Since the first reported official cases of Covid-19 the coronavirus has upended us all and launched scientists, medics and public health specialists on a warp speed science race to try and unravel the complexities of the coronavirus and ultimately find a cure, or at the very least an effective treatment.
There are many unanswered questions. Why do some infected people remain un-symptomatic? Why do some people have relatively mild symptoms and others lethal ones? What drugs best help treat sick patients? Will a vaccine work?
Scientists are trying to unknot the tangled threads of the Covid-19 conundrum and a few recent discoveries will help.
Retrospective studies are starting to reveal that Covid-19 was in Europe much earlier than originally thought.
A French doctor revisited the case of a patient he treated in December. He re-tested the patient’s swabs and they came back positive for Covid-19. The patient, who has since recovered, hadn’t travelled to an affected region so it indicates that Covid-19 was circulating in the French community since December 2019.
Lots of us and our families had a terrible dose of the flu in December and January and I know a few people who are convinced that they had Covid-19 at Christmas. More research will reveal if that’s true or not and the government have launched the SCOPI antibody test to understand Ireland’s population exposure to Covid-19. It involves a phone questionnaire and blood test so if you are one of the randomised people invited to participate – take part!
We don’t think of wastewater as being a valuable source of information, more an unpleasant effluent to be disposed of quickly but wastewater can divulge lots of information about a population. An Italian analysis of wastewater samples from Milan and Turin showed that the Covid-19 virus was in Italy before the first case was reported in China.
Many countries, Ireland included, are starting to sample wastewater to track the disease. It will be another source of population health information for public health officials to determine if the virus is starting to circulate more in the community.
Watching the powerful RTÉ Investigates documentaries ‘’ I was struck by the sheer scale of medical effort being deployed to keep people alive - machines to do the work of lungs, hearts and kidneys – devices to buy patients time until their immune systems can mount a proper defence and recover. Doctors, and their patients, are desperate for drugs that work.
Dexamethasone looks so promising at cutting death rates that the University of Oxford authors broke with conventional protocol and published their preliminary findings via press release rather than the protracted peer-reviewed published scientific paper route.
Dexamethasone is a cheap, safe corticosteroid that replicates what people naturally produce in their adrenal glands to regulate metabolism, cognition and the immune system.
Neonatologists regularly use it to improve the lung function of premature babies and support them in intensive care.
The University of Oxford trial showed that dexamethasone reduced deaths by a fifth for patients who needed supplemental oxygen and reduced deaths by a third for patients on mechanical ventilators.
Reported in Wired the researchers said the results were so “eye-popping” that they didn’t believe them at first and spent time checking and rechecking the data to make sure it was right.
This same trial also showed that the use of the antimalarial drug, hydroxychloroquine was ineffective and cancelled the study before its completion. You might remember that hydroxycholoroquine was the drug President Trump was taking as a preventative despite warnings from US doctors. Well science is definitively saying that it doesn’t work as a treatment for Covid-19.
also works but is pricey
The other drug that is really showing promise is Remdesivir. Originally created to fight Ebola it looks like this drug is also effective at treating Covid-19.
Unfortunately the price will be prohibitive to many and the US has bought up 90% of the global supply from pharmaceutical company Gilead Science for the next three months.
So although it might be useful for many Covid-19 patients they are unlikely to get their hands on it in the near future.
If you’re a nerd like me you might be interested inCovid Vaccine Tracker. It is a nifty website that has information on all the different types of vaccines being developed worldwide. You may not want to delve into the intricacies of randomised control trials but you might like to know that 17 coronavirus vaccines have been tested on humans.
One vaccine has been approved for limited use and three vaccines are doing large scale efficacy tests. If those vaccine candidates don’t work there are approximately 150 other vaccines at various stages of development.
The US have officially called the research efforts to find a vaccine ‘Operation Warp Speed’ but despite huge efforts and money being thrown at the problem many experts caution that a vaccine could still be five years away and we need to continue to suppress the virus in our communities.
Prevention is better than cure so socially distance, cough and sneeze into your sleeve, wash your hands and wear a mask! As one nurse said on RTÉ’s ‘– “we can’t go through this again”.