Bruce Y. Lee
The National Institutes of Health (NIH) now have a COVID-19 Treatment Guidelines website. (AP … [+] Photo/Pablo Martinez Monsivais)
You’re not going to find “Virus Shut Out Protection” pendants, consuming large amounts of boiled ginger, or special toothpaste on these COVID-19 Treatment Guidelines. After all, these guidelines now posted on an National Institutes of Health (NIH) website were based on a review of the scientific evidence, not someone’s anecdotes, feelings, musings, or gut instincts. This will be a living document, meaning that the website will be continuously updated as more and more scientific information emerges about this nasty virus and the disease that it can cause.
The website also clearly lists the members of the COVID-19 Treatment Guidelines Panel who put together the recommendations. So it isn’t some mysterious social media account that has a picture of a random unidentifiable person, a muskrat, or a baby that’s issuing these recommendations. The panel includes representatives from academia, major federal organizations like the National Institutes of Health (NIH), the Biomedical Advanced Research and Development Authority (BARDA), the Centers for Disease Control and Prevention (CDC), the Department of Defense (DOD), the Department of Veterans Affairs, and the Food and Drug Administration (FDA), and key professional organizations such as the Infectious Diseases Society of America (IDSA) and the Society of Critical Care Medicine. All are quite relevant organizations when it comes to COVID-19 coronavirus treatment recommendations.
Not all of the guidelines may seem immediately relevant to you. For example, unless you are a critical care doctor, nurse, or respiratory therapist or running a ventilator by yourself in your apartment (which, incidentally you shouldn’t be doing), you may not resonate with the section that covers ventilator settings to use. Some parts of the guidelines simply re-emphasize what should be known already, such as someone has to have the proper experience before putting a breathing tube down your throat and health care workers need to wear N95 masks when doing procedures on a patient with COVID-19 that may spray respiratory droplets. While these may seem as obvious as “don’t stick your tongue on a sign post in the middle of freezing weather,” unfortunately, during the COVID-19 coronavirus pandemic, there have been stories of health care workers feeling forced to do things such as seeing potentially contagious patients without wearing proper personal protective equipment. Other parts of the guidelines cover what to do about corticosteroids in critically ill patients.
Assuming that you are a human and not a packet of corticosteroids, you may be most interested in what guidelines currently say about the following questions:
Should you take anything to prevent yourself from getting infected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)?
Nope. So far, the panel hasn’t found any medication, supplement, Eye of Newt, or Nose of Dog proven scientifically to protect you. That means that if you are sitting at home by yourself wondering what you can do to keep yourself from getting infected by the virus, keep doing the first part. Social distancing, disinfecting objects, and washing your hands thoroughly and frequently are still the best ways to prevent infection. And based on the panel’s review, the only ways.
If you have been exposed to someone contagious, should you take anything to protect yourself?
That’s also a no, according to the panel. If you think that you got exposed to someone contagious, the only things that you should be doing is notifying others and quarantining yourself.
If you think you may have the infection but have no symptoms, should you get some type of treatment?
Nope. See above and below.
Have any drugs been proven to be safe and effective for treating COVID-19?
The panel did not find enough scientific evidence supporting the use of hydroxychloroquine for … [+] treating COVID-19. (Photo Illustration by Soumyabrata Roy/NurPhoto via Getty Images)
NurPhoto via Getty Images
Not yet. The guidelines did list a bunch of different antiviral or immunomodulatory therapy medications that are being considered such as chloroquine, hydroxychloroquine, remdesivir, interleukin-6 inhibitors (e.g., sarilumab, siltuximab, tocilizumab), and interleukin-1 inhibitors (e.g., anakinra). However, for all these, the panel concluded that there is “insufficient clinical data to recommend either for or against the use of the following agents for the treatment of COVID-19.” It concluded the same about using convalescent plasma or hyperimmune immunoglobulin, which are antibodies from the blood of someone who has already gone through an infection and has recovered.
But the panel did take an even stronger stance regarding certain medications. They warned against combining hydroxychloroquine plus azithromycin due to potential adverse effects such as abnormal heart rhythms. The panel also recommended against the use lopinavir/ritonavir or other HIV protease inhibitors, because clinical trials have found them to be ineffective. Moreover, the amounts of such drugs that may be required to stop SARS-CoV2 from reproducing may be too high for humans to tolerate. Interferons were on the no-no list as well, since they haven’t seemed to work for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) and could have a variety of side effect. toxicity. The panel nixed janus kinase inhibitors such as baricitinib too, because they may suppress your immune system, which is kind of defeating the purpose when your body is fighting an infection.
If you have severe COVID-19, should you get antibiotics?
Heck no, unless you also have a bacteria infection that requires antibiotics. The COVID-19 coronavirus is a virus not bacteria. Otherwise, it would be called coronabacteria. Even if you are concerned that COVID-19 may weaken your defenses, making you more susceptible to a bacteria infection, don’t take antibiotics in an attempt to prevent this from happening.
Should you use angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) to treat COVID-19?
As I’ve described before for Forbes, the SARS-CoV2 seems to use angiotensin-converting enzyme 2 (ACE2) receptors on the surface of your cells to eventually enter your cells. This raised the thought that ACE inhibitors could potentially affect this process in either a good way or a bad way. However, the panel did not find enough evidence to suggest that ACE inhibitors or ARBs will affect the course of COVID-19.
Should you use an HMG-CoA reductase inhibitor (Statins) to treat COVID-19?
Aren’t statins like atorvastatin (Lipitor), rosuvastatin (Crestor), and simvastatin (Zocor) primarily used to treat high cholesterol? What then do they have to do with COVID-19? One theory is that statins can decrease inflammation and thus somehow reduce inflammation in COVID-19. However, the panel didn’t find enough evidence so far to support their use.
Will these COVID-19 treatment guidelines change?
Potentially. Possibly. Maybe. A decent chance. It is unlikely that future recommendations will say that a person doesn’t need to have any experience before sticking a breathing tube down your throat. However, as more and more scientific studies are completed and data emerges, some of the other recommendations could change. Bookmark the website and store it along with your BTS and Billie Eilish fan site bookmarks. While these guidelines don’t offer too many new prevention and treatment options, it’s certainly a more reliable resource than some random dude or dudette on social media.