COVID19 update, July 22, 2020: beta-interferon a breakthrough treatment?; As many as 50-60% of people may have pre-existing T-cell immunity; Flare-up in Belgium

(1) This could be huge: as Dr. John Campbell explains in the following video

a team based at U. of Southampton carried out a clinical trial with beta-interferon. Dr. Campbell explains how this is part of the natural immune system of the body, and how COVID19 apparently interferes with its production, making cells not only more vulnerable to spreading COVID19 infection but indeed making them more susceptible to opportunistic secondary infection by, say, influenza viruses. (If you think COVID19 alone is bad news, imagine it together with a bad flu, and if you want a real nightmare scenario, throw a bacterial pneumonia over the top.)

Here is a press release. The TL;DR points:

  • this was a small study (100+) with a placebo group. If anything, the sample was skewed against the drug, as the treatment group had more people with risky pre-existing conditions
  • half the patients were treated with beta-interferon through inhalation, the other half with a placebo
  • the odds of developing severe disease were reduced by four-fifths in the treatment group compared to the control group
  • in the placebo group, six people died. None died in the treatment group
  • on average, patients in the treatment group were discharged after six days, versus nine days for the control/placebo group
  • subjectively, the treatment group reported much less difficulty breathing than the placebo group

It should be pointed out that beta-interferon has been in clinical use as a drug for decades, notably (under the brand names Rebif, Avenex,…) for the autoimmune disease, multiple sclerosis.

The BBC:

Interferon beta is part of the body’s first line of defence against viruses, warning it to expect a viral attack. The coronavirus seems to suppress its production as part of its strategy to evade our immune systems. The new drug is a special formulation of interferon beta delivered directly to the airways via a nebuliser which makes the protein into an aerosol. The idea is that a direct dose of the protein in the lungs will trigger a stronger anti-viral response, even in patients whose immune systems are already weak.

This type of drug is impossible to administer orally (it would just be digested): in multiple sclerosis it is injected (Avonex typically intramuscular, Rebif typically subcutaneously — with a little practice, self-administered just like insulin).

(2) As many as 50-60% of people could have T-cell immunity for COVID-19 from prior exposure to different coronaviruses, reports the BBC.

[W]hile the world has been preoccupied with antibodies, researchers have started to realise that there might be another form of immunity – one which, in some cases, has been lurking undetected in the body for years. An enigmatic type of white blood cell is gaining prominence. And though it hasn’t previously featured heavily in the public consciousness, it may well prove to be crucial in our fight against Covid-19. This could be the T cell’s big moment.
T cells are a kind of immune cell, whose main purpose is to identify and kill invading pathogens or infected cells. It does this using proteins on its surface, which can bind to proteins on the surface of these imposters. Each T cell is highly specific – there are trillions of possible versions of these surface proteins, which can each recognise a different target. Because T cells can hang around in the blood for years after an infection, they also contribute to the immune system’s “long-term memory” and allow it to mount a faster and more effective response when it’s exposed to an old foe.  

Several studies have shown that people infected with Covid-19 tend to have T cells that can target the virus, regardless of whether they have experienced symptoms. So far, so normal. But scientists have also recently discovered that some people can test negative for antibodies against Covid-19 and positive for T cells that can identify the virus. This has led to suspicions that some level of immunity against the disease might be twice as common as was previously thought.

Most bizarrely of all, when researchers tested blood samples taken years before the pandemic started, they found T cells which were specifically tailored to detect proteins on the surface of Covid-19. This suggests that some people already had a pre-existing degree of resistance against the virus before it ever infected a human. And it appears to be surprisingly prevalent: 40-60% of unexposed individuals had these cells.

Read the whole thing.

(3) After a long gap, Israel finally has a “coronavirus czar”: Prof. Gabriel “Gabi” Barbash, the recently retired medical director of Sourasky/Ichilov Medical Center in central Tel-Aviv. (This is one of the “big 4” research and teaching hospitals in Israel, together with Tel HaShomer in the Tel-Aviv borough of Ramat Gan, Hadassah in Jerusalem, and Rambam (=Maimonides) in Haifa.) He also previously (1996-9) served a stint as director-general of the Health Ministry. We wish Gabi well in his daunting task.

New infections continue to be high here (just over 2,000 yesterday) but daily recoveries are ramping up too, reaching 589 yesterday. In fact, on worldometers, the surge in recoveries seems to lag that in new infections by about 4 weeks.

In related news, following WHO recommendations, Israel has shortened the quarantine period for COVID19 from 14 to 10 days.

(4) Belgium is the latest country to see a major flare-up: “all traffic lights show red”, headlines De Standaard (in Dutch). Further back-to-normal measures there are on hold for now.

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