According to Alex Azar, secretary of Health and Human Services, and chair of President Trump’s Coronavirus Task Force,
“Although the virus represents a potentially very serious public health threat, and we expect to continue seeing more cases here, the immediate risk to the American public is low at this time,”
I agree. Especially when you look at the influenza virus, which is causing a lot of morbidity and mortality in Americans right now, it’s going around like crazy right now.
Mr. Azar also said. “We are working as quickly as possible on the many unanswered questions about this virus. That includes exactly how it spreads, how deadly it is, whether it’s commonly transmitted by patients who are not yet displaying symptoms, and other issues.”
Meanwhile, there might be an adequate drug on the horizon to treat the coronavirus.
There is currently a randomized, controlled clinical trial for a new antiviral drug for the novel coronavirus. The drug is called remdesivir, and is currently being given in China to some patients with the novel coronavirus.
On Jan 26, a 35-year-old patient in the U.S. with 2019-nCoV received remdesivir, a week after he was admitted to the hospital, according to reports.
Five days after being treated with remdesivir, with all of his symptoms resolving except for his cough, which had improved.
Remdesivir is a novel nucleotide analog prodrug, originally developed by the biopharmaceutical company Gilead Sciences as a treatment for Ebola and Marburg virus, though it has subsequently also been found to show reasonable antiviral activity against somewhat related viruses like respiratory syncytial virus and coronaviruses.
Remdesivir is yet to be approved anywhere globally, and although it appears to be safe, it still has not been proven to be safe or effective for any use.
However, the encouraging result prompted Gilead and the Chinese authorities to move the phase III trial ahead and expand it to a lot more patients who need treatment desperately.
The clinical trial is expected to be completed in April.
So as of right now, the standard of care for coronavirus consists of supportive treatment only, meaning there is no specific treatment.
Besides this drug to potentially treat coronavirus, there are also several organizations and investigators working on developing a vaccine for the 2019-nCoV.
Also, the NIH is working with Moderna Inc. to develop a vaccine built on a messenger RNA platform.
According to Dr. Fauci, “One of the first steps is to successfully get that novel coronavirus gene and insert it into the messenger RNA platform successfully and allow it to express proteins. We’ve succeeded in that.
The next step is to put it in a mouse animal model to induce immunogenicity and to get the company to make gold nanoparticle products. All of those have been successfully implemented”.
Also, as of February 7th – more action is being taken to protect Americans from a potential coronavirus epidemic.
Now let’s talk about testing for coronavirus.
The test is a real-time PCR testing.
Because this is a new virus with new testing, the exact accuracy of the test, meaning sensitivity and specificity of the test, is still not known.
A positive test becomes more accurate when there is a high positive predictive value.
For example, if someone comes into contact with someone from Wuhan, China, and they develop symptoms, and they have secretions coming from their nose, and those secretions are swabbed, a positive test result is more likely to be accurate.
In contrast, if someone who does not have symptoms, and they have a positive test result, the test is more likely to be a false positive.
Now let’s look at another situation. What if someone comes into contact with someone who has coronavirus, and then they develop symptoms, but have a negative test result? In that case, the test would have a low negative predictive value, meaning, the test is more likely to have a false negative.
So, the false-negative tests are most likely to occur when someone is tested at the onset of infection before they become more symptomatic.
Dr. Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine
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