Coronavirus - A Laymans Update By Walrus.

On 16 March Australian researchers announced the "successful" trial of an anti viral drug and Chloroquine mixture to treat hospitalised Coronavirus patients.

Latest advice this morning (Fri 2200 UTC) is that trials will start in 50 Australian hospitals next week. I would imagine that these are effectively telescoped phase two or phase three trials. I understand that China and the USA may also be conducting, or about to conduct, similar trials, the science is moving too fast to tell at the moment. If they are successful, providing certain conditions are met, then we may have the first weapon against Coronavirus apart from social distancing.

Those "certain conditions" are clinical, commercial and political. I don't know much about the clinical except to say I would hope such a treatment, if successful,  might at least take pressure off ICUs.

I am more concerned about commercial temptations, particularly if big Pharma scents there is money to be made. A treatment would probably be the subject of a Use Patent. Then there is the question of manufacture supply and distribution. I am also concerned about political pressure; it would be a tragedy if such a drug, if it ever exists, were used as a geopolitical weapon.

I apologise in advance if this is old news. I commenters will avoid the temptation to "go nationalistic"; yes, your country may have done this three weeks ago, but it's news to me and I hope its good news to you.

https://www.newsweek.com/testing-coronavirus-cure-set-start-australia-weeks-first-participant-us-vaccine-trial-due-1492437

As far as Australia is concerned, borders are closed to non residents. Outward travel is discouraged. Social distancing is encouraged, arrivals are quarantined for two weeks and major gatherings prohibited. Cafes, restaurants, theatres, sports, etc. are dead. There will no doubt be more restrictions announced next week.

From my perspective as a retired person of advanced years, the Government has moved too slowly. However if I was a young newly unemployed hospitality worker I would be forgiven for thinking the government is overreacting. The political task of navigating the pandemic is daunting. The policy seems to be one of gradualism so as not to cause general panic.

Indications are however that the police and defence forces are preparing for the possibility of social disorder, at least in the cities. It would be a brave and foolhardy criminal who ventured into our rural neighborhood.

We are confining our selves to our lovely 40 acres. I have a tennis court sized vegetable garden to tend. We have plenty of food and with our neighbors, we have access to plenty of meat if required.

I hope you are similarly prepared.

Comments

[Larry Kart]

FWIW, Dr. Fauci pretty much threw cold water on the Chloroquine option at today's Trump press conference, saying that no clinical trials have been conducted and leaving the impression that he was highly dubious. Again, FWIW.

P.S. I wonder how long Fauci will be welcomed onto that podium.

[Barbara Ann]

walrus

Good to see an update which includes the positive developments in this war. To your point on Big Pharma; I just posted a comment under the "Close the securities markets! Now!" post on reports of large amounts of hydrochloroquine being "donated" to the USG by Novartis.

As you say, the key to minimizing the economic impact seems to be the bottleneck of ICU capacity. A 'cure' may never come, but if a drug can drastically reduce the need for sufferers to be hospitalized then the social distancing stuff can be relaxed. I am hopeful this may happen sooner than many people think. The news media needs to get with the program here and report this too. All bad news will just reinforce the feeling of panic among the masses.

Another positive development in my locality today: A neighbor has delivered a note around our neighborhood saying he has set up a WhatApp group, to which we are all invited, to help those in need in the local community - shopping for essentials, sharing ideas for diversions for the kids etc. Now than my own larder is stocked to the rafters I will offer to help where I can. This is great to see and I am optimistic that the coming time of distress and hardship for some will bring people closer together. The guy responsible is one of those much maligned Millennials btw.

[Deap]

Investigate those countries where they already widely sell these anti-malaria product OTC and have for decades. Has it stopped or slowed this particular virus in Africa, SEA, Pacific Islands and/or Central America? There is a beta test just waiting to be surveyed.

[Barbara Ann]

Forgot to mention that the comma in your penultimate sentence is very important. Everybody needs good neighbors!

[Fred]

Walrus,

I believe this drug may be off patent as it has been in use for treating malaria for more than 60 years. Stay safe; and on a bright note the Governor of Florida actually issued a "Yankee Go Home" order and made it stick! Ok, he closed the beaches and most of the snowbirds are skedaddling, but hey.

[Laura Wilson]

I wish I had 40 acres and a huge garden! I do, however, have a well-stocked larder and a town where I can walk to everything and a beautiful coastline where I can take LONG walks outside in the fresh air. Life is interesting.

I have vowed not to watch any more of the morning presser updates...there won't be anyone at the hospitals to treat my extreme hypertension! Time to obey the rules and chill out.

[turcopolier]

Larry Kart

I watched that. Ah, the great man lionized medico talks down to mere mortals. someone among the media dregs asked if that meant he knew the drug would not work. He said he did not know that.

[turcopolier]

Walrus

Mutton? I have a good recipe for Circassian mutton.

[turcopolier]

larry kart

"On 16 March Australian researchers announced the "successful" trial of an anti viral drug and Chloroquine mixture to treat hospitalised Coronavirus patients.

Latest advice this morning (Fri 2200 UTC) is that trials will start in 50 Australian hospitals next week. I would imagine that these are effectively telescoped phase two or phase three trials. I understand that China and the USA may also be conducting, or about to conduct, similar trials, the science is moving too fast to tell at the moment. If they are successful, providing certain conditions are met, then we may have the first weapon against Coronavirus apart from social distancing." Perhaps Fauci should counsel them about this.

[optimax]

Chloroquine as possible treatment for reducing the worst effects of the virus has been making the rounds on the internet for some time. The difference mentioned by Walrus in the Australian study is it being used in combination with an unnamed anti-viral drug shows promise. Let us hope it works.

Eight days ago Biden was still condemning Trump for his "racist" closing of the borders with China. It's the one thing Trump did right and early. Biden is a woke fool and we're lucky he's not POTUS or we'd be in the same ICU as Italy. Hug a Chinese was not a good idea.

[Larry Kart]

"“You know, I’m not dismissing [Chloroquine] at all, and I hope that that interpretation wasn’t widespread,” Fauci said later on Fox News. “What I said is that we don’t have definitive proof that it works.”

[Fred]

Larry Kart,

That's worth about negative 3% on the DOW. "no clinical trials" We haven't spent a year and a half on a blind study with a 1,000 volunteers? No sh@$. I expect the doublespeaking bureaucrat will quickly be pushed to the background as other doctors are added to the team. PBS cut his remarks to about 2 seconds to show Trump in the worst light possible. Glad I stopped giving them money.

[Walrus]

Col. Lang, mutton, beef, kangaroo (very lean meat), rabbit and deer. Then there are carp, trout, redfin, murray cod and yabbies(fresh water crustaceans). We have plenty of wineries and one or two breweries as well.

[Larry Kart]

Like all of us, I would be delighted if the anti viral drug and Chloroquine mixture works.

[walrus]

Regarding the trials, I would expect that they would be a double blind trial with blood tests perhaps every eight hours. Assuming the report I’ve heard is correct, I would imagine preliminary results would be tabulated for the first week by next Sunday. There would be provision to provide medication to the placebo group if the results were overwhelmingly positive. That has happened before.

I would welcome JJacksons advice.

[Deap]

Local public health officer in now locked-down California metropolitan area of approx 250,000 just made the following statement: Is this truth or dare?

......(Dr PH) "said the county’s best hope moving forward is strict adherence to California’s new shelter-at-home order, as well as continued social distancing.

If we allowed the regional outbreak to run its course without the safety measures, he explained, an estimated 85 percent of XXXXX's population would get sick in the next two months, with 5 percent of the infected likely requiring hospitalization.

That translates to around 19,000 9persons) suddenly needing critical care. “It would mean our health-care system would basically collapse,” Dr PH warned. “We would be worse off than Italy.”.......

[Tidewater]

I hope that Fauci was just using an abundance of caution. Anyway, I have a gut instinct that we are going to get lucky on this coronavirus. There is an article by Amanda Woods in the New York Post on March 19, 2020, titled "Old malaria drug hydroxychloroquine may help cure coronavirus: study."

There seems to be a world wide race, as Walrus notes, to deploy an old drug that was developed in the late 1940s which can be used in combination with an antibiotic, to combat COVID-19. The drug's name is PLAQUENIL. The generic name is hydroxychloroquine. You can get one hundred 200 mg oral tablets for $1,000.00 if you buy the brand; but you can also get 50 tablets under the generic name, which I assume will become 'HCQ' in the MSM, for about forty dollars. I say this just to demonstrate that the drug has been around for a while.

"A total of 36 patients--including 20 treated individuals and 16 infected controls--were enrolled in the study, led by Didier Raoult, an infectious disease expert from l'Institut Hospitalo-Universitaire in Marseille.

"The treated group was given 600 mg of Plaquenil each day. The researchers found that 50 per cent of the treated group turned from positive to negative for the virus by the third day--and by day six that figure was up to 70 per cent.

"Of the 20 test patients, six who were treated with both Plaquenil and the antibiotic azithromycin showed impressive results--with five testing negative at day three. All six of them tested negative at day six."

"Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin' the study concluded."

Oliver Verans, the health minister, said that the French government has heard, and now intends to carry out these same tests on a grand scale. Sanofi, the French drug company, says that it has millions of doses available right now and can almost immediately start testing, or perhaps even provide treatment if they get the go-ahead, for three hundred thousand people! The drug has been used for years for the treatment of, among other things, lupus, arthritis, malaria, and interestingly, the new threat to central Virginia--lyme disease.

There is more remarkable and heartening news from the University of Virginia. The UVA laboratories simply refused to wait for commercial COVID-19 tests to arrive and went ahead and invented their own! I think it is accurate to say that anyone who can get themselves here to C'Ville could get tested, if they felt they needed to.

Me, I am maintainin', and in the calm before the storm waiting for the word that I am going to have to take care of the cat refuge that I have been involved with for years, a place I have dubbed St. Nicholas of the Cats, from the monastery on Cyprus. This, if my sturdy Cossack friend gets sick, which heaven forfend. She is out there in the world getting stuff for the cats, and there is risk in this, but she is younger and tough and Russian and I have brought Chewy.com into the fray, and am stockpiling some really good food like New Zealand's Feline Natural. I have also arranged backup from marvellous Rachel K from Rover.com, a group of pet home support folks who are remarkably methodical. My guys sit close beside me now as I write and I think they know something is up. Rachel checks in once a week for now and I have told her she is on immediate standby if I take a hit. From which I rather think I might just be triaged out,if it all goes to hell, which leaves me with immediate further arrangements. Unless the UVA students took the virus home with them, and the 'Ville is sort of like a Carolina salt marsh where an enormous volume of water goes out with the tide and then comes back in when the sky turns pink and life starts up all over again in the squabbly spartina... Though if you are really sick the Gullah say that tide might just take old buckra out with it about four a.m. ...

I read on the blog of Lloyd Snook, who is now on City Council (and a good thing, too) that there is such a thing as a 'Quarantini'. You add 1,000 mg of Vitamin C from your little packet of Emergen-C to whatever alcoholic base solution you choose. But I am thinking of tangerine juice.

[Alves]

Walrus,

Hydroxychloroquine and chloroquine are pretty old, 1930-1955 or so, and not that expensive... the problems might be to escale production and whatever else they will use with it.

Kind of confusing how things are developing here in Brazil (we probably will be hit harder than Italy), but it looks like Brazil will use it as a treatment as of today.

[Deap]

From PubMed - the NIH online medical research library:

J Crit Care. 2020 Mar 10. pii: S0883-9441(20)30390-7. doi: 10.1016/j.jcrc.2020.03.005. [Epub ahead of print]
A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19.

Cortegiani A1, Ingoglia G2, Ippolito M2, Giarratano A2, Einav S3.
Author information

Abstract

..........
RESULTS:
We included six articles (one narrative letter, one in-vitro study, one editorial, expert consensus paper, two national guideline documents) and 23 ongoing clinical trials in China. Chloroquine seems to be effective in limiting the replication of SARS-CoV-2 (virus causing COVID-19) in vitro.

CONCLUSIONS:

There is rationale, pre-clinical evidence of effectiveness and evidence of safety from long-time clinical use for other indications to justify clinical research on chloroquine in patients with COVID-19.

However, clinical use should either adhere to the Monitored Emergency Use of Unregistered Interventions (MEURI) framework or be ethically approved as a trial as stated by the World Health Organization. Safety data and data from high-quality clinical trials are urgently needed.

..........

PMID: 32173110 DOI: 10.1016/j.jcrc.2020.03.005

(NB Fair use of copyright material for educational purposes - non-commercial setting)

[JL]

If I remember correctly, a white paper out of China was the first one that raised the use of Chloriquine for Covid19 - a doctor there noticed that lupus patients were not getting hit by Covid19 and connected the 2.

But this was quite a while back (sometime early Feb ?), I would surmise China have made considerable headway into trials on this. While this drug is on the official Chinese treatment plan for covid19 (7th edition now ?), China is still chasing a vaccine. I would guess that China is not seeing this as a complete cure.

[Mathias Alexander]

The Chinese are using this drug from Cuba
The Recombinant Interferon Alpha 2B (IFNrec),
https://www.telesurenglish.net/news/cuban-antiviral-used-against-coronavirus-in-china-20200206-0005.ht

[JohninMK]

By the sound of it they are using two existing drugs in combination with one, hydrochloroquine, apparently out of patent.

This, if it works as described, is a very good and fast way forward as it cuts out months/years of approval testing. In some ways it is a much more important development than finding a vaccine as it would buy time and reduce deaths now, making it easier for the World's health systems to cope. Fingers crossed and good speed for the Aussies.

I note that neither the drug's name or the company are disclosed. The cynic in me wonders who might be buying shares in the company who's anti HIV viral it is in the combo package.

[BillWade]

In the meantime, up your immunity:

Vitamin C
Vitamin D - get some sunshine, very important
Multivitamin

Use your newly found spare time to get in shape as best you can, every ounce you shed lessens the load on your heart and improves lung function

No processed food, no sugar, cut back substantially on wheat products - pasta, bread, etc..

Dense proteins are best for improved immunity: beef, pork, chicken, then seafood.

Grocery stores seem to have ample supplies of fresh fruit and vegetable while lacking in processed foods - eat the fresh, not the packaged while it's available.

Everyone here probably knows this already but but discipline is key.

[walrus]

Elora, in the USA and Australia, mutton, lamb, sheep meat, whatever you call it, is not a delicacy for the rich like it is in Europe. Your comment reeks of misplaced envy. My favourite welcome to European visitors has always been to put a whole beef eye filet on our barbecue, washed down with good Australian Cabernet Sauvignon. We unsophisticated savages have certain advantages.

[JJackson]

The drugs in the trial are likely to be hydroxychloroquine and remdesivir. The former being the Malaria treatment and the later an anti-retroviral. Both are already in extensive use on a compassionate use basis but while there has been some anecdotal evidence that they seem useful we are only now beginning to see all the tried pharmaceuticals entering clinical trials. Remdesivir is under patent by Gilead and chloroquine is donkey’s years old, I used to take it as a child and hated the taste with a vengeance. It is derived from a tree bark and gives the bitter taste to tonic water. The WHO has set up a fast tract international trialling system but sadly not many countries seem to have signed up, choosing to develop their own trials. The WHO system's aim is to get a broad base of trials performed to the same protocol with a fairly simple set of basic question about safety and efficacy. This would produce a broad dataset with robust answers to key questions in a short time. Other trials may give more information but would not be directly comparable to each other as they each have their own protocols. Fauci is one of a handful of virologist I truly trust he is always extremely measured and precise. Given his position in the NIH, which funds most US university research grants, he is also probably the best informed person in the world on all current disease pharma research. These are likely to be double blind trials although there are also some open label trials ongoing. The bad news is that none of the drugs that have been used work to the point of obviously killing the SAR-2, their effect has been enough to say patients on treatment X seem to be doing a bit better than without. On the anecdotal evidence I have seen remdesivir seems the most promising but it is unknown how quickly production could be ramped up or how Gilead will handle the patent issue. Their stock price climbed rapidly in Feb but has been yo-yoing as conflicting reports of its efficacy circulate.