The COVID-19 marathon, in reality it’s more of relay.

By Lisa Short

You could be forgiven for waking each morning to feeling overwhelmed that overnight you’ve missed a month’s worth of information about medical advances, vaccine development, infection and death rate statistics, lockdown, easing of lockdown, political and scientific bantering, alternative therapies and all things in between. You’d be right!  To ease the burden here’s a summary of some of the major developments.

A COVID-19 Vaccine

Globally, vaccine FOMO has now emerging as a key bargaining chip in pandemic diplomacy, with China, United States and United Kingdom flexing their investment muscles and intent to share, often dependent on the political mood of some of the most volatile world leaders in history. The UK Government has largely turned a nationalised marathon into a relay by handing the baton to Gavi when it holds the Global Vaccine Summit on 4th June 2020 aimed at mobilising resources to expedite vaccine development with equitable access.

The vaccine teams with the leader’s baton

  • There are 124 candidate vaccines in development globally
  • 10 vaccines designed to prevent COVID-19 are already being tested in people, and another 114 are in development.
  • A landscape list can be found at WHO or GAVI
  • Earliest expectation of vaccine for use is end of the year or January 2021
  • A vaccine will be a valuable tool in assisting in the reduction of spread of COVID-19.

CanSino [Beijing Institute of Biotechnology] 

  • Ad5-nCoV is a weakened common cold virus (adenovirus) genetically engineered to produce the COVID-19 spike protein.
  • Is at Phase 2 trial

Sinovac [Beijing China]

  • CoronaVac consists of a chemically inactivated version of the SARS-CoV-2 virus. This is a very traditional method of creating vaccines and one that historically has proved successful.
  • Is at Phase 2 trial which has already been found to protect monkeys from being infected with the coronavirus.
  • Discussing Phase 3 trials to take place in UK
  • Building a commercial vaccine production plant to manufacture up to 100 million doses of the vaccine per year.

Moderna [National Institute of Allergy and Infectious Diseases (NIAID) USA]

  • LNP-encapsulated mRNA vaccine works on the principle of having the immune system recognise the spike proteins the coronavirus uses to enter people’s bodies. It encodes the instructions for making a spike protein into a RNA molecule that can be injected into patients.
  • Is at Phase 2 trial

Oxford University/AstraZeneca  [United Kingdom]

  • A candidate vaccine, ChAdOx1 nCoV-19, is made from the ChAdOx1 virus, a weakened version of a common cold virus (called adenovirus) that causes infections in chimpanzees, genetically modified so that it is impossible for it to replicate in humans Genetic material used to make the spike glycoprotein, the protein that the coronavirus uses to penetrate people’s cells and gain entry to their bodies, is added to ChAdOx1. Researchers hope to make the body recognize and develop immunity to these spike proteins, therefore preventing the SARS-CoV-2 virus from entering people’s bodies.
  • In Phase 2 trial
  • Phase 3 planned

Ibuprofen as a Treatment for COVID-19 Respiratory Complications

  • A pioneering trial called LIBERATE as a collaboration between London’s Guy’s & St Thomas’ NHS Foundation Trust, King’s College London and the pharmaceutical organisation the SEEK Group has commenced in early June.
  • The trial is using a type of Ibuprofen called Flarin which has a separate composition than the standard version to protect the stomach
  • Researchers believe the anti-inflammatory properties of the drug could treat severe respiratory distress syndrome, in hospital admissions, by reducing inflammation of blood vessels and subsequent blood clotting.
  • This is a good example of how scientific information has evolved during this pandemic as more knowledge is developed. Initially at the onset of the pandemic, there were concerns that ibuprofen would aggravate the infection, but this has since been withdrawn. For simple symptomatic relief of fever, paracetamol is still the preferred option as it has less impact on the stomach.

Malaria Drug Hydroxychloroquine

  • The controversial drug Hydroxychloroquine has been tested and reviewed as a treatment for COVID-19 and does NOT save lives and is NOT a treatment for COVID-19.
  • The drug has immediately been removed from the University of Oxford’s UK’s Recovery trial, which ran one the world’s largest trials shows on the drug of 11,000 patients with Covid-19.
  • The trial results showed 25.7% of people taking hydroxychloroquine had died after 28 days. This compared with 23.5% who were given standard hospital treatment.

Madagascar’s artemisia-based tonic Covid Organics

  • There is as yet, no evidence Covid Organics is a cure for COVID-19. 
  • On 22 April, Rajoelinalaunched Covid-Organics, an artemisia-based herbal drink developed by the Malagasy Institute of Applied Research to allegedly prevent and cure COVID-19.
  • The tonic was tested onfewer than 20 patients. Data from the study has not been made available.
  • On 23 April the National Academy of Medicine of Madagascar (Anamem) released a statement that the effectiveness of Covid-Organics in preventing and treating Covid-19 had not been adequately tested.
  • WHO recognises that traditional, complementary and alternative medicine has many benefits and Africa has a long history of traditional medicine and practitioners that play an important role in providing care to populations. Africans deserve to use medicines tested to the same standards as people in the rest of the world. If therapies are derived from traditional practice and are natural, establishing their efficacy and safety through rigorous clinical trials is critical.
  • WHO is working with Africa and Madagascar for medicinal plants such as Artemisia annua that are being considered as possible treatments for COVID-19 to be rigorously tested for efficacy and adverse side effects.

The Scientific Advisory Group for Emergencies [SAGE]

There is only one government appointed SAGE  for the United Kingdom for reputable and credible information and who provides scientific evidence to the Government from its various expert groups.

Other breakaway and informal groups have taken on similar names and are not government authorised.

Role:
SAGE is responsible for ensuring that timely and coordinated scientific advice is made available to decision makers to support UK cross-government decisions in the Cabinet Office Briefing Room (COBR). The advice provided by SAGE does not represent official government policy.
Important:
Science is an evolution of thinking and discovery based on what is known at any point in time. Science does not have all the answers and nor do all scientists agree. Different perspectives and approaches are based on interpretation and research and all scientists expect their work to be peer reviewed and collectively over time to arrive at the best known conclusion. It is not infallible. Science and advice changes as we learn more. Wanting all the answers, regardless of how urgent it is, is not the same as having them or knowing them or even being able to discover them.