It seems that a shorter COVID-19 quarantine period may be possible, thanks to the work of Dr. Benjamin Smith,MI4 scientist and member of the Meakins-Christie Laboratories. Dr. Smith was primarily looking to ease the burden of this virus on the healthcare system. Healthcare workers are at the greatest risk of exposure while at work and yet their presence at work is crucial to handle an ever-increasing influx of COVID-19 patients.
Dr. Smithbegan by questioning the duration of the isolation period after exposure, 14 days, and looked to reduce that window. He developed a study, and is using healthcare workers exposed to the virus as his test subjects. Testing them using a variety of methods at varying time intervals throughout their isolation has given positive results.
“Our study suggests that a simple infection control strategy consisting of symptom-triggered testing from day 0 to 7, followed by a standard home-based test on day 7, detects all or nearly all healthcare workers who develop COVID-19 after high-risk exposure. It’s a promising result. If these findings are confirmed as we test a larger number of people, this testing strategy could significantly shorten the self-isolation duration required for healthcare workers,”
Dr. Benjamin Smith
The initial findings of his study indicate that the results of a nasopharyngeal swab and saliva test on the 7th day of quarantine will predict fairly accurately the likelihood of developing the virus in day 8-14. Continued positive results in this ongoing study will bring a great sense of relief to many. A shorter COVID-19 quarantine period will benefit more than just the intended healthcare workers. Other patients looking to access the healthcare system, travellers, society as a whole will feel a burden lifting in light of this news.
The full article about Dr. Benjamin Smith’s study and the encouraging results can be read in the article COVID-19 testing: Timing may be everything, appearing in the November 18, 2020 edition of Health e-News. Photo credit: Owen Egan / Joni Dufour.
Dr. Mazer, Associate Scientific Director of the Taskforce, sums up the goal of their work as: to understand the prevalence of the virus in the community at large, and to learn about how the body responds to the virus. Completed studies in this area have revealed the following:
“We know that the prevalence of the antibodies in the population of healthy blood donors is between 0.7% and 1.0% of the population, as high as 2.9% in certain areas of Quebec and Ontario.”
Dr. Bruce Mazer
Although these numbers indicate a lack of herd immunity, he feels it is more important to understand how to treat individuals who are most at risk, to develop a vaccine, and to find answers to some of their yet-to-be-answered questions. Finding answers to questions such as why some people are more affected by this virus than others, why some people are more affected by previous viruses but not this one, and how long the antibodies created by vaccination will last in the body, would go a long way in decoding immunity to COVID-19.
Listen to Dr. Mazer’s interview by Julie Quenneville on:
Since the spring physicians have been discovering optimal treatments for COVID-19 symptoms. Dr. Nicole Ezer, a researcher with the RI-MUHC’s RESP Program, was interviewed on this subject on CJAD. Dr. Ezer explained:
Initially it was very challenging to know how to treat patients appropriately, in particular patients who presented in the emergency room and required lots of oxygen.
Dr. Nicole Ezer
Since the spring the medical community has learned a lot about this virus, thanks in part to the many publications that have come out.
The names of medications which have been found best to help hospitalized patients include the steroid dexamethasone and the antiviral remdesivir. These two medications have been very helpful in not only reducing the amount of time patients spend in hospital, but also the number of deaths caused by this virus. These were important discoveries for the medical community.
The focus remains on finding treatments to help patients with less severe symptoms. To this end, all residents of Quebec experiencing milder COVID-19 symptoms are encouraged to take part in an ongoing study at the MUHC called contain-covid19.com. No in-person visits are required. After acceptance into the trial participants will receive their medication by mail. All communications are done remotely. This is one way we can all be involved in the hunt for treatments for COVID-19.
Dr. Maziar Divangahi, Associate Director of RI-MUHC’s Meakins-Christie Laboratories, is an expert on tuberculosis and well known in the field of innate disease tolerance. In a recent interview with Markham Heid of Elemental.Medium.com, Dr. Divangahi confirms that tuberculosis is one of the world’s deadliest infectious diseases. Nevertheless, a great number of people who are infected with the bacteria do not exhibit any symptoms. They have developed an innate disease tolerance for the virus. Could we teach our bodies innate disease tolerance towards the SARS CoV-2 virus?
Dr. Divangahi explains how the body of some people reacts when the tuberculosis virus reaches their lower airways:
“Either the bacteria will be eliminated during the early phase of the infection, or the host will wall off (the virus) by forming granulomas.”
“We’ve developed very successful mechanisms that allow us to live with (this virus).”
“Rather than trying to eliminate the bug, we basically keep it in check.”
The elimination of the SARS CoV-2 virus would be ideal, however, the interview with Dr. Divangahi suggests that there may be acceptable alternatives.
Preliminary and not-yet-peer-reviewed studies suggest that flu vaccines may inhibit COVID-19 ‘s effect on the body. Dr. Maziar Divangahi, Associate Director of the RI-MUHC’s Meakins-Christie Laboratories, cautions against drawing the conclusion that flu vaccines prevent or diminish the effects of COVID-19 on the body. Much larger studies are required.
Numerous studies are taking place around the world to test the desired conclusion that flu vaccines do in fact inhibit COVID-19, but results that merely find correlations between behaviors and outcomes cannot establish cause and effect.
Dr. Nicole Ezer, of the RI-MUHC’s RESP Program, is looking for treatment options for COVID-19. Dr. Ezer is the lead researcher in the contain-covid.com study, an RI-MUHC trial that began in September 2020. The objective of the study is to find a medication that will keep COVID-19 patients at home longer, or ideally, eliminate the need for hospitalization completely.
Presently, Dr. Ezer is testing the efficiency ofciclesonide, an inhaled and nasal steroid drug currently used for asthma and nasal rhinitis, as one of the treatment options for COVID-19 in its early stages, or for patients with milder symptoms.
Dr. Ezer believes we will never be completely free of COVID-19, as vaccines are never 100% effective. Therefore it is important to have treatment options available, and to keep patients out of hospital whenever possible.
Dr. Ezer was interviewed about her research – the full story can be readhere:
We all know that 14 days of self-isolation is mandatory following exposure to the coronavirus, and this is a big problem when frontline health care workers come in close contact with infected patients. To avoid a shortage of essential medical staff, MI4 scientist Dr. Benjamin Smith is studying whether this isolation period could be shortened by as much as half. In this ongoing study, he is working with health care workers exposed to the coronavirus to find out. Each subject receives a COVID-19 test on days 7, 9, 10 and 14 after being exposed to determine how soon the virus can be detected. Preliminary results show that if the subject is going to develop COVID-19, the virus is usually detectable by day 7. Though further study is required to confirm this finding, it signals that, with the right testing strategy, isolation for health care workers may indeed be able to be reduced by half.
Dr. Smith is now expanding his study to confirm these preliminary results. The team is enrolling health care workers in the Lanaudière region and will now include family members and caregivers exposed to the coronavirus when caring for loved ones.
Dr. Nicole Ezer, of the RI-MUHC’s RESP Program, discusses COVID-19 treatment options with Claude Bernatchez of Radio-Canada’s Première Heure program.
Dr. Ezer explains how the virus causes uncontrolled inflammation in the body, which may result in serious respiratory issues. The steroid dexamethasone reduces inflammation and is currently given to hospitalized patients. Use of this steroid is favorable as it is not expensive and it has been used in the treatment of other other medical conditions for years. Thus, it is already known to physicians and specialists and has been is backed by numerous studies. Unfortunately, steroids used at such high doses as is needed to combat COVID-19 may cause other illnesses, such as diabetes; therefore, this treatment is only available to individuals who are hospitalized.
A second COVID-19 treatment option is antiviral medications, which slow the replication of the virus. Antivirals are being prescribed early in the COVID-19 diagnosis, with the intent of avoiding a future hospitalization of the patient.
Treatment with antibodies would boost the immune system and help the body to fight off the virus. Additional research could be done to determine the stage at which this type of treatment would have the greatest effect. At this point in time, the use of antibodies for treatment of COVID-19 has not been approved in Canada.
Dr. Ezer concludes by emphasizing the need for an effective and inexpensive treatment for COVID-19. A vaccine is needed, but vaccines are not always 100% effective. The virus will always be with us, and there will be many people worldwide who will catch it. We need to discover additional affordable COVID-19 treatment options.
Dr. Ezer’s interview on Radio-Canada can be heard here:
Dr. Jean Bourbeau contributed to an article in The Star on September 29, 2020. He highlights how our narrow focus on vaccines during the COVID-19 pandemic is a risk we cannot afford. Combating this virus requires an array of good treatments, based on good science (randomized, placebo-controlled clinical trials). This include antivirals, plasma trials, corticosteroids, repurposing of old drugs to address the virus, in addition to vaccines. Dr. Bourbeau is working on a Phase III clinical trial of a repurposed generic drug developed by Pulmonem, a Canadian biotech start-up, which could provide a quick, safe and cost-effective treatment for COVID-19.
Led by Dr. Nicole Ezer, a team of RI-MUHC researchers have initiated a clinical trial of ciclesonide to possibly prevent mild cases of COVID-19 from worsening.
Ciclesonide is an inhaled and nasal steroid drug currently used for asthma and nasal rhinitis. Laboratory studies have already shown that treatment with ciclesonide can decrease viral replication of SARS-Cov2, the virus responsible for the disease. This placebo-controlled randomized trial will confirm if the administration of inhaled and nasal ciclesonide can reduce the severity of respiratory symptoms among mild cases of COVID-19 and potentially avoid the need for hospitalization and oxygen.
Diagnosed with COVID? Contain COVID at the source. Protect your lungs! Register for a clinical trial of inhaled ciclesonide:
“We know the COVID-19 virus starts by multiplying in the nose and progresses downwards to the lower parts of the airways and lungs. We hope that targeting the site of viral replication with inhaled and nasal ciclesonide will reduce early viral replication and decrease severity of COVID-19 illness,”
– Nicole Ezer
Nicole Ezer, Respirologist, MD, MPH
James Martin, Respirologist, MD, Dsc
Todd Lee, Infectious Diseases, MD Msc
Emily Macdonald, Internal Medicine, MD, Msc
Susan Bartlett, Clinical Psychologist, Senior Scientist
Andrea Benedetti, Epidemiology and Biostatistics PHD