The drug hydroxychloroquine, which has been the subject of heated debate as a potential treatment for COVID-19, was not effective in preventing the disease in Canadians and Americans at high risk, according to the first gold standard clinical trial.
In Wednesday’s issue of the New England Journal of Medicine, medical researchers reported on testing the use of hydroxychloroquine in 821 adults throughout the U.S. and in Quebec, Manitoba and Alberta. The participants did not have symptoms but were exposed to someone with confirmed COVI9-19 in a health-care or household setting.
Hydroxychloroquine is often used to treat autoimmune diseases such as lupus. U.S. President Donald Trump said he’s taken hydroxychloroquine, although he’s not tested positive for the coronavirus infection. No studies have proven this drug or any others are effective against COVID-19.
The exposures were all considered high risk, because the participants were less than two meters away from a confirmed case for more than 10 minutes without wearing a mask or face shield. The goal of the randomized trial was to see if hydroxychloroquine could prevent symptoms of infection, known as postexposure prophylaxis, compared with taking a sugar pill.
“In this trial, high doses of hydroxychloroquine did not prevent illness compatible with COVID-19 when initiated within four days after a high-risk or moderate-risk exposure,” the study’s authors wrote.
Gold standard method
Dr. Emily McDonald, a physician at the Research Institute of the McGill University Health Centre, co-authored the randomized control trial in which half of participants were randomly assigned to the drug and half to the placebo without investigators knowing to avoid bias in interpreting any symptoms or their resolution.
McDonald called it the gold standard method to have the best evidence to support how to prevent spread of COVID-19.
“When we politicize the drug and we stop studies early for reasons that are perhaps not entirely valid, we risk never answering the question properly because the enrolment for the studies drops off,” McDonald said.
“There are also hundreds of patients that have contributed their data to randomized trials because they also felt a responsibility to help the scientific community answer this question.”
Overall, 107 of 821 of participants developed COVID-19 based on a swab or compatible symptoms during 14 days of followup.
No deaths occurred
Of those who received hydroxychloroquine, investigators said 49 developed the disease compared with 58 in the placebo group, a difference that could simply be random.
Two patients were hospitalized, one in each group. No deaths occurred.
Medication side-effects such as nausea and abdominal discomfort were more common for patients taking hydroxychloroquine compared to placebo (40 per cent versus 17 per cent), but no serious treatment-related adverse reactions were reported, including any heart arrhythmia.
Earlier on Wednesday, the World Health Organization announced it was resuming the hydroxychloroquine arm of its Solidarity trial into potential treatments for COVID-19 following a pause to check for any potential safety concerns such as heart problems.
The Solidarity trial includes participants and researchers in Canada.
Previous studies of hydroxychloroquine were observational in design, which greatly increases the potential for bias when managing patients compared with a well conducted, randomized clinical trial.
Health officials report new COVID-19 case in New Brunswick related to travel – NiagaraFallsReview.ca
FREDERICTON—Public health officials in New Brunswick are reporting one new case of COVID-19 today.
The new case involves a person in their 40s in the Fredericton area.
They say it is a travel-related case, and the individual is self-isolating.
Dr. Jennifer Russell, the province’s chief medical officer of health, says the number of confirmed cases in New Brunswick is 166, and 163 have recovered.
There have been two deaths, and there is one active case.
Russell says people are reminded to maintain physical distancing and public health guidelines for good hygiene.
WHO says airborne transmission of coronavirus can occur during medical procedures – Financial Post
The World Health Organization (WHO) said on Thursday airborne transmission of the novel coronavirus can occur during medical procedures that generate aerosols.
The agency said some outbreak reports related to indoor crowded spaces have suggested the possibility of aerosol transmission, combined with droplet transmission, such as during choir practice, in restaurants or in fitness classes. (https://bit.ly/2Ck7QBo)
The WHO on Tuesday acknowledged “emerging evidence” of the airborne spread of the novel coronavirus, after a group of scientists urged the global body to update its guidance on how the respiratory disease spread. (Reporting by Ankur Banerjee in Bengaluru; Editing by Shounak Dasgupta)
Nova Scotia reports zero new cases of COVID-19 – CBC.ca
Nova Scotia’s chief medical officer of health says he never should have approved a plan to allow three executives from Irving Shipbuilding to travel to America to meet with contractors and then return to work without having to self-isolate for 14 days.
The executives had approval from Dr. Robert Strang’s office ahead of taking the trip. It included strict criteria they had to follow upon their return, including being tested for COVID-19 immediately. But when workers at the Halifax shipyard learned of the exception and complained to Strang’s office, he revisited the situation.
On Wednesday, he ordered the three executives home to self-isolate for 14 days and said the company could no longer engage in business travel to America. An Irving spokesperson said Wednesday that the executives complied with all rules attached to the exception.
During a COVID-19 briefing on Thursday, Strang said his review didn’t include whether any of the executives from Irving violated the guidelines established as part of their exception. But he said upon reviewing the plan a second time, it was clear he shouldn’t have signed off on it in the first place.
“Even though safety requirements were part of my approval, the meetings could have been done virtually,” Strang said. “Upon return, the individuals can isolate at home and still manage to work.”
Exceptions will continue to be granted
Strang couldn’t say how many exceptions his office has granted, but said he’s approved plans for workers to come into the province to do work that requires specialized skills and will continue to do so as deemed appropriate. Each request is judged on its own merits and Strang said his office has turned down a number of requests.
“I’ve even turned around a planeload of workers who were in the air, about to land in Nova Scotia because I couldn’t approve the plan because it didn’t provide the right level of COVID safety,” he said.
In evaluating requests for exceptions, Strang said the lens he views things through is “appropriate protection for [the public’s] health and safety. He would only review plans if people raise issues about them. Although it’s not his job to inform employees when a a workplace receives an exception, Strang said employers should.
“The expectation would be that the company [receiving the exception] would have the appropriate communications so people are aware and they can understand what protocols are being put in place to keep them safe on the worksite,” he said.
His office reviews many plans and requests and Strang said the response won’t always be perfect.
“I’m not going to get everything I do, of the hundreds of decisions I make every week on this, I will acknowledge that I may not get everything exactly right,” Strang said.
“But I’m always happy to go back and learn from my mistakes and certainly be looking more intensely about how we make sure that we focus only on essential travel into the province where there is no other alternative.”
4 active cases
Nova Scotia reported zero new cases of COVID-19 on Thursday, with four active cases remaining in the province.
The microbiology lab at the QEII Health Sciences Centre completed 398 tests on Wednesday and continues to operate 24 hours a day.
To date, Nova Scotia has had 56,227 negative test results, 1,066 positive cases and 63 deaths caused by the coronavirus. One person who previously tested positive for COVID-19 is still in hospital, but the case is now considered resolved.
Proper health and safety protocols
Strang encouraged people to continue washing their hands frequently, keeping surfaces clean and practising proper cough etiquette by coughing into their sleeve or elbow.
He continues to strongly recommend people wear masks when they are in public places where physical distancing isn’t possible and had meetings planned with his federal counterparts Thursday to discuss mask protocol. People should bring a mask with them whenever they leave home, the way they take their keys or wallet, said Strang.
Premier Stephen McNeil said he’s now wearing a mask when he’s indoors in a confined space or someone’s place of work.
“I’ve been out to dinner a couple of times this week [and] I wore a mask into that environment,” he said.
People with one or more of the following COVID-19 symptoms are asked to visit 811’s website:
- Fever (chills, sweats).
- Cough or worsening of a previous cough.
- Sore throat.
- Shortness of breath.
- Muscle aches.
- Nasal congestion/runny nose.
- Hoarse voice.
- Unusual fatigue.
- Loss of sense of smell or taste.
- Red, purple or bluish lesions on the feet, toes or fingers that do not have a clear cause.
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