March 20 Update: drug treatment strategies for COVID-19
- March 20, 2020
MDI Biological Laboratory President, Hermann Haller, M.D., is currently self-isolating for 14 days after arriving from Germany last week. As a physician scientist, he has experience treating patients with Coronavirus infections, is serving on several taskforces for COVID-19 and is consulting (virtually) with medical professionals on MDI and across the globe. Dr. Haller has been providing leadership and guidance during this time of uncertainty and worry, and we wanted to share some of his thoughts with you.*
If you have a particular question for Dr. Haller about COVID-19/Coronavirus, you can email him at firstname.lastname@example.org
*Note: the following statements do not constitute medical advice. If you have concerns about your health, please contact your health care provider for specific advice.
March 20, 2020
I hope everyone is doing well. From an operational perspective, MDIBL is well prepared. In the best of the MDIBL tradition, our staff has risen to the occasion – volunteering to pitch in wherever they are needed. As we work to ensure our critical functions (such as the animal facility) continue to operate smoothly, Iain Drummond has organized a staffing plan that includes training members of the research staff and administration to assist with care and feeding of our animals, should that be necessary. One-on-one training (maintaining appropriate distance) begins in earnest next week.
Only a few experiments in the labs are still ongoing. There are still lots of questions, but our staff is calm as we await the storm. I continue to be in close contact with Jackson Lab, College of the Atlantic and the MDI Hospital as we work together to ensure we are as prepared as possible for what is to come.
Some of you may have seen in the news discussion of a number of potential treatments for COVID-19. I would like to add my personal analysis of the treatment strategy situation for COVID-19 below.
Drug treatment strategies for COVID-19
The question of when and which drugs will be available to treat COVID-19 is important and hotly discussed world-wide. I will try to outline where we stand:
Three approaches are possible: to use (1) existing broad-spectrum antiviral drugs, to use (2) existing compounds based on the biophysical understanding of action and/or to use (3) more “exotic” approaches using Chinese traditional medicine, such as ShuFengJieDu Capsules and Lianhuaqingwen Capsules
- Several antiviral drugs such as Lopinavir /Ritonavir, Nucleoside analogues, Neuraminidase inhibitors, Remdesivir, favipiravir, and peptide (EK1) are presently feverishly tested. However, the efficacy and safety of these drugs still need to be further confirmed by clinical experiments.
- Existing compounds. In this category the most promising drug is chloroquine*. Chloroquine is a medication used to prevent and to treat malaria. Chloroquine has antiviral effects, which works by increasing endosomal pH required for the virus/cell fusion process.. Chloroquine also seems to act as a zinc ionophore, allowing extracellular zinc to enter the cell and inhibit viral RNA dependent RNA polymerase. I have to admit that chloroquine is a possible treatment strategy. I was tempted myself to bring it with me to the US. The drug is produced by Bayer and can be safely taken. Whether it works we don´t know for sure. Importantly, the drug is not without side effects. Common side effects include muscle problems, loss of appetite, diarrhea, and skin rash. Serious side effects include problems with vision, muscle damage, seizures and bone marrow.
- The drugs in this category have been mostly recommended by Chinese doctors especially from Wuhan. I have great respect for Chinese traditional medicine but have no idea whether these compounds work in COVID-19. I have heard from colleagues form China about these drugs, but these were individual patients and cases. I would be cautious.
* Chloroquine, or hydroxychloroquine, has been used to treat malaria since 1944. David Evans just informed us that there is, as is often the case, a connection between this drug and MDIBL. He wrote: “It turns out the Bob Berliner and Gordan Zubrod were very instrumental in the early tests of the drug, and Zubrod was credited for its use in WWII, which saved thousands of lives.”
Zubrod was a visiting scientist at MDIBL from 1951 – 1959. He worked with Jim Shannon (also an MDIBL visiting scientist) at NYU testing various chemotherapy agents for malaria. Zubrod went on to work at Johns Hopkins, was later recruited to establish the Department of Medicine at St. Louis University, then ultimately recruited by Shannon to the NIH where he became the Clinical Director of the National Cancer Institute. MDIBL’s history is rich indeed.