Praying for a protected, efficient vaccine quickly – Well being and Way of life

By Rafael Castillo MD

In last week’s column, we mentioned a group of local doctors who seem excited about the use of hydroxychloroquine (HCQ) as a prophylaxis and treatment for COVID-19.

Amado San Luis, of Pasay City, asked us if it was safe to take HCQ for anyone exposed to someone with COVID-19 symptoms and confirmed the virus was present through a swab test.

HCQ or any other drug is not recommended for prophylactic treatment. A study evaluating HCQ use among health care workers who saw COVID-19 patients showed no benefit in preventing the infection.

I was one of those who thought the drug could provide the necessary remedy against the SARS-CoV-2 virus if it showed promising results in initial studies. It has been shown in laboratory studies to prevent the virus from replicating – but that didn’t translate well in terms of clinical trial results.

Studies evaluating the effectiveness of HCQ in actual COVID-19 patients have shown disappointing results. There was even a red signal that it could potentially cause harm and increase the risk of death in some patients.

Although HCQ has been around for a long time and has been shown to be effective and fairly safe in most patients with malaria, some forms of arthritis, and lupus, it has a potentially serious side effect of arrest in patients with heart problems that can lead to sudden heart attacks .

Even in patients with previously normal hearts, COVID-19 can directly affect the heart and lead to inflamed and irritated heart muscles (myocarditis). HCQ can cause potentially life-threatening arrhythmias in these patients.

The bottom line for HCQ is that the net effect in COVID-19 patients is either neutral (no effect) or slightly towards the harmful side. It is best to avoid self-medication with it. Should our doctor prescribe them for either the prevention or treatment of COVID-19, we will first ask him how safe he is.

I’m also not that keen on the benefits of vaccines to treat COVID-19. I’ve discussed my concerns about the current vaccine race front-runners in the previous columns. I see it as tipping the scales at this point, just like HCQ.

Reason for hope

Dr. However, Edsel Maurice Salvana, director of the National Institute of Health at the University of the Philippines and a key figure in the local fight against the pandemic, tells us there is reason to hope that the vaccines are currently being evaluated.

“Vaccination attempts are making good progress. Most experiments are set up as “event-driven” experiments. This means that instead of a set time frame, the attempts will end as soon as a certain number of people receive COVID-19, however long it takes. “

He explains that this facility for evaluating vaccines has two major advantages. First, it ensures that the number of patients is significant enough to make comparisons between those given the vaccine and those given the placebo (inactive substance).

“The problem with fixed time frames is that the data may not be very meaningful if there aren’t enough infections over the period,” says Dr. Salvana.

This was the case in China when COVID-19 infections were declining and researchers were unable to come up with the numbers needed.

The second benefit, says Dr. Salvana, is that if the study participants come from areas with super high COVID-19 transmission like Brazil and India, the researchers will enroll the desired number of patients, get the results faster and analyze data without having to wait for the specified one Timeframe ends.

How effective could these vaccines be?

“The expected effectiveness of the first-generation COVID-19 vaccines should be around 50 to 70 percent with two doses,” says Dr. Salvana.

However, he quickly adds that while reducing the risk of COVID-19 by 50 to 70 percent would be of great help, public health action would still be needed to eradicate the virus. “So keep wearing those masks and face shields and keep your physical distance right,” he advises.

At the speed at which the vaccine trials are being carried out, we can expect to get some preliminary data in the next month or two. I’m not that excited about this right now, but I join everyone’s prayer that we can soon have a really effective and safe vaccine.


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