By Carlena Knight
A health official is cautioning her colleagues against being hasty when prescribing medication for Covid-19 patients as, according to her, there is not enough data to support the use of any particular drug to date.
The position taken by Dr Jasmine Riviere Marcelin, an assistant professor in infectious diseases at the University of Nebraska Medical Centre, was in relation to certain treatments suggested by fellow panellist, Dr David Newton, to include zinc sulphate, an alternative to hydroxychloroquine.
The Dominican-born doctor who recently appeared on an Observer radio programme, said a delicate balance is needed when considering treatment options for the virus.
“I think it’s important for us to be careful about the way that we describe the available pharmaceutical treatments. At this stage, we don’t have good data that supports one particular pharmaceutical agent over another,” Dr Marcelin said.
“When we are talking about the people who have a severe illness, the other issues like the kidneys potentially failing and with kidney failure as well as severe pneumonia and acute respiratory distress syndrome, we really need to focus on maintaining a very stable fluid balance for the patients who are severely ill.
“Often times, that requires a combination of trying to remove fluids to try and help to improve the oxygen exchange in the lungs [where] in some cases though, people might need more fluids so that they can keep their blood vessels full, so that the heart can keep pumping and so, it’s really a delicate balance.”
Marcelin, who is also an associate medical director in the Antimicrobial Stewardship Program at the Nebraska Medical Centre, further mentioned that although there are studies to show that zinc sulphate can be used, much more research is needed to be conducted on the drug before it can be deemed as the cure.
In fact, Dr Marcelin is adamant that the studies should find ways to repurpose the drug and focus on clinical outcome in humans as the drug has a number of serious side effects.
Meanwhile, although professor and chair of microbiology/immunology at the American University of Antigua, Dr Bharati Balachandran, shared similar sentiments to Dr Marcelin, she has however hinted that there are trials underway for a vaccine.
When it comes to the use of steroids and antibiotics Dr Marcelin is confident that they should not be used in the treatment of Covid-19 as they can actually cause the illness to get worse and “can lead to more deaths”.
Although Dr Marcelin is understanding of the current stress doctors and other health officials are under at this time, she continues to encourage her colleagues to remain patient and positive.
“As a physician who has treated these patients and worked with colleagues who are on the frontlines, it is really hard to take care of people who are that sick and feel like we’re not giving them something.
“But I want to just put it into perspective [that] during our last great, big pandemic if you think about it from the infectious disease standpoint is going back to the 1918-1919 influenza pandemic and they did not have the type of ventilatory support that we have now.
“They didn’t have ECMO which is an extra way of helping to support the circulation. They did not have dialysis; they did not have a lot of the things that we have now that we can use to support people, so even though it feels like we’re not giving them an antiviral medication, right now we are working on it. There is something that we are doing with the support of treatment.
“Right now, there are multiple studies across the world that are looking at an antiviral called Remdesivir, and that was developed actually in response to the Ebola outbreak. It is being looked at from an evidence-based standpoint and these trials are fully enrolled and should be wrapping up so we just need to wait a little bit longer.”
Both women, along with Dr Newton, were guests on Observer’s Big Issues radio programme.