Of a crisis, an opportunity. Under this premise, Medicine has got to work and seeks different solutions to deal with the coronavirus epidemic . After 50 days have elapsed since the World Health Organization (WHO) reported 44 cases of pneumonia of unknown origin in the Chinese city of Wuhan, the alarms have been jumping vertiginously and the infected reach almost 76,000 . Compared to other epidemics that put governments and health systems in check, the figures speak for themselves: it is not as deadly as Ebola from West Africa or SARS.
WHO remains calm , despite a revolutionized world: a country in prolonged quarantine, cruises with landing complications, canceled world appointments, states that close borders ... While Chinese doctors take advantage of the situation to launch clinical trials , even a total of 80 that will involve thousands of patients , especially for that percentage that suffers from severe cases of pneumonia , 14% according to the WHO. In addition to HIV antivirals, Ebola and malaria, the test kit has a bit of everything: mesenchymal stem cells, umbilical cord cells, use of the microbiota, probiotics, traditional medicine, convalescent plasma ...
Perhaps, the latter is the most practical sound for his background with Ebola. Cristina Arbona , of the Spanish Society of Hematology and Hemotherapy (SEHH) , explains that it is a «passive immunotherapy». «With other viruses, some activity has already been shown in some patients. Although it has many unknowns: how is the plasma to be used, how they inactivate the virus and with what techniques. Not much is used, ”says Arbona. Also, the SEHH spokeswoman underlines the complications of finding plasma donors . «The donation is requested only to those who have passed the infection, since with the window so wide that there is contagion, before and after, it is difficult. It is the same therapeutic resource that was used against Ebola ».
A recent publication, Chinese Journal of Epidemiology , which has analyzed the data of almost 72,000 patients of the current epidemic, concludes that Covid-19 is not aggressive, as evidenced by the Chinese Center for Disease Control and Prevention (CCDC) ): 80.9% of infections are classified as mild, 13.8% severe and only 4.7% critical. For the latter, the greatest efforts are focused, because as stated in the Helsinki Declaration and international ethical guidelines for health-related research involving humans, patients who suffer the worst face of disease outbreaks have the moral right to try Non-validated medical interventions (UMI) and, therefore, their access to clinical trials is not restricted . And WHO keeps up with them.
Pneumonia represents one of the most common and, at the same time, most serious complications. Rosario Menéndez , pulmonologist and member of the Area of Respiratory Infections of the Spanish Society of Pneumology and Thoracic Surgery (Separ) , explains that “given that there are good results in cases of sepsis and in animal models, it is normal that they use stem cells in those cases more critical ». These are studies that choose volunteers well and are not very numerous, no more than 40, «because they want to measure: first, safety, and second, effectiveness. In addition, as I understand them they are expensive ». The theory on which the head of the study is based, Fu-Sheng Wang, head of the Center for Treatment and Research for Infectious Diseases at Beijing Military Hospital 302, is based on the reduction means of pathological changes of the lung and, at the same time , inhibit the influenza-mediated inflammatory cell-mediated immune response, as observed in animal models.
For them it is also important to underline the impact of traditional Chinese medicine (TCM) in some patients in whom they did not get answers with other resources. "It is an opportunity to reflect through a clinical trial, the most intrinsic approach to its history," Menéndez emphasizes. In the main hospital in Shanghai, doctors use antiviral drugs, corticosteroids (anti-inflammatories), next to it. "We have personalized treatments for patients with serious illnesses, since each person's health status is different," Lu Hongzhou emphasizes, in statements to AFP.
They also test with microbiota transplants , once called intestinal flora. Why? In the second hospital of the Nanjing University of Medicine they have decided to recruit about 40 patients to see their link between the intestinal tract and the respiratory tract works to treat the most serious infected. José María Ordovás , director of the Nutrition and Genomics Laboratory at the Jean Mayer Center at Tufts University, in Boston (USA), explains that "it is thought that it could also act to offer a greater immunological response." However, he warns that «we have to know the right moment of the treatment and the selection of the donors, since there would be bacteria that are harmless to the donor but harmful to the recipient. Therefore, they may limit age to less than 70 years.
SARS IN ASIA
WHO issued the alert on March 12, 2003, so its first 50 days were fulfilled on May 1, 2003. The first affected humans came from the Guangdong region, south of China.
5,865 cases . After the first patient, another 20 arrived with similar symptoms, the transmission rate is between 1.5 to 3, higher than Covid-19.
391 deaths The global mortality of the epidemic reached 9.2%, although in the first moments it only reached 7%.
27 countries The majority of cases, as in the coronavirus, were concentrated in China, and the spread was spread mainly throughout Asia.
MERS. SLOW
On September 22, 2012 they alerted to a strange virus, compared to the current one, the so-called MERS-CoV was slow, but deadly. Less than five cases in its first 50 days.
4 cases This count is made after seven weeks, because they correspond to November 23, 2012, because on the 1st of that month there were no significant changes.
2 deaths At the beginning, mortality was 50%, at the end of the epidemic it would drop to 35%, much higher than the current Covid-19, which barely touches 2%.
2 countries Since the species jump from camels, the main affected were Saudi Arabia and Qatar.
FLU A. GLOBAL
The outbreak had its official start on April 24, 2009. This swine flu was rapid: it took its first steps in the US and, on June 2, 2009, the expansion was global.
19,273 cases. Swine flu also spread. Spain already had in the first month and a half with more 180 infected.
117 deaths In this period, deaths were concentrated in Canada, Mexico and the United States.
66 countries For now, in front of Covid-19, it has a pandemic range, which places it in the most important to date.
ÉBOLA MORTAL
WHO gives the start of the Ebola outbreak in West Africa on April 2, 2014. In the beginning, this epidemic that splashed the US and Europe with imported cases, focused on Africa.
258 cases Given the transmissibility of the virus, which occurs through direct contact of body fluids, the contagion was not high.
174 deaths The aggressiveness of this microorganism claimed the lives of more than half of the infected patients. Not so the current coronavirus.
3 countries The affected area was extended by the triangle formed by Guinea, Liberia and Sierra Leone, so that precautions at the borders were extreme.
COVID-19. IN EXPANSION
It was on December 31, 2019, when the Chinese authorities reported on a grouping of 27 cases of pneumonia of unknown etiology.
75,284 cases. To date it is the contemporary epidemic that has produced the most infections.
2,014 deaths. Despite the volume of cases, mortality in no case exceeds the rest of the epidemics mentioned, at least to date.
30 countries This epidemic concentrates more than 90% of cases in China and its neighboring countries. The rest, mostly, is due to imported cases.
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