HCQ for asymptomatic Covid warriors

With new Covid infections peaking to record levels for the fifth day today, the Indian Council of Medical Research expanded the use of hydroxychloroquine (HCQ) as a preventive drug in all asymptomatic Covid warriors in containment zones and asymptomatic health workers in all hospitals.
The last advisory on HCQ had restricted its use among asymptomatic health workers in care of Covid patients and asymptomatic contacts.

As cases surged to 6,654 in 24 hours, taking the total disease load to 1,25,101 with 3,720 deaths, the ICMR said HCQ should now be given to “all asymptomatic healthcare workers involved in containment and treatment of Covid-19; asymptomatic healthcare workers working in non-Covid hospitals; asymptomatic frontline workers deployed in containment zones and paramilitary and police personnel involved in Covid-19 related activities”. “A study of 334 healthcare workers at AIIMS, out of which 248 took HCQ prophylaxis in New Delhi, showed that those taking it had lower incidence of infection than those not taking it,” the ICMR said.

Who all can have the drug
All asymptomatic healthcare workers, frontline workers, paramilitary and police personnel involved in Covid-related activities and asymptomatic household contacts of confirmed cases.

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Could the Heartburn Drug Famotidine Help Fight COVID-19? Here's What We Know Right Now

Scientists continue to look into potential treatments for COVID-19, and the latest to be touted is famotidine, which is the active ingredient in the popular over-the-counter heartburn medication Pepcid.

Kevin Tracey, MD, president of Feinstein Institutes for Medical Research at Northwell Health in New York City, told Science that preliminary results of a clinical trial of famotidine could be ready in the next few weeks. The trials have been underway since April 7 at Northwell, one of the largest hospital systems in New York City. As of April 25, 1,174 patients—including 187 who were critically ill—have taken part.

Dr. Tracey said that earlier in the outbreak, doctors who worked with coronavirus patients in Wuhan, China discovered that although one in five COVID-19 patients over the age of 80 died, many of those who survived had been taking heartburn meds. Studies on the Chinese patients have not yet been published, but the findings were enough to encourage US scientists to explore famotidine’s potential. 
Trialling an OTC drug intended to relieve heartburn might seem a bit out of left field, considering that COVID-19 is a disease affecting the lungs and airways. But Dr. Tracey pointed out in the Science interview that there are “many examples in the history of medicine where a drug that was designed for one purpose turns out to have an effect in another disease.”

The case for trialling famotidine was bolstered by a computer model used by Florida-based Alchem Laboratories to compile a list of existing drugs that might fight coronavirus. Famotidine showed up near the top of the list, and the company received a $20.7 million contract to conduct the trial at Northwell from the US Biomedical Advanced Research and Development Authority (BARDA).

According to Dr. Tracey, famotidine was flagged because—in theory—the drug is structured in a way that could prevent the coronavirus from replicating, in the same way that protease inhibitors, which are used to treat HIV, stop that virus from replicating.

“Famotidine is a histamine receptor blocker,” Solomon L. Lerer, MD, a gastroenterologist in Aventura, Florida, tells Health. Specifically, the compound blocks the H2 receptors that play a role in producing acid in the stomach, which can lead to heartburn, a main symptom of gastroesophageal reflux disease (GERD). Famotidine is considered a relatively safe drug, Dr. Lerer adds, but side effects can include diarrhea, muscle aches, and headaches. 

“Famotidine is most commonly used to treat gastroesophageal reflux disease,” Abraham Khan, MD, director of the Center for Esophageal Diseases at NYU Langone Health, tells Health. “Often, it works best in patients with mild GERD symptoms that do not need a daily stronger acid suppressive medication, such as a proton pump inhibitor (PPI).”

Dr. Khan says that “it is not intuitive to think that famotidine would be a successful treatment for COVID-19 patients.” However, based on the limited retrospective evidence on outcomes made available so far, as well as the possibility that the drug may bind to a viral enzyme to interfere with its replication, he believes it’s worth an official trial study to see if it can be a treatment option for COVID-19.

“The evidence from China is anecdotal, and a double-blind study is needed to really determine the effectiveness of famotidine," adds Dr. Lerer.

The patients participating in the clinical trial at Northwell Health include a group who are also taking the anti-malarial drug hydroxychloroquine, as well as patients who are on hydroxychloroquine only. Hundreds of patients treated early on in the COVID-19 outbreak are also part of the trial.

Hydroxychloroquine is the drug hailed as a “game changer” by President Trump in a coronavirus task force briefing on March 20. However, preliminary results from a study sponsored by the New York State Department of Health, which looked at about 600 patients at 22 hospitals in the greater New York City area, suggest that hydroxychloroquine "didn't really have much of an effect on the recovery rate,” according to New York Governor Andrew Cuomo, as reported by CNN.

The same discouraging result could come out of the famotidine study. Keep in mind that this is a trial, and no drug treatment—famotidine or something else—will be approved to treat COVID-19 anytime soon.

In the meantime, Dr. Lerer warns that people should absolutely not rush out to buy the drug from their local drugstore. “It's important to be aware that in this current Northwell study, patients are taking mega doses of famotidine intravenously and are not taking pills orally. There is always a possibility that mega doses of any drug can have potential negative long-term side effects,” he says. And if the general public starts stockpiling Pepcid, heartburn patients who really need it could suffer.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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Coronavirus treatments: Remdesivir, hydroxychloroquine and vaccines for COVID-19

The coronavirus has spread across the globe with speed and ferocity, reaching almost every country on the planet. The world has been sent into lock down in an attempt to flatten the curve and prevent health care systems from being overwhelmed. Major events, including the Tokyo Olympics, have been postponed or canceled altogether. As health authorities and governments continue to mitigate extensive transmission in the community, scientists and researchers are turning their attention to another goal: Development of treatments and vaccines.

Since coronavirus was first discovered as the causative agent of COVID-19, scientists have been racing to get a better understanding of the virus' genetic makeup and unravel how to effectively treat infections. There's no cure and medical specialists can only treat the symptoms of the disease. Many different treatment options have been proposed and some older drugs seem to be associated with positive outcomes -- but much more work is required. However, the long-term strategy to combat COVID-19, which has spread to every continent on Earth besides Antarctica, is to develop a vaccine.

Developing new vaccines takes time, and they must be rigorously tested and confirmed safe via clinical trials before they can be routinely used in humans. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the US, has frequently stated that a vaccine is at least a year to 18 months away. Experts agree there's a ways to go yet.

Vaccines are incredibly important in the fight against disease. We've been able to keep a handful of viral diseases at bay for decades because of vaccine development. Even so, there exists confusion and unease about their usefulness. This guide explains what vaccines are, why they are so important and how scientists will use them in the fight against the coronavirus. It also discusses the current treatment options being used and those that show promise in hospitals.

What is a vaccine?

A vaccine is a type of treatment aimed at stimulating the body's immune system to fight against infectious pathogens, like bacteria and viruses. They are, according to the World Health Organization, "one of the most effective ways to prevent diseases."

The human body is particularly resilient to disease, having evolved a natural defense system against nasty disease-causing microorganisms like bacteria and viruses. The defense system -- our immune system -- is composed of different types of white blood cells that can detect and destroy foreign invaders. Some gobble up bacteria, some produce antibodies which can tell the body what to destroy and take out the germs, and other cells memorize what the invaders look like, so the body can respond quickly if they invade again.

Vaccines are a really clever fake-out. They make the body think it's infected so it stimulates this immune response. For instance, the measles vaccine tricks the body into thinking it has measles. When you are vaccinated for measles, your body generates a record of the measles virus. If you come into contact with it in the future, the body's immune system is primed and ready to beat it back before you can get sick.

What's in a vaccine?

Vaccines contain a handful of different ingredients depending on their type and how they aim to generate an immune response. However, there's some commonality between them all. 

The most important ingredient is the antigen. This is the part of the vaccine the body can recognize as foreign. Depending on the type of vaccine, an antigen could be molecules from viruses like a strand of DNA or a protein. It could instead be weakened versions of live viruses. For instance, the measles vaccine contains a weakened version of the measles virus. When a patient receives the measles vaccine, their immune system recognizes a protein present on the measles virus and learns to fight it off.

A second important ingredient is the adjuvant. An adjuvant works to amplify the immune response to an antigen. Whether a vaccine contains an adjuvant depends on the type of vaccine it is.

Some vaccines used to be stored in vials that could be used multiple times and, as such, contained preservatives that ensured they would be able to sit on a shelf without growing other nasty bacteria inside them. One such preservative is thimerosal, which has garnered a lot of attention because it contains trace amounts of easily cleared ethylmercury. Its inclusion in vaccines hasn't been shown to cause harm, according to the CDC. In places like Australia, single-use vials are now common, and thus preservatives such as thimerosal are no longer necessary in most vaccines.

In developing a vaccine for SARS-CoV-2, scientists need to find a viable antigen that will stimulate the body's immune system into defending against infection. 

Why does vaccine production take so long? There are many steps involved and a lot of regulatory hurdles to jump through.

"For any medicine to be sold it needs to go through the standard process of clinical trials including phase 1 [to] 3 trials," said Bruce Thompson, dean of health at Swinburne University in Australia. "We need to ensure that the medicine is safe, will not do harm, and know how effective it is." 

Scientists can't assume their vaccine design will just work -- they have to test, test and test again. They have to recruit thousands of people to ensure the safety of a vaccine and how useful it will be. The process can be broken down into six phases:

    Vaccine design: Scientists study a pathogen and decide on how they will get the immune system to recognize it. 

    Animal studies: A new vaccine is tested in animal models for disease to show that it works and has no extreme adverse effects. 

    Clinical trials (phase I): These represent the first tests in human beings and test the safety, dose and side effects of a vaccine. These trials only enroll a small cohort of patients.

    Clinical trials (phase II): This is a deeper analysis of how the drug or vaccine actually works biologically. It involves a larger cohort of patients and assesses the physiological responses and interactions with the treatment. For instance, a coronavirus trial may assess if a vaccine stimulates the immune system in a certain way.

    Clinical trials (phase III): The final phase of trials sees an even greater amount of people tested over a long period of time. 

    Regulatory approval: The final hurdle sees regulatory agencies, like the US Food and Drug Administration, the European Medicines Agency and Australia's Therapeutic Goods Administration, take a look at the available evidence from experiments and trials and conclude whether a vaccine should be given the all-clear as a treatment option.

Traditionally, then, it could take a decade or more for a new vaccine to go from design to approval. In addition, once the regulatory processes have concluded a vaccine is safe, the drug companies have to send production into overdrive, so they can manufacture enough of the vaccine to increase immunity in the wider population.

With SARS-CoV-2, the process is being expedited in some instances. As STAT news reports, the vaccine in development by Moderna has moved from design straight into Phase I clinical trials of its mRNA vaccine, skipping tests in animal models. Those tests will take place at Seattle's Kaiser Permanente Washington Health Institute, and patients are now being enrolled.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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