Tuesday, September 07, 2021
Promising drug a new weapon in curbing COVID’s worst effects
Comment from Australia
Yesterday 1281 new cases of COVID-19 were reported in NSW. By October many of these will be seriously ill in hospital, some in intensive care, and a few will die. Others will progress to indefinite multifaceted illness called “Long COVID”.
Can this miserable trajectory be modified, while we wait for the vaccination drive to “stop the spread”?
Clinical trials and overseas experience with a class of therapeutic drugs called monoclonal antibodies suggests that it can – but only when they are given early. COVID-19 patients treated in a trial of one such drug called Sotrovimab exhibited an 79 per cent relative reduction in hospitalisation and deaths. In March, the independent regulator halted patient recruitment because of “profound efficacy”. Even with small numbers, before the Delta outbreak, the statistics were persuasive.
The first of 7700 doses of Sotrovimab quietly slipped into Australia three weeks ago. We have waited some time. It now has Therapeutics Goods Administration provisional approval for vulnerable patients, such as the elderly and immunocompromised. It is being used in Shepparton, Victoria. What are the plans for NSW?
Sotrovimab is the latest and, possibly, best therapeutic monoclonal antibody to inhibit the COVID-19 virus attaching to human tissue. The US Federal Drug Authority authorised its emergency use in May. The headline cost is $US2100 a dose, and it’s free to vulnerable Americans.
President Trump was treated with, among other drugs, a duo of anti-COVID monoclonal antibodies labelled Regeneron, similarly authorised in America last November. The US National Institute of Health recommends either drug for vulnerable patients. Don’t mention them in the same breath as ivermectin or hydroxychloroquine.
With COVID on the march in America, antibody distribution has massively scaled up. The Texas state government has just established public antibody infusion centres.
Intravenous antibody infusions take an hour, in infectious patients. No small short-term imposition on overstretched health systems. Yet, one which could prevent a much greater hospital overload in the months which follow. Perhaps a treatment centre on an oval near a hospital should be considered. Like the precautionary Surge Centre in Canberra.
The United Arab Emirates, where Delta is prevalent, and logistics are military-grade, announced striking results, with no deaths among 6175 COVID-19 patients treated in July.
Nevertheless, and crucially, immunologists worry that indiscriminate use of a single antibody such as Sotrovimab might cause resistant variants to emerge and leak into the community. It is no substitute for vaccination. The ethical issues are obvious.
Monoclonal antibodies attack and disable unwanted targets. Think Herceptin for breast cancer, Keytruda for melanoma , Emgality for migraine and Humira for arthritis - all monoclonals, each created or modified for a very specific target. Each is a feat of structural molecular engineering.
It was Britain’s Cambridge scientist, Sir Gregory Winter, who devised and developed the generic technology that underpins monoclonal antibodies. At first, business failed to see their potential. And so, as he recounted in his 2018 Nobel address and at Sydney University in 2019, it was seed-funding from the Australian racing industry which launched monoclonal antibodies to market. The deal was done on a boat on Sydney Harbour. He overheard a whispered comment “Let’s give Greg the money. Let’s see how the boffin trots”. Annual monoclonal revenues now well exceed $100 billion, to untold human benefit.
The Australian perspective has come full circle. Professor Daniel Christ is a former PhD student of Winter’s and is now at the Garvan Institute. He sees a way around this antibody resistance problem. And he looks to the experience in treating HIV infection with three different drugs which curbed that epidemic.
Since early 2020, his team has worked flat out to create monoclonals against COVID-19. They now have three antibodies which are more potent than Sotrovimab in vitro, When used together, they should be very resistant to mutation escape.
If these ventures succeed, Australians will have good reason to be thankful for investment in science.
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New study finds AstraZeneca more effective against Delta strain
Deakin University Chair of Epidemiology Professor Catherine Bennett says the AstraZeneca vaccine is more effective than others against the Delta strain of COVID-19 in certain instances.
Professor Bennett cited a new study from Bahrain, conducted in partnership with Columbia University in the United States, which found “extraordinary differences” when comparing a number of vaccines.
“They found for those over 50 … 44 times less likely to end up in ICU if you have AstraZeneca, and I think it’s 33 times less likely with Pfizer,” Professor Bennett told Sky News host chris Kenny.
“Both extraordinarily effective, but AstraZeneca actually has the edge on that.”
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Suicide a bigger problem than Covid
Comment from Australia
One-in-four Australians say they know someone who died by suicide or attempted to take their own life in the past year – equivalent to five million adults – a new survey has found.
Suicide Prevention Australia chief executive officer Nieves Murray said major social and economic events had historically influenced suicide rates.
“We know social and economic isolation are the biggest drivers of suicide rates and Covid-19 has seen Australians subject to 18 months of rolling lockdowns and disruption to their personal lives, employment and businesses,” she said.
“We’ve seen how quickly Covid-19 cases can get out of hand and we need to have the same national policy focus and vigilance to stop suicide rates doing the same.”
The survey commissioned by Suicide Prevention Australia and completed by YouGov in August, found 25 per cent of adult Australians surveyed knew someone who had died by suicide or attempted to take their own life in the previous 12 months. About 15 per cent knew the person directly, while another 11 per cent knew them indirectly.
About 16 per cent said they had sought help or searched for advice from a suicide prevention service in the past 12 months, about 16 per cent said they had indirectly sought help.
Most people thought “social isolation and loneliness” was the biggest risk to suicide in the next 12 months, with 64 per cent rating it as an issue.
This was followed by unemployment and job security (58 per cent); family and relationship breakdowns (57 per cent); cost of living and personal debt (55 per cent); and drugs and alcohol (53 per cent).
While the latest data from suicide registers in New South Wales, Victoria and Queensland do not show an increase in suspected suicide deaths in 2020, or since the Covid-19 pandemic began, Ms Murray said the number of deaths in 2019 had been the highest recorded in Australia, growing from 3093 in 2015, to 3318 in 2019.
“There have never been more lives lost to suicide in this country,” Ms Murray said.
Those surveyed were particularly worried about the suicide risk among young people aged 12-25 years old (42 per cent), followed by middle aged Australians aged 25-55 years old (29 per cent) and men (29 per cent).
Other people thought to be at risk were those living in regional and rural areas (24 per cent), LGBTQI Australians (21 per cent), Indigenous Australians (18 per cent) and those aged over 55 (18 per cent).
The survey also supported a stand-alone national suicide prevention act, similar to one introduced in Japan, which would require the Federal Government to consider and mitigate suicide risks when making all decisions, not just ones related to health.
About 66 per cent thought Australia should introduce similar legislation.
Ms Murray said legislation was the best prevention against suicide rates increasing.
“The heightened economic and social threat posed by Covid-19 means we cannot afford to wait to legislate,” Ms Murray said.
“Australia needs a national suicide prevention act and we need to act now. “We all have a role to play in preventing suicide. An act will legislate a whole-of-government priority to prevent suicide and focus the attention of every agency to address the risk of suicide across our community.
“Suicide prevention isn’t limited to health portfolios. Housing is suicide prevention, employment is suicide prevention, finance is suicide prevention, and education is suicide prevention.”
The organisation noted that more than three times the amount of people died from suicide in 2019 (3318 people) than have died from Covid-19 since the pandemic began (1019 people as of September 2).
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Also see my other blogs. Main ones below:
http://edwatch.blogspot.com (EDUCATION WATCH)
http://antigreen.blogspot.com (GREENIE WATCH)
http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)
http://australian-politics.blogspot.com/ (AUSTRALIAN POLITICS
http://snorphty.blogspot.com/ (TONGUE-TIED)
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