South Africa’s high tech response to Covid-19 epidemic

SOUTH AFRICA is leading the way in charting a high tech response to the pandemic. Several hospitals, including private and public facilities are utilising robots to limit exposure and infection control. A two-wheeled robot named Quinton is helping to reduce the time doctors are physically present with infected patients at Tygerberg Hospital, while Netcare has deployed germ-eradicating robots to fight infection.

Netcare Group‚Äôs chief executive officer, Dr Richard Friedland says “Both the Xenex pulsed ultraviolet (UV) robots and Yanex Pulsed-Xenon UV robots deployed in Netcare hospitals use high doses of UV light to destroy viruses, bacteria and fungal spores and disinfect hospital wards, theatres and other spaces within minutes”.

Meanwhile Prof Salim Karim outlined this morning, how his team intends to tackle the local epidemic using ‘big data’ by deploying the CSIR National Ops Centre initially created for the soccer world cup. His team is busy gathering data by geolocating tests via cellphones and identifying hotspots inside the country.

A strategy of containment has also been rolled out. Prof Karim is in the process of ‘identifying weak links in the national containment strategy’. He says the country is not just slowing the outbreak but ‘is learning from how the virus spreads’. Is concerned about potential for spread within Prisons, Mines, Hospitals, and is talking about ‘control, enforcement and more aggressive steps’.

The use of technology is proving to be a game-changer.

Local biotech company, Cape Bio Pharm is introducing spike proteins into plants, to produce “a cheaper, locally produced test kit” which would “separate the seasonal flu sufferer from a person infected with COVID-19, thereby alleviating the strain on our healthcare system”

The Health Dept recently ramped up testing by utilising a GeneXpert TB test machine repurposed for Covid-19 that will massively increase capacity.

Two entrepreneurs from CSIR have developed a lab PCR test which takes just 60 minutes.

Stellenbosch University and AzarGen Biotechnologies (Pty) Ltd, a South African biotechnology company have focused on developing ‘human therapeutic proteins’ using advanced genetic engineering and synthetic biology techniques in plants, and have joined forces in the global fight against the coronavirus.

A branded synthetic pharmaceutical, previously used for the treatment of neonatal Respiratory Distress Syndrome (nRDS), a condition where some premature babies struggle to breathe due to collapsed lung sacs, as well as treatment for acute lung injury in adults, is being tested as a supportive agent for the treatment of ARDS, the condition associated with COVID-19.

South Africa’s local biotech industry is already quite advanced, and the country has a history of medical world firsts, including the first ever heart transplant at Groote Schuur hospital.

Telemedicine is moving in leaps and bounds, but still needs a way to go within the public health sector.l

A syndromic response may be required as we move into Winter flu season. Various companies around the world have outlined the means by which multiple tests for a variety of respiratory illnesses may be combined in theory into one single test.

While SAA may have been grounded for good, Ethiopian Airlines arrived with medical supplies from China, and also tests and equipment donated by Jack Ma.

Emirates Airlines has started implementing rapid testing for passengers demonstrating the type of technology being appraised by Senegal’s Louis Pasteur Institute.

Biodx, a proudly South African company,¬† is developing ‘cutting edge antimicrobial and antiviral technologies’ with technical support from the CSIR. However UV Led Light may turn out to be a better option, as demonstrated by a 30-Second Coronavirus Kill.

South Africa’s first successful genome sequencing of a locally collected sample of the SARS-CoV-2 virus has been added to an international database to help better understand the disease. KwaZulu Natal’s Research, Innovation and Sequencing Platform (KRISP) and the Big Data Flagship Programme of the University of KwaZulu-Natal (UKZN) has a multi-disciplinary team of world-renowned experts which mainly focuses on analysis and control of viral outbreaks and genomic analysis.

SA’s 3D-printing community is making life-saving protective gear from home and the University of Johannesburg is deploying its printers in the fight against Covid-19.

The United States Centre for Disease Control and Prevention (CDC) will provide technical assistance to South Africa’s National Department of Health (NDoH) and National Institute for Communicable Diseases (NICD) in addition to 50 million rand to the countries epidemic response.

Concerns about the use of tech during the crisis taking the surveillance state to a new level have been expressed. In 2013 South Africa passed a law protecting personal data, The Personal Information Protection Act.

Hunger must be seen as a determinant of health

YESTERDAYS looting of supermarkets in several South African townships, is unfortunately driven by hunger. These food riots are indicative of an alarming situation unfolding two and a half weeks into the hard lockdown. Gatesville, Manenburg, Tafelsig, Alexandra, are where low-income families have been forced into the lockdown without any tangible relief from government. Hunger must be seen as a determinant of health alongside the burden of disease.

Instead our government appears hellbent on implementing prescriptions driven by the WHO in Geneva. Solutions which may turnout to be wholly unsuited to conditions in emerging economies such as our own. The lockdown may be wrong for Africa.

It is doubtful whether or not the hard lockdown will accomplish any of the supposed objectives laid out by our Health Minister, and should rather be replaced by a smart lockdown, or soft lockdown as soon as possible. Despite experiencing a surge, Japan has implemented a soft lock-down, as have many countries fully aware that completely suppressing the virus risks the situation where one merely postpones and lengthens the epidemic.

According to chief scientist Prof Salim Karim, ‘South Africa will know on 18 April’ if the methodology utilised against the coronovirus is inaccurate or factually correct. The measures may have bought time for our health system to prepare for a coming surge, known as the ‘delayed exponential curve of infection’.

If mitigation measures  to curtail the spread of hunger, are not implemented immediately, the problem of mass starvation could dwarf the current epidemic and grow to haunt South Africans as we move forward during an unprecedented period of economic turmoil. Most households are only able to maintain a two-week supply of food. Without income or food parcels, the situation could quickly deteriorate to conditions seen during wartime, famine and natural disasters.

“Our problem is not that we don‚Äôt have enough food in South Africa. Our problem is that the food is only available to those who have cash” writes business strategist Marius Oosthuizen.

The closure of restaurants and hotels has perversely resulted in literal food mountains. Tonnes of produce is being destroyed around the world because of the global pandemic, while ordinary consumers are ironically forced to pay more for fresh produce.

Since 2011, three million more¬†South Africans¬†have been pushed¬†below¬†the poverty line, according to a study by the national data agency, Statistics¬†South Africa.¬†More than 30.4 million South Africans‚ÄĒ55.5% of the population‚ÄĒlive on¬†less than 992 rand (about $75) per person per month. Yesterdays interest rate cut will assist middle-class households, but the problem remains that most households were already below the poverty line at the beginning of the lock-down.

Ekurhuleni mayor Mzwandile Masina on Tuesday launched a food bank to provide relief to the poor during the Covid-19 outbreak. The same plan alongside further disaster relief is required in every Metro, town and city. School feeding schemes urgently need to be restored. Other relief measures that should be contemplated include once off emergency cash payments to each and every household.

Current relief packages rolled out by national government include¬† assistance to SMMEs, tax relief, Agricultural Aid, UIF, Health and other support services. More needs to be done if the lockdown continues. As an anonymous author from Iran writes, ‘the difference between barbarism and civilisation is a plate of food’.

It is imperative that food security be seen alongside the burden of disease, as a determinant of people’s health.

 

Lockdown doing more than trashing our rights alongside the economy?

IT MUST strike readers as incredibly ironic, that a virus whose origin is China, has resulted in formerly free and open economies, closing shop and placing their markets in hibernation mode. Most economies including South Africa, UK, USA, France, Italy and Australia have implemented lock-downs and restrictions on movement and travel, with our own country choosing a ‘hard lockdown’.

Last night Professor Salim Abdool Karim outlined the events which have resulted in a low mortality rate and rate of infection (R0). Our country is not alone in this regard with New Zealand reporting similar outcomes, but unlike most experts who attribute the sterling results to the hard lockdown, Professor Karim was at pains to explain that the data needs to be ‘corrected by a fortnight’, or 14 days, to account for incubation, and therefore the elbow in the curve of infection which begins on the very day of the lock-down, is more likely the result of what had happened two weeks previously, in other words, the initial measures taken when our President announced the National State of Disaster, closing our borders, implementing social distancing and hand sanitation measures.

Several news articles rushed to misquote Professor Karim and did not carry his own interpretation of the data which he had presented. There is currently no evidence that the hard lockdown has done anything more to curb the spread of the virus, than closing our borders and tracing infections, and may turn out to be a case of Fear of Being Left Behind. However South Africa will know on 18 April if the countries fight against the coronovirus is inaccurate or factually correct.

Karim explains: “SA‚Äôs Covid-19 trajectory is unique, because unlike most other countries, it did not see an exponential increase in cases after its first 100 cases. The most likely explanation was that the country had seen three epidemics: one among travellers, a second among their contacts and a third epidemic of community transmission. By the time the lockdown began on March 26, the first two epidemics had largely burnt out, and community transmission was not occurring at a significant level,”

Nevertheless there was open speculation by yesterday’s panel on what would come next. According to the Professor, South Africa is doomed to experience a ‘delayed exponential curve‘ once the lockdown ends since the period had simply bought time, and thus various criteria for coming out of lockdown were elaborated including a suggestion that the elderly continue a voluntary lockdown until at least September.

He also outlined various measures to deal with potential hotspots, the ‘small brush fires that must be contained to avoid raging fires’. In theory a lockdown like self-quarantine creates dead-ends for infection, but so do many other measures. None of what he said is indicative of why an approach as that followed by South Korea was not considered nor whether a smart lockdown would have been better for our economy?

South Korea appears to have reined in the outbreak without some of the strict lock-down strategies deployed elsewhere in the world, while Sweden is showing data not all that different from countries which had delayed lock-down strategies.

Needless to say, the Department of Health must be commended for its proactive steps in regard to testing and lowering the threshold of surveillance of the disease , so too the unprecedented sharing of information and data as seen during last nights televised presentation. But there are many questions which remain unanswered.

The brutality and callousness with which the hard lockdown restrictions in terms of the Disaster Management Act (DMA) have been implemented by SAPS and SANDF over the past two weeks have taken many citizens by surprise. There are those who would have preferred a ‘smart lockdown’, as well as a growing list of virologists and medical authorities who question the efficacy of introducing steps which show little scientific merit, for example banishing citizens from the great outdoors in a respiratory disease epidemic where ‘fresh air may also save lives’. In this case the cure may be worse than the disease.

The economic fallout and risk of mass starvation and worse total meltdown, certainly needs to be weighed against any purported public health objectives moving forward. It is also questionable whether the DMA promulgated as it was, to deal with natural disasters such as floods, hurricanes and earthquakes is fit for purpose when it comes to a public health emergency.

Given the low mortality and infection rate, it is unclear whether the current health emergency, indeed fits the description of a national disaster if at all.

Witness images of SAPS and SANDF trashing traditional beer stills  and confiscating meat poitjies, effecting arbitrary arrests of joggers and dog-walkers whilst gangs of youths go free. The erection of concentration camps for the homeless, acts of arbitrary punishment and some 9 deaths and counting at the hands of the authorities, including the beating to death of an Alexandra resident, found with a bottle of beer inside his own home.

It is not too late to address those measures which have worked, the massive hand sanitation campaign, social distancing measures and adoption of face masks, while taking a long and hard look at those steps which appear to be little more than a brazen excuse by authoritarians to exert social control over the population.

Getting out of lockdown may be essential to combating impact of the virus

THE LOCKDOWN was never meant to do anything more than buy us time to prepare. Time to allow the public health system to adjust, to stock-up on medication, to initiate testing and special counter-measures.

Unfortunately it appears that many South Africans and government officials are under the impression that the lock-down is some form of a cure-all. It is nothing of the sort. It cannot prevent the second and third wave of infections that will undoubtedly arrive come winter, and it cannot continue being extended if our economy and way of life is to survive.

Although a return to normal is not possible, and social distancing and other measures will be in place for a very long time, the cost of extending the lock-down must be weighed against the inevitable collapse in economic activity that will result. Given that for the majority of South Africans, adapting to a world where the only economic activities will be online jobs, is neither practical nor possible over the short term, nor is it readily apparent what unskilled labour is expected to do during the crisis?

Getting out of lock-down is essential to combat the impact of the virus upon the economy, on people’s lives and livelihoods, and to avoid the continued abuse of state power by the SANDF. Where those on the left including the ANC have supported the extension of the lockdown, it is only the opposition DA which has registered its dismay.

Many of the measures already in place have little scientific or health merit. Preventing people from playing in their yards, from jogging outdoors, or engaging in other activities such as drinking alcohol, that presumably might risk the spread of the virus, is not ideal. A zero tolerance approach to infection has consequences, chief of which is that unless the state can pay its citizens a basic income ,the possibility exists of mass starvation.

There is limited capacity within our country to simply go on dishing out food parcels, to place SMMEs on life support, to postpone bond and debt payments. This while rounding up the homeless, placing such persons in ‘temporary shelters’ that resemble concentration camps. The sheer density of many informal settlements has made such steps seem ludicrous.

One approach to the problem outlined by an Australian virologist, Professor Peter Collignon, is to gradually expose parts of the population to the virus. This controversial approach to developing immunity within the broader population has some merit and should not simply be discarded. In Sweden for example, where there has been no lock-down, admittedly within an excellent health care system, the mortality figures have not been all that different from those countries which have implemented lock-down practices.

In some respects the UK which early on adopted some of the measures in Sweden, before choosing a general lock-down, is an example of the counter-intuitive logic at play. The country at first sheltered the elderly and most vulnerable. Those dying today, would have died tomorrow, argue proponents, dead in future waves of the epidemic. Without a vaccine, the only option for so-called ‘herd immunity‘ is to control the rate of infection, to flatten the curve and stall the onset of the epidemic.

Faced with the prospect that a working vaccine may only be ready in September, in six months time, South Africa has an unenviable task, that of weighing up all the options, examining the case for and against an extension of the current five week lock-down.

published in part by Natal Mercury Letters

 

 

South Africa’s C19 ‘Concentration Camp’ for the Homeless

VIDEO has emerged of appalling conditions inside what appears to be a ‘Concentration Camp for the Homeless‘. The Strandfontein temporary site was setup by the Western Cape administration acting in conjunction with National Government. Its homeless inmates were rounded up two weeks ago when the national lockdown started.

A report from inside the internment camp shows an insider explaining in Afrikaans that ‘everyone is sleeping up against each other’, there is no social distancing, no separation of men and women, lots of condensation from ground water, since the site is right on the beach in Strandfontein.

More alarming is the apparent failure to separate adults, youths and children.

SAPS Western Cape are currently investigating the circumstances surrounding the rape of an 18-year-old girl by a 36-year-old male last night at the ‘Strandfontein temporary shelter’.

A news report carried by INM, explains, that while the inmates or ‘guests of the state’ were apparently ‘free to leave’, they would simply get arrested again for disobeying the lockdown.

“We are forced here. It’s like a concentration camp.” Is how Tracey van der Pool described the conditions at the Strandfontein sports complex.

The facility is clearly operating in contravention of Article 12 of our Bill of Rights. All citizens have a fundamental right to be brought before a judge within 48 hours following their arrest, but of course, the latest annex to Pollsmoor Prison is posing as a ‘solution to the pandemic’ in terms of the National Disaster Act and nobody has been charged.

The Children’s Act defines a child as ‘any person under the age of 18.’

Earlier another video emerged of a petty confrontation between the ANC’s Cameron Dugmore and DA’s JP Smith at a media briefing at the site last week, in which Dugmore proceeds to ignore the unsanitary conditions and instead tackles JP Smith over his alleged failure to give SAPS hand sanitiser.

Human Settlements Minister Lindiwe Sisulu says her department has identified five informal settlements whose residents will be requested to relocate as concerns grow around the spread of the Covid-19 coronavirus.

Neither SAPS nor the SAHRC are likely to act given their bad track record on dealing with similar matters.

In 2002 the Mental Health Act was amended to prevent involuntary medical commitment for economic reasons.

Volunteers from various Community Action Networks have written a letter listing their objections and concerns about the living conditions at the Strandfontein Sports ground site. The group have encouraged people to sign the letter before Monday, 13 April 2020 at midday, as it will be sent to Mayor Dan Plato.

In another twist, the City has been issuing fines of R500 to inmates, which may contravene rights of prisoners.

SEE: Doctors Without Borders makes scathing findings against City’s Strandfontein shelter

SEE: The Strandfontein Relocation Camp is a test of our morality as a city

Could Hypokalemia explain COVID-19 mortality?

THAILAND MEDICAL NEWS has reported that a new research study by researchers from Wenzhou Medical University in Zhejiang province lead by Dr Don Chen ‘revealed that almost all Covid-19 patients exhibited hypokalemia and that supplementation with potassium ions was one of the many factors that assisted in their recovery.

The study apparently found that as the SARS-CoV-2 coronavirus attacks human cells via the ACE2 (Angiotensin- converting enzyme-2) receptors, it also attacks the renin‚Äďangiotensin system (RAS), causing low electrolyte levels in particularly potassium ions.

The study involving 175 patients in collaboration with Wenzhou Hospital found that ‘almost all patients exhibited hypokalemia and for those who already had hypokalemia, the situation even drastically worsened as the disease progressed.’

However, it was found from the study that ‘patients responded well to potassium ion supplements and had a better chance of recovery.’

The study has yet to be peer reviewed and has been published in the open platform medRvix : (https://www.medrxiv.org/content/10.1101/2020.02.27.20028530v1.full.pdf+html)

Meanwhile another medical paper theorises why COVID19 starves patients of oxygen and produces crushed glass imagery

UPDATE: The heme theory has apparently been debunked see below,

COVID-19: Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism.

The attack apparently will cause less and less hemoglobin that can carry oxygen and carbon dioxide.The lung cells have extremely intense poisoning and inflammatory due to the inability to exchange carbon dioxide and oxygen frequently, which eventually results in ground-glass-like lung images.

Another paper published by a group of Italian doctors claims ‘Covid-19 Does Not Lead to a ‚ÄúTypical‚ÄĚ Acute Respiratory Distress Syndrome’ and is cause for concern.

while the clinical approach to these patients is the one typically applied to severe ARDS, namely high Positive End Expiratory Pressure (PEEP) and prone positioning. However, the patients with Covid-19 pneumonia, fulfilling the Berlin criteria of ARDS, present an atypical form of the syndrome. Indeed, the primary characteristics we are observing (confirmed by colleagues in other hospitals), is the dissociation between their relatively well preserved lung mechanics and the severity of hypoxemia.

A New York City doctor explains why COVID19 is a ‘new disease requiring new treatment’ is not viral pneumonia, requires oxygen not ventilation, different protocols.

The past 48 hours or so have seen a huge revelation: COVID-19 causes prolonged and progressive hypoxia (starving your body of oxygen) by binding to the heme groups in hemoglobin in your red blood cells. People are simply desaturating (losing o2 in their blood), and that’s what eventually leads to organ failures that kill them, not any form of ARDS or pneumonia. All the damage to the lungs you see in CT scans are from the release of oxidative iron from the hemes, this overwhelms the natural defenses against pulmonary oxidative stress and causes that nice, always-bilateral ground glass opacity in the lungs. Patients returning for re-hospitalization days or weeks after recovery suffering from apparent delayed post-hypoxic leukoencephalopathy strengthen the notion COVID-19 patients are suffering from hypoxia despite no signs of respiratory ‘tire out’ or fatigue. Source

A blood test result more typically seen in disorders associated with bone marrow diseases was found in a patient with COVID-19, a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The findings were published March 25 in the American Journal of Hematology.

Reviewing the currently published literature, I am unable to find any evidence for significant SARS-CoV-2 entry into red blood cells. writes Matthew Amdahl, MD, PhD in Covid-19: Debunking the Hemoglobin Story

Covid-19 Anti-Vaxers stage a comeback, but fail to check facts

IT STARTED with an interview on Al Jazeera, some brazen French researchers making shocking off-the-cuff remarks about a study on the potential use of the BCG vaccine against COVID-19 in Africa. Taken at face value, it appeared that the French were once again conducting openly racist, TB vaccine experiments in their former colonies. That’s TB as in Tuberculosis.

The story quickly escalated and amplified into a headline grabbing: ‘Senator Wetangu’la calls on African leaders to reject COVID-19 vaccine test on continent‘. As journalists failed to check if what was being said was relevant or even true. The French embassy was moved to caution that the researcher’s opinions “do not reflect the position of the French authorities.‚ÄĚ

By Sunday, Anti-Vaxers were having a field day on twitter, but hadn’t bothered to check the facts. Yes, Covid-19 Vaccine trials are being conducted on EVERY continent, not just our own,

The first was a Phase 1 clinical trial evaluating an ‘investigational vaccine designed to protect against coronavirus disease 2019 (COVID-19)’ begun at Kaiser Permanente Washington Health Research Institute (KPWHRI) in Seattle, USA.

Phase 1 trials involve testing of drugs or vaccines on healthy volunteers for safety, and  also testing multiple doses (dose-ranging). Most countries such as South Africa have regulatory checks in place to avoid citizens becoming unwitting participants to phase 1 trials.

Our Constitution specifically outlaws such experimentation and states under Article 12¬† (2) Everyone has the right to bodily and psychological integrity, which includes the right‚ÄĒ (a) to make decisions concerning reproduction; (b) to security in and control over their body; and (c) not to be subjected to medical or scientific experiments without their informed consent.¬†

Trials of Covid-19 related vaccines have already been conducted in Japan and elsewhere.

Large scale global trials involving patients from Argentina to Thailand under the auspices of the WHO are already underway.

There appears to be some confusion as to what a vaccine does, as opposed to antiviral treatment for COVID-19. ¬†Ekurhuleni mayor, Mzwandile Masina, recently proposed using the municipality‚Äôs emergency funds ‚Äúto procure the vaccine Inferon B from Cuba‚ÄĚ, a proposal debunked by Africa Check.

The possibility that South Africa will also receive an actual trial vaccine is a big deal, not because we are likely to become lab rats, but because citizens will hopefully be able to volunteer for the phase 1 trials to assess the effectiveness of the vaccine in creating antibodies to the virus — a therapy which could prove to be a game-changer in the global pandemic.

As with any new drug or therapy, there will always be safety concerns, but the alternative is to live with permanent lock-downs and quarantines.

I would rather just get a jab in the arm thanks.

UPDATE: News24 forced to retract inaccurate coronovirus vaccine story

 

Mr President, we’re not officially at “War”

THE DEPLOYMENT of SANDF military personnel in support of SAPS enforcement of an unprecedented ‘lockdown’ in terms of the Disaster Management Act and National Health Act has resulted in at least three deaths, and countless examples of brutality and ‘cruel and unusual punishment’ reminiscent of the apartheid era.

The new regulations gazetted in terms of the legislation, and which appear to reference the colonial 1919 Public Health Act, may also turn out to be unlawful, as too the many contraventions of South Africa’s Bill of Rights.

The Disaster Management Act was drafted primarily to deal with natural disasters such as hurricanes, earthquakes, droughts and floods, and does not grant the President the kind of powers contemplated by the latest round of executive policy-making decisions.

Similarly, the National Health Act is focused on providing health care for all, and does not contain any reference to the Public Health Act written during a period in which black South Africans were deprived of property rights and other rights such as habeous corpus.

The past days stream of online visuals of combined law enforcement officials invading citizen’s homes without search warrants, shambokking residents on private property, pointing shotguns at civilians queuing for food, affecting arbitrary arrests of civilians, and in some instances, forcing South Africans as well as migrants, to do humiliating squats, brutally knocking others to the ground, rolling them on the streets and pavements, are all brutish acts calculated to force compliance with the latest rounds of regulations. As such, they deserve greater scrutiny from both our government and opposition parties.

To date, the official opposition DA has merely written a letter calling for military investigation into the incidents whilst parliament is in recess. Minister of defence Nosiviwe Mapisa-Nqakula has meekly cautioned members of the South African National Defence Force (SANDF) against their heavy-handedness during the lockdown.

With all the talk of war South Africans could be forgiven for thinking that the nation had officially declared war against the virus. Unfortunately we are in uncharted terrain so far as this is concerned, and Parliament has yet to pass a War Powers Act which would be required to allow President Ramaphosa to act as a war-time president.

At the start, the President acknowledged that the 15 March, Declaration of a National Disaster was one step away from the so-called national lockdown and a long way away from a State of Emergency. The shelter-in-place directive is unprecedented in modern times, but clearly necessary from a public health perspective. Law enforcement officials however seem to be a little overzealous in jumping the gun when it comes to the State of Emergency and special War Powers that would be needed to drive a command economy under military supervision.

Goods deemed non-essential, and therefore currently restricted from sale, quixotically include vegetable seed, general hardware, and cleaning equipment such as brooms.

Though generally muted by the past weeks events, our courts are still operating and functioning under special rules, and to my knowledge, the rule of law has not yet been suspended. It is unclear how citizens are expected to access legal aid during a lockdown.

Nevertheless Magistrates were quick to roll out summary fines of up to R5000 for contraventions of the new regulations, the magnitude of which will take some time to circulate within our communities. Legal professionals were generally silent or bunkered down, but eager to offer advice on the drafting of wills. Did we scrap the Audi rule alongside the National Environmental Management Act in the process?

We can only hope that the President supplies us with a timeline to the resumption of normality and that attempts to get ahead of the crisis will not come at the further expense of human rights.

The lockdown may be extended indefinitely, as in many other countries.

https://mg.co.za/article/2020-04-02-tension-over-whos-boss-of-courts/

South Africa’s controversial Chloroquine Phosphate adoption

WHY ANYONE would prescribe a substance such as Chloroquine Phosphate for the treatment of Covid-19 is a mystery. For starters the anti-malaria drug is an amebicide, ‘an agent used in the treatment of amoebozoa infections, called amoebiasis’ and is not an anti-viral as such.

It has a low LD50, the lethal dose at which rats and patients die (low is more toxic). It has been touted by both the Trump administration and the World Health Organisation as a treatment for the disease but has been lambasted by critics. Chloroquine: Trump’s misleading claims spark hoarding and overdoses reads one headline.

On the March 19, South Africa adopted Chloroquine Phosphate in its guidelines for the clinical management of Covid-19, published by the Department of Health and the National Institute for Communicable Diseases. A local pharmaceutical company has received permission from the medical regulator to import half a million chloroquine phosphate tablets.

New research published on Wednesday however, ‘suggested that ‚Äúoff label‚ÄĚ re-purposing of drugs such as hydroxychloroquine could lead to ‚Äúdrug-induced sudden cardiac death‚ÄĚ. The paper by the Mayo Clinic, a nonprofit medical organisation, found that ‘chloroquine and Kaletra, a HIV drug also being used against coronavirus, can cause the heart muscle to take longer than normal to recharge between beats.’

Most RNA viruses develop solely in cytoplasm (a thick solution that fills each cell and is enclosed by the cell membrane.) Unlike plasmodium malaria (amoebozoa ) viral populations do not grow through cell division, because they are acellular.

Coronaviruses are enveloped positive-stranded RNA viruses that replicate in the cytoplasm.

‘To deliver their nucleocapsid into the host cell, they rely on the fusion of their envelope with the host cell membrane. The spike glycoprotein (S) mediates virus entry and is a primary determinant of cell tropism and pathogenesis.’

There are over 100 known drug compounds capable of disrupting the viral replication of Sars-CoV-2, the coronovirus responsible for COVID-19. These substances have been located via an unprecedented bioinformatics search by two groups of scientists working round-the-clock on the equivalent of the Manhattan Project.

Their findings were published less than three weeks apart and must be considered required reading by anyone working in the field of coronovirus medicine. Unfortunately due to politics surrounding branded drugs and the Trump administration, and the machinations of the World Health Organisation, and our own government, these findings are being ignored.

Local use of the drug appears to pre-empt a WHO trial already underway in Norway and Spain.

Although Chloroquine Phosphate, ‘the phosphate salt of chloroquine, a quinoline a compound with antimalarial and anti-inflammatory properties’ appears on one of the lists provided by the researchers, the substance is not recommended by doctors as anything more than a last resort.

The chief executive of Novartis cautioned on Friday that it is ‚Äútoo soon‚ÄĚ to be sure whether the anti-malaria drugs could be a definitive treatment for the coronavirus.

‚ÄúResearchers have tried this drug on virus after virus, and it never works out in humans. The dose needed is just too high,‚ÄĚ says Susanne Herold, an expert on pulmonary infections at the University of Giessen,

The latest list of potential coronovirus drugs discovered via an unprecedented bioinformatics search, include many compounds already approved for administering by doctors, some are already in preclinical trials. Among them is a 1971 antiviral drug, Ribavirin capable of disrupting the RNA synthesis of the coronovirus itself, the bug responsible for the biggest health crisis event of the 21st Century.

The drug is described in a paper aptly entitled¬†‚ÄėBroad-spectrum coronavirus antiviral drug discovery‚Äė. It escaped media attention, perhaps due to its patent rights lapsing, while Lopinavir‚ÄďRitonavir, a relatively new HIV drug has received a lot of press, alongside Favivlavr a drug from China approved by the National Medical Products Administration of China .¬† Clinical trials of a promising COVID-19 antiviral, Remdesivir, which gets incorporated into viral RNA and prevents it being synthesised, halting viral replication, are currently underway.

Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C and some viral hemorrhagic fevers.

A team lead by Nevan Krogan of the Gladstone Institute, working around the clock have identified more than 300 human proteins that interact with SARS-CoV-2 during infection.

Since the Trump announcement there has been attempts to classify coronovirus medicine research and restrict any adverse criticism of Chloroquine, with EPA announcing broad restrictions.

Efforts to raise awareness amongst local organisers of a Peninsula community coronovirus response team were instead met with ridicule, and the writer threatened with prosecution. The lack of debate amongst local authorities is reminiscent of the HIV-denial era, since anyone publishing coronovirus information ‘not authorised by the DOH ‘ may run foul of recently gazetted regulations governing the spread of information.

It is safe to say when this epidemic broke, we were dealing with denialists who refused to believe there was an epidemic. Overnight, these same folk have turned into gatekeepers of what can and cannot be said. Now even government officials are denying there are any antiviral treatments capable of bringing down the epidemic to manageable proportions and urging us all to use Chloroquine  the most widely used drug against malaria.

The safety issues here are also reminiscent of the thalidomide disaster,  one of the darkest episodes in pharmaceutical research history

Although the mechanism of action is not fully understood, chloroquine has been shown to inhibit the parasitic enzyme heme polymerase that converts the toxic heme into non-toxic hemazoin, thereby resulting in the accumulation of toxic heme within the parasite.

Chloroquine may also interfere with the biosynthesis of nucleic acids. However the coronovirus is not a microbial parasite and more research on the use of the substance in symptomatic treatment of a condition associated with an RNA virus would be required.

The most important lesson of the 1918 influenza pandemic: Tell the damn truth

Here are 69 potential Antiviral drug treatments as the Coronovirus rips up South Africa

HERE are 69 possible antiviral drug treatments for the Coronovirus. Some of them repurpose old drugs, others involve new combinations, and are already in use for a range of diseases, including Parkinsons, Cancer and HIV. Some drugs have already been approved for administering by doctors, some are already in preclinical trials. Among them is a 1971 antiviral drug, Ribavirin capable of disrupting the RNA synthesis of the coronovirus itself, the bug responsible for the biggest health crisis event of the 21st Century.

The drug is described in a paper aptly entitled ‘Broad-spectrum coronavirus antiviral drug discovery‘. It escaped media attention, perhaps due to its patent rights lapsing, while Lopinavir‚ÄďRitonavir, a relatively new HIV drug received a lot of press, alongside Favivlavr a drug from China approved by the National Medical Products Administration of China .

It appears a massive search using the latest information technology and supercomputers was conducted.

A group of scientists including ‘Computational Medicine and Bioinformatics’ experts has raced to make the discovery as New York hits an epidemic spike that looks set to require at least 30 000 extra respirators, countless more hospital beds, and the construction of makeshift morgues. The City is currently in a state of emergency.

South Africa is about to enter a national lockdown from midnight Thursday.

The latest research dovetails a paper published on 27 February by Micholas Smith, Jeremy C. Smith on ‘Repurposing Therapeutics for COVID-19: Supercomputer-Based Docking to the SARS-CoV-2 Viral Spike Protein and Viral Spike Protein-Human ACE2 Interface.’

The newer paper was published on 22 March 2020 and should have made headline news, if only NYC wasn’t at the centre of the epidemic.

The list includes Chloroquine, a controversial anti-malaria drug with a low Lethal Dose 50 (LD50), a measure of toxicity, where low is more toxic. The drug has been touted by Donald Trump, but has not been approved by the FDA for use, and also Haloperidol, a drug used to treat so-called Schizophrenia.

Meanwhile the World Health Organisation (WHO) has launched a global megatrial of what it claims are ‘the four most promising coronavirus treatments’

Scientists in Iceland have found 40 mutations of the coronavirus among people with the deadly bug in the country. A previous study conducted in China and¬†published early this month¬†indicates that two separate types of the novel coronavirus ‚ÄĒ one more aggressive than the other ‚ÄĒ had been infecting people since the start of the outbreak.

According to a WHO official ‘Ten percent of the people who are in [intensive care units] in Italy are in their 20s, 30s or 40s. These are young, healthy people with no co-morbidities, no other diseases.’

HERE IS THE LIST OF 69:

JQ1105; RVX-208; Silmitasertib1; TMCB; Apicidin1; Valproic Acid1; Bafilomycin A11; E-52862; PD-144418; RS-PPCC; PB281; Haloperidol; Indomethacin; Metformin1; Ponatinib; H-89; Merimepodib1; Migalastat1; Mycophenolic acid12; Ribavirin; XL4131; CCT 36562312; Midostaurin13; Ruxolitinib1; ZINC17759623671; ZINC432671913; ZINC4511851; ZINC95559591; AC-555411; AZ8838; Daunorubicin1; GB110; S-verapamil; AZ3451; ABBV-744; dBET6; MZ1; CPI-0610; Sapanisertib; Rapamycin; Zotatifin; Verdinexor; Chloroquine; Dabrafenib; WDB002; Sanglifehrin; AFK-506; Pevonedistat; Ternatin 4; 4E2RCat; Tomivosert; Compound 2; Compound 10; PS30613; IHVR-190291; Captopril1; Lisinopril1; Camostat; Nafamostat; Chloramphenicol; Tigecycline; Linezolid1

FIRST LIST IDENTIFIED BY SUPERCOMPUTER

pemirolast -7.4 ZINC5783214 benserazide -7.4 ZINC3830273 Natural Product: luteolin-monoarabinoside -7.4 ZINC18185774 pyruvic acid calcium isoniazid -7.3 ZINC4974291 Natural Product: quercetol;quercitin -7.3 ZINC3869685 protirelin -7.3 ZINC4096261 carbazochrome -7.2 ZINC100029428 nitrofurantoin -7.2 ZINC3875368 benserazide -7.2 ZINC3830273 carbazochrome -7.1 ZINC100045148 sapropterin -7.1 ZINC13585233 Vidarabine -7.1 ZINC970363 Natural Product: eriodictyol -7.1 ZINC58117 tazobactum -7.1 ZINC3787060 phenformin hcl -7 ZINC5851063 carbazochrome -7 ZINC100045148 carbazochrome -7 ZINC100045148 vildagliptin -7 ZINC100003507 Natural product: demethyl-coclaurine

UPDATE: AI steps up in battle against Covid-19