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Snake oil really can bite

In American journalism, the words “Florida man” in a headline are code for a comical hick who does something you can scarcely believe a sentient human would. So, welcome, to “Arizona man” – and there’s a hard and important lesson in this for anyone from President Trump down pushing cures or treatments for Covid-19, says Peter Bale

“Arizona man dies after ingesting chloroquine in an attempt to prevent coronavirus,” an NBC News tweet informed me.

Only this week Trump used one of his soliloquies to promote the alleged effectiveness of the anti-malarial drug in combatting the effects of the Covid-19 disease triggered by the SARS-CoV-2 virus.

Remember, this is the guy who said he amazed doctors with his knowledge, attributing it to his uncle’s alleged history as an MIT researcher.

“People are really surprised I understand this stuff,” Trump said on a visit to the Centers for Disease Control in Atlanta this month. “Every one of these doctors said, ‘How do you know so much about this?’ Maybe I have a natural ability.”

Unfortunately for the Arizona man, 68, his wife saw Trump describe a human version of chloroquine used in treating malaria as a possible treatment for Covid-19. So when she, 61, found some in her cupboard – a type used for parasites in her koi fish, not humans – she had the idea that even though she and her husband had no symptoms they could protect themselves by taking some. (Yes, I know). She mixed some with soda and they drank it.

“Trump said it was basically pretty much a cure,” she told NBC News from her hospital bed. Asked what her advice was for others, she said: “Oh my God, Don’t take anything. Don’t believe anything. Don’t believe anything that the President says…call your doctor.”

The President told a news conference this week he was optimistic about signs hydroxychloroquine could have an application in treating Covid-19, saying: “It may work, it may not work. I feel good about. That’s all it is, it’s a feeling.”

The facts as outlined by his own medical authorities and the World Health Organisation, are that there is currently no known specific drug treatment for Covid-19 and certainly no known vaccine for the virus itself. There’s a good reason it’s called the “novel” coronavirus.

British, American, Japanese and Chinese scientists – and almost certainly many others – both in the public sector and private pharmaceutical industries are working on treatments and the possibility of vaccines ever since China released the genome of SARS-CoV-2 early in the epidemic. But forecasts are for a vaccine to take 18 to 24 months to develop and longer to mass-produce and distribute.

“Furthermore, there is no guarantee that initial vaccines will have high efficacy,” said the Imperial College team whose revised modeling on the spread of Covid-19 forced Britain, the United States and perhaps New Zealand to change their approach to containing the disease.

In the UK officials talked about using “herd immunity” to counter the virus – effectively allowing a majority of the population to get the disease, be sick and get over it, almost certainly achieving immunity. That approach required intense protection for the old and ill and led London to decide the cost in deaths was just too high, resulting in a move to a "suppression" approach.

President Trump has said he’s worried the economic cost of shutting down large parts of the economy may be worse than the disease itself and he has some support for that view in parts of the scientific community, particularly behavioural specialists.

“I am deeply concerned that the social, economic and public health consequences of this near-total meltdown of normal life — schools and businesses closed, gatherings banned — will be long-lasting and calamitous, possibly graver than the direct toll of the virus itself,” Dr David L Katz, president of the True Health Initiative wrote in the New York Times.

As far as a treatment for Covid-19 or vaccine against SARS-CoV-2 are concerned, below are the most solid current leads (and we will update this list as more sensible proposals and reports based on fact and science emerge).

- Favipiravir or Avigan, a drug developed by a subsidiary of Japan’s Fujifilm to treat new strains of influenza, has been said by Chinese authorities to be effective in treating coronavirus patients. Clinical trials are underway. (The Guardian)

- Up to eight promising vaccine candidates are being prepared for trials by the Coalition for Epidemic Preparedness Innovations, according to Bill Gates, writing in the New England Journal of Medicine.

- And, what about hydroxychloroquine? It appears it is one of many potential drugs and treatments which could be used in concert to treat the respiratory impact of Covid-19 but it’s no magic bullet, according to Salon magazine.

So, by all means, argue about the benefit of suppression versus mitigation but please don’t experiment with quack remedies, even if the President suggests it.

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