Hydroxychloroquine use prior to coronavirus infection may not reduce COVID-19 deaths…but clinical trials required
Hydroxychloroquine was quickly thrown into a global spotlight after it garnered simultaneous praise and criticism from a number of high-profile sources. The drug has since been investigated in several randomised clinical trials and observational studies. Most studies to date have shown no evidence of a benefit of hydroxychloroquine as a treatment for patients admitted to hospital who already have COVID-19.
As I left the UN General Assembly High-Level Meeting on Ending TB in New York two years ago, there was renewed hope that this could be a turning point for accelerating progress against tuberculosis (TB). But COVID-19 has shifted global TB control from acceleration into reverse.
Also contributing to this opinion piece were: Sharifah Sekalala, Associate Professor at the University of Warwick; Judith Bueno de Mesquita, Co-Deputy Director at the Human Rights Centre, University of Essex; Claire Lougarre, Lecturer and Director of the Centre for Health Ethics and Law at the University of Southampton; and Michel Coleman, Professor of Epidemiology and Vital Statistics at the London School of Hygiene & Tropical Medicine.
Antimicrobial resistance threatens one of the most important infrastructures created in the past century: antibiotics. At first glance, it may seem odd to think of antibiotics as infrastructure. Think again. These drugs are everywhere. So engrained has their use become that we now expect – rather than pray for – infectious diseases to be cured. But antibiotics are not only used in the treatment of acute infections.
Manipulation of the chicken gut microbiome, a possible way to reduce Campylobacter and improve poultry performance?
Chickens are a key source of protein for humans. The poultry industry is predicted to produce approximately 130 million tons of chicken meat in 2020. It is critical that we have sustainable practices to maintain an adequate supply of poultry products for the increasing human population without compromising chicken or human health.
The topic remains a top priority in everyone’s mind as more and more candidates are now going into human trials. Early safety and immunogenicity data are starting to be published for an increasing number of vaccine candidates, and several of these have already progressed to phase III efficacy studies. It’s hard to keep track! This is where we have stepped in.
Throughout January and February the first clinical descriptions of the consequences of infection with the virus, SARS-CoV-2, were being published. When the epidemic in the UK started, we still only knew relatively little about the spectrum of disease that the virus could cause. We name the disease COVID-19, but what is COVID-19? We are fortunate that we have a test (the test for HIV came several years after the first disease, and we still do not have a definitive pre-mortem test for vCJD). So the sensible definition of COVID-19 is “sick and positive test”.
Many countries face the prospect of continued large-scale transmission of COVID-19 or its re-emergence as a second wave. Responses from governments and health systems have, unsurprisingly, been mixed: we’ve seen some innovative, effective measures but we got many things wrong. What matters now is that we have remarkable opportunities to learn from the first wave.
In the UK, emergency measures were taken to reduce transmission in March. Asking people to stay at home meant that the networks through which the virus moves were broken. We know that there are four main activities and settings in which people meet: home, work, school and leisure. Leisure was closed completely, and school/work contacts reduced as much as possible.
I took off my face mask when I arrived home from the health centre with my daughter, who had just received her final round of infant vaccines. The outing left me filled with gratitude that I have such ready access to medical resources to protect myself and my family during the COVID-19 pandemic. My experience is far removed from that of so many people who live with the constant threat of infectious disease and who are less insulated from the consequences of a deadly pandemic.