Dexamethasone cannot be used to prevent Covid-19 but is a positive step towards finding a cure — experts

Experts have warned that the new Covid-9 breakthrough drug dexamethasone is available strictly on prescription and cannot be used to prevent or cure the virus, but rather to decrease the mortality rate among critically ill patients.

The warning comes less than a week after a trial by the University of Oxford which found that a low-dose steroid treatment cuts the risk of death by a third for patients on ventilators and by a fifth for those on oxygen.

Dr Moherndran Archary,  a paediatric infectious disease specialist at the University of KwaZulu-Natal, said the treatment did not work directly on the virus but rather on the immune system’s response to the virus.

“The drug is used only in patients with moderate or severe Covid disease that require either oxygen or they need to be put on a ventilator. What it does is that it prevents the immune system from overacting and causing too much damage to the body.

“It is not for everyone who’s got Covid infections. In cases where people have mild or moderate infections that don’t require oxygen, it’s probably not going to make any difference to your infection,” he said.

Archary said the treatment had been a schedule 4 medicine that would be used by doctors especially in ICU and was not available over the counter.

He emphasised that it was not a cure for the virus.

“It is a positive step in terms of finding a cure, because the main issue is that although we may not be able to find a cure or clear the infection from circulating, what we want to do is to prevent people from dying from the infection,” he told TimesLIVE.

The owners and manufacturers of the product globally, Aspen Pharmacare, said the steroid had usually been used to manage and treat various inflammatory conditions.

Spokesperson for the pharmaceutical giant Dr Stavros Nicolaou said the treatment came in the form of an injection or tablet. The injectable form was available in SA, manufactured on behalf of Aspen by a third-party manufacturer.

Commenting on the study, Stravros said the results from Oxford had been preliminary, demonstrating up to a 30% reduction in the mortality rate because treatment limits the clotting that is “partly” killing Covid-19 patients. He said 30% was a meaningful reduction in mortality rate.

He said the product had been an anti-inflammatory, used for many inflammatory diseases including asthma and certain skin conditions like dermatitis. He added the steroid had a wide range of uses.

“In this instance, the Oxford researchers are postulating that the Covid virus causes an intense immunological response and when that happens, it can affect the clotting mechanisms in the body. When it affects the clotting mechanisms, patients are inevitably clotting, some of the clotting happens in their lungs ... The hypothesis is that many of these patients are dying from these clots,” he said.

While the treatment had been available in the country, at an average cost of R100 per day to be used over a 10-day period, Stravros said the government had approached them to look at the possibility of supplying it throughout Africa.

“Our government has been really proactive, they have already contacted us on the basis of what SA’s demand could be, understanding that we are going into the peak period. We are expecting the pandemic to peak in the third week of July. We are going into an intense period now, the government is already working out what the demand is and we are in communication with them.

“Dr Mkhize is also interested in Africa, and he’s saying what is the capacity and capability to supply Africa, so we are having those discussions to see if there’s an opportunity for us to expand capacity,” he said.

He said the pharmaceutical group had existing stock in the country and had more stock coming in, but could not say if there was enough to assist the country ahead of the peak.  

“It’s very hard for us to assess what the demand is at this point,” he said.

President Cyril Ramaphosa on Wednesday said he had been encouraged by the breakthrough.  

SA has recorded 80,412 confirmed infections and 1,674 deaths.

“We believe that this will improve our management of the disease among those who are severely affected,” said Ramaphosa.