The coronavirus disease (COVID-19) continues to spread with the global number of confirmed cases approaching two million and nearly 120,000 lives lost. As at press time, the Nigeria Centre for Disease Control (NCDC), said it conducted 5,000 tests out of which 373 tested positive, 99 discharged and 11 deaths recorded.
However, months into the COVID-19 pandemic, it is still unclear which drugs could combat the viral disease and which would not. With public health on the line, the scientific community is searching for answers faster than ever. Several biotech companies are beginning trials of promising vaccines and treatments.
As the virus continues to spreads at unprecedented rates, invading the lungs of people of all ages, ethnicities and medical histories, companies are ratcheting up their efforts to fight the disease with accelerated schedules for creating new vaccines, and beginning clinical trials for potential treatments.
Efforts in finding cure
Some pundits had earlier agreed on the efficacy of chloroquine, which is an old drug for the treatment of malaria. On the national level, the Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Prof. Mojisola Adeyeye, ordered the manufacturing of chloroquine for emergency stock for possible clinical trial treatment of COVID-19.
She said: “Chloroquine, an old antimalarial is being repurposed for the clinical trial treatment of COVID-19. The drug was first tested in vitro (in the lab) using standard assays to measure the effects on the cytotoxicity, virus yield and infection rates of COVID-19.
“The drug was reported to function as antiviral at both the entry and post-entry stages of COVID-19 infection. Chloroquine has also recently been reported as potential broad-spectrum antiviral drug.
“In a recent study, chloroquine was reported by the state council of China, indicating that chloroquine phosphate had demonstrated marked efficacy and acceptable safety in treating COVID-19 associated pneumonia in multi-centre clinical trials conducted in China.
“The study involved 10 hospitals in Wuhan, Jingzhou, Guangzhou, Beijing, Shanghai, Chongqing and Ningbo, and 100 patients. The investigators reported that chloroquine phosphate is superior to the control in inhibiting the pneumonia associated with COVID-19, and shortening the course of the disease.
“Chloroquine was discontinued in Nigeria many years ago for use as antimalarial because of the resistance that the parasite developed against the drug. Therefore, sourcing the raw material active pharmaceutical ingredient (API), chloroquine phosphate could be difficult.”
There was also the approval of conditional emergency use of medical devices such as COVID-19 anti-body and anti-gen test kits as well as personal protective equipment (PPEs) to some companies.
The agency further took some regulatory steps to ensure access to health commodities that have the potential to impact positively on public health outcomes. These include diagnostics necessary to support public health infrastructure and guide the response necessary to combat and address the pandemic:
“The antibody test kits (IgG/IgM) can be used in COVID-19 confirmed individuals, who can then be tested at the designated centres using the antibody kits, to confirm that they have antibodies and as such may not be infected again.
“The antigen tests kits on the other hand, can detect the COVID-19 antigen in patients with or without symptoms. The results are only qualitative (positive or negative).”
More vaccines for human trials
On Wednesday, April 8, 2020, it was reported that Novavax, a Maryland-based biotech company in the US, said it would begin human trials in Australia in mid-May for its vaccine candidate. Novavax is one of more than two dozen companies that have announced promising vaccine programs speeding through the early stages of testing unlike ever before.
New York Times reported: “Also on the same day, the stem-cell company Mesoblast said it was starting a 240-patient clinical trial, supported by the National Institutes of Health that would test whether cells derived from bone marrow could help patients who developed a deadly immune reaction to the virus.
“In normal circumstances, development of new vaccines and treatments would take years. But the pharmaceutical industry is racing to compress this timeline with the support of non-profit organisations, government agencies and regulatory authorities.
“Novavax said its vaccine candidate had stimulated a powerful immune response in lab and animal experiments, producing antibodies that could fight off the virus. While a final product that would be widely available is still a year or more away, the Novavax effort is one of many that are ready to be tested in people.
“Again, a vaccine made by a biotech company, Moderna, is already in a clinical trial, which started on March 15, 2020. Another one, developed by Inovio Pharmaceuticals, was injected into the first adult volunteers.”
Meanwhile, Johnson & Johnson expects to start clinical trials in September. It has received a nearly $500 million partnership via a division of the U.S. Department of Health and Human Services. Experimental vaccines developed by researchers at the University of Pittsburgh and Baylor College of Medicine in Houston are also waiting for permission from the Food and Drug Administration to begin testing in people.
“We are all trying to do something which we have almost no precedents for, which is accelerating a vaccine in the middle of a pandemic,” said Dr Peter Hotez, co-director, Texas Children’s Hospital Centre for Vaccine Development at Baylor College of Medicine.
He disclosed that there is no approved treatment for COVID-19: “Researchers and doctors are testing a host of therapies in a desperate bid to save the lives of people who have few other options.
“However, (President Donald) Trump has aggressively promoted two old malaria drugs, which have shown only limited evidence of working as treatments for the virus. He has pushed for the drugs’ broader use in patients without the more rigorous clinical trials typically used to evaluate treatments. He has also urged Americans to take hydroxychloroquine, an anti-malaria drug that has not been shown to be safe or effective against COVID-19.”
Scientists race for best drugs
When the outbreak occurred, researchers and doctors quickly launched dozens of clinical trials to test existing medications against the virus. But the research done so far in China has not generated enough data for conclusive answers.
Tedros Adhanom, Director-General, World Health Organisation (WHO), said in one of his briefings: “We commend the researchers around the world who have come together to systemically evaluate experimental therapeutics.
“Multiple small trials with different methodologies may not give us the clear, strong evidence we need about which treatments help to save lives. In their fight for ‘clear, strong evidence,’ the WHO is launching a multi-country clinical trial to test four drug regimens as COIVD-19 therapies: an experimental antiviral drug called; remdesivir, the anti-malarial drug chloroquine (or the related hydroxychloroquine), a combination of two HIV drugs, and those same two HIV drugs along with the anti-inflammatory interferon beta.
“The trial will be flexible and could add or drop additional treatment approaches or locations over time. In that way, it appears to be similar to the adaptive trial that the National Institute of Allergy and Infectious Diseases started in the US in February, which initially set out to test remdesivir but could expand to other drugs. The US is not currently involved in the WHO trial as hundreds of other clinical trials are underway.”
Tales by survivors
Governor Bala Mohammed of Bauchi State and a Lagos resident, Kazeem Adedeji, were among those recently discharged by the NCDC. Both narrated their experiences.
I thought I would die –Bauchi gov
Mohammed: “I must confess that it was a traumatic experience for one to know that you have been tested for a disease that has no vaccine or cure. I thought I was going to die. But thankfully, I had a very strong will to live. I was placed on heavy medications by my doctor, like antibiotics and malaria drugs.
“Although, I never had any manifestation of the symptoms all the period I was in self isolation but was under a stricter assistance that it would come anytime. I was doing a lot of exercising and was taking things I felt would help boast my immune system like bitter kola. The will to survive was so much that one would do whatever it takes to survive.
“However, when at a period I began to feel inches on my body, I felt that was the beginning of the sickness. But after the series of test that I passed through, it came out negative and I was fit to go and so was discharged.”
An experience I don’t wish anyone –Adedeji
“My wife and mother in-law were at the isolation centre. It is something I would not want anyone to experience. Before I was discharged, I had nobody to look after my two kids except my maid who was lucky to be negative as well as my kids.
“You can imagine what it was for the kids, for their father, mother, and even their grandmother, who happened to be staying with us to be taken away suddenly and not being able to be there for them.
“No one was willing to accept my kids knowing that their parents tested positive to the deadly virus, everyone around us was scared. Back at the isolation centre, my wife was crying almost every day and my mother-in-law. I had to hold on as the man I am if not for anything but for my kids.
“After I was discharged, on my way home, I met someone an artisan who happens to do some work for me in my home. While discussing, I told him that I have just been discharged from the isolation centre where I was admitted for COVID-19.
“He couldn’t wait to hear the rest of the story and ran away. I had to call him back to explain to him that I was free and strong now and no longer pose a threat.”