CategoryTreatment

The first patients in the NHS are being offered a new drug to help treat Covid-19. As Covid treatments are changing, fewer patients are becoming seriously ill or dying. So does this mean we are finally taming the virus?

At the start of the pandemic there were no drugs for Covid. In April 2020, I stood in a Covid intensive care ward while a doctor, in full PPE, told me they had nothing but oxygen to treat critically ill patients. I watched patient after patient on ventilators being turned on to their fronts to help their lungs take in oxygen.

It’s a deeply troubling memory that will always remain with me.

Now things have changed enormously. At the Royal Victoria Infirmary in Newcastle, the critical care unit looks and feels very different. Firstly, staff are no longer in full PPE, because most wards are Covid-free. At the peak a year ago the hospital trust was caring for 90 critically ill Covid patients. Today there are just three.

It is now the exception, rather than the norm, for patients to go on a ventilator. Hospital stays are much shorter and survival rates have improved significantly.

“Two years ago we had nothing,'” says Dr Matthias Schmid, head of infectious diseases at the RVI, who treated the UK’s first Covid patient at the end of January 2020.

“Now we have a range of treatments available which reduce the severity and prevent death in a huge number of patients.”

The focus now is on keeping patients from ever needing hospital treatment. That’s where antivirals come in.

There are thousands of medicines on the shelves in the Royal Victoria Infirmary’s automated dispensary, which is the size of a couple of shipping containers. When one of the pharmacists types in the name of a drug, the robot arm races down the central aisle, selecting the medicine and dropping the pack down a chute.

The box of pills selected is called Paxlovid – it’s an antiviral which, in trials, cut Covid hospital admissions by 88%. The treatment is being dispatched to high-risk patients across the UK who have just tested positive.

Through the Antivirals Taskforce, the government has procured nearly five million doses of Paxlovid and another antiviral, molnupiravir.

Both are designed to prevent a Covid infection from turning serious and form part of the armoury of treatments we now have against Covid.

Covid will not disappear completely, but even if a new more deadly variant emerges it should be managed by a combination of vaccines and the increasing range of effective drug treatments.

Covid has been the biggest challenge ever faced by the NHS. Two years on, hospitals can begin to plan for a future not completely free of the disease, but one where it no longer dominates healthcare and society.

https://www.bbc.co.uk/news/health-60390187

Scientists have pinpointed 16 new genetic variants in people who developed severe COVID-19 in a large study published on Monday that could help researchers develop treatments for very sick patients.

The results suggest that people with severe COVID have genes that predispose them to one of two problems: failure to limit the ability of the virus to make copies of itself, or excessive inflammation and blood clotting.

The scientists said their discoveries, published in the journal Nature, could help prioritise the likely treatments that could work against the disease.

Eventually, the information could even help predict which patients were likely to become severely ill.

“It is potentially possible in future that we will be able to make predictions about patients based on their genome at the point of presenting (for) critical care,” said Kenneth Baillie, consultant in critical care medicine at the University of Edinburgh and one of the study authors, told reporters.

The genetic analysis of nearly 56,000 samples from people in Britain showed differences in 23 genes in COVID-19 patients who became critically ill, when compared with the DNA of other groups included in the study, including 16 differences that had not been previously identified.

The new findings could help guide scientists in their search for existing drugs that might be useful for treating COVID-19.

https://news.yahoo.com/scientists-identify-gene-differences-severe-160624182.html

When the second red line appeared, Gill Harrington realised her fears had finally been realised. “You get used to seeing that one line on the lateral flow test,” she said. “But to see the two lines — well, it was terrifying.”

Testing positive for the coronavirus is worrying for anyone. But Harrington, a retired legal secretary, has a rare form of blood cancer that has left her with a weakened immune system. Despite having had three coronavirus vaccines, she knew her compromised immunity meant she was extremely vulnerable.

“I’ve been shielding since February 2020,” she said. “I’ve only seen family in the garden. My grandchildren — two beautiful little girls — live over the road but have never been inside my house.”

But despite her fears, Harrington was protected. There was a new safety net: an antiviral medication called molnupiravir, a pill that studies show halves the risk of hospital admission or death from Covid.

She is one of 10,000 vulnerable people — cancer patients, transplant recipients and those with Down’s syndrome — who have received specialised drugs within days of testing positive for coronavirus.

Professor Stephen Powis, medical director of NHS England, said: “It has been a remarkable achievement for a programme only started a month ago.” By the middle of next month another drug, Pfizer’s paxlovid, is due to be provided for vulnerable people in the UK. The pills have even better trial results, cutting the risk of death or needing hospital treatment by 89 per cent.

As Britain prepares for a post-pandemic world, scientists increasingly regard antivirals as a second line of defence against future coronavirus outbreaks. “The vaccine programme is our main pharmaceutical intervention and obviously will continue to be very important,” Powis said. “But drugs are the second key therapeutic intervention.”

Antivirals are also attractive for another reason. If a catastrophic variant arrived that bypassed our vaccines, scientists are confident antivirals would remain effective.

The Covid wave is receding. Restrictions are being eased. But the virus itself has not gone away. There will be future outbreaks and future waves. Combined with vaccines, however, antivirals promise to help ensure that Covid never again causes the kind of death and disruption we have seen during the past two years.

https://www.thetimes.co.uk/article/antiviral-covid-pills-to-keep-us-out-of-hospital-hdq65pllg