Guyana is currently in the process of commencing training for medical professionals under the World Health Organization’s (WHO) Solidarity Trial which would help determine the best treatments for COVID-19 patients.
Head of Medical Services at the Georgetown Public Hospital Corporation, Dr Mahendra Carpen in an interview with Stabroek News stated that the process has started for medical professionals to do online training to understand protocols and more under the Solidarity Trial. Dr. Carpen noted that while the process started a bit late, participation in the trial is still being pursued.
According to the WHO, the Solidarity Trial is an international clinical trial to help find an effective treatment for COVID-19, which was launched by the WHO and its partners.
It will compare four treatment options against standard care, to assess their relative effectiveness against COVID-19. By enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added to the ongoing trial based on emerging evidence.
Dr. Carpen noted that so far he and his team members have been putting in efforts to find effective treatments for COVID-19 patients who would need to be hospitalized after contracting the virus. “It’s an absolute team effort and we rely heavily on every member of the team”, he said.
The head of medical services noted that so far for treatment of hospitalized COVID-19 patients a number of drugs are being used and some are quite standard. With that he noted that patients are usually administered lots of Vitamin C supplements, zinc supplements and Vitamin D supplements. Additionally he mentioned hydroxychloroquine, a drug which is usually used to treat malaria, doxycycline, an antibiotic which is usually used to treat chest infections, dental infections and even Sexually Transmitted Infections (STI) along with another antibiotic, azithromycin which is used to treat a number of bacterial infections.
“We’re now starting to use ivermectin and of course some categories of patients qualify for steroid treatments which have shown to be quite effective” he said while adding that luckily, Guyana has the type of steroids which are recommended to treat those patients. Further, Dr. Carpen told this newspaper that a specific criterion determines how the drugs are used. The criterion includes the severity of the illness in the patient and presentation. “Across the board all our patients will get vitamins, will get zinc, likely get steroids and hydroxychloroquine, sometimes in combination with the antibiotics azithromycin and doxycycline” Dr. Carpen noted.
Additionally, he detailed that as they now implement the use of ivermectin, the drug has shown a number of benefits around the world and will be used as a part of the country’s national treatment strategy. The drug which he notes is quite old is used to treat parasitic infections like filaria. “They’ve had quite encouraging results with that particular medication around the world” he said while adding that though the drug is simple, it is effective to the point that the positives outweigh the negatives even as they await the arrival of drugs like remdesivir and others. This he noted is part of using what is available in Guyana’s resource-limited environment.
Meanwhile, he went on to say that Guyana has also employed the use of convalescent plasma also as treatment for the virus.
Convalescent Plasma treatment is where the plasma in recovered COVID-19 patients is used to treat severe ill patients and assist them in fighting the virus. The plasma of recovered patients contains antibodies specific to COVID-19. “When you get the infection as a patient you will develop resistance or antibodies to fight off the infection and once those patients are recovered, their defence mechanism remains active for a while. So we take that from the recovered patients, process it, make sure it is compatible with the recipient, and then patients who are sick and meet the criteria for this treatment we transfuse it like a normal transfusion” he said.
Dr. Carpen reported that so far about six or seven patients would have received the treatment while at the hospital.
Apart from the first patient who died, the other patients have survived and recovered from the virus after having two treatments with the plasma.
Even as the United States Food and Drug Administration recently granted approval of an emergency use authorization for convalescent plasma as treatment for the COVID-19 patients, Dr. Carpen when asked, said that all options would be explored to make patients better, if the use of the treatment has to be employed on a more widespread basis it will be given that consideration.
According to the medical services head, health officials note that the antibodies developed would last in the blood for approximately three months, and so for practical purposes, if the blood of patients are taken, they do not anticipate using the plasma if it has been kept for over three months.
