Please note, I am NOT an expert in this field and this an expression of my understanding of information I have read and heard from various public broadcasts and articles.
How does COVID19 eventually overcome its unwilling host causing death, and what do I understand about the development of a vaccine and treatments of the illness.
Firstly looking at the Australian Government data results from using the suppression strategy as the chosen method of controlling the SARS COv2 virus that causes COVID19 in the Australian population to date, 20-29 year olds have the highest number of COVID19 cases recorded. The highest levels of deaths are in the 70-79 age group followed by the 80-89 and 90 plus. No deaths have occurred in anyone younger than 50 as of 16.4.20
How are people succumbing to COVID19.
The ABC’s Dr Swan explained what kills people with COVID19 is an uncontrolled over reaction of the immune system that attacks the lungs and heart and other organs which eventually brings about the demise and death of the infected person. So it is thought immune suppressants might help to fight the disease process along with various treatments.
Treatments being researched.
There is 3 approaches to treatment of an illness in the case of COVID19.
1. Dampen the life threatening immune over reaction
2. Strengthen our resistance to the virus. A drug used in sheep drenching an treatment of head lice, Ivermectin has shown to be an inhibitor of COVID19 in early laboratory tests, by blocking the viral RNA from invading healthy cells . Ivermectin is an anti parasitic drug and even though COVID19 isn’t a parasite it has shown some results by killing the covid 19 virus in a Petrie dish in 24-48 hours.
3. Find a drug that kills the virus or stops it multiplying
Hydroxychlorequine is an anti-malarial medication that also dampens the immune system. It is used to treat forms of lupus as it is an immunosuppressant. It’s critical if we are going to suppress elements of the immune response that we know what we are suppressing and the timing of it.
An electrocardiograph ( ECG) has a PQRST wave pattern. The QT wave on an ECG is critical for how well the heart beats . People with severe COVID19 can have a long QT interval which puts them at peril of fatal heart rhythms. Hydroxychlorequine is known to make the QT interval even longer.
These drugs can be dangerous if used incorrectly and should not be taken without medical advice because of such side effects.
Ivermectin was developed back in the 1970-80s. It is an anti-parasitic treatment that was first used to treat nematodes in cattle, then to combat river blindness in humans. It’s most recently been used as a topical treatment against head lice.
A pharmaceutical company GILEAD makes antiviral drugs for HIV and Hepatitis C. The COVID19 candidate drug is called remdesiver. It works by preventing the virus from making copies of its own genetic material as a result then the virus can’t replicate, it can’t then infect more human cells. It stops that replication of the virus. It was hoped to be the holy grail of an anti viral drug. Namely an antiviral that can treat more than 1 virus. However when they tried remdesiver in embola it didn’t work. It was considered for further exploration oft SARS COv2 because it is known to work against other viruses in the same family of virus such as this Caronavirus therefore given the pandemic environment it is worth exploring its activity against covid 19.
The pharmaceutical company GILEAD is taking a more traditional approach towards testing of remdesiver and using randomised control trials on hospitalised patients who receive the medication intravenously.
There are multiple studies ongoing. Australia has 2 studies going and China has and 2 other studies are being done in both the US and Europe. Researchers are hopeful they will have some initial data by the end of April 2020. The World Health Organisation (WHO) has a global co finding effort to fund trials along with hydroxychlorequine and remdesiver along with other medications. The WHO hoped that it will accelerate findings to tell if these drugs work.
Vaccine research and immunity.
There is 2 different parts to immunity. 1. The white blood cells in the blood. Some are like tanks which fight the foreign invaders themselves which in this case is the virus , and the tanks are the T cells
Immunity is our army we muster to fight our invaders. Then you have other white cells called B cells and they are the ones that produce the antibodies and it’s a coordinated attack. For viruses like SARS-COv2, the B cells produce antibodies to it. The B cells recognise there’s a foreign invader and these B cells don’t attack the virus, they produce antibodies . The antibodies find part of this virus, the foreign invader that they can latch onto and alerts the rest of the immune system to say there’s an invader and the other cells of the immune system come in an attack or chomp up the virus through various means. There’s another white blood cell that work with T cells called a macrophages which can chomp up foreign invaders . There’s a whole series of attack mechanisms but antibodies to viruses is the first line of defence that gets the rest of your immune system deployed. The core of an antibody is called immunoglobulin , IgM an early antibody response and IgG a late antibody response.
When we think of a vaccine that’s about getting our bodies to produce antibodies, IgG antibodies but immunity doesn’t always last forever. The immunity sufferers of SARS1 got lasted about 1 yr- 18 months. The immunity we get from a common cold coronavirus last a few months. This is an issue with the SARS-COv2 being a Caronavirus as I mentioned in a previous blog. It is almost certain a vaccine to SARS-COv2 will not give a lifetime immunity . The best immunity you get is from a live invasion of the virus but that’s not what you want with covid19 so second best is a vaccine.
What happens when you have an over immune response is that it actually starts to attack your own body. This is what is happening with COVID19 and how it’s killing people. It’s causing an over response of the immune system.
It’s important to develop a vaccine that won’t do this like the trial on monkeys that the SARS 1 vaccine did.
Researchers stress that scientists must stick to rigorous scientific controlled trials and not rush them on the grounds we don’t have time to waste.
The World Health Organisation
Dr Swan went on to explain, the WHO oversees health on a global scale. It’s valuable to have such an organisation because it comes into its own in crisis like these such as Ebola and a pandemic such as this and other humanitarian crisis’s. It really comes into its in own helping countries who are poorly resourced and who don’t have strong health systems which need help by intervention of coordinated expertise and that expertise which can be coordinated across borders.
For all its faults the WHO is the Organization that is going to help large numbers of people, billions of people throughout the world get through this . China and the US are large contributors of funds to the WHO organisation and there is criticism that it withheld criticism of China when this virus first was identified as it’s a big donar to WHO. The US had halted funding with the president Donald Trump saying it is doing so due to the poor handling of this virus.
I listened to an interesting interview today on the BBC Caronavirus Newscast podcast 16.4.20 with Assistant Professor Clare Wenham of Global Health Policy at the London School of Economics who discussed the WHO structure and function, it’s funding, constitution and politics which was very informative and I recommend giving it a listen. Her interview starts about 20 minutes into the podcast. https://podcasts.apple.com/au/podcast/the-coronavirus-newscast/id1234185718?i=1000471612499