Due to the nature of the disease, the COVID-19 measures in place in Singapore and many other countries are aimed at preventing infection, such as vaccines, safe distancing, and mask-wearing.

But the coronavirus, being the sneaky little devil it is, somehow always manages to break through these defences and infect a portion of the population.

When that happens, some patients might only experience mild or no symptoms because they’ve been vaccinated, but others aren’t so lucky.

So, what’s the course of action for those who fall ill to COVID-19? How are they treated?

Here are four types of COVID-19 treatments in Singapore, including a new one that will arrive next month:

Sotrovimab (Antibody Drug)

As you may know, a robust immune system will develop antibodies against an invader, such as a virus, so that it can “recognise” it the next time it enters our system and effectively fight it off.

However, not all of us are strong enough to attack viruses like COVID-19, which is where drugs like sotrovimab can help.

Sotrovimab is a single-dose monoclonal antibody drug administered through intravenous infusion, meaning it’s delivered directly into a person’s vein.

Monoclonal antibodies are antibodies made in a laboratory by cloning unique white blood cells. They behave like antibodies in helping the body fight off infections.

Made available to healthcare institutions in Singapore just this month, it has already been used on 64 patients at the National Centre for Infectious Diseases (NCID), as of 22 Sep.

It can be used for COVID-19 patients with mild to moderate symptoms who do not require oxygen supplementation but are at risk of becoming severely ill.

Tocilizumab (Arthritis Drug) & Dexamethasone (Steroid)

Tocilizumab is an immunosuppressive drug used for the treatment of rheumatoid arthritis. It’s an anti-inflammatory monoclonal antibody and is also administered intravenously.

The drug has been shown to reduce the risk of death in severe cases of COVID-19, particularly when combined with dexamethasone, a cheap steroid used to treat various conditions including arthritis, allergic reactions, skin diseases, and breathing problems.

Like many other steroids, it helps to reduce inflammation, which is often a problem for patients with severe COVID-19 as some suffer from hyper-inflammation.

In Britain, it has also been shown to reduce patients’ need for a ventilator, and shortened their hospital stay as well.

As of 22 Sep, 60 NCID patients have been on tocilizumab and another 290 on dexamethasone.

Remdesivir (Antiviral Drug)

Remdesivir is used in the early stage of COVID-19 illness, as it accelerates the recovery process.

According to Hackensack Meridian Health, remdesivir is an antiviral drug that was originally developed to treat hepatitis when it was created a decade ago.

The drug is said to help COVID-19 patients by preventing the virus from producing a particular enzyme that is necessary for the virus to replicate itself. Consequently, the virus is no longer able to spread within the body.

You may have heard of this drug, as it was approved for use outside clinical trials by the Health Sciences Authority (HSA) way back in June last year. It was also the first drug approved by the US Food and Drug Administration for treating COVID-19 last year.

580 NCID patients have been treated with remdesivir as of 22 Sep.

Regeneron/Roche Antibody Cocktail 

The latest treatment to be approved by the HSA for use here is the antibody cocktail created by Regeneron and Roche.

This treatment is also a monoclonal antibody treatment that can be used to treat patients who have mild symptoms but are at risk of severe illness.

The antibody cocktail has been shown to slash the risk of disease progression to requiring acute treatment in hospital or death by an impressive 70%.

In the clinical trials, compared to the placebo group, those who were given the antibody cocktail also had their symptoms improve on an average of four days.

Approved for use on 21 Sep, the treatment may be used for patients aged 18 and older who do not require oxygen supplementation but are at risk of progressing to severe disease.

Drugs With No Evidence of Efficacy Against COVID-19

Remember when Donald Trump was president of the United States and touted hydroxychloroquine as an effective COVID-19 treatment?

Well, surprise surprise, he was wrong. 

While some messages on WhatsApp and posts on social media might say otherwise, there are some repurposed drugs out there that have not proven to be effective against COVID-19.

These include:

• hydroxychloroquine
• lopinavir-ritonavir
• ivermectin
• probenecid

Hydroxychloroquine, which has been used in some countries to treat COVID-19, has not been shown to be effective in any randomised controlled trials.

The same goes for some antiretroviral drugs such as lopinavir-ritonavir.

Some Facebook groups have promoted ivermectin – a medication used to treat parasite infestations – to treat COVID-19, but once again, no robust randomised controlled trials have shown the drug to be effective in either preventing hospitalisation or accelerating the recovery process.

As for probenecid – a medicine used to treat gout -, there is no data from a robust human trial on its efficacy, so it cannot be recommended yet.

How Are Drugs Assessed to Be Effective?

To assess a drug’s efficacy, researchers use what’s called a double-blind randomised controlled trial.

Randomised trials are important as they ensure that there’s no bias present, which could distort the results.

In a double-blind trial, neither the researchers nor the patients know what treatment they’re getting.

One group of patients will get the drug, while the other will get a placebo.

And if the group who received the drug was shown to have better results than those in the placebo group, then the drug can be said to be effective.

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Featured Image: Medical-R/ shutterstock.com