Copyright 2021 Robert Clark
https://www.washingtonpost.com/world/researchers-ponder-why-covid-appears-more-deadly-in-the-us-and-europe-than-in-asia/2020/05/26/81889d06-8a9f-11ea-9759-6d20ba0f2c0e_story.html
This is a graphic from an article published last May that showed Asian countries had radically reduced COVID-19 fatalities compared to Western ones, sometimes by two orders of magnitude.
That was then, what about now? The fatality rates in Asian countries are still radically reduced compared to Western ones. Only now, we also have data that shows fatality rates in Africa are also radically reduced compared to Western ones, again sometimes by two orders of magnitude.
But Asia and Africa make up 3/4th’s of the worlds population. Then the West is the outlier with these horrendous fatality rates.
March 8, 2021
By David Leonhardt
Good morning. Why has Covid’s toll been surprisingly low across much of Africa and Asia?
‘An epidemiological whodunit’
It’s one of the biggest mysteries about Covid-19: Why has the death toll been relatively low across much of Africa and Asia?
The virus has killed a fraction of as many people on those continents — despite their relative lack of resources — as it has in Europe or the U.S.:
The article links to a well-written article by physician Dr. Siddhartha Mukherjee that examines the mystery.
But Mukherjee’s article, once again, does not address a key question: what are the treatment strategies in those countries with radically reduced fatality rates?
This is a doctor writing this, mind you. A doctor who’s job is to treat people. Yet he doesn’t even ask of these countries something you would think would occur to any doctor to ask: how do you treat your sick?
Coronavirus Chronicles
March 1, 2021 Issue
Why Does the Pandemic Seem to Be Hitting Some Countries Harder Than Others?
While the virus has ravaged rich nations, reported death rates in poorer ones remain relatively low. What probing this epidemiological mystery can tell us about global health.
By Siddhartha Mukherjee
February 22, 2021
https://www.newyorker.com/magazine/2021/03/01/why-does-the-pandemic-seem-to-be-hitting-some-countries-harder-than-others?te=1&nl=the-morning&emc=edit_nn_20210308
By the way, the title is a bit misleading. It is also rich Asian countries that have radically reduced fatality rates compared to the West. The only common denominator is that they either treat COVID-19 with antivirals EARLY or drugs with antiviral capability are already in wide use in these countries as antimalarials or anti-parasiticals.
In these articles once again nowhere did they even ask the question what treatments are they using in these countries with the radically reduced fatality rates. These are doctors investigating this remember, doctors whose job is to treat people, and they never ask the question how do you treat your sick.
The national treatment protocols for COVID of giving antivirals EARLY for some of the Asian countries go all the way back to last year to March. It’s stunning when you think about it but if the question had been asked of them of what treatment strategies do you use, the researchers would have gotten the answer over and over again, “We use antivirals EARLY”, “We use antivirals EARLY”, “We use antivirals EARLY”, “We use antivirals EARLY”. It would then have been apparent that EARLY treatment with antivirals is important for bringing the virus under control.
This study also concludes countries using anti-malarials are much better at keeping the epidemic under control:
Some national treatment protocols in Asian countries advising EARLY treatment with antivirals:
In China:
Chinese Clinical Guidance for COVID-19 Pneumonia Diagnosis and Treatment (7th edition)
Page Views 浏览量: 145539 Updated 发布时间:2020-03-16 12:00:32
http://kjfy.meetingchina.org/msite/news/show/cn/3337.html
And:
Health 17:30, 26-May-2020
COVID-19 treatment: Antivirals, anti-inflammatory drugs, blood thinner and mechanical ventilation
Updated 22:28, 26-May-2020
Antiviral treatment
Ranko Škrbić, dean of the Department of Pharmacology at University of Banja Luka, asked about the most effective antiviral therapy that has been used in the Chinese hospital against the coronavirus.
Hou Xinguo, Deputy Director of Endocrinology Department at Qilu Hospital, said that several antiviral drugs including alpha-interferon, ribavirin and abidol have been recommended in the COVID-19 diagnosis and treatment guideline issued by China's health authorities. But based on their clinical experience, the antivirals could be useful on patients only at the early stage of infection, as they did not have significant effects on severely ill patients.
He added that according to the guideline, no more than two antiviral drugs should be used in combination.
And:
Published online 2020 Oct 8. doi: 10.1080/20016689.2020.1818446
PMCID: PMC7580738
PMID: 33133431
Chinese guidelines related to novel coronavirus pneumonia
Tingting Qiu, Shuyao Liang, Monique Dabbous, Yitong Wang, Ru Han, and Mondher Toumi
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580738/
In South Korea:
Gov't recommends use of antiviral drugs for COVID-19 treatment
Published on Feb 13, 2020
'고령•중증에 에이즈치료제 권장'…코로나19 치료원칙 나왔다
South Korea has unveiled a set of treatment guidelines for COVID-19.
It consists of administering an anti-HIV medication twice a day.
This is the nation's first treatment protocol for those who show severe symptoms.
Kim Jae-hee has our top story.
Infectious disease experts in South Korea have agreed to the use of antiviral drugs in the treatment of severe coronavirus cases, senior patients, and those with underlying diseases.
On the other hand, it was concluded that young patients, or those with mild symptoms, seemed to have improved after 10 days and without any antiviral treatment.
"Young and healthy people have mostly shown improvement without any special treatment. But older patients or those with underlying diseases are in need of the medication from an early stage."
Expert says differences in treatment depending on a patient's age is actually quite normal.
"Most viral infections tend to heal even without any treatment... thanks to our body's immune system. But old age in itself can raise risks,... and many senior patients have underlying diseases, so it's recommended that they undergo antiviral treatment."
The government's guidelines recommend Kaletra, an anti-retroviral medication used to treat AIDS for a duration of 7 to 10 days.
Chloroquine or Hydroxychloroquine, a medication used to prevent and treat Malaria can be used as an alternative.
But experts says, while the government's announcement may sound promising, it might not make much of a difference to current treatment metThere won't be a significant difference in the treatment methods. It's an antiviral drug that we are already using, and its effectiveness has not been fully proven. It's still just a recommendation."
But the expert is optimistic, saying that the recurrence rate of the novel coronavirus is low.
"It seems unlikely that a recovered patient will catch the virus again. In fact, there are very few reports of patients being re-infected when they've recovered from other coronavirus diseases such as SARS and MERS."
He added that all seven of the patients who have made full recoveries in South Korea had no serious underlying diseases, and are unlikely to be re-infected.
Kim Jae-hee, Arirang News.
#Wuhan #coronavirus #drugs
Gov't recommends use of antiviral drugs for COVID-19 treatment
In Taiwan:
Interim Guidelines for Clinical Management of SARS-CoV-2 Infection
(5th edition)
Translation Editor-in-Chief Prof. Wang-Huei Sheng, M.D. PhD et al.
Affiliation Department of Medicine, National Taiwan University
Ministry of Health and Welfare
Taiwan Centers for Disease Control
March 26th, 2020
https://www.cdc.gov.tw/En/File/Get/_Dv_q75ZjLcNeRvlnrPgUg
In Hong Kong:
News > Medscape Medical News
Triple Antiviral Combo May Speed COVID-19 Recovery
Neil Osterweil
May 11, 2020
https://www.medscape.com/viewarticle/930336
(May need free registration.)
And:
South China Morning Post
Hong Kong public hospitals to revise Covid-19 treatment guidelines, highlight effective drugs behind low mortality rates.
Victor Ting
27 August 2020·3-min read
Hong Kong’s public hospitals will revise clinical treatment guidelines for Covid-19 patients to better highlight the effectiveness of an antiviral drug that has helped achieve one of the lowest coronavirus death rates in the world.
Dr Owen Tsang Tak-yin, medical director of the Hospital Authority’s infectious disease centre at Princess Margaret Hospital, made the revelation at a media briefing on Thursday as the city’s third wave of infections showed signs of easing, with health officials reporting 21 new cases, taking the local tally to 4,755, with 81 related deaths.
“The third wave has been very rapid and fierce,” Tsang said. “But despite that, we have one of the lowest mortality rates worldwide, at about 1.6 per cent.”
One factor that helped suppress the death rate was effective treatment, which centred on a cocktail therapy involving antiviral drug Interferon; Kaletra, a drug originally used for HIV/Aids, and Ribavirin, which was also used for hepatitis C, according to Tsang.
The treatment guidelines, which were last updated in June, would be revised “very soon”, Tsang said, and would highlight Interferon as the major medication for Covid-19, combined with Ribavirin. But Kaletra may lead to some side effects and has proved to be unsuitable for some patients, causing liver problems in such cases.
Another antiviral drug, Remdesivir, was found to be most effective among patients in severe condition requiring oxygen support, but less effective in those who are critically ill and requiring intubation, while Hydroxychloroquine and Chloroquine have been ruled out as overseas research have shown their ineffectiveness.
https://sg.news.yahoo.com/hong-kong-public-hospitals-revise-142129309.html
It’s notable that Hong Kong decided against HCQ following Western studies. But those studies did not test it for EARLY treatment which is essential for antivirals. But no matter. COVID-19 is a virus easy to treat. Multiple antivirals are effective treating if given EARLY.
In Thailand:
Am J Trop Med Hyg. 2020 Jul; 103(1): 48–54.
Published online 2020 May 18. doi: 10.4269/ajtmh.20-0442
PMCID: PMC7356442
PMID: 32431287
Critical Care Management of Patients with COVID-19: Early Experience in Thailand
Ranistha Ratanarat,1,* Chaisith Sivakorn,2 Tanuwong Viarasilpa,1 and Marcus J. Schultz3,4,5
Antiviral treatment before ICU admission.
Thailand has set national guidelines for antiviral treatment. Patients with mild symptoms receive chloroquine or hydroxychloroquine plus a boosted protease inhibitor, lopinavir or darunavir plus ritonavir. Favipiravir is not recommended in mild cases because of its limited availability.8
Favipiravir is an antiviral RNA polymerase inhibitor for which most preclinical data are derived from its influenza and Ebola activity.16 It is given to all patients with proven COVID-19 who have symptoms or signs consistent with pneumonia, or when there is hypoxemia (SpO2 < 95% on room air).8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356442/
In Singapore:
Interim Treatment Guidelines for COVID-19 (Version 1.0, dated 2 April 2020)
ABSTRACT Background In December 2019, pneumonia cases caused by a novel coronavirus occurred in Wuhan, Hubei Province. As of 11th February 2020, the World Health Organisation has officially named the disease “COVID-19”. In addition, virologists in the coronavirus study group have officially announced the name of the virus to be “SARS-CoV-2”. This guideline provides evidence-based recommendations on the therapeutic management of patients with COVID-19 in Singapore.
Robert Clark
