Are old malaria drugs really the COVID-19 'game changer' some people believe? Not so fast, warn health officials - National Post | Canada News Media
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Are old malaria drugs really the COVID-19 'game changer' some people believe? Not so fast, warn health officials – National Post

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U.S. president Donald Trump considers them a COVID-19 “game changer,” his top infectious diseases advisor says the evidence is flimsy, while ethicists worry pouring millions of the tablets into hospitals is a long shot that could make people sicker.

Two old anti-malaria medications are being pushed as potential treatments in the scramble to find something, anything, to neutralize the virus causing COVID-19.

Already, U.S. media are reporting a run on the drugs since Trump said they hold “tremendous promise.” In Nigeria, two people have overdosed after self-medicating with the pills, and Lagos State health authorities are urging against massive consumption of the tablets chloroquine and hydroxychloroquine.

There are concerns people could start hoarding the pills, the way many did with the anti-viral Tamiflu during the bird flu fright in 2005, and self-medicate in the hope of staving off the virus.

“You should not take medication without the scientific evidence,” Dr. Theresa Tam, Canada’s chief public health officer, said Monday. “These drugs are not without side effects. In fact, they have quite significant side effects.

“People have to be really, really careful about this. Don’t do it.”

One million doses of hydroxychloroquine are being donated to Canadian hospitals by Quebec-based JAMP Pharma Group. The company says its offer is twofold: to make the drugs available for people hospitalized with COVID-19, and to avoid a shortage of the pills for people who already need them to survive. Hydroxychloroquine, a less toxic version of chloroquine, is a common generic drug that’s used to treat lupus and rheumatoid arthritis, and lupus organizations are already reporting people are having problems filling prescriptions because of Trump’s exuberance. Those living with lupus are immune-compromised, putting them at greater risk of COVID-19.

Both drugs have shown activity against the virus that causes COVID-19 in vitro, meaning in tissue cultures. But some papers suggest the drugs can increase viral replication. “That is to say it can hurt you potentially,” said Dr. Anand Kumar, a critical care doctor at Winnipeg Health Sciences Centre, who is also trained in infectious diseases.

“There is the odd study that says these compounds could help, but there are just as many that fail to show any benefit and others that go the other way and suggest potential harm, Kumar said.

“Absolutely, it should be studied in a randomized trial, I have no problem with that. But the idea that people should start taking chloroquine because it’s a game-changer, I think is just nuts, frankly.”


Researchers at the University of Minnesota work with coronavirus samples as a trial begins to see whether malaria treatment hydroxychloroquine can treat COVID-19, March 19, 2020.

Craig Lassig/Reuters

The drug is already being given to hospitalized COVID-19 patients on an “uncontrolled basis” in multiple countries, including the U.S., according to the U.S. Centers for Disease Control and Prevention. It’s one of several drugs under investigation in a mega trial sponsored by the World Health Organization — Solidarity — that’s looking at whether existing drugs can be repurposed to fight COVID-19.

But there’s no agreement on optimal dosing, and while the antimalarials are generally well tolerated in the healthy, it may not be true for the frail and the sick.

“It would be much better if the government could come up with a policy that said, for dying or severely compromised patients we will try some agents and we’ll do it in an organized manner so that we can figure out if anything helps and we don’t cause a slew of unexpected side effects,” said Dr. Arthur Caplan, head of the division of bioethics at NYU Langone Medical School. Caplan says the data from China is hyper-weak and “pouring zillions of pills into the world’s population achieves nothing but risking side-effects, at present.”

Outside of randomized controlled trials, several of which are underway in Canada, including to test whether hydroxychloroquine could prevent infections in frontline health-care workers, Kumar said the pills might be used as “salvage” therapy, when doctors have nothing left. “But frankly, the probability of it being useful in that situation is extremely low, slim to zero.”

In every single pandemic, everybody has hundreds of solutions they think might work

One theory is that the drug may dampen down an over-exuberant cytokine storm. Normally when exposed to a virus, the body stimulates the immune cells to produce chemicals to throw off the invader. But the cells can become so hyper-stimulated they start attacking the self, your own tissue.

Other contenders include Gilead Sciences’ Remdesivir, which Trump also mentioned last week. The drug has been given to hundreds of infected people in the U.S., Europe and Japan on an emergency access basis. Demand has flooded the company’s emergency treatment access system, which was never set up to handle a pandemic. The company has temporarily halted access while it pivots to a new system.

“If it works well, and that’s a big if, that could be a game-changer,” Kumar said. However a similar drug was used years ago in SARS and failed, because toxicity was too great.

“In every single pandemic, everybody has hundreds of solutions they think might work,” Tam said. “We can’t rule out the fact they don’t work, but let’s prioritize the top ones that world scientists think are important and do proper trials.”

• Email: skirkey@postmedia.com | Twitter:

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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.

The Canadian Press. All rights reserved.

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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.

The Canadian Press. All rights reserved.

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