical management guidelines are inaccessible; likely their server is overloaded. The U.K.’s NICE guidelines (which are used by the N.H.S.) don’t seem to make specific recommendations about experimental treatments, so instead, we’ll turn to the Centers for Disease Control and Prevention in the U.S. to see what they have to say.
The C.D.C. reports that there are 3 clinical trials ongoing for the investigational antiviral drug remdesivir. There is also an emergency access option available for hospitals not involved in trials to get a supply of the drug. In the same treatment guidance document, the C.D.C. recommends the use of hydroxychloroquine or chloroquine based on the limited data that is available (I covered this in an earlier post). Hydroxychloroquine appears to have more potent activity against the novel coronavirus. Caution is urged if either of these are combined with azithromycin, due to the potential for cardiac side effects.
The C.D.C. goes on to say that trials are underway looking at whether hydroxychloroquine is effective for pre- or post-exposure prophylaxis, i.e. whether it has a preventative effect when taken before someone is exposed to the virus, or whether it can prevent infection after someone’s been exposed. No data is available yet.
According to clinicaltrials.gov, some of the other drugs being investigated around the world include sildenafil (Viagra), angiotensin II receptor blockers (typically used for blood pressure), the antiviral drug combination lopinavir/ritonavir, and thalidomide (the drug that causes severe birth defects).
The W.H.O. reports that as of March 21, there are 2 candidate vaccines in the clinical evaluation phase, and 48 candidate vaccines in preclinical evaluations.
Ways to get information
The W.H.O has partnered with Facebook and Whatsapp to provide alert messages through Whatsapp. This can be accessed via the W.HO. website.
The W.H.O has OpenWHO Massive Online Open Courses for COVID-19, including one on hygiene measures to prevent infection and how to implement them.
For a lot of people, isolation is hard, without a doubt. It’s not going to last forever, though. This is necessary to slow down the spread. Once it’s more contained and testing is scaled up, the public health folks will be able to start doing the same thing they do with TB or measles outbreaks – isolate the people who have it, trace any contacts they’ve had, and isolate those people too.
In the meantime, make sure you’re getting your information from reliable sources. And while some politicians may be reliable if they stay on script, the people that actually know what they’re talking about are the public health experts.
I’ve put together a COVID-19 coping toolkit with some resources to help with managing the stress of the current pandemic.