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Coronavirus cure: What progress are we making on treatments? Coronavirus cure: What progress are we making on treatments?
(25 days later)
There are a significant number of studies under way into potential treatments for Covid-19. Trials around the world are attempting to identify treatments for people with severe Covid-19.
And some progress has been made in the search for effective medicines. The first drugs that do make a difference are now being identified.
What work is being done to find treatments?What work is being done to find treatments?
More than 150 different drugs are being researched around the world. Most are existing drugs that are being trialled against the virus. More than 150 different drugs are being researched in different countries. Most are existing drugs that are being trialled against the virus.
What types of drugs might work?
There are three broad approaches being investigated:There are three broad approaches being investigated:
What are the most promising coronavirus drugs? It is possible that different drugs will work better at different stages - such as anti-virals at the beginning and immune drugs in late-stage diseases. Combinations of therapies will also be investigated.
Dexamethasone, the first drug shown to save the lives of people with Covid-19, has been hailed as a breakthrough. The only life-saving drug
Initial findings showed the low-cost steroid cut the risk of death by a third for patients on ventilators and a fifth for those on oxygen. Of all the drugs being trialled, only one has been been proven to save lives - dexamethasone - and it is a significant breakthrough in the fight against coronavirus.
Coronavirus infection triggers inflammation as the body tries to fight it off. The UK's Recovery trial showed the drug cut the risk of death by a third for patients on ventilators and by a fifth for those on oxygen.
This can prompt the immune system to go into overdrive, and it's this reaction that can prove fatal. Dexamethasone damps down this response. Dexamethasone is a steroid that calms down inflammation (part of the immune response) in the body.
Clinical trials of remdesivir, an antiviral drug originally developed to treat Ebola, have also been encouraging. Crucially it is also cheap which means it could be used all around the world.
A US-led trial of more than 1,000 people worldwide found remdesivir cut the duration of symptoms from 15 days to 11. Some were given the drug and others were given a placebo (dummy) treatment. However, the drug does not work on people with milder symptoms.
It is one of the four drugs in the Solidarity trial and its manufacturer, Gilead, is also organising trials. What other drugs look promising?
But, although remdesivir may aid recovery - and possibly stop people having to be treated in intensive care - studies have so far not given any clear indication whether it can prevent deaths from coronavirus. Remdesivir is an antiviral drug that was originally developed to treat Ebola.
It is thought that antivirals may be more effective in the early stages, and immune drugs later in the disease. Clinical trials of more than 1,000 people found it cut the duration of symptoms from 15 days to 11. It has not been shown to save lives, although studies are still continuing.
The UK government has made both dexamethasone and remdesivir available on the NHS. However, the US has bought almost all of the supply, with the manufacturer Gilead also donating some to South Korea.
However, the US has bought almost all of Gilead's forthcoming supply of the drug. The Department of Health and Human Services says it has secured 500,000 doses, which amounts to 100% of Gilead's production in July, 90% of it in August and 90% in September. Interferon beta is a protein that the body normally makes to dampen down inflammation. It is used as a treatment for multiple sclerosis.
Gilead has also donated an unknown quantity of remdesivir to South Korea. The UK company Synairgen is delivering the drug directly to Covid-19 patients' lungs using a nebuliser.
Initial findings suggest the treatment cut the odds of a patient in hospital developing severe disease, but larger clinical trials are now needed.
What do I need to know about the coronavirus?What do I need to know about the coronavirus?
Can HIV drugs treat coronavirus?Can HIV drugs treat coronavirus?
There has been much talk, but little evidence, that a pair of HIV drugs - lopinavir and ritonavir - could be effective at treating coronavirus. No.
There has been some evidence they can work in the laboratory, but studies in people have been disappointing. A pair of drugs called lopinavir and ritonavir are antiviral drugs that stop HIV from replicating.
The combination did not improve recovery, reduce deaths or lower levels of the virus in patients with serious Covid-19. There has been much talk and even early laboratory studies hinting they could be effective against coronavirus too.
However, as the trial was conducted with extremely sick patients (nearly a quarter died) it may have been too late in the infection for the drugs to work. However, the UK's Recovery trial showed they were ineffective and the WHO has also pulled the drugs from their Solidarity trial.
Can malaria drugs stop coronavirus?Can malaria drugs stop coronavirus?
Malaria drugs are part of both the Solidarity and Recovery trials. It's another no.
Chloroquine, and a related derivative, hydroxychloroquine, may have antiviral and immune-calming properties. Hydroxychloroquine is also used as a treatment for rheumatoid arthritis, because it can help regulate the immune system. Chloroquine, and the related drug, hydroxychloroquine, may have antiviral and immune-calming properties.
The drugs were thrust into the spotlight as potential coronavirus therapies, largely because of claims made by President Trump, but there is still limited evidence on their effectiveness. The drugs were thrust into the spotlight as potential coronavirus therapies, largely because of claims made by President Trump, and because early laboratory tests showed they could inhibit the coronavirus.
Early laboratory tests showed it can inhibit the coronavirus, but concerns emerged about its use against the disease. However, the UK's Recovery trial found that hydroxychloroquine does not work as a treatment for Covid-19 and the WHO has stopped trialling the drug.
The UK's Recovery trial, run by the University of Oxford, found that hydroxychloroquine does not work as a treatment for Covid-19, and it was pulled from that trial.
The WHO had previously suspended its global trials of hydroxychloroquine following a large-scale study in the Lancet which found the drug's use can cause heart problems, and actually increased the likelihood of death.
However, that study was subsequently discredited, and on 30 June, the UK's Medicines and Healthcare products Regulatory Agency (MHRA) said that Oxford University can resume its hydroxychloroquine trials.
Researchers are keen to continue exploring whether the drug might prevent infections.
Can survivors' blood treat coronavirus?Can survivors' blood treat coronavirus?
People who survive an infection should have antibodies in their blood that can attack the virus.People who survive an infection should have antibodies in their blood that can attack the virus.
The idea is you take the blood plasma (the part which contains the antibodies) and give that to a sick patient as a therapy. The idea is to extract blood plasma (the part which contains the antibodies) from those who have recovered. This "convalescent plasma" is then given to a sick patient as a therapy.
The US has already treated 500 patients with what's known as "convalescent plasma", and other countries are getting involved too. The approach has been proven to work in other diseases, but not yet in coronavirus.
How long until we have a cure?How long until we have a cure?
It is too soon to know when we might have a drug that can treat the coronavirus. We may never get a "cure" for coronavirus. We don't have one for flu or the common cold or other similar infections.
However, we should start to get the results of trials in the next few months. This is much earlier than we will know whether a vaccine (which protects against infection rather than treat it) is effective. However, there is now one treatment that works and others that look promising.
This is because doctors are testing drugs that have already been developed and are known to be safe enough to use, whereas vaccines researchers are starting from scratch. Doctors are testing drugs that have already been developed and are known to be safe enough to use, so more trial results can be expected relatively soon.
Some completely new, experimental, coronavirus drugs are also being tested in the laboratory but are not yet ready for human tests. This contrasts with trials for vaccines (which protect against infection rather than treating it) where researchers are starting from scratch.
Some completely new experimental coronavirus drugs are also being tested in the laboratory, but are not yet ready for human tests.
Why do we need a treatment?Why do we need a treatment?
The most obvious reason for wanting a treatment is it will save lives, but it could also allow further lockdown measures to be lifted. The most obvious reason for wanting a treatment is it will save lives, but it could also allow the lifting of restrictions such as lockdowns and social distancing.
Having an effective treatment would, in essence, make coronavirus a milder disease.Having an effective treatment would, in essence, make coronavirus a milder disease.
If it stopped people who were admitted to hospital from needing ventilation, then there would be less risk of intensive care units being overwhelmed, so controls on people's lives may not need to be as strict. If it stopped people who were admitted to hospital from needing ventilation, then there would be less risk of intensive care units being overwhelmed, so controls on people's lives would not need to be as strict.
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