Issue link: https://www.ahpindiestylist.com/i/1250436
42 indie stylist Volume 1 Issue 1 would involve isolating the serum or plasma alone—a simple, easy, and safe technique. A clinical trial is about to commence at Johns Hopkins to clarify the safety and effectiveness of using this method for COVID-19, and if results are promising, it may be recommended as a stop-gap method to provide a form of immunity on a grand scale until a proper vaccine can be developed. It is more effective when used for prevention, rather than in those already infected, and there are some known risks attached, which will be explored in the trials. Transfusion is not equivalent to, or a replacement for, a vaccine. Using plasma is a crude approach because with this method, the biotechnicians do not isolate the COVID-19- specific antibodies, but provide the patient with the full range of antibodies in the donor's plasma. This has two effects; it may water down the overall immune response, or it may confuse it. In addition, antibodies do not remain in the bloodstream permanently, but it may work as a temporary way to delay more infections and to protect frontline health-care workers until a vaccine emerges. Vaccines are altogether more sophisticated because they target specific aspects of the viral reproductive process and anatomy to stop it before it begins infecting host cells. However, the steps and time needed to produce a safe, effective vaccination may reach well into 2021, and despite the lengthy processes also needed to gain evidence and approval for the plasma method, it may be quicker and more effective if all the moving parts are able to coordinate. 33 WHAT NEXT? As shown in the examples above, it is very easy to jump to conclusions, make assumptions based more on our own fears than on reality, and to make connections for which there is simply no evidence. Ideally, you should not take my word for this. Compare the sources against the checklist provided earlier, and use your own judgment—but attempt to avoid reading more or less into the material than is present. It is crucial to realize that precisely because this virus is new, there are still many unknowns. "No evidence" or "incomplete evidence" is not the same as "negative evidence." Unknowns are areas that need research and clarification—fewer words, not more. that the studies conducted so far have been too small to provide meaningful evidence, and noting that the research methods and quality of reporting has been especially poor, mainly due to the urgent conditions under which they are being conducted. 28 So, the research continues, but these are just some of the hindrances to finding appropriate treatments. Other drugs tested in more robustly designed clinical trials do not yet seem to have generated positive results. A recent Chinese trial of the HIV protease inhibitors lopinavir/ritonavir combination yielded no sign of benefits. 29 As of April 11, 2020, no proven effective treatment for this virus had yet been confirmed. Remdesivir was suggested as being the most promising, through in-vitro (test-tube) studies, but this had not yet been confirmed in human subjects. Clinical trials are currently under way, but no conclusive evidence has yet been found. 30 It is worth remembering that all reputable clinical trials should bear database registration numbers and follow the most stringent international reporting guidelines if they are to be considered reliable. 31 Currently, there is no evidence available from full-scale controlled trials to clarify whether any of these medications or their combinations are safe and effective, as most of them so far have failed to stand up to robust testing. There have been several reports of people self-medicating and taking fatal overdoses of chloroquine and other substances since these trials were first reported on, in an extreme example of why so much care is needed with science reporting, and with interpreting the quality and content of what is presented as evidence. 32 TRUE OR FALSE? COVID-19 antibodies are the cure! This is one of the oldest methods used over a century ago to slow down outbreaks and epidemics. Decades ago, the blood of patients who had successfully convalesced from a disease (such as measles) was used, sometimes as crudely as by direct transfusion, to provide antibodies to those who had not yet caught it, in a form of primitive vaccination known as "convalescent plasma" or convalescent sera. More modern techniques According to the Johns Hopkins source cited earlier, and based on what now seems to be majority consensus formed as physicians and researchers gain more experience of this virus, transmission occurs by respiratory droplets and fomites (objects on which droplets may have fallen). This information is confirmed by the American Red Cross, citing the US Food and Drug Administration (FDA) and the CDC. 25 According to current knowledge, the virus does not spread through blood, but even if it does, screening is in place to ensure that infected blood does not reach blood banks. TRUE OR FALSE? We have the cure! Chloroquine has made international headlines, spurred on by recent US presidential statements. Numerous other drugs have been mentioned in international news sources as potential "cures" for COVID-19, with various governments ordering them by the truckload in the hope of lowering the mortality rate. Both the research and WHO guidelines reveal a rather different picture than the news reports. At the time of this writing, there is no proven effective intervention for COVID-19. The medication cocktails being used are off-label and highly experimental, with wildly different approaches taken to disease staging (deciding when is the right time to apply certain types of treatment) and treatment approaches (choice of drugs, use of ventilators, etc.). 26 Some limited success has been seen in small trials and desperate cases. It is those small trials that led to news reports raising hopes that chloroquine or its safer derivative, hydroxychloroquine, an anti-malarial drug could offer benefits following reports of French trials based on Chinese in vitro (laboratory) studies. 27 However, the most recent commentary notes that optimal safe dosage has not yet been established, that the drug can be highly toxic if misused, and makes it clear that more research is needed before we know for certain whether these, and other drugs have a replicable effect, and what the safe timing and dosage is. Scientists have conducted reviews of all the work done thus far to explore the potential of these drugs and have concluded