Update: Wednesday 20th May 2020
The most recent data now suggests that, in the US, the total number of confirmed cases sits at around 1.56 million (up 19, 662 from yesterday), with 297,000 recoveries and the number of casualties at just over 92,000. Despite the set of large numbers, both the rate of infection and mortality are on a gradual decline. The pattern is, on the whole, being repeated across the world as strict lock-down measures taken a few months back are now seeing positive results.
In recent weeks, a 17-page report, collated by scientists at the Centers for Disease Control and Prevention, that aimed to provide a road map for states on how to safely reopen their communities was shelved by the US government. Instead, the President has made clear repeatedly that he wants states to make their own decisions over lock-down protocol; and has urged officials to reopen where they can for the sake of the economy. As a contrast, the UK remains under strict restrictions, with slight differences across the individual nations. Though it varies from region to region, the general consensus is that the UK rate of infection [r] is somewhere between 0.7-1, which is not yet manageable.
Despite the differences in the overall approach from country to country, the fight back against the virus by clinical research everywhere has been strong and consistent. Today, we survey the key clinical studies being carried out right now and what their breakthroughs could mean for the West in the long run.
Data analytics company, GlobalData, released a report a few weeks ago detailing the results of 21 trials currently underway. Of the 21, 16 have shown positive results in their early stages. The majority of clinical research is being carried out in drug development, with four multinational, large-scale clinical trials investigating remdesivir, sarilumab and bevacizumab. Hydroxychloroquine, an immunosuppressive drug recently supported by President Donald Trump, has also been among the substances tested in several of these studies. However, in recent weeks, the drug has failed to meet endpoints and has seen adverse events in a retrospective study. In fact, patients treated with hydroxychloroquine had a higher mortality rate overall. Nonetheless, the number of clinical trials investigating hydroxychloroquine or chloroquine as a primary or secondary drug continues to expand.
Evidence published this week from Moderna’s phase 1 clinical trials, made up of 45 participants, showed that each participant produced an antibody response similar to that seen in people who have had the disease. The results underpin that the vaccine is safe for use in humans as part of a preliminary safety study, and therefore, unfortunately, do not demonstrate that the treatment will work. However, the report's findings are certainly encouraging.
Gilead’s remdesivir trials continue to see positive results as evidence published at the end of April saw similar clinical improvements in patients receiving a ten-day treatment to those receiving the same treatment over a five-day period. If this wasn’t enough, according to Senior Analyst of MPH at GlobalData, Scotty Chung-Siu, more than half of patients in both treatment groups were discharged by Day 14 while also achieving clinical recovery. Chung-Siu, delighted with the results, has, however, asked for caution:
“While many of the current COVID-19 clinical trials show promising early results, conclusions can only be drawn once the final data are reported. With 597 planned clinical trials, there will be more data to draw insights in the coming months and possibly a key drug candidate treatment for COVID-19 will emerge.”
In the UK, the hopes of the nation lie primarily with the compound currently under observation at Oxford University. This is because no major developments have been published from the government-run RECOVERY trial that began early last month. The focus of the Oxford study, ChAdOx1 nCoV-19, has been shown to protect macaque monkeys against pneumonia; however, it does not stop them contracting the disease and spreading it, despite the lesser symptoms recorded.
More recent developments has seen the UK government follow up on the recommendation of the project's leader who, last month, claimed an 80% chance of success; in that funding to produce 30 million doses of the vaccine, if successful, was approved on Monday. Pharmaceutical company, AstraZeneca, is now partnering with the group, after government approval, to make sure that this target is met if all goes to plan. If further testing is successful, the UK could be looking at a speedy recovery and faster return to normal than expected.
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