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Malaria Drug Helps Virus Patients Improve, in Small Study Malaria Drug Helps Virus Patients Improve, in Small Study
(32 minutes later)
The malaria drug hydroxychloroquine helped to speed the recovery of a small number of patients who were mildly ill from the coronavirus, doctors in China reported this week.The malaria drug hydroxychloroquine helped to speed the recovery of a small number of patients who were mildly ill from the coronavirus, doctors in China reported this week.
Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug. The authors of the report said that the medication was promising, but that more research was needed to clarify how it might work in treating coronavirus disease and to determine the best way to use it.Cough, fever and pneumonia went away faster, and the disease seemed less likely to turn severe in people who received hydroxychloroquine than in a comparison group not given the drug. The authors of the report said that the medication was promising, but that more research was needed to clarify how it might work in treating coronavirus disease and to determine the best way to use it.
“It’s going to send a ripple of excitement out through the treating community,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.“It’s going to send a ripple of excitement out through the treating community,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University.
The study was small and limited to patients who were mildly or moderately ill, not severe cases. Like many reports about the coronavirus, it was posted at medRxiv, an online server for medical articles, before undergoing peer review by other researchers.The study was small and limited to patients who were mildly or moderately ill, not severe cases. Like many reports about the coronavirus, it was posted at medRxiv, an online server for medical articles, before undergoing peer review by other researchers.
But the findings strongly support earlier studies suggesting a role for the drug, Dr. Schaffner said.But the findings strongly support earlier studies suggesting a role for the drug, Dr. Schaffner said.
“I think it will reinforce the inclination of many people across the country who are not in a position to enter their patients into clinical trials but have already begun using hydroxychloroquine,” he said.“I think it will reinforce the inclination of many people across the country who are not in a position to enter their patients into clinical trials but have already begun using hydroxychloroquine,” he said.
Previous reports from China and France that the drug seemed to help patients, along with enthusiastic comments from President Trump, have created a buzz around hydroxychloroquine and the closely related chloroquine, which are decades-old drugs used to treat malaria and autoimmune diseases like lupus and rheumatoid arthritis. A resulting spike in demand has led to hoarding and shortages, and left patients who rely on the drugs for chronic diseases wondering whether they will be able to fill their prescriptions.Previous reports from China and France that the drug seemed to help patients, along with enthusiastic comments from President Trump, have created a buzz around hydroxychloroquine and the closely related chloroquine, which are decades-old drugs used to treat malaria and autoimmune diseases like lupus and rheumatoid arthritis. A resulting spike in demand has led to hoarding and shortages, and left patients who rely on the drugs for chronic diseases wondering whether they will be able to fill their prescriptions.
With no proven treatment for the coronavirus, many hospitals have simply been giving hydroxychloroquine to patients, reasoning that it might help and probably will not hurt, because it is relatively safe.With no proven treatment for the coronavirus, many hospitals have simply been giving hydroxychloroquine to patients, reasoning that it might help and probably will not hurt, because it is relatively safe.
The earlier reports from France and China drew criticism because they did not include control groups to compare treated versus untreated patients. Researchers called the reports anecdotal, and said the lack of controls made it impossible to determine whether the drugs worked.The earlier reports from France and China drew criticism because they did not include control groups to compare treated versus untreated patients. Researchers called the reports anecdotal, and said the lack of controls made it impossible to determine whether the drugs worked.
Among health officials who declined to endorse the drugs, and who called for clinical trials, were some members of the president’s coronavirus task force — including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr. Stephen Hahn, commissioner of the Food and Drug Administration.Among health officials who declined to endorse the drugs, and who called for clinical trials, were some members of the president’s coronavirus task force — including Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Dr. Stephen Hahn, commissioner of the Food and Drug Administration.
The new study, of 62 patients with an average age of about 45, did have a control group. It was conducted at the Renmin Hospital of Wuhan University, in Wuhan, China. The patients were carefully chosen to exclude people with medical problems that could be made worse by hydroxychloroquine, like abnormal heart rhythms, certain eye diseases, and liver or kidney problems.The new study, of 62 patients with an average age of about 45, did have a control group. It was conducted at the Renmin Hospital of Wuhan University, in Wuhan, China. The patients were carefully chosen to exclude people with medical problems that could be made worse by hydroxychloroquine, like abnormal heart rhythms, certain eye diseases, and liver or kidney problems.
Half the subjects — the controls — received just the usual care given to coronavirus patients, and half had usual care plus hydroxychloroquine. The usual care included oxygen, antiviral drugs, antibiotics and other treatments.Half the subjects — the controls — received just the usual care given to coronavirus patients, and half had usual care plus hydroxychloroquine. The usual care included oxygen, antiviral drugs, antibiotics and other treatments.
Their disease was considered mild, even though all had pneumonia that showed up on CT scans. After giving informed consent, they were assigned at random to either the hydroxychloroquine or the control group. They were treated for five days, and their fevers and coughing were monitored. They also had chest CT scans the day before the study treatment began, and the day after it ended.Their disease was considered mild, even though all had pneumonia that showed up on CT scans. After giving informed consent, they were assigned at random to either the hydroxychloroquine or the control group. They were treated for five days, and their fevers and coughing were monitored. They also had chest CT scans the day before the study treatment began, and the day after it ended.
Updated June 30, 2020
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
Coughing and fever eased a day or so earlier in the patients who received hydroxychloroquine, and pneumonia improved in 25 of 31, as opposed to 17 of 31 in the controls.Coughing and fever eased a day or so earlier in the patients who received hydroxychloroquine, and pneumonia improved in 25 of 31, as opposed to 17 of 31 in the controls.
The illness turned severe in four patients — all in the control group.The illness turned severe in four patients — all in the control group.
Two patients had minor side effects from hydroxychloroquine: One had a rash and another had a headache.Two patients had minor side effects from hydroxychloroquine: One had a rash and another had a headache.
Dr. Schaffner cautioned that the results applied only to patients with relatively mild illness, like the ones in the study, and could not be generalized to advanced cases.Dr. Schaffner cautioned that the results applied only to patients with relatively mild illness, like the ones in the study, and could not be generalized to advanced cases.
“If you want to treat people who are already seriously ill, we don’t know how well this will work,” he said.“If you want to treat people who are already seriously ill, we don’t know how well this will work,” he said.
If the drug is helping, it is not clear how. There are two possible ways. In laboratory studies, it can stop the virus from invading cells. But hydroxychloroquine can also dial back an overactive immune system, which is why it can treat autoimmune diseases. And a powerful immune reaction to the coronavirus is suspected of playing a role in some of the severest cases of the disease.If the drug is helping, it is not clear how. There are two possible ways. In laboratory studies, it can stop the virus from invading cells. But hydroxychloroquine can also dial back an overactive immune system, which is why it can treat autoimmune diseases. And a powerful immune reaction to the coronavirus is suspected of playing a role in some of the severest cases of the disease.
“We don’t know which of the pharmacologic aspects of hydroxychloroquine are most active, the antiviral part, or the immunomodulatory part,” Dr. Schaffner said. “We don’t know, but it does reinforce the notion, as the authors say briefly, it reinforces the thinking about the nature of many of these pneumonias we are seeing, which seem to have an immune basis, as opposed to being secondary bacterial pneumonia, which we see so often in influenza.”“We don’t know which of the pharmacologic aspects of hydroxychloroquine are most active, the antiviral part, or the immunomodulatory part,” Dr. Schaffner said. “We don’t know, but it does reinforce the notion, as the authors say briefly, it reinforces the thinking about the nature of many of these pneumonias we are seeing, which seem to have an immune basis, as opposed to being secondary bacterial pneumonia, which we see so often in influenza.”