The issue with Trump’s new virus cure

 

Yesterday Donald Trump unveiled what he called a "major breakthrough" in the world's fight against coronavirus.

He said American authorities have secured emergency approval to use blood plasma from recovered coronavirus patients as a treatment against the disease.

He went on to claim the treatment has had an "incredible rate of success" so far.

However, some experts say plasma has not yet been proven to be effective or 100 per cent safe.

There were tense scenes in Mr Trump's press conference this morning after a reporter questioned how effective the treatment was.

So what is the treatment and could it be our miracle cure for the virus?

WHAT IS THE TREATMENT TRUMP IS PUSHING?

The idea is to inject people who are sick with coronavirus with something called convalescent plasma to help them fight the disease.

Here's how it works.

When people get sick from COVID-19 their bodies create antibodies to fight the disease.

These antibody proteins float in their blood plasma - the liquid component of blood that suspends blood cells.

Scientists can take that plasma, test it for safety, and then purify it to isolate the antibodies they need.

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This is what is known as "convalescent plasma" and it can be injected into another patient sick with coronavirus.

The antibodies in the plasma can help the body tackle the virus early in an infection as a sort of headstart while the infected person's immune system builds its own antibodies to fight the virus.

Despite Mr Trump's office describing the treatment as "groundbreaking", it has been used in past outbreaks, including ebola disease - even as far back as the 1918 influenza pandemic.

Even if it works against coronavirus, it wouldn't be the same as having a vaccine. But it's hoped it could be used to help protect at-risk people, like healthcare workers.

DOES IT WORK FOR COVID?

The first study into convalescent plasma being used for COVID-19 was done in China.

It compared the outcomes of 52 people who got the treatment with 51 people who didn't.

Researchers didn't hit their sample size target of 200 patients and it showed no statistically significant benefits.

In an editorial published by the JAMA Network in June said it showed "potentially hopeful signals".

In the US, a large, non-peer reviewed study of more than 35,000 patients led by the Mayo Clinic found that providing COVID-19 patients with infusions of plasma early on in their illness showed a benefit in reducing the number of deaths in patients with severe illness.

Data show that patients were 35 per cent less likely to die if they received a high dose of convalescent plasma, compared with those who got lower doses.

Those who received transfusions within three days of diagnosis had a seven-day death rate of 8.7 per cent, while patients who got plasma after four or more days had a mortality rate of 11.9 per cent. That difference met the standard for statistical significance.

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It is not clear wether the treatment is effective against COVID. Picture: Guillermo Legaria/Getty Images
It is not clear wether the treatment is effective against COVID. Picture: Guillermo Legaria/Getty Images

However without a placebo group for comparison, it's unclear just how valuable the treatment might be and the results haven't been published in a medical journal - so they don't have the same rigour as a clinical trial.

There have been other studies around the world, but the sample sizes have been too small to draw any meaningful scientific conclusions.

And, that's why some experts are treating Mr Trump's announcement today with scepticism.

Ben Corb, public affairs director for the American Society for Biochemistry and Molecular Biology, said in a statement that Mr Trump was showing an "unwillingness" to listen to medical experts, and that "breakthroughs require the collection of data" to ensure safety and efficacy of treatments.

"This process is necessary to ensure our safety, and to ensure that a treatment isn't worse than the disease," Mr Corb's statement read. "I am deeply concerned by this action, and concerned about the timing."

While the treatment has already been used on patients in the United States and other nations, the extent of its effectiveness is still debated by experts and some have warned that it could carry side effects.

But some experts appear cautiously optimistic.

"Convalescent plasma probably works - though it still needs to be proven in clinical trials - but not as a rescue treatment for people who are already severely ill," Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York, told AFP.

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He said that plasma would likely work much better right after a person was exposed to the virus, when the body is trying to neutralise the infection.

However, several top health officials in the US have pushed back against the treatment.

Led by director of the National Institutes of Health Dr Francis Collins, the government's top infectious disease expert Dr Anthony Fauci, and Dr Clifford Lane, they urged their colleagues last week to hold off, citing the Mayo Clinic study.

They said the study's data to date was not strong enough to warrant an emergency approval.

"The three of us are pretty aligned on the importance of robust data through randomised control trials, and that a pandemic does not change that," Dr Lane said on Tuesday.

TRUMP REACTS WITH FURY

The pushback against the treatment has been met with anger from Mr Trump. He even suggested there was a "deep state" conspiracy to suppress treatments and a vaccine to stop him getting re-elected in November.

He tweeted: "The deep state, or whoever, over at the FDA is making it very difficult for drug companies to get people in order to test the vaccines and therapeutics.

"Obviously, they are hoping to delay the answer until after November 3. Must focus on speed, and saving lives!"

Mr Trump tweeted again FDA's decision to revoke emergency authorisation of hydroxychloroquine and chloroquine for treating COVID-19 because it was "unlikely to be effective".

But he claimed: "Many doctors and studies disagree with this!"

This morning he told reporters the emergency authorisation of convalescent plasma was a "historic breakthrough".

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"This is what I've been looking to do for a long time," Mr Trump told reporters on Sunday at the White House. "I'm pleased to make a truly historic announcement in our battle against the China virus that will save countless lives."

Mr Trump took a couple of question from reporters before one asked about how safe and effective the treatment is - which the reporter implied Mr Trump was over-egging.

Mr Trump handed over to FDA commissioner Stephen Hahn who said: "If you're one of these 35 out of 100 people who this data suggest, or show survive as a result of it, this is pretty significant for that person and their family."

Mr Trump then abruptly ended the conference after three questions.

"This is a very big day, a day we've been looking forward to. Thank you very much; great question," he said before walking out to a barrage of questions from reporters.

Originally published as The issue with Trump's new virus cure


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