The United States now has the most cases of COVID-19 in the world because we were not prepared for the pandemic. COVID-19 first appeared in early December in a seafood and live animal market located next to a major train station in Wuhan, China. Three nearby countries, South Korea, Taiwan and Vietnam, were able to control the spread of COVID-19 because by the end of December, they had recognized the potential epidemic and aggressively tested suspected cases to separate them from society before they spread the disease exponentially through their communities. A key to stopping an epidemic is to find and isolate cases before they infect the community. These countries:
• warned their citizens of the seriousness of COVID-19,
• had the available diagnostic testing to diagnose infection,
• offered special booths for testing individuals by insulated and protected workers, and
• isolated the people who were found to be infected.
As of 3/27/20, we have no drugs that have been proven to be effective for shortening the course of COVID-19 infections. Several possible drugs are currently being tested in the midst of the massive outbreak in New York City. The inexpensive malaria drug, chloroquine phosphate, has been reported to reduce symptoms and hasten recovery in small studies (Biosci Trends, Mar 16, 2020;14(1):72-73). This is the drug that has been used for more than 70 years to treat malaria. The similar drug, hydroxychloroquine (trade name Plaquinil), is also being tested, alone or in combination with azithromycin (Zithromax), an antibiotic. The Japanese antiviral drug, favipiravir (Avigan) or favilavir, was tried in two studies in China, one on 340 patients and one on 70 patients, and appeared to be “safe and effective.” AIDS drugs, flu drugs, ACE inhibitor blood pressure pills, and interferon are all controversial, with most experts saying that they have not been shown scientifically to be effective. Pain medicines such as ibuprophen or Tylenol may relieve some of the discomfort, but do not shorten the course of the disease.
Many companies are working to develop blood tests to see if a person has been infected with COVID-19 and is therefore now immune and protected from getting the infection again. These people may then be in the front lines to treat people who are currently infected, and may be able to donate blood with antibodies that could be helpful in treating COVID-19 patients. Vaccines are also being developed but are not likely to be ready for 12-24 months.
Restrictions on movement and social distancing should not be lifted until the number of cases of COVID-19 starts to go down, and in my opinion, that is not likely to happen until July or August. For my latest summary and recommendations on COVID-19, see The Current Coronavirus Pandemic
