Despite loud appeals for caution, Africans are rushing to embrace chloroquine, the venerable anti-malaria drug touted as a possible treatment for coronavirus.

From hospitals in Senegal to pharmaceutical companies in South Africa and street sellers in Cameroon, chloroquine has fired hopes of a medicinal fix against a virus that is set to scythe through Africa’s poorly protected countries.

Chloroquine and derivatives such as hydroxychloroquine have been used for decades as cheap and safe drugs against malaria, although their effectiveness in this field is now undermined by growing parasite resistance.

Small-scale tests in China and France — either unpublished or outside the rigorous framework of mainstream drug trials — suggest that chloroquine reduces virus levels in people with coronavirus.

On March 24, President Donald Trump said chloroquine could be a “gift from God” — a comment that sparked strident criticism.

Health watchdogs have issued calls for caution until larger clinical trials are carried out, and there have been several recorded deaths from self-medication because of toxic side effects.

Despite this, in many settings across Africa, chloroquine has been placed in the front line against coronavirus.

Its rise stems partly from desperation, given Africa’s meager capacity to deal with a pandemic on the scale seen in Europe or the United States.

Burkina Faso, Cameroon and South Africa have swiftly authorized hospitals to treat virus patients with the drugs.

Around half of infected people in Senegal are already being prescribed hydroxychloroquine, Moussa Seydi, a professor at Dakar’s Fann Hospital, told AFP last Thursday.

Every patient who was recommended the drug accepted it, “with no exceptions,” he said.

In Democratic Republic of Congo, President Felix Tshisekedi last week declared it was “urgent” to produce chloroquine “in industrial quantities”.

South Africa has already said it will join a large-scale trial, and one of the country’s biggest pharmaceutical companies has promised to donate half a million pills to the health authorities.

Africa last in line?

Even if the effectiveness of the drugs against coronavirus remains for now unproven, concern about securing enough of them already runs deep.

Two decades ago, Africa, the continent worst hit by HIV, was last in line to get new antiretroviral AIDS drugs when the treatment emerged from the labs.

“If it turns out that chloroquine is effective, Africa, which imports most of its drugs, perhaps won’t be a priority for (the pharmaceutical) industry,” said Professor Yap Boum of Epicenter Africa, the research arm of the medical charity Doctors Without Borders (MSF).

France has already imposed a ban on exporting chloroquine and Morocco has requisitioned all stocks of the drug.

“You won’t find any in pharmacies in Yaounde, everyone is out of stock,” Boum said, referring to the Cameroonian capital.

“Local people have been buying it, apparently without prescription, which is dangerous.”

The Cameroonian government has officially asked health professionals “not to yield to the desire for profit” and to avoid prescribing chloroquine preventatively.

AFP correspondents report frantic demand in pharmacies in Abidjan, Ivory Coast’s economic hub, in the Angolan capital Luanda and also in Malawi — one of a handful of sub-Saharan nations where there are still no recorded cases of coronavirus.

The rush is a deep source of anxiety for people with the auto-immune disease called lupus, which is also treated with chloroquine.

In the Gabonese capital Libreville, Armelle Oyabi, head of an association of people with lupus, has been closely monitoring purchases at the only pharmacy left in the city that still has chloroquine.

“I check that the drug is being given to people who actually need it,” she said.

“If we can’t get this drug, we will not only be hit by lupus but also be more vulnerable to coronavirus.”

Chloroquine has been part of the medical toolkit from before World War II — it was developed in 1934 as a synthetic derivative of quinine.

Backstreet sales

Alice Desclaux, a doctor at the Institute of Development Research (IRD) in Senegal, said the risks from self-medication from chloroquine were largely rooted in illegal sales.

“Chloroquine has always been on sale informally in Africa,” she said.

“It’s still used to cause abortions” and even for attempted suicide, Desclaux said.

In one backstreet pharmacy in Douala, Cameroon’s economic hub, the manager said he had run out of stock.

For anyone who wished to order some, “careful, the price has gone up,” he said. A pill now changes hands for the equivalent of 71 US cents, four times more than a month ago.

The chloroquine craze is not just affecting the black market for drugs — it is also spurring the production of counterfeit medications.

Cameroon’s government has already issued a warning about fake chloroquine, samples of which have surfaced in health centers.

Source: AFP

As the number of worldwide confirmed coronavirus cases climbs towards 1 million, the number of recoveries is thankfully more than four times the death toll. But medical experts told FRANCE 24 that COVID-19 can cause severe long-term damage to the lungs, heart, brain and other organs – and that for some patients, these complications may be permanent.

Out of more than 950,000 cases of coronavirus so far across the globe, over 202,000 people have recovered, while more than 48,000 have died. However, clinicians have pointed out that some COVID-19 survivors have developed acute respiratory distress syndrome (ARDS) – a severe condition that, for the worst-affected patients, can last for the rest of their lives.

The doyen of medical journals, The Lancet, was one of the first to sound the alarm, publishing a report in February showing that 29 percent of a group of patients in Wuhan whom the researchers tracked between mid-December and early January had got ARDS.

A similar report by the British Faculty of Intensive Care Medicine, published in The Sunday Times on March 15, found that some 17 percent of intensive care patients whose treatments they analysed developed the syndrome. In addition, a few days before the British doctors released their findings, medical researchers in Hong Kong found that, out of a small study of 12 patients who left hospital after recovering from the coronavirus, two or three had diminished lung function.

‘The damage you can have is for a lifetime’

The coronavirus has been treated “as though it’s life and death – if you have the right medical care you can survive – but some survivors are having issues that are lingering”, noted Lynn Goldman, dean of the Milken Institute School of Public Health at George Washington University. “Because of how serious the ARDS is, the damage that you can have for that is for a lifetime.”

“Large numbers of ARDS survivors are not able to go back to work,” added Onjen Gajic, a critical care specialist at the Pulmonary Medical Department of the Mayo Clinic in Rochester, Minnesota.

>> How long will coronavirus lockdowns last?

ARDS is not a new phenomenon – it was first described in 1967. Common causes include pneumonia, sepsis and serious influenza cases. Symptoms include extreme shortness of breath, and feelings of exhaustion and confusion. As well as the respiratory and cardiovascular systems, it can damage other vital organs by preventing the lungs from supplying them with sufficient oxygen.

With coronavirus, patients can suffer from “inflammation and the build-up of fluid in a significant portion of their lungs, which limits their ability to get enough oxygen into their blood to support normal organ function”, explained Julie Fischer, an associate research professor of microbiology and immunology at Georgetown University.

“The most severely ill patients require mechanical ventilation to keep their tissues supplied with oxygen until the inflammation subsides,” Fischer continued. “Both the inflammation and the mechanical ventilation required to help patients survive can damage the delicate tissues of the lung that are involved in oxygen transfer, which may affect the function of the lungs even after recovery from acute COVID-19 disease.”

‘Survival is just the beginning’

In serious cases of COVID-19, “the associated viral pneumonia progresses to ARDS more often than in influenza”, Gajic observed.

Over the medium- and long-terms “the decline in lung function itself is less pronounced than other consequences” for ARDS sufferers, Gajic continued. The most serious of these ramifications are a “decline in physical and functional status, changes in cognitive function and psychological effects”, he said.

A significant amount of the damage outside the lungs is a side-effect of necessary but invasive treatments in intensive care, explained Panagis Galiatsatos, a pulmonologist and assistant professor at Johns Hopkins University School of Medicine: “The challenge in critical care is that the two organs we put a lot of emphasis on are the heart and lungs, and when we put so much strategy into trying to protect them we know that’s going to come as a consequence for other organ systems.

“Kidneys for instance, begin to self-destruct, so it’s common that patients on medical ventilators for ARDS require dialysis – and flooding the brain with medications to provoke a medically induced coma will cause some level of delirium that’s going to be hard to undo,” he continued.

Galiatsatos agreed with Goldman that for some survivors, the effects of ARDS caused by the coronavirus may never go away: “Some patients will recover within three months, but for others it can be a lifetime.”

He said that the severity and duration of these complications will depend on three factors. Firstly, “how good your lungs are to begin with; if you’ve got good lungs and have breathed good air your entire life, you’re in a better position to recover quickly”. Secondly, “how bad the ARDS was”. Thirdly, given that breathing machines themselves can cause lung damage, “whether you needed a medical ventilator”.

“Survival is just the beginning of the journey for an individual,” Galiatsatos emphasised. “The more that we recognise that this is going to be the next chapter of the pandemic, the better.”

Culled from France 24

Confirmed coronavirus infections around the world approached one million Thursday as the pandemic spread at a “near-exponential” rate, with a six-week-old baby becoming one of the youngest known victims.

Half the planet is under some form of lockdown as governments struggle to tamp down a virus that has killed tens of thousands of people.

Those restrictions — while necessary for health — risk causing global food shortages, experts have warned, as supply chains gum up and panic buying sparks export controls.

The death toll from COVID-19 continued its relentless march upwards, with more than 46,000 people known to have died worldwide.

The United States, which now accounts for almost a quarter of reported global infections, logged its 5,000th death overnight, according to a tally by Johns Hopkins University.

And, said President Donald Trump, things were going to get worse.

“We’re going to have a couple of weeks, starting pretty much now, but especially a few days from now, that are going to be horrific,” he said.

“But even in the most challenging of times, Americans do not despair. We do not give in to fear.”

Among the latest US fatalities was a six-week-old baby who was taken to a Connecticut hospital late last week.

“Testing confirmed last night that the newborn was COVID-19 positive,” the state’s Governor Ned Lamont tweeted. “This is absolutely heartbreaking.”

The new coronavirus has chiefly affected the elderly and those with pre-existing medical conditions, but a number of recent cases have highlighted that it can affect people from all walks of life.

The dead have included a 13-year-old in France, a 12-year-old in Belgium and 13-year-old Ismail Mohamed Abdullah in Britain, whose family said the “gentle and kind” boy had no underlying health issues.

World Health Organization head Tedros Adhanom Ghebreyesus said the disease’s rapid spread was alarming.

“Over the past five weeks, we have witnessed a near exponential growth in the number of new cases, reaching almost every country,” he said.

“The number of deaths has more than doubled in the past week. In the next few days we will reach one million confirmed cases and 50,000 deaths.”

– Spanish peak? –

Britain and France both reported their highest daily death tolls from COVID-19 on Wednesday, although there were signs the epidemic could be peaking in Europe.

Italy’s toll — the highest in the world — climbed past 13,000, while Spain surpassed 9,000.

But epidemiologists said the infection rate was continuing to slow.

Fernando Simon, head of Spain’s health ministry’s emergency coordination unit, said it appeared the country may have passed the peak.

The US is rapidly becoming the worst hit country, with its total number of infections rising above 215,000.

More than three-quarters of Americans are under lockdown, including tens of thousands of prisoners, who were told Wednesday they would be confined to their cells for two weeks.

Officials also shuttered the Grand Canyon to prevent tourists gathering there and New York announced that basketball courts would be closed as the city grapples with sky-rocketing infections and a severely strained health system.

America’s unwanted title as most-infected country was questioned Wednesday by a Bloomberg report, which cited US intelligence as saying China’s infection rate was far worse than officially acknowledged.

China says it has around 81,000 infections, and 3,300 deaths.

Republicans, many of whom are naturally skeptical of Beijing, attacked China’s numbers as “garbage propaganda”.

“Without commenting on any classified information, this much is painfully obvious: The Chinese Communist Party has lied, is lying, and will continue to lie about coronavirus to protect the regime,” Senator Ben Sasse said.

– Sporting victim –

Having already caused the Tokyo 2020 Olympics to be postponed for a year, the pandemic on Wednesday claimed its latest sporting victim as the Wimbledon tennis tournament was shelved.

The cancellation of the world’s oldest Grand Slam tournament — for the first time since World War II — leaves the season in disarray, with no tennis set to be played until mid-July.

Roger Federer proclaimed himself “devastated” by the news, while Serena Williams said: “I’m shooked”.

But the loss of sporting events in the developed world paled in comparison with the hardships imposed on those in poorer parts of the globe, where lockdowns were threatening whole communities.

Dwellers of South Africa’s townships say it is simply impossible to stay at home.

“We don’t have toilets… we don’t have water, so you must go out,” said Irene Tsetse, 55, who shares a one-bedroom shack in Khayelitsha township with her son.

The macroeconomic impacts of such measures could be far-reaching, experts warned.

The Food and Agriculture Organization, WHO and World Trade Organization said panic buying could threaten food supplies.

“Uncertainty about food availability can spark a wave of export restrictions, creating a shortage on the global market,” they said.

Source: AFP

Spain and the United Kingdom have recorded their biggest one-day death tolls from the novel coronavirus, which has so far infected over 900,000 people across the world.

Spain on Wednesday recorded its highest daily death toll – another 864 people – while infections jumped to 102,136, up from 94,417.

The country, which has the second highest number of COVID-19 fatalities after Italy, has imposed a lockdown that brings economic activity to a virtual standstill.

The UK’s death toll also rose by 563 in 24 hours, a record jump that brought the number of patients who died in hospital to 2,352, the country’s Health Ministry announced.

The death toll in the United States has also exceeded 4,000 and the number of confirmed cases surpassed 200,000.

Also in Germany, the social distancing measures were extended through the end of the Easter holiday break (at least April 19), Chancellor Angela Merkel announced on Wednesday following a call with state leaders.

“A pandemic doesn’t take a vacation,” Merkel said announcing the decision. The restrictions were initially due to end on April 5.

The decision was made shortly after the country confirmed 5,453 new cases, including 149 deaths. The figures increased Germany’s death toll to 909 and total cases to 77,558, according to the data collected by Johns Hopkins University.

Right now, at least 926,095 people have been infected by the deadly virus across the world, out of whom 46,252 have died, and 193,031 have recovered.

On Tuesday, UN Secretary-General Antonio Guterres described the coronavirus outbreak as the worst global crisis since World War II, warning that it could trigger conflicts around the world.

He said that the large magnitude of the crisis was due to “a disease that represents a threat to everybody in the world and… an economic impact that will bring a recession that probably has no parallel in the recent past.”

“A stronger and more effective response… is only possible in solidarity if everybody comes together and if we forget political games and understand that it is humankind that is at stake,” Guterres said.

Source: Presstv