Guyana is participating in the World Health Organization’s (WHO) “Solidarity” clinical trial with several treatments being used to treat COVID-19 patients in the country.
This was revealed by Chief Medical Officer (CMO) Dr Shamdeo Persaud on Friday during a webinar hosted by the Texila American University on the ‘Impact of COVID-19 on Medical Education and Clinical Training in Guyana’.
“Solidarity” is an international clinical trial to help find an effective treatment for COVID-19, which was launched by the WHO and its partners. It will compare four treatment options against standard care, to assess their relative effectiveness against COVID-19. By enrolling patients in multiple countries, the Solidarity trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence, the WHO said on its website. It said that as of 3 June 2020, more than 3,500 patients have been recruited in 35 countries, with over 400 hospitals actively recruiting patients. Overall, over 100 countries have joined or expressed an interest in joining the trial, the WHO said.
Dr Persaud revealed that in joining the research programme, Guyana registered for the use of Hydroxychloroquine, Remdesivir and Dexamethasone, along with Convalescent Plasma Treatment (treatment using plasma from patients who have recovered). He noted that the treatments are being selectively applied as the Ministry of Public Health is working with the WHO’s protocol even as the implementation of the said treatments was cleared by the institutional review board in the country.
“We gave them permission to start these pilot treatments under close clinical monitoring, collect all the relevant data and provide that on a periodic basis to the global programme,” he said.
The CMO noted that there are certain challenges even as he observed that there are no specific antiviral agents that are being used so treatment is based more on supportive care. He revealed that the specialised COVID-19 Intensive Care Unit (ICU) has expanded its care package to include treatment of sepsis and has enhanced rehabilitative therapies inclusive of respiratory therapy.
As he spoke about the ICU facility, Dr Persaud highlighted that there were a few persons who were successfully taken off ventilators inclusive of some who were “high risk” patients.
“We had three persons we were able to remove from ventilator support and even discharged back to their residence in a good state of health,” he said, relating that those patients came from the Palms Geriatric Home.
Further, he mentioned that there are other facilities at hospitals around the country including at West Demerara, Diamond, Linden, Suddie and New Amsterdam. Dr Persaud added that if the need arises, they are equipped to put persons on ventilator support or oxygen therapy.
“But we’re hoping to bring all of this to a new facility we’re developing at the former Ocean View Hotel, which is being converted to being a specialised infectious diseases hospital,” he said.
Meantime, Dr Dheeraj Bansal, the Dean, College of Medicine at Texila, observed that COVID-19 is not one simple condition but it can be very complex. Fortunate-ly, he said, the majority of the patients can be asymptomatic or develop mild symptoms and will recover, while a few of them will develop severe respiratory complications.
Speaking on the impact that the pandemic has had on medical education in Guyana, Dr Persaud said that around the world, a number of institutions have been able to adjust and continue teaching and even have examinations through the use of online mediums. However, for medical and nursing students, clinical training where those students would work in the hospitals, has stopped due to the virus but it is a critical part of training.
“Once we start back with the clinical engagement and the clinical experiences of the students… I hope that we can provide them with all that is necessary to make it safe for them, the faculty and their patients,” the CMO said.
In relation to the possibility of having medical students back in the hospitals, he said that there is a phased plan for that and they are currently in phase two of the plan for health facilities. He noted that while COVID-19 is here, there is still a need for essential services like treatment for chronic diseases, surgeries and more. As part of this phase, there has been a restarting of the implementation of prevention programmes inclusive of immunisations, distribution of contraceptives, and more.
“Phase three we might be able to incorporate the clinical students. Once we recommence surgeries and the regular clinics, the clinical years can start,” Dr Persaud said, while adding that at phase four, there may be a possibility of having all the other categories of students at the hospital. Further, he added that if there is a 14-day period where no cases are recorded, that may be the point to move to the next phase.
