Even with the progression of vaccinations, people will continue to become very sick due to the coronavirus. Doctors who treat people with COVID-19 in hospital wards, intensive care units and out in the community continue to juggle conflicting clinical trial results — sometimes for the same treatment based on studies in different countries — most of which feature data from a small numbers of patients.
Dr. Lynora Saxinger, an infectious disease physician in Edmonton, follows the advances in treatments and how they’re communicated.
„Enthusiasm travels so quickly and becomes ingrained before you even have a chance to really support whether it’s a good idea,” she told CBC News. „Then you’re facing a bit of a battle to actually calm down enthusiasm if the data are less strong than the press release really suggested.”
Media releases can be accompanied by what are known as preprints, or draft manuscripts that haven’t been checked for errors and include all of the available data and a study’s methods.
Last week, for example, Canadian hospitals put out news releases about two potential treatments: heparin, a common blood thinner for patients with moderate COVID-19 and colchicine, an oral medication used to treat gout.
As a result, Dr. Zain Chagla, an infectious disease physician in Hamilton, Ont., says he experienced the mismatch between patient expectations and what he could offer firsthand.
„When you put out a press release on Friday night and your patients that test positive for COVID on Saturday are saying, 'OK, where’s my colchicine?’ It’s very hard … to counsel them appropriately.”
Saxinger said she’s „provisionally excited” about the colchicine findings so far. Chagla and Saxinger both said ivermectin, an anti-parasite drug, needs further study in clinical trials, while Saxinger puts potential treatments with antivirals, monoclonal antibodies and convalescent plasma in the too-soon-to-tell group because larger or better trials are still needed.
The rub is that studies running in multiple countries can also be difficult to set up, especially since health-care systems are already stretched. Contracts and insurance paperwork can also bog down the trials.
„Outpatient trials are super hard to fund,” Chagla said. „It’s hard to navigate.”
Despite all of the advances in treatments, and as Canada progresses in vaccine coverage of the eligible population, Saxinger sees greater potential in prevention from public health measures such as physical distancing, masking and staying close to home.