Racing against time.

WHO says AstraZeneca, Modena leading Covid vaccine race

Use dexamethasone over methylprednisolone, says new Covid protocol

Agency Report | New Delhi/Geneva | 27 June, 2020 |

After admitting that the world may have a Covid-19 vaccine within one year or even a few months earlier, the World Health Organization (WHO) on Friday said that UK-based AstraZeneca is leading the vaccine race while US-based pharmaceutical major Moderan is not far behind.

WHO Chief Scientist Soumya Swaminathan stated that the AstraZeneca’s coronavirus vaccine candidate is the most advanced vaccine currently in terms of development.

“I think AstraZeneca certainly has a more global scope at the moment in terms of where they are doing and planning their vaccine trials,” she told the media.

AstraZeneca’s Covid-19 vaccine candidate developed by researchers from the Oxford University will likely provide protection against the disease for one year, the British drug maker’s CEO told Belgian radio station Bel RTL this month.

The Oxford University last month announced the start of a Phase II/III UK trial of the vaccine, named AZD1222 (formerly known as ChAdOx1 nCoV-19), in about 10,000 adult volunteers. Other late-stage trials are due to begin in a number of countries.

Last week, Swaminathan had said that nearly 2 billion doses of the Covid-19 vaccine would be ready by the end of next year.

Addressing the media from Geneva, she said that “at the moment, we do not have a proven vaccine but if we are lucky, there will be one or two successful candidates before the end of this year” and 2 billion doses by the end of next year.

Scientists predict that the world may have a Covid-19 vaccine within one year or even a few months earlier, said the Director-General of the World Health Organization even as he underlined the importance of global cooperation to develop, manufacture and distribute the vaccines.

However, making the vaccine available and distributing it to all will be a challenge and will require political will, WHO chief Tedros Adhanom Ghebreyesus said on Thursday during a meeting with the European Parliament’s Committee for Environment, Public Health and Food Safety.

One option would be to give the vaccine only to those who are most vulnerable to the virus.

There are currently over 100 Covid-19 vaccine candidates in various stages of development.
The Union Ministry of Health and Family Welfare on Saturday released an updated clinical management protocol for managing Covid-19 cases, advising use of dexamethasone as an alternative to methylprednisolone for managing moderate to severe cases of the disease.

Keeping pace with evolving knowledge about Covid-19, especially in terms of effective drugs, the ministry released the updated clinical management protocol in which some changes have been made after considering the latest available evidence and after expert consultation.

Dexamethasone is a corticosteroid drug used in a wide range of conditions for its anti-inflammatory and immunosuppressant effects. The drug has been tested in hospitalised patients with Covid-19 in the recovery clinical trial and was found to have benefits for critically-ill patients. It has been shown to reduce mortality by about one-third for patients on ventilators, and by about one-fifth for patients being maintained on oxygen therapy.

The drug is also a part of the National List of Essential Medicines (NLEM) and is widely available.

Union Health Secretary Preeti Sudan has forwarded the updated protocol with all states and Union Territories to make necessary arrangements for availability and use of the updated protocol and dexamethasone at the institutional level also.

The last update to the clinical management protocol was done on June 13.

As per the updated protocol, Covid-19 patients reporting to various Covid treatment facilities have reported signs and symptoms like fever, cough, fatigue, shortness of breath, expectoration, myalgia, rhinorrhea, sore throat and diarrhoea.

Loss of smell (anosmia) or loss or taste (ageusia) preceding the onset of respiratory symptoms has also been reported. Older people and immune-suppressed patients in particular may present with atypical symptoms such as fatigue, reduced alertness, reduced mobility, diarrhoea, loss of appetite, delirium, and absence of fever,the protocol mentions.

“Children might not have reported fever or cough as frequently as adults,” it says.

As per data from the Integrated Health Information Platform (IHIP) or Integrated Disease Surveillance Programme (IDSP) portal case investigation forms for Covid-19 of 15,366 people as on June 11, the details on the signs and symptoms reported are fever (27 per cent), cough (21 per cent), sore throat (10 per cent), breathlessness (8 per cent), weakness (7 per cent), running nose (3 per cent) and others 24 per cent.

The major risk factors for severe disease are age more than 60 years (increasing with age), underlying non-communicable disease (NCDs) such as diabetes, hypertension, cardiac disease, chronic lung disease, cerebro-vascular disease, chronic kidney disease, immune-suppression and cancer.