While waiting for coronavirus vaccine rollout and/or treatment! Part 1

While expecting Covid-19 vaccine rollout and/or treatment, there are several things governments, healthcare professionals, scientists, and citizens could do to limit further spread and loss of lives. The world is making progress, but we cannot become complacent! Governments need to be honest and transparent with their citizens and listen to experts. Scientists and healthcare professionals need to be willing to share information and experiences with their colleagues around the globe. It's time for some healthcare professionals like Pharmacists to step up and embrace other responsibilities. We are in this together!

Globally, efforts are focused on taking steps to contain the outbreak and forestall further spread. With confirmed COVID-19 cases worldwide nearly 110 million (and over 2.3 million deaths) and continuing to grow, scientists are pushing forward with efforts to develop vaccines and/or treatments to slow the pandemic and lessen the disease’s damage. The general consensus amongst scientists and experts in the field of pandemics is that some of the earliest treatments will most likely be drugs that are already in use for treating other conditions or are have been tested on other viruses. Several companies are also busy working to develop vaccines that would be used as a preventive measure against the disease.

Researchers are testing 67 vaccines at different clinical trial stages on humans, and 20 have reached the final stages of testing. Also, 89 preclinical vaccines are under active investigation in animals. Thirty-five vaccines are at the Phase 1 clinical trial stage, 26 at Phase 2, and another 20 at Phase 3. Four vaccines (by PfizerBioNTech, Moderna, Oxford-AstraZeneca and Sinopharm) are approved for full use, 6 vaccines have limited use/early use in some jurisdictions and 4 were abandoned after clinical trials. Until a master rollout plan is in place for Africa and other jurisdictions, the foremost effective strategy to stop illness is to avoid being exposed to the virus. It is known that the virus spreads mainly from person-to-person. In general, the more closely you interact with others, and the longer that interaction, the higher the probabilities of COVID-19 spread.

Drug development is typically described as a pipeline with compounds moving from early laboratory development to laboratory and animal testing to clinical trials in people (https://www.modernghana.com/news/1012484/clinical-trialshero-or-villain.html). It can take a decade or more for a brand-new compound to travel from initial discovery to the marketplace. A very high percentage of compounds never make it that far. This is one reason why medications being targeted as potential treatments for COVID-19 are drugs that exist already.

Apart from antiviral drugs and vaccines, researchers are carefully studying other treatment options, some supported by an interesting hypothesis:

Ibuprofen clinical test: the thought is predicated on ibuprofen’s anti-inflammatory qualities, which could help to ease breathing difficulties associated with the illness.

Interferon-beta: this protein is produced by the body during viral infections.

Applied: employed in treating autoimmune diseases and follicular lymphoma. The hypothesis is that applied can block cellular entry of the virus that causes COVID-19.

Monoclonal antibodies: These drugs trigger our immune system to attack the virus.

Convalescent plasma: this is plasma from people who have recovered from COVID-19 infection. The rationale is that their plasma contains antibodies that will attack this particular coronavirus.

Immune modulators – It has been observed that when some people get infected with the virus, their system goes into overdrive, releasing large amounts of small proteins called cytokines, which are associated with the severity of the infection. The most popular drug used to combat cytokine storm is the inexpensive corticosteroid dexamethasone

Stem cells: phase II/III clinical trials are currently ongoing for potential somatic cell treatment.

While the main targets are looking at the development of new treatments and/or vaccines for COVID-19, improvements in how Physicians take care of patients using the prevailing technology are also crucial. We need more testing and contact tracing, mandatory masks under all circumstances, hand sanitisers, more personal protective equipment and if necessary, a ban on non-essential travels. Hand sanitisers aren't a substitute for handwashing, but a necessary substitute when a chance for the latter isn't available. Neither are face shields a substitute for face masks. There is an absolute need for evidence-based but flexible standard treatment guidelines (STGs). Fortunately, most countries do have a robust STG for COVID-19.

The general public should be sensitized and educated on the potential need for volunteers for clinical trials.2 Also, COVID-19 recovered patients must be educated and sensitized to become convalescent plasma donors to help the severely and critically ill patients. Our researchers/healthcare professionals must keep and document all relevant data on the virus and make these available through publications for the advantage of their colleagues in other jurisdictions. Most healthcare professionals are doing an exquisite job with limited resources, and these cannot go unnoticed.

Governments must listen to the experts and not solely be thinking about the impact of COVID-19 on the economy! They must be proactive in educating and engaging anti-vaxxers and roll out educational programs against vaccine conspiracy propagation from the fear of autism development in developed countries to fear of intentional reproductive health decline in developing countries. Unfortunately, conspiracy theories spread faster than the virus! Governments must provide frequent and transparent communications to the general public, and embark on community engagements, so the public can maintain trust within the system to safely meet their essential needs. Such activities ensure that people will seek care when appropriate, and adhere to public health advice.

Governments must be proactive so their citizens aren't left behind when any treatment/vaccine becomes available. They ought also to plan appropriately on effective and efficient ways to roll out treatments/vaccines seamlessly once they become available. The COVID-19 pandemic is straining health systems worldwide. The increasing demand for health facilities, workers, and services is a threat to health systems. This situation could completely shut down some already weak and fragile systems.

Victor Wutor

PhD, MBA, MSc, B.Pharm (Hons)

vcwutor@gmail.com

Lethbridge, AB.

CANADA