A growing number of new cancer drugs have come on the market in recent years, yet the cost of therapies in Europe and the United States have risen. This is driving up healthcare costs, which poses a challenge not only for the Swiss social insurance system, but for patients all over the world. But are the high prices of cancer drugs justified? Does the cost correspond to the particular drug’s effectiveness in combating the disease? An international research team from the University of Zurich and Harvard Medical School carried out a study to examine these questions.

Grace, 26, doesn’t look it but she’s deemed extremely vulnerable – here’s how she’s dealing with having to shield.

Children who experience “dependent” or clingy relationships with their preschool teachers tend to also have difficulties in their relationships with their mothers finds researchers at the NYU Steinhardt School of Culture, Education, and Human Development. The research, published in peer-reviewed academic research journal Attachment and Human Behavior, went even further to find that later in elementary school, these children were prone to being anxious, withdrawn, and overly shy.

Researchers have discovered a system of ridges spread across the nearside of the Moon topped with freshly exposed boulders. The ridges could be evidence of active lunar tectonic processes, the researchers say, possibly the echo of a long-ago impact that nearly tore the Moon apart.

Hospital chiefs say the figure is a “red herring” and the UK must move to mass testing.

Urgent services should return to pre-Covid-19 levels, a letter to local trusts and GPs says.

Domenico Piccininni is one of the hundreds of thousands of people who have had a Covid-19 infection and recovered after a bit of misery, but with no lasting complications.

What sets him apart from many other survivors is that Piccininni is trying to help people who now have more severe Covid-19 infections.

On Thursday, the Atlanta-area resident donated his plasma. Plasma is a component of blood that contains antibodies, which are made by the immune system in response to a specific infection. Because the 50-year-old Piccininni recovered from a Covid-19 infection, his body now produces antibodies that are primed to fight the new coronavirus.

The hope is that giving his plasma and antibodies (called “convalescent plasma”) will help kick-start the fight against the virus for people who are currently very sick with Covid-19 infections.

‘My wife volunteered me’

Piccininni is a reluctant hero, though. At first, he thought he wouldn’t want anyone to even know that he had been sick with Covid-19. He worried there might be a potential stigma.

“I felt like [having had the infection] might be like a scarlet letter, but the doctor said I should think of it more like a badge of honour, because I could help people,” Piccininni said.

He also admitted to being a bit uneasy about the procedure because he didn’t quite know what to expect.

“My wife volunteered me,” he said, laughing. “I’ve never even donated blood before. But, we have five kids and if one of them were on the edge, I would hope someone would help. As nervous as it might make you feel, you have to think about your fellow humankind. How can you not think about saving a life if you can?”

The good news is that the donation process isn’t a big deal – just a little bit of time and a needlestick.

Dr Kent Holland, medical director of the Blood and Marrow Transplant Program at Northside Hospital (the hospital where Piccininni donated) and Atlanta Blood Services in Atlanta, said, “The donation process is pretty straightforward. The whole process takes about 75 to 90 minutes, and there really aren’t any significant risks.”

Who can donate?

He added that some people may briefly get light-headed and some may have a bruise where the needle went in.

During the donation process, some blood is drawn from you. It’s then run through a special machine that separates the plasma from the rest of the blood. Your blood is then returned to your body, minus the plasma, Holland explained.

Dr Jed Gorlin, medical director of Innovative Blood Resources (a New York Blood Center Enterprise) in St. Paul, Minnesota, said, “Your appointment may be an hour or an hour and a half altogether, but the actual collection time is only about 45 minutes.”

Who can donate? Holland said people who have had a proven Covid-19 infection and have recovered may be eligible to donate. It needs to be at least two weeks since they last had symptoms.

Gorlin said loss of smell is one exception to that symptom rule, however. He said it can take longer than two weeks for the sense of smell to return to normal.

Both experts also said that all the usual rules of blood donation apply, and donors must be considered healthy. People can donate more than once.

Doctors are hopeful

For people receiving the convalescent plasma, it’s like a blood infusion through an IV. Gorlin said it’s only about a cup of fluid, so it’s not a lot of volume. He said the risks to a patient are very low. The most common side effect is a mild allergic reaction.

Theoretically, a reaction might make the inflammatory response of a Covid-19 infection worse, but Gorlin said doctors just don’t know yet if that’s a concern because this hasn’t been well-studied.

Both said convalescent plasma has been used in the past. Holland noted that it was used as far back as the 1918 Spanish flu, and as recently as the SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome) viral infections.

Patients who are in hospitals participating in studies of convalescent plasma can access the treatment. If a patient is in a hospital that isn’t conducting a study, doctors can apply for what’s called an “Emergency IND” – that’s individual expanded access for emergency use – from the US Food and Drug Administration.

Gorlin noted that physicians can also request convalescent plasma through the Mayo Clinic extended access programme.

Holland said that while doctors are hopeful the convalescent plasma will help patients recover faster, “It’s too early to know yet. It’s a relatively safe therapy, but I would caution people that while it looks promising, all the evidence right now is anecdotal.”

READ | Could tiny blood clots make Covid-19 more lethal?

READ | Could coronavirus survivors’ blood help save very ill patients?

READ | More evidence that coronavirus survivors’ blood could help very ill patients

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Boris Johnson will lead the Downing Street briefing later for the first time since his return to work.

WHAT’S HAPPENING IN SA

Cases update: 

The latest number of confirmed cases is 5 350.

According to the latest update, 103 deaths have been recorded in the country.

So far, 197 127 tests have been conducted, with more than 11 600 new tests.

The Western Cape is an area of concern, as highlighted in a release from Health Minister Zweli Mkhize:

“The number of new cases in WC has almost doubled from 133 the day before to 264 today. This was also the highest number of new cases in this province in any 24 hour cycle.

“Also of note is that this province has the highest positivity yield from their tests in the past 24 hours at 7.5% when compared to other provinces.

“In the past 24 hours the Western Cape contributed to 75% of the total new cases nationally while only contributing 30% of total tests over the same period.”

READ MORE |All the confirmed cases of coronavirus in SA

Latest news:

SEE | Here is a list of what you can and not do under level 4 lockdown

Come Friday, cigarettes will still not be allowed to be sold at level four of lockdown.

The u-turn comes after government received over 2 000 submissions from the public opposing the sale of tobacco products, Minister of Cooperative Governance and Traditional Affairs Nkosazna Dlamini-Zuma said.

The minister was speaking at a briefing on Wednesday evening on the new regulations for industries which will restart their operations as the country gradually starts resuming economic activity.

Last week President Cyril Ramaphosa announced that the restrictions on economic activity would be lifted in a gradual risk-adjusted process, based on five coronavirus levels. The country is currently at level five which only allows essential services to operate. More businesses however will be able to operate from Friday, when we move to level four.

Initially government had proposed that the sale of cigarettes would be allowed at level four, but government had received submissions from the public opposing it on the grounds that it posed a health risk, Dlamini-Zuma said. “Besides the effects of tobacco on lungs and the way tobacco is shared, it does not allow for social distancing and encourages the spread of the virus.”

The minister specifically raised an example made in one submission, where concerns were raised about spreading the virus in saliva, when one has to lick paper when rolling a “zol”.

READ MORE | Lockdown: Cigarettes, liquor still won’t be for sale on Level 4

South Africans can run, cycle and walk from Friday but only within a 5km radius from their homes between 06:00 and 09:00.

This was announced on Wednesday evening by Cooperative Governance and Traditional Affairs Minister Nkosazana Dlamini-Zuma.

She said more than 22 000 South Africans had submitted pleas to exercise during the government’s public participation period.

President Cyril Ramaphosa previously promised some respite for his cooped-up countrymen, but “under very strict conditions”, Dlamini-Zuma reminded the nation.

READ MORE | Level 4 lockdown: You can now run, cycle, walk but only under strict conditions

Minister of Cooperative Governance and Traditional Affairs, Nkosazana Dlamini-Zuma, said government will allow the energy and refineries sector to return to operation under the terms of level 4 of the national lockdown.

Dlamini-Zuma was speaking on Wednesday evening and unpacked which industries would be allowed to operate under level 4 of the coronavirus lockdown which will come into effect on Friday, when lockdown deescalates from level 5.

According to the South African Petroleum Industry Association, the local sector supplies to 200 depots, 4600 service stations and 100 000 consumers nationally.

Last week President Cyril Ramaphosa announced a five-level system would be put in place from 1 May to allow the economy to return to function in phases.

Coal miners supplying Eskom were allowed to continue operating during lockdown and mining companies have been granted permission to return to work on a case-by-case basis in recent weeks.

Dlamini-Zuma said bringing refineries back to operation under level 4 was a critical part of getting the economy ticking again.

READ MORE | Lockdown: Refineries to return to operation under level 4

E-commerce may be expanded incrementally during lockdown level 4, now referred to as Alert Level 4 in government documents, to include items currently excluded, trade and industry minister Ebrahim Patel said on Thursday night. 

South Africa is due to embark on a phased reopening of the economy on Friday, starting with lockdown level 4, which will see several industries returning to work, and the purchase of additional items allowed. 

Patel said online retailers will be allowed to sell essential food items, winter clothing, bedding, hot foods, stationery and cellphones during lockdown level 4 – but that could change.

“E-commerce will be expanded incrementally as an immediate step,” Patel said during a press conference on the differences between hard lockdown and level 4. “Deliveries of a larger list of products will be possible and it will be expanded further in level 4”

But regulations from the department of cooperative governance and traditional, due to be gazetted on Thursday, say that before e-commere is expanded, how to limit movement on roads will be considered. 

READ MORE | New regulations hint online retailers may get to sell more stuff under level 4 – eventually

In a media briefing on Wednesday evening, Minister of Cooperative Governance and Traditional Affairs Nkosazana Dlamini-Zuma confirmed that despite public calls for hairdressers and nail salons to re-open, this will not be happening in Level 4 of lockdown.

The danger of contracting Covid-19 is too high with these services, given that there is “no social distancing”, Dlamini Zuma said.

According to government’s current risk adjusted strategy, hairdressers and beauty salons may only open when South Africa reaches Level 1. 

“People are touching,” she said, adding that it was “too risky”.

But she said that products that will allow people to treat their own hair, and do pedicures and hand manicures at home, have been added to the list of goods that may be sold in Level 4. 

READ MORE | Hairdressers, salons stay shut – but you can buy products to do manicures at home from Friday

President Cyril Ramaphosa is still considering the release of 19 000 prisoners amid the coronavirus pandemic.

So says Deputy Justice Minister Patekile Holomisa who was addressing a virtual meeting of the Portfolio Committee on Justice and Correctional Services and Select Committee on Security and Justice on Wednesday.

MPs had asked him about the release of the prisoners, which was mooted earlier.

“That is a matter that is still being considered by the president,” Holomisa said, adding the department had presented its plan to Ramaphosa.

“So, we are not in a position to pronounce on what the details are.”

Earlier, Justice Minister Ronald Lamola told the committees physical distancing was not practical at correctional centres.

READ MORE | President still considering release of 19 000 inmates amid Covid-19 outbreak

WHAT’S HAPPENING IN THE REST OF THE WORLD 

Cases update:

For the latest global data, follow this interactive map from Johns Hopkins University & Medicine.

Late on Wednesday night, positive cases worldwide were close to 3.18 million, while deaths were more than 226 000.

The United States had the most cases in the world – close to 1  035 000, as well as the most deaths – more than 60 000.

READ MORE | All the confirmed cases worldwide

Latest news:

Gilead Science’s remdesivir, one of the most highly anticipated drugs being tested against the new coronavirus, showed positive results in a large-scale US government trial, the company said Wednesday.

Remdesivir is an anti-viral drug.

“We understand that the trial has met its primary endpoint and that National Institute of Allergy and Infectious Diseases (Niaid) will provide detailed information at an upcoming briefing,” the company said.

Though it is difficult to precisely quantify the finding in the absence of results, it represents the first time any drug has been shown to improve outcomes against the Covid-19 illness, which has claimed more than 200 000 lives globally and brought the world economy to a grinding halt.

READ MORE | Covid-19 remdesivir drug trials: manufacturer says its working, but a study finds ‘no benefits’

The Swedish university town of Lund will spread foul smelling chicken fertiliser in its main park this week to deter revellers holding spring celebrations as part of efforts to curb the coronavirus outbreak, officials said on Wednesday.

City officials have asked residents to skip the traditional Walpurgis Eve celebrations on 30 April, known in Sweden as Valborg, and plan to fence off the Lund city park.

But they told AFP they would also go a step further and take the opportunity to spread one ton of chicken droppings in the park.

While giving the lawns a welcome dose of nutrition, they also hope it will keep at bay those who would otherwise be tempted to defy the coronavirus restrictions.

“Well, chicken manure simply smells awful,” Gustav Lundblad, chairman of the city’s environment board, told AFP.

“It’s not very pleasant to sit around drinking beer in that smell,” Lundblad added.

The park is a popular gathering spot for afternoon and early evening picnics on 30 April, before the traditional bonfires later in the evening.

Since the festivities – which can attract up to 30 000 visitors – are “spontaneous”, the city cannot outright ban them but given the coronavirus outbreak, Lundblad said the city strongly wanted to avoid them.

READ MORE | Swedish town to use ‘stinky’ fertiliser to deter spring revellers

LATEST RESEARCH

As the list for possible treatments for the new coronavirus grows, a new ingredient, famotidine, has joined the ranks.

This is the active ingredient found in common over-the-counter heartburn remedies.

Testing this compound against the novel coronavirus began, when on 7 April 2020, Covid-19 patients at Northwell Health in the New York City area began receiving famotidine intravenously, according to reports.

The dose given to these patients is nine times higher than the dose needed to treat heartburn. The hospital kept quiet about the test to prevent people from stockpiling this common drug before it was even proven to work

READ MORE | Heartburn remedy in clinical trial for coronavirus

As the world continues to fight the coronavirus pandemic, with over 2.3 million reported cases at the time of publishing this article, many countries are seeing a rise in cases – South Africa included.

As of 28 April, the country has a total number of 4 793 confirmed cases, and 87 confirmed deaths. And, according to News24, Africa, and by extension South Africa, is not currently on the top of supply lists for life-saving ventilators.

However, a multidisciplinary team of engineers and healthcare practitioners at the University of Johannesburg (UJ), led by UJ’s Dr Deon Sabatta and Dr Samson Masebinu, aim to create open-source, cheap ventilators, a media release explained.

Government projections indicate that the virus could peak in South Africa in September 2020. If the lockdown hadn’t happened, the peak rate would have been expected in July. Currently, 27 Covid-19 patients are on ventilator support in hospitals, which is seemingly in line with government’s projections, reports News24.

READ MORE | Amid SA’s looming shortage, UJ creates open-source, cheap ventilators

Last week Health24 reported on the latest coronavirus vaccine development in Germany – the fourth candidate to go to the clinical trial phase.

Now, a vaccine candidate from the Jenner Institute at the Oxford University, UK, was able to leap ahead as they have had previous trials with similar types of injections, according to reports.

According to information from the Jenner Institute, a chimpanzee adenovirus vaccine vector was chosen as the most suitable vaccine type for the new coronavirus, as it can create a strong immune response from only one dose.

This new development is called ChAdOx1 nCoV-19 and will be produced on a mass-scale.

READ MORE | Oxford University moves forward in coronavirus vaccine race

While there is no vaccine to protect against the new coronavirus, scientists and medical experts are buying time by looking at the effects of existing drugs.

Lopinavir-ritonavir (LPV/r) is a combination of antivirals used to treat HIV.

The possibility of using this drug combination to treat Covid-19 started when the World Health Organization (WHO) announced their Solidarity trial – a collaboration between different countries, where four existing drugs would be trialled to determine their effect on Covid-19 patients.

One of these drugs is the lopinavir-ritonavir combination. While there was no certainty that it would be effective in Covid-19 patients, there were some positive indications from laboratory experiments, according to the WHO.

READ MORE | Lopinavir-ritonavir not effective against Covid-19, says Department of Health

HEALTH TIPS (as recommended by the NICD and WHO)

• Maintain physical distancing – stay at least one metre away from somebody who is coughing or sneezing

• Practise frequent hand-washing, especially after direct contact with ill people or their environment

• Avoid touching your eyes, nose and mouth, as your hands touch many surfaces and could potentially transfer the virus

• Practise respiratory hygiene – cover your mouth with your bent elbow or tissue when you cough or sneeze. Remember to dispose the tissue immediately after use.

READ MORE: Coronavirus 101 

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