We are just at the beginning of what might become one of the world’s biggest viral pandemic ever seen. Every day that goes by we are hearing more and more about the impact of this flu pandemic. Why is it happening? Will it go away? How many people will die? Will I get infected? How can I protect myself and my family? Are there any drug treatments? I am sure these are all questions that everyone is asking at the moment.
For many of these questions the answer is we don’t know. All we can and should do is follow government advice rigorously. COVID-19 seems far more infectious than many flu viruses seen before. That’s why it’s so important to practice good hand hygiene, self-isolate, reduce social interactions and comply with all government advice. We need to be our own monitors to ensure that everyone plays their part in breaking the infection cycle.
Why is the coronavirus pandemic happening?
Viral pandemics unfortunately are nothing new. They happen because we have no immunity against a particular virus. We have never been exposed to the COVID-19 coronavirus variant before. So, our immune system cannot fight it off it until we mount an immune response. COVID-19 (or to give its full technical name Severe Acute Respiratory Syndrome coronavirus 2 or SARS-CoV-2 as it is related to SARS) like all flu pandemic viruses has jumped the species barrier from animals to humans. As far as we are concerned it is a completely new infectious agent which the body has never seen before. There appears to be no cross-immunity between COVID-19 and any flu virus we have been previously exposed to. That is why it is causing us such a problem.
For the majority of COVID-19 infected patients (80% or more), their flu symptoms will be relatively mild. These people will recover within a few days. Their immune system has successfully attacked and killed the virus. It seems that for most people they kill off the COVID-19 virus in their bodies in the same way as if they had regular winter flu.
However, some groups in the population, for reasons we do not yet understand, are unable to produce a significant immune response against the virus and it is these people who are most at risk. That is why such people must not be exposed to the virus otherwise if they get an infection it is very serious, even life-threatening. As with most infectious agents (bacteria and viruses) it is the very young and the elderly who are most at risk. These groups lack a fully functioning immune system so are likely to get seriously ill.
For more information about COVID-19 and what you can do about it see https://www.nhs.uk/conditions/coronavirus-covid-19/
Bacterial infection as a consequence of coronavirus infection
When someone gets infected with any general flu type virus, the virus can hijack the persons immune system. As a consequence, that person is then susceptible to getting what is called a secondary bacterial infection. It is estimated that in general between 10 – 30% of patients with a flu type virus will get a secondary bacterial infection.
However, COVID-19 seems to behave differently to the typical flu virus. Iit is much more likely to lead to viral pneumonia than flu. That is why the only treatment for hospitalised COVID-19 patients at the moment is administering oxygen whilst the person’s immune system attacks the virus.
To guard against such patients getting a secondary bacterial infection whilst being treated in hospital, antibiotics are administered as part of their intensive hospital treatment. Without effective antibiotics, very ill hospitalised patients would die from these secondary infections. That is why it so important that we keep our existing antibiotics working. There are no new ones on the horizon.
In Wuhan, China where the COVID-19 virus originated a preliminary paper published in the Lancet by Zhou et al (Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet, March 2020) stated that of the patients who died from infection around half had a secondary bacterial infection leading to sepsis and death.
Fighting bacterial infections with combinations of old drugs
From the above, it can be seen why effective antibiotics could be pivotal to successful treatment outcomes in patients acquiring a secondary bacterial infection as a result of their primary COVID-19 infection. Patients on ventilators in intensive care units are highly dependent on antibiotics to keep secondary bacterial infections at bay.
Antibiotic Research UK since its formation in mid-2014. We are fully aware of the need for effective antibiotic treatments especially to treat drug-resistant bacteria. It was the reason the charity was created in the first place. Very little has happened since our creation that gives us confidence that the problem of drug-resistance is being taken seriously by governments around the world.
Realising that we could not develop new antibiotics because of the scale and complexity of such an activity, we have been working on taking existing drugs and finding out if they might overcome resistance. In one of our programmes, we discovered that an old penicillin-like antibiotic, cefepime, when combined with the bacterial beta-lactamase enzyme inhibitor sulbactam could break resistance in some of the most common bacteria responsible for lung, blood stream and urinary tract infections (technically Gram-negative bacteria known as the ESKAPE pathogens). These test tube studies conducted in one laboratory at Queen Mary’s, University of London supervised by Dr David Wareham (to read the published paper click HERE) are now being repeated in a wide range of UK hospital microbiology laboratories to see if the initial findings can be reproduced. If we find our preliminary findings are reproducible then the next stage is to progress the cefepime / sulbactam combination to a trial in hospital patients. To do this will require substantial funds to be raised.
Will you help us get our new antibiotic treatment using old drugs into patients? You can DONATE here