OTTAWA — As Canada takes part in a rapid global test of multiple drugs that might be promising for treating COVID-19, the country’s top public health official is warning not to prejudge outcomes and cautioning against the dangers of using unproven therapies.
One of the best-known of these is hydroxychloroquine, also known more simply as chloroquine, a long-standing staple treatment for malaria.
U.S. President Donald Trump caused a stir last week when he touted chloroquine as a possible treatment for victims of the novel coronavirus. Trump even decreed it has been approved by the Food and Drug Administration.
That turned out not to be true, but it did spark interest in the drug around the world.
Former Alberta Wildrose party leader Danielle Smith pronounced a few days later on social media that a French study had found “hydroxychloroquine cures 100 per cent of coronavirus patients within six days of treatment.”
Those doctors did find that the drug reduced detection of the virus in the upper respiratory tracts of patients treated with it compared to another group. But according to the Centers for Disease Control in the U.S., the study was small, not randomized, and did not look at the eventual outcomes of the patients, including deaths.
The authors acknowledged that some of the people treated with chloroquine were dropped from the study because they stopped taking it, because their conditions had deteriorated.
Smith has since apologized for the tweet, and any undue anxiety and frustration it may have caused.
In the wake of these promising claims about the drug, Canadian drug company JAMP Pharma Group announced plans Monday to donate one million doses to Canadian hospitals as a treatment for COVID-19.
That move sparked a stern warning from the country’s chief public health officer, Dr. Theresa Tam.
“People have to be really, really careful about this. Don’t do it,” Tam said in a briefing Monday.
The CDC said there is no available data from randomized clinical trials to inform the use of hydroxychloroquine against the novel coronavirus.
Using untested medication might not only be ineffective against COVID-19, it could also be dangerous, as all drugs come with side effects, Tam said.
“We need the evidence before you can provide medication to people,” Tam said.
“It is absolutely essential that you do science based treatment.”
Earl Brown, an emeritus professor of virology with the University Ottawa, said the drug works by lowering the acidity inside cells, making it more difficult for the virus to get in.
In a lab setting it works against several strains of virus, he said, but it hasn’t been proven for use in patients with COVID-19.
He said it should be used with caution under the best circumstances.
“The daily dose is around a gram, and a dangerous dose is around two grams,” he said, adding that you don’t typically want the optimal dose and the dangerous dose to be so close.
“It suggests a bit more risk,” he said, which can include death.
Other side effects include blurred vision, nausea, vomiting, abdominal cramps, headache, and diarrhea. Long-term use can cause vision loss. Other drugs have generally taken over from chloroquine as go-to malaria treatments.
Health officials in Nigeria, where chloroquine is more fairly widely available, have reported overdoses in the last few days.
Still, chloroquine is one of a “vast suite” of drugs identified by the World Health Organization that merits further testing, Tam said.
Canada is part of a massive global study started by the WHO to look into the use of chloroquine and other pre-existing drugs that could be repurposed as potential treatments for COVID-19.
The other treatments being evaluated are:
—Remdesivir, a drug that attacks some viruses’ ability to replicate
—Ritonavir/lopinavir, a drug pair developed to fight HIV
—Ritonavir/lopinavir combined with interferon-beta, which affects the body’s inflammation response
Tam said she’s impressed with the large-scale randomized clinical trials. She said it’s simple to sign patients up, and the results can be analyzed in real time.
This report by The Canadian Press was first published March 23, 2020.
Laura Osman, The Canadian Press
19 new cases of COVID-19 in the region – KitchenerToday.com
The health department in Waterloo Region is reporting 19 new cases of COVID-19.
It brings the local total to 148 confirmed and presumptive positive cases.
29 cases have been resolved, and the region is awaiting the results from over 400 tests.
As well, there are six outbreaks that have been declared at long-term care and retirement residences: Forest Heights Revera Long Term Care in Kitchener, The Village at University Gates in Waterloo, Saint Luke’s Place in Cambridge, Sunnyside Home in Kitchener, and Kitchener’s Highview Residences.
Chartwell Westmount Long Term Care Residence was added to the list on Friday morning.
The region’s first two deaths related to the virus were confirmed earlier this week.
The acting medical officer of health told a news conference on Friday that so far the pandemic has been manageable – which is the primary goal – to make sure our healthcare system can cope.
Dr. Hsiu-Li Wang says we are still into the “early phases of the pandemic”, but measures that have been taken to date have had an impact.
She also added there’s a “long road to travel,” in the fight against COVID-19.
You can find more statistics on the region’s website.
Ontario now has over 3,200 cases.
Coronavirus: Phone data shows Canadians avoiding restaurants, transit, stores, offices – Global News
In mid-March, Canada started to shut down in response to the new coronavirus.
It was visible all around us, as schools and offices emptied.
And it was also visible to Google, as location data sent by our phones showed a quick and profound change to our way of life.
Starting in about the second week in March, Canadians’ phones started spending less time in workplaces, on transit and in retail stores, and more time at home, our phones told Google.
The data showed that we also started shopping much less than normal. The reduction was about 60 per cent for destinations like restaurants and movie theatres, but only about 35 per cent for grocery stores and pharmacies.
“It’s less appealing than before to go grocery shopping,” says Dalhousie University professor Sylvain Charlebois. “Most grocery stores, especially during peak hours, you have to wait outside. You go in, and you feel that pressure of doing as much as you can in an allotted time.”
Coronavirus outbreak: Is Canada considering using phone tracking to enforce social distancing?
“Because of lineups, because of what’s been happening with online grocery shopping, people are actually forced to plan. If you have to plan, you don’t have to show up to the grocery store as often.”
Restaurants have been only allowed to serve customers takeout food in much of the country. To the extent that people use that option, they — and their phones — are spending much less time in restaurants than if they sat down for a meal.
“You show up at the counter, you’re trying to physically distance yourself from everyone else, and you want to get out as soon as possible. You’re not going to have a chat or anything like that. You’re just going to leave.”
Data in Google’s reports come from users who enabled Google’s “Location History” feature on their devices. The company said it adopted technical measures to ensure that no individual could be identified.
Google cautions that the accuracy of location tracking and their ability to put places into categories (like knowing that the place your phone is in is a grocery store) varies from region to region, so the company discourages using the data to compare countries with each other.
The data shows Canadians spending 16 per cent less time in parks than they did in mid-February, but this data is harder to interpret.
The coronavirus has changed how Canadians use outdoor space, but in contradictory ways.
On the other hand, public health officials say it’s fine to take walks outside, so long as people practise social distancing from people they don’t live with. And with many other outlets for spare energy closed off, there isn’t a whole lot else to do.
Also, the weather is much more inviting than it was in mid-February, confusing the data somewhat.
Here’s how patterns of daily life have changed in Quebec, at least so far the hardest-hit province:
On a global scale, the analysis of location data from billions of Google users’ phones is the largest public dataset available to help health authorities assess if people are abiding with shelter-in-place and similar orders issued across the world to rein in the virus.
The company released reports for 131 countries, including Canada, with charts that compare traffic from Feb. 16 to March 29 to retail and recreational venues, train and bus stations, grocery stores and workplaces with a five-week period earlier this year.
Google said it published the reports to avoid any confusion about what it was providing to authorities, given the global debate that has emerged about balancing privacy-invasive location tracking with the need to prevent further outbreaks.
The data often correlated with the severity of outbreaks and the harshness and breadth of orders imposed by governments.
Italy and Spain, two of the hardest-hit countries, both saw visits to retail and recreation locations such as restaurants and movie theaters plunge 94 per cent. The United Kingdom, France and Philippines had declines of more than 80 per cent while India, which went into a sudden 21-day lockdown on March 25, was also notable at 77 per cent.
Why contact tracing is so important for tracking the coronavirus
In the United States, where state responses have varied greatly, and in Australia, where good weather initially prompted many people to go the beach before social distancing measures were ratcheted up, the drops were less steep at under 50 per cent.
In contrast, in Japan and Sweden, where authorities have not imposed harsh restrictions, visits to retail and recreation sites fell by roughly only a quarter. While in South Korea, which has successfully contained a large outbreak through aggressive testing and contact tracing, the decline was just 19 per cent.
The data also underscores some challenges authorities have faced in keeping people apart. Grocery store visits surged in Singapore, the U.K. and elsewhere as travel restrictions were set to go into place.
The data also underscores how the mood of people around the world has shifted. In New Orleans, during its annual Mardi Gras celebrations Feb. 16-25, which has with hindsight been criticized for helping spread the virus, there were off-the-chart increases in traffic to transit stations, parks and businesses.
But three weeks later in Dublin, heart of the St. Patrick’s holiday celebrations, traffic was down at retail and recreational venues as the country ordered big events cancelled.
Why contact tracing is so important for tracking the coronavirus
Google declined to comment on whether it has received any legal requests to share more detailed data to help with efforts to tackle the pandemic.
Facebook Inc., which like Google has billions of users, has shared location data with non-governmental researchers that are producing similar reports for authorities in several countries. But the social media giant has not published any findings.
With files from Reuters
© 2020 Global News, a division of Corus Entertainment Inc.
New study from UBC researcher outlines pathway toward blocking COVID-19 virus – CBC.ca
The University of British Columbia announced Thursday that an international team led by Dr. Josef Penninger has found a potential drug that helps block infection from the virus that causes COVID-19.
Penninger, a biomedical researcher from Austria, is a professor in UBC’s faculty of medicine and director of the Life Sciences Institute there.
His study published April 2 in the peer-reviewed journal Cell focuses on a protein on the surface of human cells which is a key receptor for the spikes of glycoprotein characteristic in the novel coronavirus that causes COVID-19.
The study provides direct evidence that a protein called APN01 (human recombinant soluble angiotensin-converting enzyme 2 – hrsACE2) — is useful as an “antiviral therapy” for the novel coronavirus, say its authors, because the virus binds to it rather than a cell wall.
Penninger has been working for decades to shine a light on cellular doorways, or receptors, that allow viruses entry into human organs. He’s now turned to the virus that causes COVID-19.
“This virus hits the good guy and gets rid of the good guy, and that’s why this virus is really dangerous because we lose protection of multiple tissues,” said Penniger in a telephone call from Austria where he is stuck because of the global lockdown to stop the disease’s spread.
There are now more than one million cases of COVID-19 worldwide and tens of thousands are dead. As the virus spreads so does the intense search for treatments, as there are no tested antiviral therapies yet.
Penninger has split his life between Vancouver and Vienna since 2018 and his Arnold Schwarzenegger-style accent sounds raspy after months of working 19 hours a day.
It was Penniger’s passion for the natural world that led him to the discovery of the receptor at the heart of his current research, while he was studying fruit flies in a Toronto university lab 21 years ago.
“I love fruit flies. … I’m totally obsessed with nature,” he said. “The virus, if you look at it, it’s beautiful.”
He and colleagues at the University of Toronto and the Institute of Molecular Biology in Vienna conducted earlier work on the same receptor using the SARS virus, which is also a coronavirus.
“This virus is a brother or sister of the SARS virus,” said Penninger.
Human drug trials begin soon
APN01 is scheduled to begin clinical trials in Europe, according to the UBC news release.
Penninger said he twigged that his drug might be able to help back in January when a Chinese scientist published the genetic sequence of the novel coronavirus and he saw the similarity to SARS.
So far, his team’s latest research related to COVID-19 has been conducted on cells and engineered human tissue in a laboratory setting.
‘Promising’ say experts
Infectious disease physician and researcher at the University of Toronto, Isaac Bogoch, said the drug is interesting, but it will take time before it’s available even if it pans out in upcoming human trials.
“This is seen as one of the crucial pathways for COVID-19. This is clearly a big step in the right direction,” said Bogoch.
Arthur Caplan, founding head of the Division of Medical Ethics at New York University’s School of Medicine in New York City, said in an email the leap from a laboratory to the real worlds is huge.
“Very interesting. But, still a long way from proof of clinical safety or efficacy. Many things fail that look promising in a dish.
“Organized, controlled human testing is still very much needed before giving this to anyone.”
The former head of the Centre For Immunization and Respiratory Infectious Diseases with the Public Health Agency of Canada agrees.
“It looks like a promising drug; however, the real test will be what happens in humans … whether the dose that might inhibit the virus is achievable in humans and not too toxic to them,” said Dr. John Spika in an email.
The research was supported, in part, by federal emergency funding aimed at accelerating testing and development of potential cures or treatments to help deal with the outbreak, said UBC.
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