Odds favour Thunberg for Peace Prize; experts sceptical

Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

The death toll in China's coronavirus rose sharply to 425 with 64 deaths on Monday alone while 3,235 new confirmed cases were reported, taking the number of those infected with the deadly disease to 20,438, Chinese health authorities said on Tuesday.

The 64 people who died on Monday were all from the Hubei province, the epicentre of the virus, China's National Health Commission said.

Also, 3,235 new confirmed cases of novel coronavirus infection were reported, a big increase in a day.

Another 5,072 new suspected cases were reported on Monday, said the commission, adding that 492 patients became seriously ill.

The commission said that 2,788 patients remained in severe condition and 23,214 people were suspected of being infected with the virus, a pointer that it is increasingly turning virulent.

The overall confirmed cases on the Chinese mainland had reached 20,438 by the end of Monday, the commission said, noting that a total of 425 people had died of the disease.

A total of 632 people had been discharged from hospital after recovery, state-run Xinhua news agency reported As the virus spreads from human to human, 221,015 close contacts had been traced, with 171,329 others still under medical observation.

By the end of Monday, 15 confirmed cases had been reported in Hong Kong, eight in the Macao and 10 in Taiwan.

The Philippines reported the first overseas death from the virus on Sunday while 148 cases have been reported from abroad.

India has reported three cases of the coronavirus. All the three patients from Kerala recently returned from the affected Wuhan city.

Currently, 647 Indians and seven Maldivians who have been evacuated from Wuhan and Hubei are in 14-day quarantine at a medical camp in Manesar, near Delhi.

As the virus continued to spread at an alarming rate, Chinese President Xi Jinping on Monday warned officials of punishment if they shirked responsibility in tackling the virus outbreak.

On Monday, China has opened a 1,000-bed hospital built in record nine days in Wuhan city and started trials for new drug to contain the virus and is set to open another 1,300 bed hospital next to it on Wednesday.

The ruling Communist Party of China on Monday held its political bureau meeting presided by President Xi to review the steps being taken on various fronts to halt the spread of the deadly virus.

The outcome of the epidemic prevention and control directly affects people's lives and health, the overall economic and social stability and the country's opening-up, Xi said.

"Those who disobey the unified command or shirk off responsibilities will be punished," Xi was quoted as saying by the state-run Xinhua news agency.

Xi said that the party and government leaders supervising them would also be held accountable in severe cases.

Chinese armament firms, including those building aircraft carrier and military aircraft, have postponed planned work in order to concentrate on controlling the risk of coronavirus, state-run Global Times reported.

Noted Chinese health expert Zhong Nanshan has said that based on the fresh evidence, the novel coronavirus, which is spreading rapidly in China and the world, may reach its peak in the next 10 to 14 days, contrary to earlier estimates of climaxing sooner.

This means that the cases would drastically increase in the next two weeks before slowing down.

Also, China has begun clinical trials to test a drug to treat the patients of the coronavirus which till now has no cure.

Currently, patients are being treated with a combination of antivirals and other measures, as scientists race to find a vaccine.

Some reports said drugs to treat HIV too was being tried to treat the patients.

The experimental antiviral drug, Remdesivir, to be tested in field trials is developed by US-based Gilead Sciences. It is aimed at treating infectious diseases such as Ebola and SARS, South China Morning Post reported.

It was given to the first US patient last week - a 35-year-old man whose condition appeared to improve within a day, it said.