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Science

Remdesivir: cure for COVID-19? More studies needed

The race is on to find a cure for COVID-19 as the pandemic continues to wreak havoc on countries, shuttering economies, straining public health systems and taking many lives. As of this writing there are 2, 160, 207 confirmed cases with 146, 088 deaths worldwide.

The World Health Organization has taken the lead in a global “Solidarity trial” of at least four candidate drugs that could potentially cure the disease: Remdesivir; Lopinavir/Ritonavir; Lopinavir/Ritonavir with Interferon beta-1a; and Chloroquine or Hydroxychloroquine.

First to grab headlines was Hydroxychloroquine which US President Trump has mentioned on many of his earlier briefings to the press.

Remdesivir
Chemical structure of Remdesivir.

Now, attention has shifted to remdesivir which has shown promising results based on a few studies in the US. The drug is made by Gilead Sciences and was initially tested against Ebola but had little success. Multiple studies in animals showed the drug could both prevent and treat coronaviruses related to COVID-19, including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome).

The US NIH came out with a report that remdesivir prevented COVID-19 from progressing in rhesus macaque monkeys based on mild- to-moderate cases of the human disease.

Although the “solidarity trial” is unprecedented and groundbreaking as it has never been done before, experts are saying that more rigorous studies are needed as the urgency to find a cure may compromise the global effort.

Dr. Rahul Ganatra, director of Continuing Medical Education at Brigham and Women’s Hospital in Boston, Massachusetts has scrutinized a paper published in the New England Journal of Medicine on the use of remdesivir for patients with severe COVID-19. His initial appraisal is that the study was based on a population of small size – only 61 patients, there were missing data like the definition of what is “standard care”, and perhaps most importantly, it lacked a control group. To his mind, these threaten the promise of remdesivir being a cure for COVID-19. His conclusion: more well-designed trials like ones with control-groups are needed.

It is hoped that indeed researchers would bear in mind that a cure for COVID-19 would only be found through good science and that the goal is not only to be the first in finding it, rather finding a cure that really works.

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Science

How hand washing with soap & water kills the SARS-CoV-2

The inevitable has happened, there are now 24 confirmed cases of COVID-19 in the Philippines and as I write this, the World Health Organization is on the brink of calling the outbreak a pandemic.

You may have doubts or misgivings about our own Department of Health, but they are still the best source of information about COVID-19 cases in the Philippines. Sharing unverified information via social media only helps to fuel panic and paranoia which could worsen the outbreak for all of us.

With the virus spreading locally, it’s important that we do our share to help contain or minimize its spread. You’ve often heard from medical professionals, government officials, your HR folk, the World Health Organization and media that one of the most effective ways to fight the spread of the SARS-CoV-2 is by frequent hand washing with soap and water. How so? It’s all rooted in the morphology or physical characteristics of the coronavirus. See the illustration below:

Coronavirus is a type of “enveloped” virus which means its core genetic material is surrounded by a membrane. That membrane, encircled in the image above, is called a lipid bilayer or two layers of phospholipids.

By Bensaccount – http://en.wikipedia.org/wiki/Image:Lipid_bilayer_section.gif, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2929946

Lipid is a molecule that is like fat. Since soaps dissolve fat, washing your hands with soap and water for a sufficient amount of time, experts say singing “Happy birthday” twice does the trick, dissolves that lipid bilayer envelope of the coronavirus which in turn destroys the virus itself. This simple practice is very effective against germs, that’s why you often see surgeons spending a great deal of time thoroughly scrubbing their hands with soap and water before and after a surgery as shown in popular TV shows like Grey’s Anatomy or The Good Doctor.

So let’s do our part, frequently wash our hands with soap and water to keep it clean and fight off nasty germs like the coronavirus. Remember, before and after eating, wash your hands. After using the toiltet, wash your hands. Just got home from work or outside, wash your hands before touching anything else or your loved ones.

It cannot be overstated: wash your hands with soap and water.

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Daily dose

How vulnerable am I to the COVID-19?

The SARS-CoV-2 continues to spread throughout the world and there’s now talk of the COVID-19 reaching pandemic levels. It’s not going to be the end of the world or the start of a zombie breakout but one cannot avoid getting anxious. I myself have been worrying ever since reading about it back in December last year. Primarily because I have not been of the greatest of health; underweight, prone to allergic rhinitis which would easily develop into upper respiratory infection. That alone is enough to make life very hard for at least a couple of weeks until it gets resolved. To top it all off, I work in an office building where there’s a lot of foreign nationals on a daily basis.

So the worry is real. Thankfully most of the answers to the question in the title of this post, can be found on an article by Dr Edsel Maurice Salvaña, M.D., DTM&H, FPCP, FIDSA on Esquire Magazine:

Early data is showing that about 80% of people who get sick with COVID-19 will develop only mild symptoms, while 20% can develop more severe disease. The ones at highest risk for a bad outcome are the elderly and those with chronic illnesses such as diabetes, heart disease, and lung disease. A greater percentage of men compared with women with COVID-19 have died in China, and this may have been partly because more males smoke in China. Protecting your loved ones means avoiding unnecessary travel and practicing social distancing. Elderly people should avoid crowds and crowded places. Make sure everyone’s vaccinations for influenza and bacterial pneumonia are up to date since these can prove fatal if they occur at the same time as a COVID-19 infection. Now is also the best time to stop smoking.

Dr Edsel Maurice Salvaña, M.D. A Coronavirus Pandemic Isn’t the End of the World

I may not be young anymore but certainly not too old to be considered an ‘elderly’ just yet. Heart disease and diabetes free. However, I do have a history of lung disease and that’s where the worry really comes from. On the other hand some level of comfort comes from the fact that I don’t smoke cigarettes and having been on a drinking hiatus since last October, my exposure to second-hand smoke has been practically eliminated.

The real trick now is to keep my self in better health. Wash my hands more often and minimize travel. I even started to use my elbows in pushing the elevator buttons and consciously avoid touching door handles and the overhead bar at jeepneys.

In addition, I regularly keep myself updated with news & information about the COVID-19 from credible sources. Hopefully it would be enough to be spared from this disease along with my family. Hoping even more that a local outbreak would not happen even though the recent moves of the government in response to SARS-CoV-2 spread does not inspire confidence and even adds to our worries, there’s only so much that we can do.

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Science

Novel coronavirus 2019 disease & virus gets official names

Two official names have been made public today in relation to the on-going pandemic, yes I said it, of novel coronavirus: the disease and the virus that causes it.

As per the World Health Organization:

For the virus:

Similar to how one should distinguish the AIDS (disease) from HIV (virus). With the official names now available, research and news reporting would be much clearer.

So let’s recap: the disease is called Coronavirus Disease-19 or COVID-19 and the virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).