Pills, inhalers and nasal sprays could become the way for people to help treat symptoms that accompany Covid-19 and reduce recovery time.
People are facing the prospect of a new normal, a situation in which the country is likely to have no case as the country moves away from its elimination strategy.
Internationally, this has led to the development of new drugs that can prevent or help treat symptoms of Covid-19.
In the UK, researchers were studying how llama antibodies as a neutralizing agent, while last week a US drug developer announced an experimental antiviral pill and claimed it could halve the risk of hospitalizations and deaths.
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Other drugs that have been used to treat conditions such as arthritis and asthma are also used. Locally, drugs and pharmaceuticals already funded to help treat Covid-19 include dexamethasone, tocilizumab, remdesivir, and budesonide.
Sarah Fitt, chief executive of Pharmac, said she was working with pharmaceutical companies to research and fund new treatments.
Pharmac has set up a Covid-19 Clinical Expert Advisory Group that is reviewing evidence for new treatments and was working with the Department of Health’s Scientific and Technical Advisory Group and its Therapeutic Technical Advisory Group.
While Pharmac could not disclose any other drugs he was evaluating or the drug companies he was engaging with due to the “confidential nature of the negotiations,” he would provide an update in the coming days, Fitt said. .
Vaccination has remained the key to preventing the spread of Covid-19, Fitt said.
A spokesperson for the Department of Health said he was considering purchasing a range of drugs, including antiviral drugs to fight Covid-19, but in the meantime vaccination was the best protection. He was monitoring updates on the antiviral pill Merck – internationally touted as a game changer – which was not endorsed by Medsafe, and would advise it soon.
An anti-inflammatory drug or officially known as a corticosteroid, dexamethasone is used for a wide range of conditions.
Known for its anti-inflammatory and immunosuppressive effects, the World Health Organization has recommended dexamethasone for patients with severe and critical symptoms.
In September, Pharmac expanded its funding for tocilizumab, a drug used to treat arthritis, to treat people hospitalized with Covid-19.
Pharmac said studies have shown that tocilizumab can reduce the severity of the virus and the time spent in hospital. WHO has also recommended its use as a treatment for severe cases.
However, it has not been approved by Medsafe to treat Covid-19 and should be prescribed by an authorized person.
Pharmac had also obtained an additional supply of remdesivir – an antiviral drug – to treat people hospitalized with moderate to severe Covid-19, although the WHO issued a conditional recommendation against the use of remdesivir in hospitalized patients, regardless of either severity, as there was “no evidence that remdisivir improves survival and other outcomes in these patients.”
A limited amount has been available for district health boards to order since the end of 2020 and 17 patients – most from the current community outbreak – have taken remdesivir, by intravenous injection.
Like tocilizumab, Remdesivir has not been approved by Medsafe to treat Covid-19, so it must also be prescribed by an authorized person.
A corticosteroid, budesonide, comes as an inhaler and nasal spray.
The inhaler is used to prevent asthma while the nasal spray is used to treat allergic rhinitis and nasal polyps.
Research at the University of Oxford has claimed that it could reduce the risk of people becoming seriously ill with Covid-19 if taken within the first week of a person developing symptoms.
“No perfect drug”
Cardiac anesthesiologist Dr Ryan Salter, a recently returned Kiwi, worked at the UK’s Royal Papworth Hospital in Cambridge during his second wave of Covid-19 where tocilizumab, remdesivir and dexamethasone were used.
“Almost everyone who went to Papworth Hospital started taking dexamethasone.”
Evidence released towards the end of the second wave revealed that tocilizumab was also effective, “which was part of the treatment strategy for most people,” he said.
Remdesivir was used early in treatment, but questions were raised about its effectiveness in patients who were already sick enough to require intensive care, he said.
“If the patients hadn’t started before they got to the ICU, we didn’t start it.”
The sickest patients were referred for a treatment called ECMO (extracorporeal membrane oxygenation) – a machine that takes over from the heart and lungs when these organs can no longer pump and oxygenate the blood.
Salter said he was resource hungry. Australian standards require two critical care nurses at all times for each ECMO patient. The only place in New Zealand that accepts ECMO referrals for adults is the Cardiothoracic Unit at Auckland City Hospital.
“But so far there is no perfect medicine,” Salter said.
“There is still a lot of uncertainty about the optimal dose and the optimal time. They certainly seem to be better than nothing and at the population level, they seem to save lives.”