This week's message from the doctor 4th Oct
Hello Everyone,
The Delta variant remains the dominant strain of SARS-CoV-2 around the globe. The number of worldwide deaths has now reached 5 million with unvaccinated people being the main victims. In the last week, more attention has been focused on poorer countries where the vast majority of their population has not received even one dose whilst rich nations such as the USA, UK and Europe are already giving booster jabs.
The World Health Organisation (WHO) is now pushing its CoVax distribution programme to countries with the lowest levels of coverage whilst the rich nations are contributing more vaccines and money to this cause. But it is not only the poorer nations being affected. The USA has reached 700,000 deaths and the UK is nearly 137,000.
One in 20 secondary school children are infected with the virus and as that figure increases a greater number will be admitted to hospital and some may become very seriously ill. The death of 15 year old Jorja Halliday in Portsmouth last week is a reminder that while Covid is not often serious in young people, it can occasionally be fatal. Jorja died from acute myocarditis – an inflammation of the heart muscle. Mild myocarditis has been recorded as a very rare side effect of the vaccine and usually settles in 3-4 days. The risk of myocarditis is significantly higher from Covid infection and can cause serious heart problems.
The roll-out of vaccination for 12-15 yr olds in England was due on 20th September but it has had a slow start as the vaccine is given in schools and parental consent is needed beforehand. The recommendation is a single shot of the Pfizer-BioNTech vaccine.
Prevention (ie mask-wearing, social distancing) and vaccination have been the mainstays of tackling Covid. But what about other developments that can help when someone actually gets Covid?
Molnupiravir is an antiviral drug that was initially designed to treat flu but recent research has found that it can reduce hospitalisations and death from Covid-19 by 50% if given early on in the disease. If further studies confirm these findings and it is authorised for use then it will be the first oral antiviral medication for Covid. Molnupiravir works by interfering with the processes that the virus uses to replicate so preventing it from spreading inside the body. Scientists think that this should also take this medicine effective in any new variants that may arise in the future. A similar drug to Molnupiravir is Favipiravir – another antiviral agent licensed to treat flu in Japan since 2014. It works in the same way and results from its trials are expected soon.
Pfizer, which is one of the companies that make vaccines, are also developing an antiviral drug they hope will help treat Covid by the same mode of action.
As well as oral drugs some companies are looking at inhaled medications also. Interferons, first used to treat Chronic obstructive pulmonary disease (COPD) are given via a nebuliser as a fine mist. Once it is breathed in it stimulates the lungs’ immune defences.
Budesonide is an inhaled steroid often used to treat asthma and COPD. Although not yet a standard treatment for Covid, initial studies have found that it can help shorten recovery time by 3 days – as long as you are not bad enough to be admitted.
Another steroid made headlines early on in the pandemic. Dexamethasone is over 50 years old, fairly cheap and when given to seriously ill people with Covid in the hospital saved the lives of one in eight people. It works by dampening down the overreaction of the immune system (‘cytokine storm’) to the Covid infection.
Remdesivir is yet another antiviral drug – just like Molnupiravir and Favipiravir. It was given emergency use status by many countries during the covid pandemic but its benefits to patients have not been convincing, it is very expensive and can only be given through the vein.
Sometimes an idea sounds so good and logical that it is given lots of publicity even before it has been thoroughly tried and tested. This was the case with convalescent blood plasma. Basically, it was thought that blood containing antibodies collected from people who had recovered from Covid would have a protective effect. In fact, the USA gave it emergency authorisation and thousands of people both in the US and UK started to donate their plasma once they had recovered from their Covid infection. Unfortunately, a large US study involving 500,000 people hospitalised with Covid infection showed no benefit.
Some people have put off having the vaccine because they have had Covid already and feel that they are therefore immune. What the latest research is telling us is that immunity from vaccination is superior to that acquired from getting an infection. Apparently, Covid infection induces a lot of antibodies that do not attach well to the SARS-CoV-2 – the virus that causes Covid.
So the good news is that we are learning more about Covid-19 and developing effective ways to treat this virus. In the meantime, vaccination and prevention remain our best defence.
Keep Safe Everyone
Bye for now
Dr M Tanvir Jamil
The Delta variant remains the dominant strain of SARS-CoV-2 around the globe. The number of worldwide deaths has now reached 5 million with unvaccinated people being the main victims. In the last week, more attention has been focused on poorer countries where the vast majority of their population has not received even one dose whilst rich nations such as the USA, UK and Europe are already giving booster jabs.
The World Health Organisation (WHO) is now pushing its CoVax distribution programme to countries with the lowest levels of coverage whilst the rich nations are contributing more vaccines and money to this cause. But it is not only the poorer nations being affected. The USA has reached 700,000 deaths and the UK is nearly 137,000.
One in 20 secondary school children are infected with the virus and as that figure increases a greater number will be admitted to hospital and some may become very seriously ill. The death of 15 year old Jorja Halliday in Portsmouth last week is a reminder that while Covid is not often serious in young people, it can occasionally be fatal. Jorja died from acute myocarditis – an inflammation of the heart muscle. Mild myocarditis has been recorded as a very rare side effect of the vaccine and usually settles in 3-4 days. The risk of myocarditis is significantly higher from Covid infection and can cause serious heart problems.
The roll-out of vaccination for 12-15 yr olds in England was due on 20th September but it has had a slow start as the vaccine is given in schools and parental consent is needed beforehand. The recommendation is a single shot of the Pfizer-BioNTech vaccine.
Prevention (ie mask-wearing, social distancing) and vaccination have been the mainstays of tackling Covid. But what about other developments that can help when someone actually gets Covid?
Molnupiravir is an antiviral drug that was initially designed to treat flu but recent research has found that it can reduce hospitalisations and death from Covid-19 by 50% if given early on in the disease. If further studies confirm these findings and it is authorised for use then it will be the first oral antiviral medication for Covid. Molnupiravir works by interfering with the processes that the virus uses to replicate so preventing it from spreading inside the body. Scientists think that this should also take this medicine effective in any new variants that may arise in the future. A similar drug to Molnupiravir is Favipiravir – another antiviral agent licensed to treat flu in Japan since 2014. It works in the same way and results from its trials are expected soon.
Pfizer, which is one of the companies that make vaccines, are also developing an antiviral drug they hope will help treat Covid by the same mode of action.
As well as oral drugs some companies are looking at inhaled medications also. Interferons, first used to treat Chronic obstructive pulmonary disease (COPD) are given via a nebuliser as a fine mist. Once it is breathed in it stimulates the lungs’ immune defences.
Budesonide is an inhaled steroid often used to treat asthma and COPD. Although not yet a standard treatment for Covid, initial studies have found that it can help shorten recovery time by 3 days – as long as you are not bad enough to be admitted.
Another steroid made headlines early on in the pandemic. Dexamethasone is over 50 years old, fairly cheap and when given to seriously ill people with Covid in the hospital saved the lives of one in eight people. It works by dampening down the overreaction of the immune system (‘cytokine storm’) to the Covid infection.
Remdesivir is yet another antiviral drug – just like Molnupiravir and Favipiravir. It was given emergency use status by many countries during the covid pandemic but its benefits to patients have not been convincing, it is very expensive and can only be given through the vein.
Sometimes an idea sounds so good and logical that it is given lots of publicity even before it has been thoroughly tried and tested. This was the case with convalescent blood plasma. Basically, it was thought that blood containing antibodies collected from people who had recovered from Covid would have a protective effect. In fact, the USA gave it emergency authorisation and thousands of people both in the US and UK started to donate their plasma once they had recovered from their Covid infection. Unfortunately, a large US study involving 500,000 people hospitalised with Covid infection showed no benefit.
Some people have put off having the vaccine because they have had Covid already and feel that they are therefore immune. What the latest research is telling us is that immunity from vaccination is superior to that acquired from getting an infection. Apparently, Covid infection induces a lot of antibodies that do not attach well to the SARS-CoV-2 – the virus that causes Covid.
So the good news is that we are learning more about Covid-19 and developing effective ways to treat this virus. In the meantime, vaccination and prevention remain our best defence.
Keep Safe Everyone
Bye for now
Dr M Tanvir Jamil
