Of Herd Immunity, Plasma Therapy, Vaccines And Drugs For COVID-19!

In view of the worrying surge of SARS-CoV-2 (COVID-19 or the new Coronavirus) the world over with the worst affected country USA having a second wave and in India, Brazil and others the infections going unabated desperation for treatment measures is growing all the time. Besides, the World Health Organization (WHO) has been consistently maintaining that possibility of having a vaccine is at least one and half years away. The WHO has also maintained that there is no proven cure for COVID-19 so far. The basic reason that justifies such kind of desperation is that this virus is far more dangerous than the recent viruses, its mortality rate almost 10 times higher than those. The virus has caused havoc on planet Earth before the humans came to understand and know much about it. Therefore, various issues concerning herd immunity, plasma therapy, development of vaccines and use of repurposed drugs are being discussed and experimented continuously all over the globe.

The term ‘herd immunity’ basically means that if most part of the population becomes immune to a particular infectious disease then they will get indirect protection than those who are not immune to it. For example, if 80% of the population gets immunity then four out of five people won’t get sick despite coming into contact with infected people. At least 70 to 90% immunity will be required for effective herd immunity that can keep the virus under control. The problems come when talking about how to achieve this herd immunity. There are two ways of achieving herd immunity: with precautions and social norms not being followed strictly a large portion of the population is likely to get infected and if it is at least 70%, the population can get herd immunity, and secondly, simply through the development of a vaccine. In the first case the cost of a large number of people getting infected will be very heavy and high in terms of loss of lives. In India and other populous countries large chunks of population are susceptible or exposed to the virus, and to achieve herd immunity through the first way is not advisable at all. Therefore, the only way to achieve this would be through a developed vaccine, and till it is ready for mass use the infections must be kept under control by enforcing strict social distancing and other norms.

Plasma Therapy has been emerging as a very positive development for treating serious COVID-19 patients where the blood plasma is collected from recovered Coronavirus patients is injected into them and the anti-bodies contained in that helps curing them. In India, this therapy is being practiced with good results; plasma banks are being established in Delhi, Haryana and Maharashtra among others with requests to recovered patients to donate plasma. In fact, the Health Minister of Delhi who got seriously ill with COVID-19 recovered finally with this therapy.

The WHO has stipulated very stringent procedures for development of COVID Vaccines: the produced vaccine has to go through three rigorous phases of clinical trials with increasing numbers of human volunteers given doses before being declared safe for use which would take several months apart from the months needed for mass manufacture and distribution. At the moment there are around 100 vaccine candidates the world over including seven firms in India with a few of them already approved for clinical human trials: the Oxford vaccine developed in the United Kingdom currently in the third phase of trial; CureVac from Germany approved for clinical trials; a Russian COVID vaccine claims to have successfully completed the three phases of human trial and now ready for mass production and at least two vaccines on trials in India with the first-ever Indian vaccine candidate Covaxin by Bharat Biotech getting approval from the Drug Controller General of India (DCGI) for human trials. In fact, the Indian Council of Medical Research (ICMR), the apex medical body, created a controversy recently by directing the stakeholders to fast-track Covaxin making it ready for mass use by 15th of August 2020 which was promptly rebuffed by the Government of India. It is to be emphasized here that even if a vaccine is finally approved for mass use its effectiveness will still be under scanner, because every vaccine mutates often and so, there is no guarantee that a vaccinated person won’t get COVID-19 in possibly a year or more.

As an integral part of the desperate search for COVID cures or treatments various repurposed drugs have been tried continuously for treating the SARS-CoV-2 virus. Hydroxychloroquine, a drug used successfully for treatment of malaria in India, was first tried on the infected medical fraternity leading to a spree of exports by India on demand from various countries including the US. However, finally, the WHO has discontinued its trials in July 2020 for reasons of side effects and safety. Antiviral drug Favipiravir, originally produced in Japan to fight influenza, under the name of Fabiflu distributed by Glenmark Pharma was officially approved in June 2020 to treat mild to moderate Corona patients in several countries. However, its side effects are under scanner and the DCGI has only approved emergency use with prescriptions.

The WHO has been very hopeful on the efficacy of a corticosteroid called Dexamethasone as a life-saving medicine for critically ill Corona patients based on the clinical trial in the United Kingdom. Since Dexamethasone is basically an anti-inflammatory drug its use is only to cut mortality rates in patients requiring oxygen or ventilator support. Another antiviral drug, Remdesivir (Covifor) produced by Gilead Sciences is so far the only accepted medicine for treatment of COVID-19 given approval by the Food and Drug Administration (FDA), and recently distributed in India too that led to a craze with reported black marketing. However, this medicine not for public purchase in chemists, and only for supply to hospitals for doctors to prescribe under discretion for serious COVID patients. The overall safety of the drug is yet to be proved though.

Desperate times call for desperate measures. And the quest for a possible cure for the killer virus goes on. In the meantime, humankind must adapt to the new normal following stringent social distancing norms and other precautions, for at least a year more, hopefully.

Chinmay Chakravarty is a professional specialized in the creative field with over two decades of experience in journalistic writing, media co-ordination, film script writing, film dubbing, film & video making, management of international film festivals and editing of books & journals. Proficient in providing professional services in these related fields. Was an officer of Indian Information Service and superannuated from the post of Director, Press Information Bureau, Kolkata in November, 2019. Published his first solo book ‘Laugh and Let Laugh’ in 2017.

COVID-19 Vaccine Only Hope As Practiced Treatments Fail To Show Results?

Even after almost a year of its worldwide invasion the SARS-Cov-2 virus called COVID-19 continues to enjoy an edge over humankind which is not surprising considering the unprecedented crisis brought in by a virus hardly known to anybody, its seemingly selective approach in terms of mildness or severity of the infection, baffling all medical scientists and doctors. Humankind, in its present very advanced stage of the knowledge search, is never a party to accept defeat, and therefore, the quest has been relentlessly going on all over for an effective vaccine, and in the meantime intent research on anti-viral or anti-malarial repurposed drugs, plasma therapy and other possible methods of treatment. The main concern of all efforts being at least to reduce the mortality rates which also differ country-wise and inexplicably, and till today it has been an accepted fact that there is no cure for the disease. Various vaccine projects in various stages of development are in full swing in various countries with most of them promising a vaccine by the new year day or early next year. Now, the latest disappointing developments on treatment methods practiced so far have posed the most relevant question: is an effective vaccine only hope for humankind?

Most of us remember the desperate international craving for a basically Indian anti-malarial drug called Hydroxychloroquine (HCQ) when the pandemic was raging furiously in Europe and the US, and the US President going to the extent of threatening India if supplies of HCQ were not. However, slowly over time this drug was found ineffective and a bit harmful too in respect to natural immunity. Then there were several other drugs and steroids that were used with seemingly hopeful results, Remdesivir being the one most welcomed one as a life-saver.

The results of the Solidarity Clinical Trial, one of the largest international Randomized Controlled Trials (RCT), that has been conducted by the World Health Organization (WHO) since March 2020 were declared recently which marked four of the most promising drugs as ineffective in reducing mortality. The four evaluated treatment methods, HCQ, Remdesivir, Lopinavir or Ritonavir and Interferon, have been found to have little or no impact on mortality rates. As far as the RCTs conducted in various countries of the world including in China are concerned there have always been doubts on their findings, and experts feel the need for more such studies. Objections were raised against the Solidarity Trial too as regards to its sampling methodology from various quarters, with one Indian hospital refusing to stop using Remdesivir claiming its benefits over the months in their patients. However, technically, it means that except for Corticosteroids which have been proven effective in treating critical patients there is no other deemed treatment method, and it also must be remembered that steroids are not recommended for less-severe or general patients.

More disappointing news came next from the Indian Council of Medical Research (ICMR) on the efficacy of the Convalescent Plasma Therapy (CPT), so far permitted as an investigational therapy in progressive stages of the disease in India, which involves taking out blood plasma from recovered COVID-19 patients and injecting this antibody-rich extract into positive patients, particularly the more severe ones treated in hospitals. Over the months it has been developed into a systematic treatment method creating proper channels of donations across the states as infected doctors too made it a point to donate the precious plasma.

The Director General of the ICMR declared the results on 20th October 2020 after conducting its own RCT during April-July period of the year covering over 400 hospitals across 39 medical centers of the country. Based on the results the ICMR has concluded that the CPT fails to reduce the mortality rates or prevent the progression of COVID-19 infections from moderate to severe stages. Following this finding the Government of India is mulling removal of CPT from its COVID-19 protocol for national clinical management. This is indeed sad news as CPT has been a very popular method of COVID-19 treatment in the absence of an effective vaccine.

Experts, however, are not convinced about the CPT results saying that it may have had to do with the delay of the infusion and the quality of the antibodies. Internationally, the CPT continues to be a treatment method meant only for emergency use. Anyway, in view of all these findings the importance of discovering an effective vaccine grows even more. The pandemic is far from keeping its clutches off humankind yet: after over six months of haphazard acceleration India has finally reached its peak in the third week of September 2020 with new cases still hovering around fifty thousand a day and 500+ daily deaths while the European countries and the US are experiencing a second wave.

Chinmay Chakravarty is a professional specialized in the creative field with over two decades of experience in journalistic writing, media co-ordination, film script writing, film dubbing, film & video making, management of international film festivals and editing of books & journals. Proficient in providing professional services in these related fields. Was an officer of Indian Information Service and superannuated from the post of Director, Press Information Bureau, Kolkata in November, 2019. Published his first solo book ‘Laugh and Let Laugh’ in 2017.

Hydroxychloroquine – What You Should Know About This Drug

What is Hydroxychloroquine used for?
Hydroxychloroquine is a prescription medicine for treating malaria. It is categorized in a group of drugs called quinolines. Malaria is a serious disease that occurs when a person gets bitten by a mosquito that is carrying germs. There are different strains of malaria and some of them cannot be controlled with Hydroxychloroquine. As it is an antirheumatic medicine, Hydroxychloroquine is also prescribed for the treatment of lupus and rheumatoid arthritis. It is imperative to take the whole dose even if your malaria symptoms improve before the date you are supposed to discontinue use. To buy sometimes it spelled out like hydroxychloroquinine or hydroxychloroquinne but correct name is Hydroxychloroquine.

Hydroxychloroquine has not been approved to treat coronavirus or COVID-19. However, the US Food and Drug Administration (FDA) has authorized emergency use of hydroxychloroquine in adults and adolescents weighing at least 110 pounds (50 kilograms) who are hospitalized with COVID-19.

Hydroxychloroquine is being used to try and stop coronavirus from spreading inside your body. It is not yet known if hydroxychloroquine is a safe and effective treatment for COVID-19, and this use is still experimental.

How is Hydroxychloroquine dosage taken?
It is imperative to take Hydroxychloroquine just as your doctor prescribes it. Hence, don’t take a smaller or a larger dose than your doctor recommends. Moreover, take this medicine for the suggested duration only. If you are asked to take once a week, then do exactly that; take Hydroxychloroquine the same day every week. It has to be taken either with a meal or a full glass of milk.

Hydroquin 200mg (Hydroxychloroquine) is taken orally with food. The dose is 400mg/day for 4-6 weeks. Maintenance dose is 200mg/day. Do not take the drug if you have a history of vision changes. The dosage preferably depends upon your weight, age, your medical history and your response to the treatment. Therefore the correct dose will be decided by your doctor.

What are the side effects of Hydroquin 200mg (Hydroxychloroquine)?

The following is a list of possible side effects that may occur;

Nightmares
PsychosisStomach
CrampsDizziness
Muscle painNerve pain
Loss of hairDifficulty in visual space
A headacheVomiting Constipation
Low blood pressure

Tell the doctor if you have any liver problems, have had strokes and ever had an allergic reaction to any medicine.

Before taking this medicine
You should not use hydroxychloroquine if you are allergic to hydroxychloroquine or chloroquine.

High doses or long-term use of hydroxychloroquine may cause irreversible damage to your retina (the membrane layer inside your eye that helps produce vision). This could progress to permanent vision problems. The risk of retinal damage is higher in people with pre-existing eye problems, kidney disease, or people who also take tamoxifen.

To make sure hydroxychloroquine is safe for you, tell your doctor if you have ever had:

vision changes or damage to your retina caused by an anti-malaria medication;
heart disease, heart rhythm disorder (such as long QT syndrome);diabetes;
a stomach disorder;an allergy to quinine;
liver or kidney disease;psoriasis;
alcoholism;porphyria (a genetic enzyme disorder that causes symptoms affecting the skin or nervous system); or
a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.