Repurposed medicines are well-known medicines being used for a new purpose.
Sometimes a new medication’s side effects prove more useful than its original purpose. Amiodarone was originally developed to treat thyroid disease, but its ‘side effect’ on the heart proved so useful that it is now a heart medicine with side effects on the thyroid!
Dexamethasone: the coronavirus pandemic led to an international race to find ‘repurposed medicines’. It was soon established that influenza vaccine would not help, nor the stores of unused Ebola vaccine, and initially hydoxychloroquine and Remdesivir were used but found to have little effect. The most promising results arose from the discovery that the common and cheap medication dexamethasone helped those who were seriously ill with COVID-19.
Vaccines: the greatest hope was that the new Cispr technology would develop a vaccine more rapidly than usual, and so it proved to be. The coronavirus genome was sequenced in rapid time within a month, and the new technology depended on chemical processes rather than biological processes so that vaccine production could be speeded up and scaled up faster than usual. Early promise has come good and the solution for this pandemic and for future viral diseases will be even quicker and more targetted even than traditional antibiotics. Its potential application to cancer and other diseases is very great.
However, there were some simple provisions that were not addressed during this pandemic. Early quarantine was ignored in favour of herd immunity – a crazy decision for a new and unknown disease among humans. Long-term and delayed effects from infectious diseases are well-known, such as rheumatic heart disease decades after rheumatic fever in childhood. The healthy were quarantined rather than tracing the unwell to quarantine them. After a second wave of coronavirus and two new variants of the coronavirus, the UK has locked down again. The details are well-known and documented elsewhere.
What is not so well-known are the simple provisions that were ignored.
Ivermectin: the Front Line COVID-19 Critical Care (FLCCC) Alliance has investigated repurposed medicines and drew attention to the value of dexamethasone. It has also identified Ivermectin as an important medication for preventing and treating COVID-19. This was noted early in the pandemic but for some reason it was ignored, possibly because of disappointments with other medications, and the Director of the FDA’s Center for Veterinary Medicine in the United States more or less banned it as early as Apr 2020 as not suitable for humans, and the same attitude was possibly adopted in the UK. There seems to be a UK lockdown on the sale of Ivermectin – a medication lockdown in addition to the coronavirus pandemic lockdown. Here is a short interview with an FLCCC Alliance spokesman explaining to doctors the benefits of Ivermectin.
What was once readily available as worming tablets in the UK in 2019 was no longer available for humans in 2021. Ivermection is not available on the NHS in Scotland as I write this blogpost. I can document active attempts to close down information, but possibly this report in the International Journal of Infectious Diseases will give some credibility to Ivermectin – or these papers analysing Randomised Control Trials (RCTs) posted not only by the FLCCC Alliance but in the UK – 1. this Evidence-Based reviewer and 2. the Financial Times of London reports on the University of Liverpool Andrew Hill’s meta-analysis of RCT data. Hill is “encouraged by the findings” on Ivermectin. You need to register with the FT website but you can read a summary here and in The Week, a UK which summarises the main articles in the world’s media.
Gargle: advice about hygiene for one’s hands and solid surfaces were not supplemented with throat hygiene with a gargle. Why clean all sorts of surfaces but not the surface of your mouth, throat and nasopharynx with a gargle to kill off virus in your mouth and throat? Public policy makers seem to have taken leave of their senses, as if common sense has been lost in the panic of policy-making.
Masks: advice on masks was very slow in order to save masks initially for health-care workers because of the lack of PPE (Personal Protective Equipment) in the UK. It took a long time to establish the value of masks and some aspects are still not addressed
Quack medicine: there has been justifiable concern about quack medicine, conspiracy theory and monetary fraud. The inability of the population to distinguish truth from error is a profound effect of fake news and the failure to teach people to tell the truth.
Observation: as a young medical student I was taught that doctors need to be observant. Doctors now use machines and instruments and some think that the only way to determine if something works is to have a large randomised double-blind randomised control trial (RCT). This is only partially true. There is such a thing as using one’s eyes. Doctors in earlier times had to do so. Nor did they ignore ‘old wives’ tales’ but recognised that there may be a kernal of truth that needs to be extracted. Thus William Withering followed through such stories to discover Digitalis in the foxglove and revolutionise the treatment of heart failure, or Edward Jenner’s experimenting with cowpox to make the first smallpox vaccine.
There is more than one way to skin a cat and to prove a point. Some things are so urgent, and COVID-19 is one of them, that they cannot await a RCT before empirical treatment is made available, especially for those who are willing to try it. In her dying months, Tessa Jowell MP pled on the floor of the British Parliament for speedier and experimental treatments to be made available for terminally ill patients, but in 2021 a person cannot get a prescription for a cheap and safe medication whose discoverers received the Nobel Prize for Medicine in 2015 for its worldwide impact on disease. There is not much money to be made in repurposed medications, for which pharamaceutical companies are unlikely to fund an expensive RCT. However, there are other ways to establish truth and effectiveness. Besides, Cispr technology is here to stay and the need for vaccines will continue for a long time to come.
It was politics that delayed the Chinese authorities reporting to the world what Chinese clinicians could see with their eyes. Meanwhile, let our politicians, scientists, lawyers and epidemiologists learn to credit our Front Line clinicians who use their eyes as well as their clinical skills.
2 Feb 2021: the BBC news showed the US Anthony Fauci saying that ‘double masking’ is “common sense”! Wonderful! If it is common sense, why was common sense not followed long ago, such as this time last year?
2 Feb 2021: gradually common sense is promoting mouthwash! It seems that people will only accept common sense if there are scientific trials to support it. Dr Campbell didn’t know about gargle. WHO did not adopt gargling. The presenter in this video more or less repeats what I said here 11 months ago, and goes on to suggest that antiflammatory colchicine is another useful repurposed medicine, which Dr Campbell liked as we know about familiar medications. This video promotes gargling, repurposed medicines. and suggests good Vit D3 levels improve T-cell response (a good immune response) at vaccination sites.