UWI lecturer highlights COVID considerations
LECTURER in Clinical Pharmacology at the University of the West Indies Dr. Kenneth Connell says there are a number of factors to be considered in the fight against COVID 19, a virus which he noted is as confusing to the medical fraternity as it is to patients.
He was one of the panellists discussing the possibilities of a cure during the People’s Business on the island’s lone state-owned television station recently, where explained that there are two to three ways in which the virus may have to be tackled as the race continues across the globe for ways to manage or eliminate the virus completely.
According to Dr. Connell, “There are two main pockets if you want to look at how COVID 19 acts. The virus attacks your body. Your body puts up a defence via the immune system. That defence usually works and it might be assisted with things like antibiotics but usually your own body’s defence system fights the infection and you get rid of it.”
“The catch with COVID is your defence system seems to also go awry. So in its fight against the virus, it also fights against the body. The immune system is attacking various organs causing lots of problems that are unwarranted. If I had to use an example, it’s as if a fly were to land on our hand and someone took a sledge hammer to kill it. It would certainly kill the fly but your hand would be no use afterwards.”
It is for this reason he explained, that treatments must attack the virus infection and the immune response, the latter of which he said, is not an easy task.
“If you attack the immune system too early, then that means that you have no immune system to fight the virus. If you attack it too late, it means it has already destroyed many of the organs of the body. And so it is no surprise therefore that the clinical trials looking at either therapeutic agents, or vaccines, aimed at one of these boxes.”
“For instance they may attack the virus using a cocktail of drugs, called antivirals. Many people are familiar with cocktails of drugs used to treat viruses like HIV and hepatitis. We have been using them for a very long time. The reason why we have to use a cocktail and not just one shot of a drug is because these viruses mutate. They have various mechanisms. The best way is to attack them at several points.”
He further explained that when it comes to dampening the immune system, it must be done in a “sophisticated” way. “And so drugs such as steroids, that kind of blunt the entire immune system... can do that. And so patients who have severe cases, on ventilatory support, dexamethasone has been stated in one clinical trial though not published, to have some benefit.”
“The problem of course is how do you predict who goes on to have a really bad immune response? You can’t look at a person and say that ‘I think you are going to give a bad immune response, let me give you a shot of dexamethasone now or take it before you even have C19’ because you can’t fight off the infection in the early.”
“So in summary the clinical trials have to be divided into two or even three pockets. Either you treat the infection or in this case a virus or you dampen the response at a particular time or the gold-standard, what we are all hoping for is a vaccine, where you train the immune system to recognise the virus and to fight it,” he said. (JH)