Talk Evidence covid-19 update - Remdesivir, care homes, and death data
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What is the main topic discussed in this episode?
Welcome back to your now weekly talk, Evidence, which we're recording on a beautiful sunny afternoon on Wednesday the 15th of April. As always, in this new world of coronavirus, we're focusing on that. Last week, we talked about hydroxychloroquine as a potential therapeutic, prognostic models and face masks.
What is remdesivir and why is it considered a potential therapeutic?
Today, we're going to talk about remdesivir, another potential therapeutic, smoking, care homes, and what the latest data on mortality is in the UK. I'm Duncan Jarvis, multimedia editor here at the BMJ, and as always, I'm joined by our two favourite EBM nerds, Helen MacDonald and Carl Hannigan. Helen, can I get you to introduce yourself?
Yes, I'm Helen MacDonald, UK Research Editor at the BMJ. And Carl.
Hi, I'm Carl Hennigan. I am Professor of Evidence-Based Medicine at the University of Oxford and Editor-in-Chief of BMJ EBM.
So as it's been such glorious sunny weather here, it got me thinking, Carl, is there any evidence yet that warmer weather is having the effect that we hope that it might reduce coronaviruses spread?
Well, there's lots of evidence about seasonal viruses, particularly the ones that have a lipid envelope. ones like RSV and normal coronaviruses, that three things really have an impact.
Why is smoking cessation important during the COVID-19 pandemic?
As the temperature goes up, the humidity goes up, and it seems the humidity has a significant impact on the stabilization of the lipid envelope, which is highly fragile and can break down quite easily if you wash your hands. And the other factor is UV light seems to be important. So being outside is actually a good thing in that UV light and a higher temperature should, if it operates like all the other respiratory viruses, actually destabilize the virus, if you like, make it more fragile, and we should see a seasonal dip occur.
What research shows about infection spread in care homes?
There are just some slight concerns because with MERS and SARS in the past, that didn't quite happen in the same way. Nobody's quite sure about that. But actually, as we seem to warm up and go above 14 degrees C, which it is today, we should see an impact on the virus and its ability to transmit.
So fingers crossed there. And I suppose we might see that in a few weeks time when the numbers come in then. And that takes us on to what we're talking about later on about the latest figures on death. But before that, it's time to look at what to start and what to stop. So last week, we looked at hydroxychloroquine as a potential antiviral agent. Now, one of the other ones that has been tested, and there was a new paper of slightly dubious quality in the NEJM, looking at remdesivir. And Helen, you've been reading about this.
Yes, indeed.
How do excess death rates in the UK relate to COVID-19?
In my chat with Robin Ferner last week about hydroxychloroquine and chloroquine, he mentioned having greater hope for this drug remdesivir. So I was quite interested when I saw this research paper on remdesivir in New England Journal of Medicine a few days ago. It described compassionate use of remdesivir for patients with severe COVID-19.
What are the challenges in interpreting COVID-19 death data?
But to be quite frank, it didn't really bring me any clarity. It was A descriptive paper of 61 or so people in a whole variety of settings in many countries around the world that didn't have any kind of comparison group. So it sort of left me back at square one. So instead, I called Robin's colleague, Jeff Aronson at the University of Oxford, who together with Robin Ferner has been taking a broader look at the evidence around this drug. So I think we should hear from them.
Hi, yes, I'm Jeff Adamson. I'm a physician working in Oxford, and my specialty is clinical pharmacology, which means I'm interested in, well, anything to do with medicines, really. If they move, I shoot them. I think to understand why a drug like this might be beneficial, you need to know something about how the virus works. And there are two major Dr. Michael Gomez- Aspects of that one is how the virus gets into your cells in the first place. And the second is once they're in your cells. How does it reproduce Dr. Michael Gomez- And overwhelm your body. So for me, those are the two major points that would offer targets for drug therapy.
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Chapters
8 chapters
1
What is the main topic discussed in this episode?
0:07–0:36
2
What is remdesivir and why is it considered a potential therapeutic?
0:36–1:52
3
Why is smoking cessation important during the COVID-19 pandemic?
1:52–2:28
4
What research shows about infection spread in care homes?
2:28–3:36
5
How do excess death rates in the UK relate to COVID-19?
3:36–3:59
6
What are the challenges in interpreting COVID-19 death data?
3:59–5:30
7
How does the quality of clinical trials impact COVID-19 treatments?
5:30–6:23
8
What role does hand hygiene play in preventing infections in care homes?
6:23–51:54
Speakers
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