Chengdu, China – As the deadly coronavirus spreads to every continent except Antarctica and the death toll climbs above 3,000, scientists and doctors around the world are rushing to find a way to cure the disease, COVID-19, before it infects more people and poses an even bigger challenge to global health.
The progress made by the Chinese health workers in treating the disease offers hope: more than half the patients in China where the outbreak first originated late last year have reportedly been discharged, reducing the remaining number of confirmed cases to less than 35,000.
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China has been touting the recovery rate and offering to provide medical help to other countries in need. Foreign Minister Wang Yi called his counterparts in the hard-hit countries of Italy and Iran at the weekend to offer assistance.
Most of those who have recovered only suffered mild symptoms of the disease, but the mortality rate among the elderly and those whose infection progresses to the critical stage remains high.
That remains a significant challenge for medical workers treating COVID-19 patients, according to a doctor working at one of the leading hospitals in Wuhan who requested anonymity because the hospital management had banned its medics from talking to the media.
The overall mortality rate among the infected is approximately 2.3 percent in China. However, according to a study on early samples that was published in The Lancet, a UK-based medical journallast week the disease killed 61.5 percent of the critically ill.
“The normal procedure of treating pneumonia, such as using ventilators, putting the patients on antiviral and antibacterial treatment and using steroids, has been proven relatively ineffective in treating patients reaching the last stage of the disease,” the doctor told Al Jazeera.
A picture made available by the National Institutes of Health (NIH) shows a transmission electron microscope image of SARS-CoV-2 – also known as 2019-nCoV, the virus that causes COVID-19 – isolated from a patient in the USA. Doctors in China say the virus does not respond to traditional pneumonia treatments [NIAID- RML/National Institutes of Health via EPA]
“The unsatisfactory supply of ECMO machines and effective drugs contributed to the high mortality rate,” the doctor continued, referring to the machine that provides cardiac and respiratory support to patients whose heart and lungs are failing.
Stopping disease progression
Such concerns have been echoed by China’s National Health Commission.
Officials have stressed the importance of reducing the mortality rate among those who are more severely affected, usually people who are older or who have existing health problems such as heart disease, diabetes and high blood pressure.
“One of the main things we are trying to do at this moment is to reduce the number of patients whose conditions progress to the critically ill stage and improve the survival rate of those who have already reached that stage,” said the doctor. “To do this, we need to understand which drugs would be helpful.”
There are, so far, 293 clinical trials on various existing drugs’ ability to fight off the novel coronavirus, according to the latest data on Chinese Clinical Trial Registry. Despite the usual logic of “more trials, better chance of success,” some experts have voiced concern over the sheer number of trials and how that might actually impede the research process.
“Frankly, it’s a bit ridiculous that so many clinical trials are continuing, especially given the fact that the drugs used in some trials have practically no possibility of being effective in treating this disease,” a doctor at a leading research institute in Beijing who requested anonymity told Al Jazeera.
“Consequently, it leaves less room for trials that actually have a shot at effectively treating the patients and indirectly slows down the process of finding an actual cure.”
Although there are currently no drugs that have allowed scientists to conclusively determine their efficacy against the disease, among all the 293 drugs or combination of drugs being tested, one has stood out: Remdesivir, an antiviral drug produced by the US-based pharmaceutical company Gilead Sciences and aimed at fighting the Ebola virus.
“There is only one drug right now that we think may have real efficacy and that’s Remdesivir,” the World Health Organization or WHO Assistant Director-General Bruce Aylward said at a press briefing in Beijing after visiting the outbreak’s epicentre in Wuhan.
The drug made its debut in the fight against COVID-19 at the beginning of last month when a paper reporting that Remdesivir was used in the treatment of the first discharged case in the US was published in The New England Journal of Medicine.
Two days later, the China-Japan Friendship Hospital in Wuhan also started its clinical trial and the outcome is expected in April, which could offer doctors a more definite answer to the medicine’s efficacy.
Plasma donations
Gilead also announced on February 26 the initiation of two Phase 3 clinical studies to evaluate the drug’s safety and efficacy, which would include 1,000 infected adults.
Researchers around the world are working to find effective treatments and vaccines as the coronavirus spreads to nearly all continents of the world [Matteo Corner/EPA]
Apart from Remdesivir, doctors in China are also putting a few other contenders into clinical trials, including chloroquine phosphate, an anti-malaria drug, after finding “apparent efficacy” in the treatment of COVID-19. Earlier, anti-HIV drugs, such as Lopinavir or Arbidor, were also included in China’s diagnosis and treatment plan, which has been updated six times since the outbreak began.
None of these drugs has yet been proved to be universally applicable to every patient battling the novel coronavirus.
This problem also extends to the plasma extracted from the donated blood of those who have recovered. Earlier this month, doctors confirmed the usage of the plasma had had some use in fighting the disease, but experts remain cautious.
“Any drug or supplement options only constitute part of the entire treatment plan, so the idea of injecting the plasma to the patients yielding immediate results can only be seen in movies,” said Dr Zhang Wenhong, the leader of a medical team sent from Shanghai to Wuhan to help tackle the outbreak. “The result is limited, and the usage of plasma will probably reduce the time needed to treat the disease from five to 10 days to three to five days.”
Other are also cautious on treatments, preferring to wait until the outcome of the trials is known.
“It’s unclear how effective these drugs will be and whether we need some new drugs to effectively curb the progression of the disease, so only clinical trials can tell,” said Dr David Ho, a prominent Columbia University professor who made significant contributions to the development of anti-HIV/AIDS drugs.
Apart from making use of existing drugs, the development of a vaccine has also been put under the spotlight since a group of scientists in Shanghai first released the viral genome of the virus early in January.
Finding a vaccine
Despite a concerted effort from across the globe, experts believe it will take at least a year for any vaccine to be available to the general public.
Moderna, a biotech company based in the US, is leading the global race and released the first batch of a vaccine against the novel coronavirus for human use on February 24. In a statement, the company said the vials of mRNA-1273, the official name for the vaccine, had been shipped to the National Institute of Allergy and Infectious Diseases (NIAID) to be used in the Phase 1 study in the US.
The clinical trials will first take place at a research centre in Seattle among 45 volunteers and are expected to run 13 months with the main objective being to detect if the vaccine will trigger an immune system response and whether it is safe.
After Phase 1, clinical trials to actually test the vaccine’s ability to resist the novel coronavirus will take place.
“The earliest efficacy trial will take an additional six to eight months, so although it is the fastest we have gone from getting the sequence of the virus to a trial, it still would not be applicable to the current epidemic unless this goes on for another year or year and a half,” Anthony Fauci, the director of NIAID, said at a news conference held by US President Donald Trump last week.
In addition to the long process of developing a vaccine from scratch, researchers also voiced concern over its fate: many suspect its development could be halted if the outbreak begins to taper off, as happened with SARS, the last large outbreak to originate in China.
“We never had a chance to test the SARS vaccines because there was no need to continue the development at that time,” Dr Zhong Nanshan, a leading pulmonary disease expert in China, said. “However, I do think it’s important to continue the effort in this case because of the fast-spreading nature of the virus and the subsequent unpredictability on how long this epidemic will last.”
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.
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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