What’s next for COVID-19? Testing, treatment and vaccine
While most people are concerned with social distancing and limiting potential expose to COVID-19, there are medical professionals and scientists focused on improving the situation long term. This comes in the form of better testing, a treatment method and a potential vaccine.
The key to identifying cases of COVID-19 is testing, which local physician Dr. Steve Nagy said, takes an average of 4-5 days for results from private labs.
However, Nagy said scientists are working on a commercially developed test that would have results in about 45 minutes that is expected to be released within the next week. He also said a self test is in development that is also expected to come out soon.
The current test, Nagy explained, is a nasal swab taken by a medical professional after the patient meets certain criteria. The professional needs to get dressed in proper protective gear, which includes a gown, gloves, eye protection and N-95 mask. The swab goes into the back of the patient’s nose, which can cause them to sneeze or cough, prompting the need for protective gear.
“The self test will be, you’ll actually go to a testing facility and you’ll actually test by putting the swab in your own nose, you won’t actually put it to the back of the nose,” Nagy said.
The test would swab the front part of the person’s nose on each side, he said. The patient would then give the specimen to a health care provider, who is standing a safe distance away, for it to be tested.
“That way you don’t have to have the health care provider in full personal protective equipment, which uses up the PPE that is very, very critically needed for hospitals,” he said. “That will help not only improve the number of people who can get tested, but also preserve some of the precious supplies that are in such short supply right now.”
Treatment on horizon?
Approximately 80% of those who do contract the virus experience only mild symptoms, Nagy said. Those cases can be treated symptomatically such as Tylenol for a fever.
More severe cases, he said, don’t currently have a treatment protocol, but research is being done using a number of different medications, including existing antiviral medications.
One possibility Nagy said is showing promise is a combination of two existing medications: the anti-malarial drug hydroxychloroquine and the antibiotic azithromycin.
Hydroxychloroquine is now used to treat autoimmune diseases such as lupus and rheumatoid arthritis, Nagy said, and is being shown to prevent the replication of the virus as well as keep it from entering the lung cells.
Azithromycin is usually used to treat bacterial infections, but is being shown to have antiviral effects as well, Nagy said, which isn’t completely understood right now.
“There was a French study of 30 patients with COVID-19 done (in February) where they found that the combination of hydroxychloroquine and azithromycin for five days completely eradicated the presence of the virus,” Nagy said. “There is a physician in New York who has treated 350 patients with that combination and found that respiratory symptoms improved in all of the individuals. There were zero deaths and zero hospitalizations from that treatment regimen.”
This possible treatment is still being studied and isn’t approved by the Food and Drug Administration for general use fighting COVID-19. Nagy said the FDA has approved it for certain patients hospitalized with COVID-19.
“Right now, the advice that physicians are getting from the (Centers for Disease Control) is to use our discretion and discuss with patients the fact that it doesn’t have an approved indication for treating this, but it could provide benefit,” Nagy said. “The other feature about these two treatment modalities is usually they’re both very well tolerated medications. So the risk of treating is low and if there is benefit, then obviously that would result in a marked improvement of the course of the COVID-19 infection.”
Another treatment that scientists are currently looking at includes a procedure similar to a blood transfusion using convalescent plasma. Plasma is the liquid portion of a person’s blood, according to the American Red Cross, and comprises about 55% of blood.
This procedure, being researched by the National Institutes of Health involves using the blood plasma from a person who has recovered from COVID-19 and giving it to a person who is ill with the virus, Nagy explained.
“They’re over the infection clinically, and there’s absolutely no evidence of the virus when they’re tested,” Nagy said. “Of course, when their body was fighting the infection it produced antibodies against the virus. (Scientists) are able to isolate those antibodies in the plasma and they will be able to infuse those antibodies in the form of a plasma transfusion to individuals who are critically ill to help their immune system fight the infection.”
Another medication being looked at is the use of the rheumatoid arthritis drug actemra. Nagy said the drug is being used in people who are on ventilators, with severe illness, to prevent the lung damage caused by COVID-19.
“It relieves the inflammation cascade that has been started by a severe infection with the virus,” he said. “That’s the other agents not for routine use for the average person, but for the critically ill individual to prevent lung damage. It actually doesn’t kill the virus but relieves the damage from the inflammation that the body’s producing while fighting it.”
Vaccine up to 12 months out
Nagy said there are several possible vaccines currently in clinical studies.
One possible vaccine in testing, Nagy explained, started in the first phase of trials last month with the first dose given out.
If this vaccine is approved, it would be a two dose process. Patients would receive the first dose and then a second one, or booster, 28 days later.
“That vaccine is designed to stimulate your immune system to recognize the virus and attack it and prevent people from getting it when they’re exposed in the future, kind of like the flu vaccine would,” he said.
Vaccine development takes a lot more time than treatment protocols, Nagy said. If this vaccine is approved by the FDA, it would be about 12 to 18 months before it is used in the general public.