To protect communities from COVID-19, it takes a village
A year and almost six months have passed since the Philippines recorded its first case of the deadly COVID-19. Most of it, we have spent while in quarantine to avoid any form of transmission. Despite these strict lockdown measures, however, we have tallied more than 1.7 million cases and 30,340 deaths as of writing time. The days aren’t looking as good with the Aug. 15, 2021 record at 14,749 cases—our second highest daily number yet. Amid the increase of incidents related to the highly infectious Delta mutation (807), the country also recorded its first case of the Lambda variant last Sunday.
While we continue demanding for a better healthcare system from our national government, the time that has passed only spotlit our dear frontliners. Our hardworking medical professionals, plus the many maintenance and logistics personnel and volunteers, who have poured their heart out to impede the spread of the virus, deserve not only these empty praises and prayers but tangible support and compensation.
As we have seen, it does take a village for society to repair itself. Beyond the community, there’s also the critical but low-key logistics sector quietly lending a hand.
Among these companies is PharmaServ Express, which the Department of Health (DOH) has tapped as its national cold-chain and logistics partner for its COVID-19 vaccination program. PharmaServ, based in Marikina City, has taken charge in storing and packing COVID-19 vaccines before delivering them to the farthest areas in the country.
Vaccine czar Carlito Galvez has commended PharmaServ’s “world-class” cold-chain facility, for its capability to accommodate different brands of COVID-19 vaccines of varying storage temperatures. It has received around 38 million doses of COVID-19 vaccines as of August 8, with most already deployed.
Just this June, a three-man team from the Israeli Ministry of Health who visited the country to share their expertise, also lauded PharmaServ’s packaging and distribution method that ensures the safety and efficacy of vaccines.
A spark of hope: Molnupiravir, an oral pill for COVID-19 in development
Another vital sector of the "village" would also be the scientists, who have been hard-pressed in developing vaccines and drugs to help prevent the infection and hopefully stop the pandemic for good. Whereas previous vaccines required years of tests and research before deployment for public use, these frontliners have stepped up to the task by producing coronavirus vaccines in less the time.
As of Aug. 12, 2021, on The New York Times’ coronavirus vaccine tracker, the world now has eight vaccines approved for full use: Pfizer-BioNTech, Moderna, Johnson and Johnson/Janssen, AstraZeneca, Sputnik V, Sinovac, Novavax and Covaxin.
There are 99 vaccines used in clinical trials on humans, 33 of which have reached the final stages of testing, the report added. More than 75 preclinical vaccines are used on animals. Meanwhile, a total of 4,428,168,759 vaccine doses have been administered as of the latest report.
Next to conducting these vaccine trials, some of our heroic scientists are developing oral antivirals to kill the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or the virus at fault for COVID-19. Once proven safe and effective, oral antivirals can help alleviate the pressure off of any already suffering healthcare sector like ours. These drugs will also prove practical for developing countries like the Philippines, where most families can’t even afford hospital care.
Good news have been coming out of clinics recently, concerning the efficacy of Molnupiravir, an oral pill to help treat mild to moderate COVID-19 cases currently in clinical trial. Curious? In our recent “Pamilya Talk” episode, I had the opportunity to learn more about this promising drug with the help of Lung Center of the Philippines (LCP) clinical trial investigator Gigi delos Reyes, Merck Sharp & Dohme (MSD) - Philippines country medical lead Maan Galang-Escalona, and Quezon City LGU BantAI COVID representative Loysa Orense. I further learned courtesy of these “heart-working” doctors how we as ordinary citizens can all help in hastening the cure.
Read on!
How did Molnupiravir come about?
Molnupiravir was invented at Drug Innovations at Emory, LLC, a non-profit biotech company that Emory University in Atlanta Georgia owns.
The drug is now being developed by MSD, a centuries-old pharmaceuticals company that hails from Germany and now a multinational American brand headquartered in Kenilworth, New Jersey. MSD is reputable in the industry, having ranked 69th on Fortune magazine’s Fortune 500 and 92nd on Forbes’ Forbes Global 2000. (Both income records were from 2020.)
Molnupiravir, according to MSD, is “an investigational, orally administered form of a potent ribonucleoside analog that inhibits the replication of multiple RNA viruses including SARS-CoV-2, the causative agent of COVID-19.”
Originally developed for influenza, Molnupiravir is now being pegged to be the first drug to treat the disease orally.
How far is Molnupiravir in the trial stage?
Clinical trials are a series of studies and research to help determine and evaluate the effects of a drug. MSD has partnered with Florida-based biotech company Ridgeback Biotherapeutics, not only in perfecting the pill but also in implementing these trails.
Dubbed the MOVe-OUT study, the trials are now at Phase 3. Meaning, following “encouraging” results from Phase 2, studies are now being conducted on humans with the virus.
The trial applies the compare-and-contrast principle, administering one group with the Molnupiravir and another with a placebo. The study has the subjects orally ingest the drug twice a day in the early stages of the disease or every 12 hours for five days.
MSD - Philippines has pegged a minimum of 25 volunteers to participate in the tests, with the LCP as the local trial site. It started its run of trials in mid-May. Globally, the tests are conducted in over 100 sites with a target of 1,850 volunteers altogether.
What does it take to volunteer for the trials?
Requirements for willing participants are very specific. First, they should be at least 18 years old. As the drug aims to treat mild to moderate cases, they should have tested positive only in the last five days exhibiting at least one symptom. They should also have a health condition or comorbidity that would most likely lead to a severe case.
Volunteers should be away from any hospital environment, which might have medicated them already. They also shouldn’t have taken any COVID-19 vaccine dose yet, to avoid any “drug-drug interaction” that would only defeat the purpose of the trials.
Explained Dr. Galang-Escalona, “Ibig sabihin, yung epekto ng isang gamot ‘pag sinabay mo sya sa Molnupiravir, tulad ng Remdesivir o iba na nasa clinical practice guides natin, walang makikita na significant (effect).”
Are these trials risky for the volunteers?
Any clinical test is risky. Volunteers willing to participate in the trial are thus as important as frontliners in the medical field exposed to the virus on the daily. With the help of these volunteer patients, MOVe-OUT study takes a step closer to clinical discoveries that will hopefully stop the severity of infections and eventually limit the number of casualties.
The LCP assures prioritizing the health and safety of the volunteers first, giving them options to do the trials on site, at home (with a provided caregiver), or online. It welcomes any form of withdrawal from the trials anytime and for any reason, provided the volunteers have a final visit for medical tests and exams.
“Matiitignan ka ng doktor ‘pag sa ospital. May home care providers to check on you. Di lang yung gamot ang mabibigay, yung pag-aalaga during the entire duration of the trial din. May side effects ba or progression? We have the capacity to help them kasi may facility and resources kami para sa COVID,” said Dr. delos Reyes.
What will happen after the trials?
The drug is administered for five days early in the course of the disease. Participants who volunteered for the clinical trial will continue to be followed up by the study team.
With the future of humanity on the lifeline, MSD thus finds itself in a “race” to finish the trials. It aims to gather the final data from the MOVe-OUT Phase 3 this Second-half of 2021. Emergency Use Authorization will be applied in the US in the second half of 2021 once the interim results of Phase 3 are out. It will hopefully roll out in the other countries, which will then give way to the manufacture and deployment.
“Nandito tayo sa panahong mabilis mag-mutate ang mga virus na ito na nagkakaroon ng iba’t-ibang variant. So kelangan mas mabilis ang syensya,” Dr. Galang-Escalona stressed.
“Ang mga scientists, ginagawa nila ang lahat. May mga na-de-depriotize na mga bagay para mapagtuunang pansin kung ano ang makakapagpigil sa COVID. Ma-a-assure ko na nag-do-double time, triple time ang mga scientists sa pananaliksik nila upang magkapagbigay ng solusyon sa COVID. Hindi po nasasakripisyo ang quality.”
Dr. Orense, on the other hand, talks about how the public and private sectors have been hand in hand over time. This has been felt since the launch of BantAI COVID, the AI-based contact tracing system, which piloted in Quezon City in July last year.
Dr. Orense said, not only has BantAI COVID bridged online consultations between suspected cases and medical volunteers from the Philippine Medical Association, but it has also helped the LGU source subjects for the MOVe-OUT study.
Where do we go from here?
Indeed, in the middle of all these bad news, it’s these silent, low-profile, background workers who are making it feel like the world is still happy and hopeful. I myself have psoriasis. I have taken part in past trials where I, in the process, have seen the amount of love these scientists and health workers have put into their work. I salute all of you, including all fellow volunteers who have in many ways risked their safety with the future of our children and children’s children in mind.
As for the rest of us, let us not take things for granted. Let’s continue to hold hands until we reach the end of this pandemic. Of all the many things we can do to contribute to the cause, we can start by strictly following health protocols. Let’s act like we already have the virus. Let’s always take care of everyone by being mindful of the things we do. After all, what we do today is what will dictate our future. Stay healthy and get vaccinated already!
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