— Russia, other ‘vaccine developers’ being engaged by Guyana

By Navendra Seoraj

GUYANA has already lost 46 persons to the dreaded Novel Coronavirus (COVID-19), but authorities will be looking to reduce the mortality rate with the introduction of the ‘Remdesivir’ drug which is being used by several countries to treat symptoms of COVID-19.
In the absence of a specific drug or vaccine to treat/prevent COVID-19, countries have been utilising drugs like remdesivir and hydroxychloroquine to limit the effects of the disease on infected persons.

While Guyana has been able to acquire and use hydroxychloroquine, Health Minister, Dr. Frank Anthony, said remdesivir has been out of the country’s reach for quite some time, as the supplier has been producing only limited amounts.
“Most of it is being consumed by the US…We have, however, been able to get a generic version from India,” said the minister, adding that Guyana has received 240 doses of the drug.

According to New England Journal of Medicine (NEJM), remdesivir, a nucleotide analogue pro-drug that inhibits viral RNA polymerases, has shown in-vitro activity against SARS-CoV-2 (COVID-19).

“We provided remdesivir on a compassionate-use basis to patients hospitalised with COVID-19, the illness caused by infection with SARS-CoV-2. Patients were those with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94 per cent or less while they were breathing ambient air or who were receiving oxygen support.

“Patients received a 10-day course of remdesivir, consisting of 200 mg administered intravenously on day one, followed by 100 mg daily for the remaining nine days of treatment,” said NEJM in an article published on April 10, 2020.

According to the report, of the 61 patients who received at least one dose of remdesivir, data from eight could not be analysed, meaning there were seven patients with no post-treatment data and one with a dosing error.
Of the remaining 53 patients whose data were analysed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan.

At baseline, 30 patients (57 per cent) were receiving mechanical ventilation and four (eight per cent) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68 per cent) had an improvement in oxygen-support class, including 17 of 30 patients (57 per cent) receiving mechanical ventilation who were extubated- when the doctor takes out a tube that helps you breathe.
The study found that a total of 25 patients (47 per cent) were discharged, and seven patients (13 per cent) died; mortality was 18 per cent (6 of 34) among patients receiving invasive ventilation and five per cent (1 of 19) among those not receiving invasive ventilation.
Guyana, having acquired the drug and having analysed available data, will be looking to use remdesivir in the COVID-19 Intensive care Unit (ICU) from this week. There are 16 patients in the unit.

CRITICALLY-ILL PATIENTS
“We have already decided on the protocol of use, so critically ill patients will benefit from it… we have seen that with the use of it in the US, it has reduced the severity and people, who have benefited from it, have recovered…hopefully we can get the same results,” said Dr. Anthony.
The remdesivir treatment will supplement the existing “convalescent plasma” treatment. It was reported that six critically-ill persons have been successfully treated using this method.

Monoclonal antibody therapy, as the treatment is called, is defined as a form of immunotherapy that uses monoclonal antibodies to bind specifically to certain cells or proteins.

The objective is that this treatment will stimulate the patient’s immune system to attack those cells. And, according to the World Health Organisation (WHO), since the last century, passive immunisation has been used for the prevention and treatment of some human infectious diseases. The serum of convalescent patients is the treatment of choice in cases of Argentine Hemorrhagic Fever.
In addition, WHO said it was used during outbreaks of Ebola in Africa and also during the SARS and MERS outbreaks, as no other therapeutic options existed.

“Experience to date with the use of convalescent plasma for the treatment of COVID-19 is limited, but preliminary results indicate potential usefulness. Several controlled clinical trials are underway, to collect more quality scientific evidence to confirm the safety and efficacy of this intervention,” said the international health organisation.

Given the positive results locally, Dr. Anthony said Guyana will continue to utilise the plasma treatment.
“I want to urge the public and persons who would have had COVID-19 and recovered from the infection, if they can help us by coming to the blood bank and donating plasma, it can make a difference between life and death,” said the health minister.

VACCINES

With treatment being secured for now, government has started engaging vaccine developers so that when a vaccine is approved, Guyana will not be left out.
The BBC News had reported recently that two trials of the Russian vaccine, named Sputnik-V, were conducted between June and July. According to the report, 38 healthy volunteers were given a dose of the vaccine and then a booster vaccine three weeks later.

The participants – aged between 18 and 60 – were monitored for 42 days and all of them developed antibodies within three weeks. Among the most common side effects were headaches and joint pain, said the BBC.

The trials are now in phase three, but the Russian Government has already told Guyana that the country can access the vaccine once the trials are completed and the vaccine gets approval. Next Thursday, a team from the Ministry of Health will be engaging the Russian Government on the vaccine.
“One of the things needed for us to exit COVID-19 is an effective vaccine… we are already in talks with facilities to be able to acquire a vaccine when it becomes available,” said Dr. Anthony.

In addition to Russia, local authorities have been engaging the Global Vaccine Alliance and the WHO, to ensure that vaccines are provided to Guyana when they become available. Guyana has also signed a letter of intent to be part of COVAX- an organisation co-led by WHO, which is examining 15 potential vaccines.

The Government of India through the Serum Institute is also looking to produce one billion doses of vaccine, and once those vaccines prove to be safe, Guyana will be able to benefit.

Guyana is also actively engaging Argentina and Mexico, but until a vaccine is approved, authorities will have to continue placing emphasis on reducing the spread of the disease and effectively managing cases.

If you have symptoms of COVID-19 or any concerns about which you need information, please contact the COVID-19 Hotline numbers – 231-1166, 226-7480 or 624-6674 – or visit the Ministry of Health’s website at www.health.gov.gy.