A triple antiviral therapy that has shown promise in treating COVID-19 patients with mild symptoms in Hong Kong is not being recommended in Taiwan because it can cause side effects, Central Epidemic Command Center (CECC) specialist advisory panel convener Chang Shan-chwen (張上淳) said on Sunday.
Researchers in Hong Kong have found that patients experiencing milder symptoms recover more quickly if they are treated with the antiviral cocktail soon after symptoms appear.
Early treatment with the therapy — which combines interferon beta-1b, lopinavir-ritonavir and ribavirin — rapidly suppresses the amount of virus in a patient’s body and alleviates symptoms, according to a study published in The Lancet on Friday.
Photo: Wu Liang-yi, Taipei Times
Asked about the therapy, Chang said the panel had considered including the use of the multiple sclerosis treatment interferon beta-1b with the hepatitis drug ribavirin in its treatment guidelines for COVID-19, but dropped the idea, because clinical figures show that the treatment causes side effects in a high percentage of patients.
Although Chang did not detail the side effects of the drugs, the article in The Lancet said that the main side effects are nausea, diarrhea, fever and increased alanine transaminase levels.
As for the HIV therapy lopinavir-ritonavir, Chang said that although it causes fewer side effects and was included in the first treatment guidelines, its use alone is not effective in treating COVID-19.
Separately on Saturday at the third weekly briefing on the epidemiological characteristics of COVID-19 cases in Taiwan, Chang explained how the nation successfully fought against an H1N1 (swine flu) pandemic in 2009.
The first swine flu outbreak was reported in Mexico and the US in late April. The Taiwan Centers for Disease Control (CDC) designated it as a category 1 notifiable communicable disease on April 27 and set up the CECC on April 22, Chang said.
On April 29, it began tracing travelers who might have been exposed to the disease, while the first imported case was confirmed on May 20, he added.
The disease prevention strategy against the H1N1 virus at the time is similar to that being used to prevent a COVID-19 outbreak, including the first stage of “containment” and the second stage of “mitigation,” as well as detailed policies, including border controls, class suspension standards and hospital infection control measures, he said.
The first local swine flu infection was reported on July 2, 2009, and the first death was recorded on July 30, and although rapid test kits and antiviral agents were provided in August, the number of hospitalized patients and suspended classes increased until November, when a vaccine started being administered, Chang said.
While some specialists in August 2009 forecast that more than 7 million people would be infected with the swine flu in Taiwan, resulting in more than 7,000 deaths, only about 930 people had been hospitalized for serious complications as of June 21, 2010, and 42 had died as of May 10, 2010 — one of the lowest mortality rates compared with Organisation for Economic Co-operation and Development countries — Chang added.
Predictions based on simulation models might sometimes be inaccurate when facing a new virus, Chang said, adding that collective public efforts, such as wearing masks to avoid droplet infection and preventing the wearer from touching their face, can change the outcome.
Knowledge gleaned from the nation’s disease prevention experiences have contributed to its successful performance in fighting COVID-19, he added.
However, Chang said that developing an effective and safe vaccine for the novel coronavirus might be more difficult and would likely take longer, but added that it is difficult to predict how long it would take, even though medical technology has been advancing.
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