Even after almost a year of its worldwide invasion the SARS-Cov-2 virus called COVID-19 continues to enjoy an edge over humankind which is not surprising considering the unprecedented crisis brought in by a virus hardly known to anybody, its seemingly selective approach in terms of mildness or severity of the infection, baffling all medical scientists and doctors. Humankind, in its present very advanced stage of the knowledge search, is never a party to accept defeat, and therefore, the quest has been relentlessly going on all over for an effective vaccine, and in the meantime intent research on anti-viral or anti-malarial repurposed drugs, plasma therapy and other possible methods of treatment. The main concern of all efforts being at least to reduce the mortality rates which also differ country-wise and inexplicably, and till today it has been an accepted fact that there is no cure for the disease. Various vaccine projects in various stages of development are in full swing in various countries with most of them promising a vaccine by the new year day or early next year. Now, the latest disappointing developments on treatment methods practiced so far have posed the most relevant question: is an effective vaccine only hope for humankind?
Most of us remember the desperate international craving for a basically Indian anti-malarial drug called Hydroxychloroquine (HCQ) when the pandemic was raging furiously in Europe and the US, and the US President going to the extent of threatening India if supplies of HCQ were not. However, slowly over time this drug was found ineffective and a bit harmful too in respect to natural immunity. Then there were several other drugs and steroids that were used with seemingly hopeful results, Remdesivir being the one most welcomed one as a life-saver.
The results of the Solidarity Clinical Trial, one of the largest international Randomized Controlled Trials (RCT), that has been conducted by the World Health Organization (WHO) since March 2020 were declared recently which marked four of the most promising drugs as ineffective in reducing mortality. The four evaluated treatment methods, HCQ, Remdesivir, Lopinavir or Ritonavir and Interferon, have been found to have little or no impact on mortality rates. As far as the RCTs conducted in various countries of the world including in China are concerned there have always been doubts on their findings, and experts feel the need for more such studies. Objections were raised against the Solidarity Trial too as regards to its sampling methodology from various quarters, with one Indian hospital refusing to stop using Remdesivir claiming its benefits over the months in their patients. However, technically, it means that except for Corticosteroids which have been proven effective in treating critical patients there is no other deemed treatment method, and it also must be remembered that steroids are not recommended for less-severe or general patients.
More disappointing news came next from the Indian Council of Medical Research (ICMR) on the efficacy of the Convalescent Plasma Therapy (CPT), so far permitted as an investigational therapy in progressive stages of the disease in India, which involves taking out blood plasma from recovered COVID-19 patients and injecting this antibody-rich extract into positive patients, particularly the more severe ones treated in hospitals. Over the months it has been developed into a systematic treatment method creating proper channels of donations across the states as infected doctors too made it a point to donate the precious plasma.
The Director General of the ICMR declared the results on 20th October 2020 after conducting its own RCT during April-July period of the year covering over 400 hospitals across 39 medical centers of the country. Based on the results the ICMR has concluded that the CPT fails to reduce the mortality rates or prevent the progression of COVID-19 infections from moderate to severe stages. Following this finding the Government of India is mulling removal of CPT from its COVID-19 protocol for national clinical management. This is indeed sad news as CPT has been a very popular method of COVID-19 treatment in the absence of an effective vaccine.
Experts, however, are not convinced about the CPT results saying that it may have had to do with the delay of the infusion and the quality of the antibodies. Internationally, the CPT continues to be a treatment method meant only for emergency use. Anyway, in view of all these findings the importance of discovering an effective vaccine grows even more. The pandemic is far from keeping its clutches off humankind yet: after over six months of haphazard acceleration India has finally reached its peak in the third week of September 2020 with new cases still hovering around fifty thousand a day and 500+ daily deaths while the European countries and the US are experiencing a second wave.
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