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Canada takes cautious approach to unapproved COVID-19 drugs, as others prescribe wide use


A doctor guest on Fox News called it “the beginning of the end of the pandemic.” President Donald Trump said it could be a “game changer,” and the U.S. Food and Drug Administration gave physicians a qualified green light to use it on COVID-19 patients.

The malaria drug hydroxychloroquine is a hot item in the United States, embraced by the highest politician in the land and many in the medical community, despite minimal evidence that it helps those stricken by the novel coronavirus.

India and Brazil have similarly doubled down on using the drugs to treat the pandemic virus.

But it’s a different story in Canada, where hydroxychloroquine and other potential COVID-19 medicines are being met more with a cautious interest than unbridled enthusiasm.

Canadian researchers are actively involved in several studies of the malaria drug and others, with the federal government spending millions to support them.

But in contrast to the FDA, health organizations here have discouraged their use except as part of those clinical trials — studies designed to carefully assess the drugs’ effectiveness and possible harmful side effects.

And some experts warn that widespread use outside of studies — which typically include a control group of patients who don’t receive the drug — could make it difficult to ever determine whether they work or not.

“When people become very ill … your impulse is to try anything that might help, and that’s driven the response in some places,” said Dr. Lynora Saxinger, an infectious disease specialist at the University of Alberta. “But as people have been wrapping their heads around the data underpinning these drugs, it’s really pretty thin on the ground.”

Dr. Salim Yusuf, a professor at Hamilton’s McMaster University and leading clinical-trials expert, is helping design a fast-tracked hydroxychloroquine study. He said he understands the urge to try unproven treatments but worries about the consequences.

It could result in harm

“One perspective is ‘We’re in a time of desperation and let’s throw anything we can at it to save people’s lives.’ I understand that,” he said. “The danger is it’s not objective. It could result in harm.”

Just as the scientific community has entered an extraordinary, expedited race to develop a vaccine for the virus causing COVID-19, it is rapidly testing whether a number of new drugs or ones used for other conditions might help the minority of patients made critically sick by the pathogen.

Health Canada alone has approved eight separate COVID-19 trials.

The malaria drug has drawn the most attention worldwide, initially because of a small French study that seemed to show that combining it with the antibiotic azithromycin had some effectiveness against the coronavirus.

Trump gave his endorsement and then it became a political issue, with opponents of the president seeming eager to see it debunked, supporters trumpeting the drugs as a miracle cure.

And on Monday, the FDA made its surprise pronouncement, saying it was worth the risk of trying an unproven remedy for seriously ill patients.

Canadian doctors, like their American counterparts, are legally allowed to prescribe approved medicines “off-label” for uses other than those specified in their licences.

But Health Canada has not followed the U.S. lead by encouraging they do so with hydroxychloroquine.

Meanwhile, the B.C. Centre for Disease Control recommended in a lengthy March 30 report against using any of several potential COVID-19 drugs except as part of clinical trials.

Quebec’s National Institute of Excellence in Health and Social Services said in a news release Thursday that treating coronavirus patients with the malaria pills should “be done within the framework of research protocols.”


University of Minnesota researchers set up an automated liquid handler as they begin a trial to see whether malaria treatment hydroxychloroquine can prevent or reduce the severity of COVID-19.

Craig Lassig/Reuters/File

And guidelines developed by University of Toronto-based critical care doctors also say experimental therapies ought to be used only as part of clinical trials, or else after consulting an infectious-disease specialist and getting the patient’s informed consent.

Saxinger said she agreed with such advice, though she said exceptions may have to be made in smaller centres where there’s no chance of a patient joining a clinical trial.

Having heard positive reports about some of the drugs, patients might balk at being part of a clinical trial, where half would not receive the medicine, said Dr. Gordon Rubenfeld, a critical-care doctor at Toronto’s Sunnybrook Health Sciences Centre. But before using the treatments widely “we should find out whether these work.”

The accelerated effort to conduct those studies is remarkable, said Yusuf. Researchers would typically take two or more years first to study a drug and then set up the trial. His group’s trial involving hydroxychloroquine was launched two weeks ago and, pending Health Canada approval, aims to start enrolling patients in a week or so.

“This is unprecedented … at least in my lifetime.”

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University of Guelph pauses search for new president, names interim one – Guelph


The University of Guelph says it is suspending its search for a new president and vice-chancellor amid the novel coronavirus pandemic.

Instead, the board of governors have appointed current provost and vice-president Charlotte Yates as president on an interim basis for two years.


READ MORE:
University of Guelph cancels ‘face-to-face’ classes, events in response to COVID-19

Board chair Shauneen Bruder said universities and organizations worldwide are focused on addressing the COVID-19 pandemic and this is where their efforts and resources should be concentrated.

“COVID-19 is creating much uncertainty, both now and for the future,” Bruder said in a statement. “We expect that even once the crisis subsides, the implications will be long-lasting. At the same time, there are many other strategic imperatives the university must address to continue to move forward.”

Yates replaces outgoing president and vice-chancellor Franco Vaccarino, who announced last year that he was stepping down. His term will end on Aug. 1 and Yates will officially take over the following day.

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A search committee has been working since last fall and the university said it was at a critical stage of the process when it made the decision to pause the search.

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Bruder said Yates was chosen in part because of her effectiveness in a range of complex situations and circumstances.

“Her significant experience and extensive knowledge of the complexities and challenges facing the university will enable her to act immediately on priorities during this critical period,” Bruder said.


READ MORE:
McGill University students design 3D-printable masks for health-care workers

Yates has served as provost since 2015 and the university said since then she has built a strong leadership team that includes five new deans and other key academic leaders.

She previously served as dean of the Faculty of Social Sciences at McMaster University.

“I am deeply honoured by the trust the board has placed in me to lead the University of Guelph during this challenging time,” Yates said.

“I welcome this opportunity. The university has extraordinary, dedicated faculty, staff and students and exceptionally strong academic and administrative leaders. Working together, we will rise to meet the challenges before us while also enhancing our reputation for quality and excellence.”

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An announcement regarding an interim provost and vice-president to replace Yates will be forthcoming, the university said.


READ MORE:
Here’s why frequent handwashing is recommended in preventing spread of COVID-19

In response to the pandemic, the University of Guelph has cancelled all in-person classes for the remainder of the winter semester and more than 4,000 students living on residence have moved out.

Classes resumed on Monday in what the university called an “alternative delivery format.”

More information on its response to the pandemic can be found on the university’s website.










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China to supply Europe with masks and medical equipment



In a tweet published on Wednesday, European Commission President Ursula von der Leyen announced that China will provide Europe with medical equipment and test kits, following talks with the country’s Prime Minister Minister Li Keqiang.

China’s medical supplies include 2 million surgical masks, 200,000 N95 masks and 50,000 testing kits, as the EU27 bloc is running out of medical equipment, having recording dozens of thousands of COVID-19 cases.

On Wednesday, a group of 300 Chinese intensive-care doctors began to arrive in Italy, the worst-affected country by Coronavirus outside China. To date, Italy has 41,035 confirmed cases and 3,405 deaths.

Belgium’s Health Minister Maggie De Block announced on Wednesday that the Chinese billionaire Jack Ma and founder of e-commerce colossus Alibaba would ship 500,000 masks and 30,000 test kits, to be distributed among the health providers.





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