Latest status on Covid-19 cases - First case of Covid-19 can be traced back to November 17, 2019 but interviews with whistle-blowers from the medical community suggest Chinese doctors only realised they were dealing with a new disease only in late December. Now, it has become a global health crisis. As at yesterday, John Hopkins University reported that the infection rate crosses 1 million cases with a mortality rate of 5.2% and a recovery rate of 20.9% across 204 countries, territories and 2 international conveyances. The US has the most cases, and more than 1,000 died there in the past day. Nearly a quarter of cases have been registered in the United States, while Europe accounts for around half.

In the case of Malaysia, we have 3,116 Covid-19 cases, death of 50 (mortality rate of 1.6%) and 767 recovered (24.6% recovery rate) respectively. Malaysia has the highest number of known infections in Southeast Asia. According to WHO, a peak of number Covid-19 cases is likely to take place by mid-April. There are signs of a flattening of the infection curve. Health Ministry has ramped up its diagnostic testing capacity in recent days, testing over 7,000 a day compared to last week's 3,500.

Treatment Options - There is currently no proven effective treatment for the disease. In the case of China, they opted for a combination of Western and Traditional Chinese Medicine (TCM). Nearly 5,000 medical staff in the TCM field were sent to Hubei, the worst-hit province. About 74,200 people or 91.5% of the total patients nationwide received TCM treatment. For a low to moderate infection rate, plasma treatment is administered to bind with the virus' proteins and able to block viral entry. According to a Sino-U.S. biotech firm, Brii Biosciences, they are in an effort "to advance multiple candidates for prophylactic and therapeutic intervention". One should be cautious that this is not a vaccine treatment.

Other options include a combination of the HIV antiretrovirals – lopinavir & ritonavir, remdesivir, ribavirin, methylprednisolone and azvudine with reported success in countries like Singapore, Thailand among others. Kaletra, a combination of two anti-HIV drugs, lopinavir and ritonavir, has been used on patients in a trial in China since 18 January 2020 to control viral replication. Chloroquine, and hydrochloroquine -anti-malaria treatment is also a powerful antiviral.

On top of these options, researchers are working on anti-inflammatory drug like Barcitinib, Camostat Mesylate that exhibited good progress in blocking the entry of the SARS-CoV-2 virus into lung cells.

Influenza drugs like favipiravir also showed promising results. It is used to prevent the virus from multiplying in patients. X-rays confirmed improvements in lung condition in about 91% of the patients who were treated with favipiravir. In 2016, the Japanese government supplied favipiravir as an emergency aid to counter the Ebola virus outbreak in Guinea. Also, more than 40,000 people were treated for influenza by doctors with experimental drugs, mostly oseltamivir, better known as Tamiflu, which is licensed for seasonal flu.

Latest development on vaccine. WHO reported that at least 41 proposed vaccines for testing against coronavirus. Vaccines are a prevention strategy. One of the most advanced efforts is happening in China with a recombinant adenovirus vector-based vaccine based on the SARS-CoV-2 S gene and already in Phase 1 trial started on March 16, 2020. Other efforts include recombinant, protein and nucleic acid vaccines are still in the pre-clinical phase.

Chances of finding one that will work are high. This article is not intended to be a comprehensive review of all ongoing antiviral and vaccine trials.

Chee Seng, Wong
CIO, Athena Advisors