As Canadians and the rest of the world await a vaccine for the novel coronavirus with bated breath, experts say it is imperative that other treatments for the respiratory illness also be developed.
It is “extremely important” that good treatments for COVID-19 are developed because it’s unclear when a vaccine could be ready for public consumption, Dr. Isaac Bogoch, an infectious diseases specialist and faculty member at the University of Toronto, said.
“Vaccine development and vaccine rollout is going to take a long time and no one’s entirely sure how long it’s going to take,” he said.
While the vaccine will be a “trigger toward the path to normalcy,” Bogoch said, Canada can still expect to see cases of COVID-19 even after one is available.
Most viral illnesses though do not have treatments, Bogoch said.
“But it’s incredible what you can do if you have the world’s attention and have infinite resources and brainpower available to help develop or look for drugs to mitigate the severity of infection,” he said. “And that’s exactly what’s happening.”
Dr. Timothy Sly, an epidemiologist with Ryerson University’s school of public health, echoed Bogoch’s remarks, saying it is difficult to develop treatments for viruses.
“So that’s what we’re hoping for.”
But better anti-virals and treatments for COVID-19 need to be developed, especially as the country continues to reopen, Sly said.
What’s happening:
- The Public Health Agency of Canada (PHAC) says it is “closely tracking all potential drugs and vaccines in development” in Canada and around the world.
- According to the agency’s website, a total of $54.2 million has been spent to support 99 research teams across Canada who are focusing on medical countermeasures including vaccines and therapeutics and on social and policy countermeasures surrounding the virus.
What this means: While there are many drugs being tested, Bogoch said, good quality data is needed to prove any of them will be effective and safe for treating COVID-19.
“I don’t get excited until we have high-quality data,” he said. “And that means prospective studies that are randomized, that are blinded and that are placebo-controlled.”
Here’s a look at a few of the types of drugs being tested:
Anti-viral drugs
How it works: Antiviral drugs work to block a virus’ ability to replicate its cells inside an infected person. Sly said these medications interfere with how effective the virus is at making someone sick.
What this means: Sly said anti-virals are only effective if taken within the first few days of infection, posing an issue for asymptomatic patients. He said viruses can also develop a resistance to these types of drugs over time.
In July, Health Canada authorized an anti-viral drug remdesivir for treatment of COVID-19 patients with severe symptoms.
Remdesivir is the first drug the agency authorized in Canada to treat the virus.
Trials testing anti-malaria drugs including chloroquine and hydroxychloroquine are also underway, though, the efficacy and safety of the medications have not yet been proven.
U.S. President Donald Trump has repeatedly touted hydroxychloroquine, claiming he had taken the drug in May.
However, a recent study published in the New England Journal of Medicine in June found the drug did not prevent COVID-19 in people exposed to the virus.
Convalescent plasma trials
How it works: Convalescent plasma therapy, Sly explained, sees antibodies taken from the blood of recovered COVID-19 patients and injected into someone else.
“What this does is it provides a kind of a ready-made antibody to the virus that can work,” Sly explained.
What this means: Sly said this approach does not provide “instant immunity,” and the efficacy can vary. It can also be difficult to find people to donate the plasma, as it can not be replicated in a laboratory.
Corticosteroids
How it works: Corticosteroids help to suppress the immune system which — when faced with COVID-19 or any other virus — can overreact causing inflammation and other complications, Sly explained.
These drugs may be able to help COVID-19 patients who are experiencing swelling in their lung tissue.
Last week a study published by the Journal of the American Medical Association, found that treating critically ill COVID-19 patients with corticosteroid drugs reduces the risk of death by 20 per cent.
The analysis – which pooled data from seven international trials of a low dose of hydrocortisone, dexamethasone and methylprednisolone – found that steroids improve survival rates of patients sick enough to be in intensive care in hospital.
What this means: Sly cautioned that steroids are far from a “silver bullet” solution.
“These are no earthshaking reactions,” he said. “But there are slight improvements.”
Repurposing drugs to treat COVID-19
A newly approved Phase 3 clinical trial slated to begin this month will seek to determine whether a decades-old antibacterial drug known as dapsone, can be reformulated to treat COVID-19.
The drug is used to treat malaria, lupus and HIV.
Researchers at Pulmonem Inc., a Canadian biotech startup, say the newly formulated, patented drug could help limit lung inflammation, and prevent “excessive immune reactions” in COVID-19 patients.
The trial led by the Research Institute of McGill University Health Centre (RI-MUHC) will include over 2,000 patients and will be run in seven centres — two in Canada and five in the U.S.
Repurposing a drug with a well-known safety profile allows researchers to “immediately move to a Phase 3 trial,” accelerating the timeline, Dr. Jean Bourbeau a respirologist at the McGill University Health Centre and director of the McConnell Centre of Innovative Medicine at the MUHC, said.
What’s more, if the reformulated drug is found to be effective in treating COVID-19, it would help keep the costs of manufacturing down, which would make it an affordable option for patients, Dr. Houfar Sekhavat, CEO of Pulmonem, said.
If Canada is going to “win the war that is called COVID-19,” we must develop safe, effective and affordable treatment options, Bourbeau said.
By the numbers:
- Since the pandemic began, Canada has seen 131,773 confirmed cases of COVID-19.
- The virus has claimed 9,145 lives in Canada.
- More than 6,782,282 tests for the novel coronavirus have been conducted in Canada
- 116,311 have recovered after falling ill in Canada.
- Worldwide, 26,918,965 cases of the virus have been confirmed, according to a tally from Johns Hopkins University.
- Since the pandemic began, a total of 880,341 people have died worldwide.
–With files from Reuters.
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