At the bottom of the kit

From the beginning of the epidemic diseases COVID-2019 caused by the coronavirus SARS-CoV-2, the office of the State Committee on Affairs of health of China has repeatedly updated the document , entitled “Methods for diagnosis and treatment of pneumonia caused by a new type of coronavirus”. To date, released six of its editions.

In it, besides other nonspecific therapies, were several antiviral drugs. In particular, for the treatment of patients with coronavirus infection was suggested that lopinavir and ritonavir used to treat HIV infection. This list also includes inhaled interferon Alfa and ribavirin, is recommended in combination with lopinavir/ritonavir or interferon, as well as phosphate chloroquine. Particular attention in our country attracted recommended by the Chinese “Method” of the drug Arbidol (阿比多尔).

Based on what these recommendations are and whether it is possible to say that these tools really help from the new coronavirus?

Protease inhibitors

In January 2020 in the journal The Lancet has published an articledevoted to the results of a study of 41 patients, who were at that time on treatment in the hospital, “Jin Intan” in Wuhan.

The authors stated the positive experience of randomized controlled trials of a combination of lopinavir and ritonavir in the treatment of patients infected with “old coronavirus” SARS-CoV, which in the early 2000-ies provoked the outbreak of SARS and other coronavirus infection — MERS, middle East respiratory syndrome, the outbreak which happened in Saudi Arabia in 2012-2013.

The combination of these drugs inhibit protease, the enzyme that HIV uses to synthesize viral proteins. Chinese researchers said that this combination provides a lesser amount of unfavorable clinical outcomes and coronavirus infection.

However, not all of the Western colleagues share the optimism of the Chinese scientists about the effectiveness of this pair. So, 10 Jan Ralph baric from the University of North Carolina, who conducted the study on mice, wrote in Nature Communicationsthat the above-mentioned “cocktail” is quite weak — it is effective against HIV but not against coronaviruses.

Another protease inhibitor, is capable, according to American doctors, to effectively counter the new coronavirus is ramdevpir effective against the Ebola virus. However, its effect on the new type of coronavirus remains in doubt: an American doctors used it in treating the first infected in the US, but was unable to verify that he played a crucial role in the recovery of the patient. In Chinese “Technique” this drug is missing.

According to the American biologist Anchi Baranova, Professor, George Mason University, antiretroviral drugs can affect coronavirus, in particular, to inhibit its replication. However, suppression of replication by itself is not a therapeutic task. The therapeutic task, like a scientist, is to prevent the development of acute respiratory distress syndrome.

“In antiretroviral therapy have many side effects, and chronic and very serious. For example, they disrupt lipid metabolism and face of the person in hyperlipidemia and hyperglycemia, cause exacerbation of chronic diseases,” says Baranova.

“The population of patients with HIV, and that about one percent of the population have been well studied, and its example we can see how they have exacerbated chronic diseases. Therefore, if people begin to take antiretroviral drugs, the number of diabetics in the country from the current 4.5 million will jump to more significant digits, as pre-diabetes, many go into a real disease,” she fears.

Between the two medicines

Given that the new coronavirus infection, occurring in mild form, it is treated by the immune system of the patient, to help going and such traditional Chinese treatments like 多喝水 – “dopasuj”: “drink more water”. With the help of this recipe of Chinese doctors often treat a variety of diseases.

The so-called Western, or European, evidence-based medicine became available to the wider population relatively recently, only after the formation of the people’s Republic of China. The country has not abandoned its own practice of traditional Chinese medicine, despite the fact that the average life expectancy after the beginning of mass application of Western medicine has increased almost twice.

Today doctors China are trying to balance between two often conflicting methods and systems for treatment, but because of the lack of deep traditions of treatment and diagnosis in the West the scheme does not shy away from experiments and often make mistakes even in reading the ultrasound.

As a rule, the doctor in a public hospital in less than five minutes. The doctor listens to the complaint, sends the patient for a blood test and, at best, an ultrasound, and, without waiting for tests, prescribing a drug from the Arsenal of folk medicine.

If the health of the patient a few days is deteriorating, the doctor prescribes a loading dose of antibiotics if it is bacterial infection. When flu symptoms it is likely to be sent home to take ibuprofen, “dopasuj” and more rest.

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