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Monday, March 4, 2024

Preventing the collapse of our healthcare system

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"There should be a concerted effort to promote home care remedies and other proven treatments in all their forms."


Now that President Duterte has greenlighted the conduct of clinical trials on the anti-parasitic drug ivermectin for possible repurposing as a prophylaxis or even treatment against COVID-19 it behooves the Department of Health, Department of Science and Technology and the Food and Drug Administration, and their associated networks of scientists and researchers, public and private, including accredited universities, to come around together, fast track the trials and check other possible ways which can be useful in our continuing battle against this deadly virus. There are lessons to be learned not only from our own experience but from the rest of the world after one year of the global lockdown.

In our Wednesday column, we highlighted the need for an enhanced and more expansive home care program for a number of reasons. Refocusing the importance of personal hygiene and responsibility as well as family solidarity in the overall anti Covid program solidifies ground level responses which to my mind ultimately leads to stronger communities. There is no better way to motivate people than to provide simple, easily actionable information and educational materials, affordable home care kits or their equivalent and enhanced barangay emergency response capability.

As experience shows, our health care system, which is essentially drug oriented, hospital centric and now, vaccine dependent, cannot cope with the demands for care and cure in this pandemic. Giving our people the basic knowledge and means to take care of themselves and their families – this ground up effort – will definitely spill over to enhanced community participation and give us a better than even chance in overcoming the challenges on hand. Even if the vaccine roll out gets to the desired levels there remains an urgent need to look for other treatments against this virus.

We should add more to the call for an enhanced and expanded home care program and, hopefully, the distribution of a repurposed ivermectin. Thankfully, an increasing number of studies and trials are now ongoing precisely for purposes of making available as many possible treatments and protocols in this global endeavor.

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The inhalable asthma medication, Budesonide, is now undergoing clinical trial as possible treatment for COVID-19. In one such trial involving more than 4,600 people at risk of serious COVID-19 undertaken at the University of Oxford, it was found that this inexpensive and widely available drug shortened the duration of disease symptoms by about three days.

Another inhaler treatment, the EXO-CD24 inhaler treatment, developed by Prof Nadir Arber at the Tel Aviv Sourasky Medical Center (Ichilov Hospital), was tested on 30 patients with moderate to severe condition, all of whom recovered within just three to five days. The treatment which has been hailed as a “miracle drug” by Israeli Prime Minister Netanyahu will now move to confirmatory trial phases which may take at least a year. But this early, scientists have declared that it may turn out to be a real game changer moving no less than Greek Prime Minister Kyriako Mitsotakis to suggest that Greece will be happy to participate in the expanded trials.

A number of reports have also indicated that the US FDA has approved other therapies for people with severe COVID-19 prior to hospitalization. Last November, the agency granted emergency use authorization for non-hospitalized adults and children over 12 years with mild and moderate COVID-19 symptoms and are at risk to develop severe COVID-19 or being hospitalized to two monoclonal antibody treatments. These two monoclonal antibody treatments, Bamlanivimab, made by Eli Lilly; and a combination of Casirivimab and Imdevimab, made by Regeneron, given intravenously have been shown to reduce the risk of hospitalization and emergency room visits..

On the other hand, hospitalized patients have been treated with several drugs such as Dexamethasone and other anti-inflammatory drugs such as prednisone and methylprednisolone which have led to a high rate of recovery. The WHO and the US FDA also approved early on the use of the antiviral drug Remdesivir to treat COVID-19 which has been in use up to this day despite a WHO advisory towards the end of last year that it has no therapeutic value. Finally, doctors have also been one in using blood thinners as part of the standard hospital treatment for Covid 19 patients. These anti-coagulants have become even more critical with the latest findings about blood coagulation leading to severe COVID-19 or even death associated with some of the vaccines which have been given emergency use authorization.

Our very own experts have also been advocating the use of virgin coconut oil or other native respiratory products such as lagundi, ginger, turmeric and even banaba extracts as possible treatments against the virus. Again, these should be subjected to more rigorous trials to get them included in the expanded treatment menu against this deadly disease.

I am sure there are other measures which have proven their worth against Covid 19 in many other countries which we should proactively look into such as the best practices in Vietnam, UAE and Cuba, to name just three, of the more successful programs.

In the meantime, there should be a concerted effort to promote home care remedies and other proven treatments in all their forms if we are to further promote personal responsibility and family solidarity and, equally important, prevent the collapse of our overburdened health care system.

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