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Coronavirus

Remdesivir to be available in South Africa by the end of July

A drug that can has been shown to reduce the time to recovery of Covid-19 patients will soon be available in South Africa.

Update:
Essen (Germany), 03/07/2020.- Illustration - A medical worker checks an ampoule of the antiviral drug Remdesivir for patients infected with SARS-CoV-2 coronavirus at the University hospital in Essen, Germany, 03 June 2020. According to reports, the EU has
SASCHA STEINBACHEFE

Remdesivir, an antiviral drug which has provisional approval in several countries for treating Covid-19, should be available in South Africa by the end of the month.

Cipla South Africa have announced they plan to bring their generic version of remdesivir to South Africa before the end of July. The company's CEO said that although the medicine can cost about $390 per vial in the USA, Cipla plan to sell it at around $55 per vial in South Africa. A course of treatment for Covid-19 would be around six to 10 vials. The company, which is manufacturing the drug in India, where its parent company is located, said it would bring in a first batch of 30,000 doses.

The drug has been shown to reduce the time to recovery of Covid-19 patients from 15 to 11 days In the trial, published in the New England Journal of Medicine, there was a reduction in mortality among those treated with remdesivir, but this was not statistically significant.  It should be noted that of the 531 patients treated with remdesivir in the trial, 7.1% still died. The drug patent holder Gilead provided the drug for the trial, but did not provide financial support.

Remdesivir could have a double impact and save thousands of lives

The impact in South Africa could be doubly beneficial. A study published in Clinical Infectious Diseases journal claims by shortening the time people are in intensive care, that in effect increases hospital's capacity to look after very sick patients. According to the study, this increase in ICU capacity could help save the lives of up to 6,862 patients during the peak months of infection where ICU capacity is breached. The authors of the study also calculated the number of lives that could be saved if Remdesivir also reduces mortality directly, estimating that up to 19,453 lives could be saved from June to December 2020. 

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The study's lead author, Brooke Nichol noted, "There are many countries with limited ICU capacity that could benefit from this double impact on mortality."

South Africa only has 3,450 ICU beds available for Covid-19 patients, with some provinces are expected to fall short of beds for months, as the virus is estimated to reach its peak in August.

The study also suggested "Without remdesivir, it is expected that  23,416 to 31,269 people will occupy an ICU bed during peak months when ICU capacity is expected to be breached. With Remdesivir, that number is expected to grow to 36,291 to 47,827 patients treated in ICU by December 2020. "

By administering Remdesivir to ICU patients during peak period, the study reiterates that 3,295 to 6,814 deaths can be averted.

Remdesivir - an anti-viral drug found in the hunt for a hep C cure

Remdesivir was initially discovered by Gilead in their search for a cure for hepatitis C, tests then showed it might inhibit certain kinds of virus, whose genome is made of RNA, by stopping them from making copies of their genome, meaning they cannot replicate. Lab tests showed it might be effective against several RNA-based viruses including Ebola and several coronaviruses.

It was tested as a treatment for Ebola in 2018 and 2019, but it did not work as well as two antibodies which tested at the same time. 

Various versions of the treatment are now being produced by licensed companies to supply the drug to more than 127 countries with low and medium resources to offer a treatment for coronavirus.

Whilst it can shorten the time to recovery for patients, the authors of the New England Journal of Medicine note: "Given high mortality despite the use of remdesivir, it is clear that treatment with an antiviral drug alone is not likely to be sufficient. Future strategies should evaluate antiviral agents in combination with other therapeutic approaches or combinations of antiviral agents to continue to improve patient outcomes in Covid-19."