In Italy, at one point the world’s most affected country, the numbers of the pandemic provoked by the novel coronavirus are continually, gradually decreasing, both in terms of cases of infection and severity of symptoms.
Covid-19 intensive units in hospitals are discharging their patients.
It’s important to understand why this is happening, because it can give an indication about the disease and its course not just for Italy.
Maybe there is something in what a digital, not medical, expert wrote some time ago, to the effect that numbers are numbers and, if you look statistically at past epidemics, you see that their course generally describes a Bell Curve: at first it goes up, reaches a peak and then goes down. He was quite rudely castigated by a medical expert for that, but perhaps he was onto something.
Possibly there are 3 factors at work: 1) a general tendency of viral epidemics, as described above, in conjunction with the fact that Italy was among the first countries to be seriously hit; 2) the effects of a very strict lockdown in Italy; 3) some new directions in treatment that in Italy have been implemented.
Italy and World Current State of Science on Covid-19
A scientific paper entitled “Treatments for COVID-19: emerging drugs against the coronavirus” written by Italian researchers from the University of Parma, Italy, and the University of Washington, Seattle, WA, USA, was published at the end of April on the journal Acta Biomedica.
It offers a panoramic view of the current situation, particularly the drugs studied for the first time in connection with this novel virus SARS-CoV-2.
If you think that this is just a false pandemic, exaggerated by the media for political purposes, or even man-made in various different ways (there are several of these pathways and corresponding theories), I cannot say that you are necessarily wrong. Or right, for that matter.
The situation is still too fluid and unknown to take an unequivocal stance one way or the other.
But prudence is a Catholic virtue, and not just for Catholics.
I think that we should just explore different possibilities for as long as the uncertainty remains.
And, whatever the origin of the new coronavirus, we still need to find a way to deal with it.
So, going back to the Italian scientific paper, it says that a rising number of trials are currently authorised worldwide (902 as of 26th April), 13 of which are in Italy.
Lopinavir/ritonavir is a combination of two antiretrovirals used for the treatment of patients with HIV-1 infection, approved by EMA (European Medicines Agency) and FDA (the US Food and Drug Administration). But its efficacy for COVID-19 is yet to be confirmed, and its use in treatment should be limited to lesser severe cases in the initial stages of the disease.
Another antiviral medication, remdesivir, probably the most tested against COVID-19, has shown only modest effects in humans, despite the strong antiviral activity it demonstrated in non-human primates.
But it should by now be well-known that experiments on animals are akin to tossing a coin, they could help as much as they could hinder (50/50). It’s not just me saying that, an FDA study some years ago showed that half of the drugs approved by the FDA after being tested on animals and marketed had to be withdrawn from the market for being either ineffective or harmful. Animal experiments should be avoided: the only real trial, if you want to treat humans, can only be on humans.
In fact, we only know if a particular test on animals has been useful or damaging after its results are transferred or applied to humans. So, it’s the other way around: it’s human trials which tell us about animal studies, not vice versa. Human trials are the real moment of acquisition of knowledge. We know about their validity, but only post hoc, after the event, with hindsight. In sum: the real experiment, like it or not, is on humans. It’s unavoidable.
The content of the two above paragraphs was not in the paper I’m examining, which simply says that trials on the use of remdesivir against human COVID-19 are non-conclusive.
The therapeutic use of chloroquine (CQ) and hydroxychloroquine (HCQ) dates back to the mid-twentieth century. They are indicated in the treatment of malaria and some autoimmune diseases, but they haven’t done much for COVID-19: “These findings” says the study “highlight the importance of awaiting the results of ongoing prospective RCTs [Randomised Controlled Trials] (64,65) before recommending a widespread use of these drugs.”
Several other antivirals have been used to fight COVID-19, but most of them, including oseltamivir and ribavirin, have shown limited utility.
In the next post, the second part of this article, I’ll examine what are now the most promising medications, drugs targeting inflammation and hypercoagulability, as well as the so-called “convalescent” plasma, isolated from putatively immune subjects.