Promising Case Study in Thailand
For many, the specter of infectious disease has always seemed to be an event that could possibly take society to the brink. Year after year, we experience a new infectious disease outbreak which crosses oceans and causes concern: Ebola, Zika, Chikungunya, Influenza, and now, Coronavirus 2019-nCoV, have always been just a mutation away from becoming worldwide disasters.
Unlike diseases caused by bacteria, all those listed above are viruses which can’t be cured with antibiotics. Indeed, our success treating illnesses caused by viruses has been spotty, and most still are beyond even the high technology of modern medicine. The current 2019-nCoV epidemic raging in China is an example.
I’ve been writing about this epidemic since there were only 60 known cases (Jan. 7th). To show how contagious it is, more than 2500 new cases have been reported in just the 24 hours preceding the publishing of this article (Feb. 2nd). Most experts think 2019-nCoV will continue to spread in the near future. They continue to search for any opportunities to contain the disease.
Containment will give time for new treatments to be developed that will combat 2019-nCoV. Experience with related viruses like Sudden Acute Respiratory Syndrome (Asia) and Middle East Respiratory Syndrome can help, but some novel approaches may be needed to kill a novel coronavirus.
Epidemiologist Dr. Eric Feigl-Ding has been studying the virus and has noticed some strange characteristics of 2019-nCoV. The virus appears to have some genetic code in common with and act similarly to certain strains of Human Immunodeficiency Virus (HIV). Indeed, he believes that 2019-nCoV binds to the same receptors as the HIV virus.
(Note: A common conspiracy theory is that Wuhan’s Biosafety Level 4 lab (the only one in China) may have accidentally released a weaponized viral “Frankenstein’s monster”. While it makes for exciting reading, no hard evidence exists for such an occurrence.)
In Thailand, two doctors decided to put together a “cocktail” of different antiviral drugs to try on sick patients. These include a popular anti-influenza drug, oseltamivir (you know it as Tamiflu) and two anti-HIV drugs, lopinavir and ritonavir. The anti-flu drug was given in higher doses than usual.
The combination of drugs seems to have caused improvement in a 70-year-old female coronavirus patient. The woman had tested positive for 2019-nCoV for 10 days; the test results came back negative after 48 hours of treatment. It’s not yet considered a cure, however, and some other patients have exhibited allergic reactions to the mixture.
Combining several drugs and using non-standard dosing is risky, but thinking outside the box may be necessary to battle a highly contagious infection. Certainly, the coronavirus epidemic is not business as usual. Action is needed if we are to prevent a worldwide pandemic.
Joe Alton MD
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