Special project "COVID-19 pandemic: a year later": how is the coronavirus treated a year later

Doctors all over the world are desperate to find cures for COVID-19, but even a year later, there are no major changes to the treatment protocol.

How is COVID-19 treated: officially

Tanya MELNIK, Associate Professor of Medicine at the University of Minnesota, spoke about which drugs are on the recommended list of the National Institutes of Health (NIH) and which have received an Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA).

- Unfortunately, we still do not have many drugs with proven effectiveness. Many different trials are underway at the same time, and it is hoped that new approved drugs will emerge. The most effective available for outpatients is monoclonal antibodies. The two antibody cocktails, Bamlanivimab / Etesevimab and Kasirivimab / Imdevimab, have received EUA and are being used very successfully. In clinical trials, treatment with an antibody cocktail has been shown to reduce the risk of severe illness and hospitalization by 70%. The drugs are recommended for children and adults at high risk, with diseases such as diabetes, heart and kidney diseases, obesity, asthma. One of the indications is old age.

Monoclonal antibodies are given intravenously. This is a one-time dose, and the administration of the drug takes about an hour. Infusions are done in specially equipped centers at hospitals, but in certain cases, nurses come to patients' homes.

This treatment is expensive, but it is covered by insurance. If you don't have insurance, the federal program pays for it, it won't cost you anything.

But this cocktail is prescribed, unfortunately, not often enough. First, the main difficulty lies in the fact that it must be applied within the first 10 days after the onset of symptoms. Many patients do not go for testing right away, so time may be lost. Secondly, there is low awareness among doctors. Not everyone knows about such treatment or is not aware of how to refer a patient to it.

As for other commonly prescribed outpatient medications - antipyretics, cough syrup - these are all symptomatic treatments that are not specifically directed against COVID-19. Research on bromhexine is underway, and preliminary results are encouraging so far. You can also take a teaspoon of honey for a cough (for those who do not have allergies and for children over a year old). In general, the benefits of most herbal supplements have not been studied, and there is no reliable evidence base. So it is with vitamins. It is known that people with a vitamin D3 deficiency have a high risk of hospitalization and severe illness. At the moment, vitamin D cannot be recommended as a treatment for covid due to insufficient information about its effect on the course of the disease. At the same time, vitamin D deficiency is a common and easily corrected problem.

Antibiotics (azithromycin or doxycycline) do not affect the course of viral infections. They can be prescribed if bacterial pneumonia is suspected. But as an antiviral or prophylactic treatment, their use is unfounded and involves the risk of growth of antibiotic-resistant bacteria.

As for hospitalized patients, the NIH currently only recommends corticosteroids (dexamethasone, methylprednisolone, or prednisone) and anticoagulants. In some cases, corticosteroids are given together with the immunosuppressant drug tocilizumab or the antiviral remdesivir. But this, I draw your attention, is only for hospitalized patients. For those who are treated at home, such medications are not indicated and are potentially dangerous.

Unfortunately, remdesivir itself was not as effective as we would like. The NIH and Infectious Disease Society of America (IDSA) recommend it only for patients requiring oxygen support based on multiple clinical trials and with low to moderate confidence. The use of remdesivir for the treatment of covid is not recommended by WHO outside of clinical trials.

As for hydroxychloroquine and ivermectin, they are not currently approved for COVID-19, and the NIH recommends prescribing them only as part of clinical trials. I believe these drugs deserve separate, independent trials. Believe me, doctors are no less interested in the fact that good medicines finally appear.

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Now it is interesting to compare how they tried to treat the coronavirus in April last year. You can read about it here .

How COVID-19 is treated: unofficially

“The owl put its ear to Buratino's chest.

“The patient is more dead than alive,” she whispered and turned her head back one hundred and eighty degrees.

The toad crumpled with a damp paw for a long time. Thinking, she looked with bulging eyes in different directions. She splashed with her big mouth:

- The patient is more likely alive than dead ...

The folk healer Mantis began to touch Buratino with his hands dry as grass blades. “One of two things,” he whispered, “either the patient is alive or he is dead. If he is alive, he will remain alive or he will not remain alive. If he is dead, he can be revived or not revived.

This is how, unfortunately, patients with COVID-19 are now being treated in many countries: they are sent home with antipyretics in anticipation of the development of the situation. Either the patient's condition will improve, or worsen, otherwise it is not given. And doctors and experts who insist on the need for early early treatment are ridiculed and obstructed. We decided to restore justice and gave the floor to the biochemist, the famous Russian-speaking  scientific  observer Veniamin ZAITSEV .

- The new virus - SARS-CoV-2 - is the most aggressive of all known coronaviruses in terms of contagiousness, but it is still the same respiratory virus. The mechanisms of infection and replication in the respiratory tract, as well as its further effects on the body, have already been described. But in many countries, medical officials stubbornly reject early treatment. The authorities took a strange path, announcing to people: if you feel symptoms, then sit at home and drink antipyretic. Despite the fact that mortality from covid is higher than that of influenza, and the more decisively early therapy and prevention should be applied!

As early as February 2020, China reported the success of numerous clinical trials to treat COVID-19 patients with chloroquine (CQ) and hydroxychloroquine (HCQ). A little later, the famous French professor Didier Raoul in his clinic in Marseille began to use the combination HCQ + azithromycin. He published a small clinical study that showed a therapeutic effect.

But then a historic event happened. During a press briefing by the Coronavirus Task Force on March 19, President Trump first mentioned that HCQ “could be a game changer” in the fight against COVID-19. I don’t want to touch on the issues of politics, but what happened next cannot be called otherwise than political games. A real scandal erupted in the oldest medical journal Lancet, which was dubbed "Lancetogate". There has been published a fraudulent analysis on the dangers of HCQ. When the article was withdrawn and the Lancet apologized for the publication, it was already too late - the text spread throughout the mainstream media, and it is still cited in various publications.

At the same time, 267 studies on HCQ have been published to date. It has been determined to be ineffective when taken very late at high dosages over a long period, but much more effective when taken early (first 5 days from the onset of symptoms) and at the correct dosage. It should also be taken with zinc, which has a strong inhibitory effect on viral replication by inhibiting the protease protein.

But be that as it may, under pressure from politicians, officials and other "interested parties", we have lost HCQ for early therapy. This is a cheap drug, you can't make money on it. At the same time, the same expensive Remdesivir is still recommended by the FDA and continues to be sold in 50 countries of the world, although even the WHO has recognized the inability of this drug to reduce mortality. Here is the answer to why cheap drugs are not approved.

Typically, research is paid for by a pharmaceutical company that markets its drug and wants to make money on it; it turns out that we are all hostages of producers' interests.

The same fate, I am sure, awaits ivermectin. An excellent drug with the same long history of use as HCQ. The scientist who discovered ivermectin received the Nobel Prize for it. For more than 30 years, almost 4 billion doses have been prescribed, hundreds of millions of people have been treated - all this indicates the high safety of the drug. It is known that this antiparasitic drug blocks the penetration of the virus into cells. To date, 70 studies have been carried out with the participation of 15.5 thousand people; 46 of them compared the results of the experimental and control groups. All 46 studies reported a positive effect of the drug. As a prophylactic agent, its effectiveness is 89%, with early treatment - 79%.

I would like to cite India as an example. There, despite the population density and high poverty, as well as the inaccessibility of medicine, there is a significant decrease in mortality. The Indian authorities at some point did not heed the recommendations of the WHO or foreign regulators that deny early therapy, but introduced preventive therapy and the principles of early treatment. There they began to produce Ziverdo kits, where there are three drugs in one blister - ivermectin, zinc and doxycycline. But in developed countries, they only relied on vaccines. I am not against vaccines, they have saved humanity from many serious diseases. But we simply cannot do large-scale vaccinations at the same time around the world.

What further improves the clinical picture. These are vitamin D3, zinc, bromhexine, loratidine, famotidine, quercetin + bromelain, spironolactone, good old aspirin, vitamin C. It turned out that melatonin, a well-known regulator of circadian rhythms, has antiviral activity. These are all inexpensive medicines and supplements, and they can be combined depending on the course of the disease and symptoms. Remember that all medications have contraindications, and be sure to consult your doctor. Choose the optimal regimen for you, based on your individual characteristics and medical history.

The virus is not so terrible, the main thing is to start treatment on time. The first 5 days from the onset of symptoms is a golden time, don't miss it! Don't wait until you feel bad and have difficulty breathing. Find your doctor with whom you can talk frankly about all possible medications and treatment regimens.

Victoria Averbukh

Published by " In the New World " March 19, 2021