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Are anti-malaria drugs really a game changer for coronavirus patients? – Firstpost

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The novel coronavirus ravaging the planet currently has no cure. The virus, which evidence suggests originated in a wet market in Wuhan, China, belongs to the same coronavirus family which caused SARS (severe acute respiratory syndrome) in 2002 and is attributed to 15% of flu cases. The SARS-CoV-2 strain which causes COVID-19, however, has never been seen before which means that no therapy has been developed specifically for it. As stated by the WHO, currently no treatment or cure directly addresses COVID-19 – all medical intervention is currently focused on easing and fighting symptoms. Developing new drugs is a technological and bureaucratical task which can take years – but the world needs answers right now. 

Representational image. Getty Images

Previously developed drugs, among them broadspectrum anti-virals, HIV drugs, and those developed for Ebola and SARS have seen a surge of interest and clinical trials are underway to gauge their effectiveness in treating COVID-19.

Interestingly, anti-malaria drug chloroquine, and its derivative hydroxychloroquine, has entered the fold as well. President Trump insists that it could be a game-changer, and several countries, including India as of yesterday, have given a nod to the drug. 

What is the evidence in favour of the drugs?

The fact is that evidence so far is limited and based on anecdotal reports from doctors combating the disease. Many clinical trials are currently underway, and it will be a while before any consensus emerges from them. 

A highly cited French study is being used to prop up chloroquine’s effectiveness. The unblinded, 25 participant study showed that those treated with the drug had a decrease in viral load; positive cases went from 90% to 25%. Supplemented with azithromycin, a broad-based antibiotic, the decrease in viral load was even greater. 

However, this is a highly flawed study; the sample size is tiny, and an examination of supplementary data shows that only 4 participants underwent PCR testing to assess viral loads – the rest of the data was qualitative. A poorly designed, small study is hardly the benchmark for basing national drug policies. 

Previous in-vitro studies have shown that chloroquine and hydroxychloroquine reduce the spread of the virus strain that caused SARS (SARS-CoV-1). Since SARS-CoV-1 and SARS-CoV-2 are very similar, these findings have raised hopes in the medical community. 

However, Dr Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases who appears regularly alongside President Trump, has maintained that the evidence for the drug’s effectiveness remains unconvincing. While it may play a role in treating COVID-19, clinical trials, which are currently underway, will have the final say in the matter. 

What is chloroquine?

Chloroquine is an oral prescription drug, derived from the naturally occurring quinine, which was discovered in 1820. Quinine is the active ingredient in antimalarials and has helped to dramatically reduce the number of malaria-related deaths. Tonic water has some quinine in it – it has been suggested that the combination of gin and tonic was consumed widely in colonial India to ward off the mosquito-based infection. 

Hydroxychloroquine is used for treating lupus and rheumatoid arthritis. 

Why may the drug be useful against COVID-19? Previous research with SARS-CoV has shown that the drug inhibits the ability of the virus to replicate. 

Health officials urge not to self medicate

At least three cases of overdoses have been reported in Nigeria and one in the US as well. While the advantages of the drugs are that they are easily available, cheap and well-tolerated, side effects do exist – such as nausea, altered state, and diarrhoea. Dangerous interactions have also been noted in medical literature, so it is advised to not take the drug on your own volition. 

In approving hydroxychloroquine, ICMR emphasized that it was only for health workers and caregivers treating sick family members. 

While times are unpredictable and scary, it is always a bad idea to self-medicate, especially when prescription drugs are involved. Until stronger studies and clinical trials are able to corroborate current suspicions, preventive measures remain the best course of action.

For more tips, read our article on Coronavirus.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health

Updated Date: Mar 24, 2020 16:25:07 IST

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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

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