Health

Which experimental drugs could Prime Minister Boris Johnson be given in intensive care? 


Prime Minister Boris Johnson is currently in a London intensive care unit fighting the coronavirus, leaving Britons waiting with bated breath for more news. He posted a video about his symptoms on Friday (pictured)

Prime Minister Boris Johnson is currently in a London intensive care unit fighting the coronavirus, leaving Britons waiting with bated breath for more news. He posted a video about his symptoms on Friday (pictured)

Prime Minister Boris Johnson is currently in a London intensive care unit fighting the coronavirus, with Britain waiting for more updates on his health. 

The dramatic twist of events last night left experts fearing the worst. But the news the 55-year-old was in a ‘stable condition’ today offered a glimmer of hope. 

Donald Trump last night asked two drug giants working with the US government on experimental drugs to ‘contact London’ and offer the PM support. Number 10 today thanked the President and said officials are in ‘constant contact’ with US officials.

Mr Johnson is being cared for at St Thomas’ Hospital, a central London hospital involved with major trials of experimental drugs on COVID-19 patients. 

The medicines – including the promising antimalarial drug hydroxychloroquine – have been approved by drug regulators for clinical trial purposes only. 

Other candidates being tested in Britain include HIV drug combination lopinavir and ritonavir, as well as experimental Ebola drug remdesivir. 

Doctors across the UK will assess how thousands of patients – some of whom will be in a critically ill condition – respond to these medicines. 

So what are the drugs being trialed in the UK to treat COVID-19 patients, including those in intensive care? 

Mr Johnson is at a central London hospital involved with major trials of experimental drugs on COVID-19 patients. He is pictured in the cabinet office on March 3, before he became ill

Mr Johnson is at a central London hospital involved with major trials of experimental drugs on COVID-19 patients. He is pictured in the cabinet office on March 3, before he became ill 

Mr Johnson last night became an ICU patient at St Thomas' Hospital in central London (pictured), having been admitted to hospital on Monday night.

Mr Johnson last night became an ICU patient at St Thomas’ Hospital in central London (pictured), having been admitted to hospital on Monday night.

The dramatic twist of events last night left experts fearing the worst. But the news Mr Johnson was in a 'stable condition' today offered a glimmer of hope. Pictured, outside No10

The dramatic twist of events last night left experts fearing the worst. But the news Mr Johnson was in a ‘stable condition’ today offered a glimmer of hope. Pictured, outside No10

WHAT ARE THE MOST PROMISING DRUGS BEING TESTED? 

Hydroxychloroquine (Malaria)

What are the brand versions of the drug?

Plaquenil.

What does it treat?

Malaria, lupus and rheumatoid arthritis. It is a less powerful and, by some experts’ accounts, less toxic, version of chloroquine phosphate.

Hydroxychloroquine, sold under the brand name Plaquenil, may treat COVID-19

Hydroxychloroquine, sold under the brand name Plaquenil, may treat COVID-19

Who makes it and where has it already been tested?

Drug giant Sanofi carried out a study on 24 patients, which the French government described as ‘promising’. 

French health officials are now planning on a larger trial of the drug, which is used on the NHS. 

What have studies shown?

Results from the French study showed three quarters of patients treated with the drug were cleared of the virus within six days. None of the placebo group were treated. 

How does it work?

It interferes with viral molecules replicating in red blood cells.

Is it being tested in the UK?

Hydroxychloroquine is one of the first drugs to be trialled in the Principle study. It involves high-risk patients in primary care, aged between 50 to 64, who have COVID-19 symptoms and a chronic health condition such as heart disease, asthma or cancer. 

It is unclear how many patients are taking part, and the study will run until March next year. So it will be a while before results are clear.

The study is being run at the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) in Surrey.

Hydroxychloroquine is also thought to be among 1,000 drugs being tested at Queens University Belfast. 

What are its side effects?  

Skin rashes, nausea, diarrhoea and headaches.

What do the experts think?

Chinese scientists investigating the other form of chloroquine penned a letter to a prestigious journal saying its ‘less toxic’ derivative may also help.

In the comment to Cell Discovery – owned by publisher Nature, they said it shares similar chemical structures and mechanisms.

The team of experts added: ‘It is easy to conjure up the idea that hydroxychloroquine may be a potent candidate to treat infection by SARS-CoV-2.’ 

Lopinavir/ritonavir 

What are the brand versions of the drug?

Kaletra and Aluvia.

What does it treat? 

Lopinavir/ritonavir, marketed under the brand names Kaletra and Aluvia, is an anti-HIV medicine

Lopinavir/ritonavir, marketed under the brand names Kaletra and Aluvia, is an anti-HIV medicine

It is an anti-HIV medicine given to people living with the virus to prevent it developing into AIDS. HIV patients were prescribed either Kaltra or ritonavir alone around 1,400 times in 2018.

Who makes it?

Illinois-based manufacturer AbbVie donated free supplies of the drug to authorities in China, the US and Europe for tests.

What have studies shown? 

Chinese media reported that the drug was successfully used to cure patients with the coronavirus, but the reports have not been scientifically proven.

A separate Chinese study published in the New England Journal of Medicine found that the lopinavir-ritonavir combination did not improve survival or speed recovery of COVID-19 patients.

However, the authors noted they had enrolled a ‘severely ill population’ of patients.

In a clinical trial submission, scientists in South Korea said lab studies have: ‘In vitro [laboratory] studies revealed that lopinavir/ritonavir [has] antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).’

How does it work? 

It is a class of drug called a protease inhibitor, which essentially stick to an enzyme on a virus which is vital to the virus reproducing. 

By doing this it blocks the process the virus would normally use to clone itself and spread the infection further.

Is it being tested in the UK?

It is not prescribed on the NHS for coronavirus because it hasn’t been approved – but will be used in the Recovery trial, a massive study run by the University of Oxford for COVID-19 patients already in hospital.

The trial started enrolling patients on March 23, with the aim of reaching COVID-19 patients in more than 150 UK hospitals within two weeks.  

The drug is also being trialled on coronavirus patients in China and at the University of Nebraska.

What are its side effects? 

Known side effects include diarrhea, headaches, upset stomachs, drowsiness, dizziness, a bad taste in the mouth, and trouble sleeping.

What do the experts think?

The drugs have been described as ‘promising’ by experts. But there has been some hesitancy about the drug combination due to the NEJM study. 

Interferon beta-1b/SNG001 

What are the brand versions of the drug?

The drug is still in development and goes by the name of SNG001.

What does it treat?

Interferon beta-1b (IFN-beta) is a naturally occurring protein that orchestrates the body’s anti-viral responses.

Interferon beta-1b (IFN-beta) is a naturally occurring protein that orchestrates the body's anti-viral responses

Interferon beta-1b (IFN-beta) is a naturally occurring protein that orchestrates the body’s anti-viral responses 

SNG001 is a formulation of IFN-beta developed by Synairgen to prevent severe lower respiratory tract illness caused by cold and flu infections. 

A different formulation using the protein is used to treat patients with multiple sclerosis (MS). 

The drug called Extavia is self-injected every two days and works by slowing down the damage to the nervous system and by reducing the number of relapses. 

Where has it already been tested?  

Synairgen is a UK-based company, and it appears their formulation hasn’t crossed overseas yet. 

But it does say has been approached by, and is in discussion with, a number of scientific and governmental bodies in the US and internationally since the COVID-19 outbreak began. 

What have studies shown?  

Laboratory studies have shown IFN-beta can protect cells from infection by a range of respiratory viruses. 

These include the MERS and SARS coronavirus strains, leaving scientists expecting IFN-beta to also protect against the COVID-19 strain.

It has already been shown to improve the recovery of asthma and COPD (chronic obstructive pulmonary disease) patients who have other lung infections, such as flu. 

Richard Marsden, CEO of Synairgen, said: ‘SNG001 has been well tolerated in clinical trials in over 200 respiratory patients to date and has accelerated lung function recovery in two Phase II asthma trials in patients with a cold or flu infection.’ 

How does it work?   

SNG001 is inhaled with a nebuliser, which helps deliver drugs to the lungs. 

Scientists believe it will prevent the coronavirus from taking over lung cells to replicate. This would prevent patients deteriorating until the point they need ventilation to survive. 

Viruses, including coronaviruses, can evolve the ability to suppresses IFN-beta production in the body, thereby helping the virus evade.  

Is it being tested in the UK? 

Southampton researchers are conducting a Phase II SNG001 trial on COVID-19 patients to see if it could prevent worsening symptoms in those most at risk.

The trial, led by Professor Tom Wilkinson at University Hospital Southampton, will involve 100 patients at Southampton and up to ten other NHS hospitals. It started recruiting mid-March.

Those patients will receive the best current COVID19 care, whilst inhaling either a placebo or SNG001 for 14 days.

What are its side effects?   

Doctors are currently clueless. Side effects will be reported with the findings of the clinic trial. 

Other forms of interferon beta can cause headaches, vaginal bleeding and diminish libido. 

What do the experts think?   

Tom Wilkinson told Sky News: ‘We are hoping that the drug will increase the rate of recovery from infection, that it will increase the protection in the bit of the lungs that are not infected yet and will reduce the number of patients that decline significantly and require intubation and ventilation.’

Mr Marsden said: ‘A successful outcome from this trial [at Southampton] in COVID-19 patients would be a major breakthrough in the fight against this coronavirus pandemic.’ 

Dexamethasone is a steroid drug is used to treat allergies and asthma, as well as some types of cancer

Dexamethasone is a steroid drug is used to treat allergies and asthma, as well as some types of cancer

Dexamethasone

What are the brand versions of the drug?

Ozurdex and Baycadron.  

What does it treat? 

The steroid drug is used to treat allergies and asthma, as well as some types of cancer. 

Who makes it?

Baycadron is made by Wockhardt Usa, Llc, while Ozurdex is made by Allergan, the manufacturer of a commonly used textured breast implant.

What have studies shown? 

No studies have yet to prove dexamethasone can treat SARS-CoV-2 – but it has been tested on patients with MERS and SARS, two different coronaviruses. 

One retrospective study of critically-ill patients with MERS found that almost half of the people that received steroids needed additional treatments such as assistance in breathing, drugs to increase blood pressure, and a form of dialysis. 

Those given steroids were found to take longer to clear the virus from their bodies.

Other studies found that the virus was still present in SARS patients who took the drugs up to three weeks after infection.

How does it work?  

Steroids are often used by doctors to reduce inflammation, which is present in the lungs of patients with the coronavirus.  

However, steroids also impair the immune system’s ability to fight viruses and other infections that often develop in patients with life-threatening illness.

Is it being tested in the UK?

Dexamethasone is one of the drugs being used in the RECOVERY trial launched by the University of Oxford. It will include patients at more than 130 NHS hospitals across the UK.

What are its side effects? 

The drug is known to cause an increase in appetite and heartburn, as well as muscle weakness and insomnia.

What do the experts think?

In a piece in prestigious medical journal The Lancet, three experts warned: ‘No unique reason exists to expect that patients with 2019-nCoV infection will benefit from corticosteroids.

‘And they might be more likely to be harmed with such treatment. 

‘We conclude that corticosteroid treatment should not be used for the treatment of 2019-nCoV-induced lung injury or shock outside of a clinical trial.’

Remdesivir 

Remdesivir is an anti-viral drug that works in essentially the same way as favipiravir – by crippling the RNA polymerase enzyme, stopping a virus from reproducing

Remdesivir is an anti-viral drug that works in essentially the same way as favipiravir – by crippling the RNA polymerase enzyme, stopping a virus from reproducing

What are the brand versions of the drug?

Remdesivir – no brand name currently exists because it is only experimental.

What does it treat? 

It was developed around 10 years ago with the intention of it destroying the Ebola virus. It was pushed aside, however, when other, better candidates emerged.

Who makes it?

California-based pharmaceutical company Gilead Sciences, the firm behind the life-changing HIV-preventing pill Truvada, or PrEP.

What have studies shown? 

Lab tests of remdesivir have shown promise against coronaviruses – but human trials are still in their early days.

Doctors in the US have tried it on patients and it managed to speed up the recovery of the first person to be treated for the virus there.

WHAT ARE THE THREE MAIN CORONAVIRUS TRIALS IN THE UK?

Principle 

The Principle trial is studying people aged 50 to 64 who have COVID-19 symptoms and a chronic health condition such as heart disease, asthma or cancer. 

It is unclear how many patients are taking part. 

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It is also open to those aged 65 or over, with or without other illnesses.

The first drug that will be trialled is hydroxychloroquine, sold as Plaquenil. Other potential treatments will be used if they show promise in pre-clinical studies.

The study is being run at the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) in Surrey.

It will last until March next year.

Recovery

The Randomised Evaluation of COV-id19 thERapY (RECOVERY) trial is being run by the University of Oxford. 

It will test the HIV drug lopinavir/ritonavir, marketed as Kaletra and Aluvia, hydroxychloroquine, a malaria medication sold as Plaquenil, and dexamethasone, a type of steroid use in a range of conditions to reduce inflammation.

Almost 1,000 patients from 132 different hospitals have been already recruited in just 15 days.

Thousands more are expected to join the trial in the coming weeks, making it the largest randomised controlled trial of potential COVID-19 treatments in the world.

Definitive results on whether the treatments are safe and effective are expected within months and, if positive, they could potentially benefit hundreds of thousands of people worldwide. 

REMAP-CAP

The REMAP-CAP trial is an international effort, with more than 50 research teams around the world – in around 13 countries – taking part. 

It is looking specifically at patients who develop community-acquired pneumonia (CAP) as a result of viral infections.   

The study will test 16 drugs, including  hydroxychloroquine, lopinavir/ritonavir and interferon beta, which have all shown promise in pre-clinical trials.

Between 2,000 and 4,000 patients will be enrolled.

Adaptive COVID-19 Treatment Trial  

The Adaptive trial is taking place in about 75 hospitals globally to assess the experimental Ebola drug remdesivir in patients with moderate to severe COVID-19.

University College London (UCL) is leading the UK part, called ACTT-EU/UK, which recruited its first patient this week. 

The trial will involve thousands of people across 15 NHS trusts in London, Liverpool, Sheffield, Glasgow and Plymouth and more.

Initially the trial aims to recruit 440 people who will be followed up by 29 days. Researchers hope to have the first results from the trial by the beginning of this summer.  

The a 35-year-old man in Washington state, close to Seattle – whose infection was announced on January 20 – recovered after being given the drug.  

A Californian woman who doctors ‘thought was going to pass away’ also recovered in the US after being given the drug.

Four American passengers on board the Diamond Princess cruise ship treated with the drug in Japan also recovered.  

Officials in Liguria – a coastal region of Italy – also announced an infected man in his 70s had recovered and could go home after 12 days in hospital.

How does it work? 

Remdesivir is an anti-viral drug that works in essentially the same way as favipiravir – by crippling the RNA polymerase enzyme, stopping a virus from reproducing.

Is it being tested in the UK?

The Adaptive COVID-19 Treatment Trial (ACTT-EU/UK) trial, which is taking place in about 75 hospitals globally, recruited its first UK patient this week.

The study, led by the MRC Clinical Trials Unit at University College London, will evaluate the safety and efficacy of remdesivir in patients with moderate to severe Covid-19. It will be administered via IV.

The trial will involve thousands of people across 15 NHS trusts in London, Liverpool, Sheffield, Glasgow and Plymouth and more.

Initially the trial aims to recruit 440 people who will be followed up by 29 days. Researchers hope to have the first results from the trial by the beginning of this summer. 

Critically, a clinical trial of this size will highlight the true efficacy of remdesivir and any potential side effects.   

The drug is also being trialled on coronavirus patients in China and at the University of Nebraska.

What are its side effects? 

Scientists are full of hope because the drug is proven to be safe in humans. Its side effects are still not well understood.

What do the experts think?

Professor Devi Sridhar, chair of global public health at the University of Edinburgh, hailed remdesivir as ‘one of the most promising antivirals’ being investigated.

While Dr Alfredo Garzino-Demo, of the University of Maryland School of Medicine, said evidence shows it has the ability to treat COVID-19 patients.

Ceftriaxone 

What are the brand versions of the drug? 

Rocephin.

What does it treat? 

The antibiotic treat many kinds of bacterial infections, including severe or life-threatening forms such as meningitis.  

Ceftriaxone is an antibiotic treat many kinds of bacterial infections, including severe or life-threatening forms such as meningitis

Ceftriaxone is an antibiotic treat many kinds of bacterial infections, including severe or life-threatening forms such as meningitis

It’s also used to prevent infection in people having certain types of surgery. 

Rocephin is injected into a muscle, or into a vein through an IV. 

Who makes it?

Roche Laboratories, the Swiss pharmaceutical giant.

What have studies shown? 

No studies have yet proven Ceftriaxone can treat the new coronavirus.

Is it being tested in the UK? 

It is currently being tested on humans as part of the REMAP-CAP trial, an international effort involving more than 50 research teams around the world.

The drug will be trialled on patients who develop pneumonia as a result of the virus, including those in UK hospitals. 

How does it work?  

It works by by interfering with bacteria trying to multiply and grow.

Ceftriaxone blocks the bacteria from making a cell wall, which eventually kills off the infection-causing bugs.   

What are its side effects? 

The drug may cause mild diarrhea, warmth or a hard lump where the injection was given, vaginal itching or discharge, rash, or poor liver function.  

Moxifloxacin is being studied as part of the REMAP-CAP trial looking into its effectiveness on coronavirus patients with pneumonia

Moxifloxacin is being studied as part of the REMAP-CAP trial looking into its effectiveness on coronavirus patients with pneumonia

Moxifloxacin 

What are the brand versions of the drug? 

Avelox.

What does it treat? 

The antibiotic is used to treat a number of bacterial infections, including pneumonia, conjunctivitis, tuberculosis, sinusitis and heart infections. 

It is taken orally, by injection into a vein, or as an eye drop. 

Who makes it?

The German firm Bayer AG, one of the largest pharmaceutical companies in the world.

What have studies shown? 

There have been no studies into its effect on coronavirus patients yet.

Is it being tested in the UK?  

Moxifloxacin is also part of the REMAP-CAP trial which spans across the globe, including the UK. It will be used on patients with pneumonia – which COVID-19’s can trigger in worst-case scenarios.

Moxifloxacin is on the World Health Organization’s List of Essential Medicines, the safest and most effective medicines needed in a health system. 

How does it work? 

It kills off bacteria by blocking their ability to duplicate. 

What are its side effects? 

Common side effects include diarrhea, dizziness, and headache.

In rare instances, it may cause spontaneous tendon ruptures, nerve damage, and skeletal muscle weakness.

Piperacillin-tazobactam is a combination medication containing the antibiotic piperacillin and the β-lactamase inhibitor tazobactam, a group of enzymes that combat antibiotic resistance

Piperacillin-tazobactam is a combination medication containing the antibiotic piperacillin and the β-lactamase inhibitor tazobactam, a group of enzymes that combat antibiotic resistance

Piperacillin-tazobactam 

What are the brand versions of the drug? 

Tazocin.

What does it treat? 

Piperacillin-tazobactam is a combination medication containing the antibiotic piperacillin and the β-lactamase inhibitor tazobactam, a group of enzymes that combat antibiotic resistance.

It is used to treat pelvic inflammatory disease, intra-abdominal infection, pneumonia, cellulitis, and sepsis. It is administered by injection into a vein.  

Who makes it?

The German firm Bayer AG, one of the largest pharmaceutical companies in the world.

What have studies shown? 

There have been no studies into its effect on coronavirus patients yet.

Is it being tested in the UK?  

Piperacillin-tazobactam is also on the WHO’s List of Essential Medicines, and so has been pulled into the REMAP-CAP trial on COVID-19 patients with pneumonia.

How does it work? 

The drug kills bacteria through blocking their ability to make a cell wall and duplicate.

What are its side effects? 

Common adverse effects include headache, trouble sleeping, rash, nausea, constipation, and diarrhoea. 

Macrolide 

What are the brand versions of the drug?  

Zithromax, Klacid, Erymax, Erythrocin, Erythroped and Erythroped A. 

Macrolide are a group of antibiotics used to treat pneumonia and respiratory infections. It is sold under the brand name Zithromax

Macrolide are a group of antibiotics used to treat pneumonia and respiratory infections. It is sold under the brand name Zithromax 

What does it treat?  

Macrolides are a group of antibiotics used to treat pneumonia and respiratory infections. 

Who makes it? 

Pfizer, best known as the creator of Viagra, makes the most common macrolide, Zithromax.

What have studies shown?  

It has been used since 1952 as a substitute to penicillin in cases where patients were allergic to penicillin or had penicillin-resistant illnesses. 

Macrolides have long been shown to be effective at treating pneumonia and the serious bouts of the flu.

Is it being tested in the UK?  

There are high hopes its effectiveness for treating COVID-19 will come to light in the REMAP-CAP trial. 

How does it work? 

They act by inhibiting bacterial protein synthesis, or stopping bugs from growing in the body. 

What are its side effects?  

The drugs have long been considered safe for the vast majority of people.

But a 2008 British Medical Journal article highlights that the combination of some macrolides and statins (used for lowering cholesterol) is not advisable and can lead mto Muscular disease. 

Some macrolides are also known to cause cholestasis, a condition where bile cannot flow from the liver to the intestine.

Cholestasis can lead to itchiness, jaundice and abnormally concentrated urine.

The antiviral medication is used to treat and prevent influenza A, the most common version of the flu, and influenza B

The antiviral medication is used to treat and prevent influenza A, the most common version of the flu, and influenza B

Oseltamivir 

What are the brand versions of the drug?   

Tamiflu. 

What does it treat?   

The antiviral medication is used to treat and prevent influenza A, the most common version of the flu, and influenza B. 

It is recommend it in people who have complications or are at high risk of complications within 48 hours of first symptoms of infection. 

Oseltamivir is taken by mouth, either as a pill or liquid.

Who makes it?  

Roche Laboratories, the Swiss pharmaceutical giant.

What have studies shown?   

A tiny study of four medics, aged 30 to 36, who contracted coronavirus suggested Oseltamivir suppressed the virus’ reproduction.

The study, published in the journal JAMA on February 27, followed four medical professionals ages 30 to 36 years old who developed COVID-19 in the outbreak’s epicentre in Wuhan, China.

All of the individuals recovered after being treated with Tamiflu.

Is it being tested in the UK?   

The drug is being trialled by British and international researchers as part of the REMAP-CAP study. 

How does it work?  

Tamflu works by attacking flu viruses to keep them from multiplying in the body.

What are its side effects?   

Common side effects include nausea, vomiting, diarrhea, dizziness, headache, nosebleeds, eye redness or discomfort and sleeping problems.

The flu itself or Tamiflu may rarely cause mood changes, which is more common in children. 

Amoxicillin-clavulanate 

What are the brand versions of the drug?   

Augmentin. It is taken as a tablet.

Amoxicillin-clavulanate is useful for the treatment of a number of bacterial infections

Amoxicillin-clavulanate is useful for the treatment of a number of bacterial infections

What does it treat?    

The penicillin antibiotic is useful for the treatment of a number of bacterial infections, including sinusitis, pneumonia, ear infections, bronchitis, urinary tract infections, and skin infections.

Clavulanate potassium is a beta-lactamase inhibitor that helps prevent certain bacteria from becoming resistant to amoxicillin. 

Who makes it?   

The British drug giant GlaxoSmithKlin, based in Brentford, London.

What have studies shown?    

No studies have investigated its effect on the coronavirus. 

Is it being trialled in the UK? 

It’s on the extensive list of drugs being tested in the the REMAP-CAP trial, involving between 2,000 and 4,000 patients in 13 countries, including the UK.

How does it work?   

It stops the growth of bacteria and is only used to treat bacterial infections. It is not thought to be effective for viral infections such as the common cold and flu.

What are the side effects?

The drug is considered generally safe for most people and has very little side effects.

In some circumstances, the drug can cause hives, general itching, itching of the vagina or genital area, pain during sexual intercourse, redness of the skin, vaginal discharge. 

But there have been reports of the antibiotic causing bloody or cloudy urine, fever, greatly decreased frequency of urination or amount of urine, seizures and swelling of the feet or lower legs.

The antibiotic is prescribed for complicated skin infections, including MRSA, and pneumonia

The antibiotic is prescribed for complicated skin infections, including MRSA, and pneumonia

Ceftaroline   

What are the brand versions of the drug?    

Teflaro in the US and Zinforo in Europe 

What does it treat?    

The antibiotic is prescribed for complicated skin infections, including MRSA, and pneumonia.

It is given via drip into a vein, usually in hospital. 

Who makes it?   

The New York City based drug giant, Pfizer.

What have studies shown?    

The antibiotic is being trialled on an international group of patients, including Britons, along with 15 other drugs as part of the REM-CAP trial.

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How does it work?   

The active substance in Zinforo, ceftaroline fosamil, is a type of antibiotic called cephalosporin belonging to the group ‘beta-lactams’.

It interferes with the production of complex molecules called peptidoglycans, which are essential components of bacterial cell walls. 

What are its side effects?    

The most common side effects with Zinforo – seen in more than 3 per cent of patients – are diarrhoea, headache, nausea, and itching.

 

Boris Johnson is ‘breathing unassisted’ and does NOT have pneumonia: Downing Street say PM is ‘stable’ and in ‘good spirits’ in intensive care as he battles coronavirus 

Boris Johnson is ‘breathing without assistance’ in intensive care and does not have pneumonia, Downing Street said categorically today.

Forced to issue a statement to quash rampant speculation, the PM’s spokesman said he was ‘stable overnight and remains in good spirits’, having received ‘standard oxygen treatment’.  

Mr Johnson has also not needed a mechanical ventilator despite mounting concerns over his health. 

The more positive news came after Michael Gove said the premier’s plight is ‘truly frightening’ and ministers are ‘praying’ for his swift recovery. Foreign Secretary Dominic Raab has been ‘deputised’ to take charge while he is out of action.

But there are growing concerns about the effectiveness of the government machine while the incumbent of No10 is unable to lead the crisis response, potentially for many weeks to come. Some survivors of the virus have warned it took them two months to recover fully.

Mr Johnson was moved to ICU at St Thomas’ Hospital in central London and given oxygen last night after his health deteriorated sharply over just two hours, leaving doctors fearing he will end up needing a ventilator. 

But the 55-year-old’s spokesman said today: ‘The Prime Minister has been stable overnight and remains in good spirits. 

‘He is receiving standard oxygen treatment and breathing without any other assistance. He has not required mechanical ventilation or non-invasive respiratory support.’ 

In a round of broadcast interviews this morning, Mr Gove played down concerns that the government will be paralysed with the leader out of action, insisting that Mr Johnson had already been on a ‘stripped back diary’ for days and ‘Cabinet is the supreme decision making body’, 

However, within hours it had emerged that Mr Gove himself had also been impacted by coronavirus, as he has gone into self-isolation following a family member displaying symptoms.  

New Prime Ministers usually write ‘letters of last resort’ to nuclear submarine captains, setting out instructions if government is wiped out by an enemy strike. But No10 said Mr Johnson’s existing letters will continue to apply, rather than Mr Raab writing new ones. 

MPs have raised alarm that hostile states such as Russia – which has already been accused of spreading disinformation about Mr Johnson’s condition – could try to exploit Britain’s ‘weakness’. 

General Sir Nick Carter, chief of the defence staff, said the armed forces ‘work straight through to the Prime Minister’, although he suggested the National Security Council (NSC) will now fill the gap.

Asked who will be in control of the nuclear deterrent and armed forces, the PM’s spokesman said: ‘In relation to national security matters the First Secretary of State and the Cabinet have the authority and the ability to respond in the Prime Minister’s absence.’ 

The Queen is being kept informed about Mr Johnson’s condition and has send a message of support to Mr Johnson’s pregnant partner Carrie Symond and the PM’s family.

But she will not grant audiences to Mr Raab while he is standing in for the premier. The monarch appoints the PM, choosing the individual who is best placed to carry a majority in the Commons.

Meanwhile, Donald Trump revealed he has offered to send Mr Johnson experimental drugs to treat his coronavirus. 

As the Prime Minister was treated in hospital:

  • A record high 854 coronavirus deaths have been announced in the UK today, taking the total to 6,227, and dashing faint hopes that the peak might have been reached; 
  • The Queen has sent a message to Ms Symonds and the Johnson family saying they were in her thoughts and that she wished the Prime Minister a ‘full and speedy recovery’; 
  • Aides to Mr Gove said he was following the official guidance by going into quarantine for 14 days, but was not himself feeling ill and would continue working;
  • No10 chief adviser Dominic Cummings is still working from home after self-isolating just after Mr Johnson;
  • The Queen has issued a message to NHS workers praising their ‘selfless coommitment and diligence’ as she marked World Health Day amid the coronavirus crisis;  
  • World leaders and politicians around the globe rallied around Mr Johnson, who received well wishers from David Cameron, Emmanuel Macron and Donald Trump;
  • Health experts have warned that the PM’s admission to intensive care means he is ‘extremely sick’ and he is ‘likely’ to end up needing a ventilator; 
Mr Raab raised concerns as he was seen coughing leaving the Foreign Office to go to Downing Street this morning

Mr Raab raised concerns as he was seen coughing leaving the Foreign Office to go to Downing Street this morning

Workers in personal protection gear were cleaning buildings in Westminster today amid fears it is a hotbed for coronavirus

Workers in personal protection gear were cleaning buildings in Westminster today amid fears it is a hotbed for coronavirus

Mr Gove revealed today that he has gone into self-isolation after a family member started showing coronavirus symptoms

Mr Gove revealed today that he has gone into self-isolation after a family member started showing coronavirus symptoms

Donald Trump offers experimental drugs as world rallies round virus-stricken Prime Minister 

Donald Trump joined world leaders throwing their support behind Boris Johnson as he wished him a speedy recovery

Donald Trump joined world leaders throwing their support behind Boris Johnson as he wished him a speedy recovery

Donald Trump has offered to send Boris Johnson experimental drugs to treat his coronavirus.  

The US president joined world leaders throwing their support behind the PM after he was moved in to intensive care.

Hundreds of messages of support have been sent to Mr Johnson by Conservative colleagues, opposition MPs and world leaders.

The President, speaking at a White House press briefing, said: ‘I want to send best wishes to a great friend of mine, and a great friend of our nation, Boris Johnson.

‘We are very saddened to hear that he was taken into intensive car this afternoon, a little while ago. Americans are all praying for him. He’s been a really good friend.

‘He’s very strong, resolute. Doesn’t quit, doesn’t give up.’

Mr Trump said: ‘I’ve asked two of the leading companies … They’ve come with the solutions and just have done incredible jobs – and I’ve asked him to contact London immediately. 

‘The London office has whatever they need. We’ll see if we can be of help. We’ve contacted all of Boris’s doctors, and we’ll see what is going to take place, but they are ready to go.’ 

French President Emmanuel Macron also wished Mr Johnson well, saying: ‘All my support for Boris Johnson, his family and the British people at this difficult time.

‘I wish him to overcome this ordeal quickly.’ 

The PM’s sharp downturn came 11 days after he first suffered coronavirus symptoms and went into isolation. He looked increasingly unwell when glimpsed in public and in ‘selfie’ videos posted on on social media, and ministers were then shocked by his grim appearance at a Zoom conference on Sunday.

Downing Street sources confirmed Mr Johnson is not yet on a ventilator – but was moved to intensive care to be near one if needed. Some medical experts forecasting this course of action is now ‘very likely’.

Two thirds of patients in intensive care with coronavirus are sedated and put on a ventilator within 24 hours of arriving as the illness attacks their lungs. 

Only two hours before his move to intensive care, No10 was insisting Mr Johnson was still spearheading the government’s coronavirus response, despite de facto deputy Mr Raab chairing the morning crisis meeting.

Yet shortly after the Foreign Secretary left the Number 10 podium following the daily 5pm press briefing, Mr Johnson, 55, suffered breathing problem. 

Sir Mark Sedwill, the cabinet secretary, held an emergency video conference with the cabinet to tell them the bad news, in a moment one minister described as ‘truly shocking’. 

No10 has been urged to be more ‘transparent’ about the premier’s condition, amid claims a hospital bed was being prepared for him as early as last Thursday. 

Mr Gove said today: ‘If there is any change in his condition we will ensure the country is updated.’  

Downing Street said Mr Raab is working from the Foreign Office but is being assisted by officials from ‘across Government’ as he co-ordinates the coronavirus response. 

The spokesman said Mr Raab and the Cabinet would be able to order military action without the consent of the Prime Minister.

As First Secretary of State, he would chair any meeting of the National Security Council.

Should Mr Raab be forced to self-isolate or take ill, Chancellor Rishi Sunak would be next in line to take over.

Former cabinet member and Tory peer Baroness Nicky Morgan described Mr Johnson’s condition as ‘worrying’, adding she understood it was ‘very much a skeleton staff now’ at Downing Street. 

Speaking to ITV News, former prime minister David Cameron said: ‘Well obviously it’s very worrying news and all of us are praying for Boris and thinking of him and praying and thinking of his family.

‘And hoping he gets well soon and gets back to Number 10, where I know he wants to be and where we all want him to be.

‘Boris is very tough, very resilient, very fit person, I know that from facing him on the tennis court and I’m sure he’ll come through this.

‘Of course he’s very resilient, he’s tough, also he’s got a tremendous zest for life, and getting things done, and for leading and for taking decisions.

‘I know he’ll want to get well and get back in charge again, and that’s what we all want for him. And we’re hoping and praying that that’s the case and that’s the case very soon.’

Mr Johnson was conscious last night and had not been intubated – the process of putting a tube in the windpipe to aid breathing. 

He required around four litres of oxygen rather than the 15 litres used by an average Covid-19 ICU patient, according to the Times. 

Speaking last night, Mr Raab vowed that ‘government business will continue’ and said there is a strong ‘team spirit’ rallying around the leader.  He also reassured that the premier was ‘receiving excellent care’ and thanked the NHS staff who were treating him and other patients across Britain. 

Mr Johnson’s handing of power to Mr Raab – the second most senior cabinet minister after the PM himself – came after days of insisting he remained in the driving seat of the UK’s fightback against the virus.

But on Sunday, the tenth day of isolation in his Number 11 flat, Mr Johnson’s declining health became clear to Cabinet colleagues during a 10am Zoom video conference call. 

During the 45-minute meeting with ministers including Michael Gove, Rishi Sunak and Matt Hancock, insiders described the PM as pale and strained, while some detected breathlessness as he spoke. 

A Number 10 spokeswoman said last night: ‘Since Sunday evening, the Prime Minister has been under the care of doctors at St Thomas’ Hospital, in London, after being admitted with persistent symptoms of coronavirus.

‘Over the course of this afternoon, the condition of the Prime Minister has worsened and, on the advice of his medical team, he has been moved to the Intensive Care Unit at the hospital.

‘The PM has asked Foreign Secretary Dominic Raab, who is the First Secretary of State, to deputise for him where necessary.

‘The PM is receiving excellent care, and thanks all NHS staff for their hard work and dedication.’

Downing Street has been accused of downplaying the seriousness of Mr Johnson’s illness.

When he was admitted to hospital on Sunday night, Number 10 made clear he was undergoing tests as a precaution on the advice of his doctor.

Cummings ‘is still working from home’ 

Dominic Cummings is yet to return to Downing Street after developing coronavirus symptoms and entering self-isolation more than a week ago.  

Boris Johnson‘s top aide has not been seen in public since before Monday March 30 when he put himself into isolation after getting symptoms over the weekend. 

Number 10 has been insistent that Mr Cummings is working remotely but his continued absence is likely to spark further scrutiny of the health of key government players, especially after Mr Johnson was hospitalised with the disease. 

There are growing concerns about the state of the Downing Street operation after numerous staff were laid low by the killer bug.

The PM’s other top adviser, Sir Eddie Lister, 70, has not been seen in public since the start of lockdown with his age putting him in an at-risk group. A number of other aides have also been off with symptoms. 

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The return of Mr Cummings would therefore act as a major boost to the government and dampen accusations of there being a political vacuum at the heart of Whitehall after Dominic Raab became de facto prime minister.  

Downing Street said that Mr Cummings is working but not from Number 10 and insisted Number 10 is ‘fully operational’. 

But a Tory source said: ‘No 10 tried to play this down but think it through: the Prime Minister was being taken to hospital in his car at 8pm on Sunday, the precise moment the Queen was making her broadcast to the nation. It therefore cannot have been completely routine.’

Insiders on the Sunday Zoom cabinet call also claimed it was clear Mr Johnson was not well.

A senior Whitehall source said: ‘His symptoms were persisting. He was plainly not getting any better. In fact he’d got worse.’  

Determined to emulate the grit of his political hero Winston Churchill, insiders said Mr Johnson was reluctant to go to hospital. 

A source said: ‘Do not underestimate the macho nature of the Westminster political Establishment. Boris will not have wanted to look weak.’  

However, he eventually gave ground to his doctor and travelled to St Thomas’ with bodyguards on Sunday night. 

It was the first time Mr Johnson was believed to have left Downing Street since Thursday, when he stood on the steps of Number 11 to applaud NHS workers at 8pm. 

This was the last time the PM has been seen in public and came amid whisperings in Westminster that he was not as well as aides were claiming. 

The next day, wearing an open collar shirt and looking exhausted, the PM used a Twitter video to reveal he had failed to shake off his high temperature and so would continue to self-isolate, while still keeping a firm hand on the tiller. 

Mr Raab is now primed to take charge of the government’s coronavirus response and deputise for Mr Johnson ‘where necessary’, although it is understood he will not be a temporary PM. 

At yesterday’s Downing Street press briefing, he confirmed a further 439 coronavirus deaths, taking the toll to 5,373, while the number of patients rose by 3,802 to 51,608.   

The army has been on patrol outside St Thomas' Hospital in central London, where Mr Johnson is being treated

The army has been on patrol outside St Thomas’ Hospital in central London, where Mr Johnson is being treated

In a round of broadcast interviews this morning, Cabinet minister Michael Gove said Mr Johnson was getting the 'best care'

In a round of broadcast interviews this morning, Cabinet minister Michael Gove said Mr Johnson was getting the ‘best care’

Fit for office? UK Prime Ministers who have fallen ill while at the helm 

On Monday evening Prime Minister Boris Johnson was taken into intensive care in London after his coronavirus symptoms worsened. 

But he’s not the only British Prime Minister to become incapacitated by illness while serving at the helm.

David Lloyd George: Lloyd George served as Prime Minister from 1916 to 1922.

In September 1918 he developed a sore throat after visiting Manchester’s Albert Square and mingling in crowds during a ceremony for soldiers and munitions workers.

It later became clear he had Spanish influenza. He spent 11 days inside and was hooked up to a ventilator.  

Harold Wilson: Wilson served as Prime Minister from 1964 to 1970 and from 1974 to 1976.

During his second term in office from 1974 to 1976 he suffered from colon cancer.

It was also suggested that he had suffered from Alzheimer’s after doctors analysed his speech patterns during his previous addresses. 

Winston Churchill: Churchill served as Prime Minister from 1940 to 1945 and again from 1951 to 1955.

His personal physician claimed he suffered from clinical depression throughout his time as Prime Minister.

In 1941 he suffered a heart attack at the White House and contracted pneumonia a few years later. 

In 1949 he also suffered a stroke on holiday and suffered a third while in office in 1953, leaving him paralysed on one side. 

In 1956 he suffered another stroke. 

Tony Blair: Blair served as Prime Minister from 1997 to 2007. 

In 2004 he was rushed to Hammersmith Hospital, where he was found to be suffering from supraventricular tachycardia, which is when a person suffers from an abnormal heart rhythm. 

In 2005 he received treatment for a heart flutter.

Gordon Brown: Brown served as Prime Minister from 2007 to 2010.

After a rugby accident as a teenager Mr Brown lost his sight in one eye.

In 2009 he told the Andrew Marr show that this had made it difficult for him over the years.

He said: ‘I feel that I have done everything to show people that I can do the job even with the handicap that I’ve had as a result of a rugby injury.’ 

Theresa May: May served as Prime Minster from 2016-2019.

In 2012 she visited the doctor because she thought she had bronchitis but was actually diagnosed as having Type 1 Diabetes. 

Health experts tonight appeared unanimous in their view that the PM’s admission to intensive care means he is ‘extremely sick’. 

But the four litres of oxygen which the Times reports were given to Mr Johnson is below the 15-litre threshold for typical intensive care patients, suggesting he is not as ill as most in ICUs. 

World leaders and politicians around the globe rallied around Mr Johnson, who received well wishers from David Cameron, Emmanuel Macron and Donald Trump.   

Japan’s Prime Minister Shinzo Abe has sent a tweet saying his thoughts and prayers are with Mr Johnson this morning.

He said: ‘To my dear friend @BorisJohnson , my thoughts and prayers are with you and your family, as you fight for a swift recovery. The people of Japan stand with the British people at this difficult time.’

The Queen has also been kept informed by Downing Street about Mr Johnson’s condition, Buckingham Palace said. 

Mr Raab last night vowed to keep the machines of government firing on all cylinders while the PM recovered.

The one-time Tory leadership contender said: ‘The Prime Minister is in safe hands with that brilliant team at St Thomas’ hospital, and the focus of the Government will continue to be on making sure that the Prime Minister’s direction, all the plans for making sure that we can defeat coronavirus and can pull the country through this challenge, will be taken forward.’

He added: ‘There’s an incredibly strong team spirit behind the Prime Minister, and making sure that we get all of the plans the Prime Minister’s instructed us to deliver, to get them implemented as soon as possible.

‘And that’s the way it will bring the whole country through the coronavirus challenge that we face right now.’

Senior doctors branded the PM’s admission to intensive care a ‘huge concern’ and underscores how indiscriminate the virus is.

Dr Simon Clarke, a professor on cellular microbiology at Reading University, told Sky News: ‘The NHS particularly in this moment doesn’t give up intensive care beds just for people to be looked over. It doesn’t work that way even for PMs.

‘He wouldn’t be in intensive care unless he needed to be in intensive care. Especially not at this time.’

He added: ‘It is probably about time that the press people in No10 started levelling with us about what his condition really is.’ 

Downing Street sources confirmed Mr Johnson is not yet on a ventilator, although medical experts forecast this course of action is ‘very likely’. 

Prof Derek Hill, Professor of Medical Imaging, University College London, said: ‘As often happens with COVID-19, his condition has now deteriorated so he has been admitted to intensive care where he is very likely to have been put on a mechanical ventilator to breath for him.’

He added: ‘One of the features of COVID-19 in all countries seems to be that many more men become seriously ill than women – especially in the over 40 age group. 

‘Also we know that people under about 60 seem to have a higher chance of making a recovery from critical illness with COVID-19 than older people. But there is no doubt this turn of events means Boris Johnson is extremely sick.’  

Politicians of all stripes rallied around Mr Johnson, including from ex-prime minister David Cameron and French President Emmanuel Macron

Now Michael Gove goes into self-isolation  

Michael Gove has gone into self-isolation after a family member showed symptoms of coronavirus, it was revealed today.

The Cabinet Office minister said he was following the official guidance by going into quarantine for 14 days, but was not himself feeling ill.

Posting on Twitter, Mr Gove said: ‘In accordance with the guidance, I am isolating at home after a member of my family started to display mild symptoms of coronavirus on Sunday. 

‘I have not displayed any symptoms and am continuing to work as normal.’

Despite the reassurance, the news will heighten concerns about paralysis at the heart of government. 

Mr Johnson’s pregnant fiancée Carrie Symonds, who is due in the early summer, is self-isolating in her own Camberwell apartment with the couple’s dog Dilyn after symptoms surfaced. 

The 32-year-old said on Saturday: ‘I’ve spent the past week in bed with the main symptoms of Coronavirus. I haven’t needed to be tested and, after seven days of rest, I feel stronger and I’m on the mend.’ 

Politicians of all stripes rallied around Mr Johnson, including from ex-prime minister David Cameron and French President Emmanuel Macron.

Scotland First Minister Nicola Sturgeon tweeted: ‘My thoughts are with the PM and his family – sending him every good wish.’

Business minister Nadim Zahawi tweeted: ‘Thoughts & prayers for Boris Johnson & Carrie Symonds and their family. 

‘I have known Boris for 20 years he is a fighter and will beat this virus.’

Politicians of all stripes rallied around Mr Johnson, including from ex-prime minister David Cameron and French President Emmanuel Macron

Chancellor Rishi Sunak tweeted: ‘My thoughts tonight are with Boris Johnson and Carrie Symonds. I know he’ll be getting the best care possible and will come out of this even stronger.’

Members of the newly-formed shadow cabinet offered their support for the PM.

Shadow justice secretary David Lammy tweeted: ‘Awful news. My very best wishes to the Prime Minister, as well as his partner Carrie, family and friends. Get well soon Boris Johnson.’ 

Coronavirus survivors warn PM that recovery can take months 

Survivors of coronavirus who spent time on intensive care wards have shared their experience of fighting the disease as Boris Johnson battles the killer infection in hospital.

Matt Dockray, 39, described the illness as ‘the most horrible experience you will go through’ – and warned that recovery is likely to take six-eight weeks. 

Appearing on ITV’s Good Morning Britain, the father-of-one said: ‘It’s a horrible, horrible experience. You’re very lonely. You don’t have any friends or family there so you don’t have that emotional, personal support you rely on in your hardest times.’ 

But he warned that recovery can take six to eight weeks. ‘There’s people who have been on those ventilators for a lot longer and they’ve come out and lived to tell the tale.There’s quite a few of us getting clapped out of the hospital that prove you can get back to normal,’ he said.

‘There’s still a long road of recovery, it takes about six to eight weeks, but you can sit here and tell the tale and fight this.’

Mr Johnson fell ill with the virus on the same day as Health Secretary Matt Hancock, who has since recovered.

Alarm bells started ringing that the nerve centre of the government’s crisis response had been compromised when chief medical officer Professor Chris Whitty and top Downing Street adviser Dominic Cummings also began showing symptoms. Meetings have since taken place via videolink.  

Survivors of coronavirus who spent time on intensive care wards have shared their experience of fighting the disease as Boris Johnson battles the killer infection in hospital.

Matt Dockray, 39, described the illness as ‘the most horrible experience you will go through,’ when he appeared on ITV’s Good Morning Britain.

The father-of-one said: ‘It’s a horrible, horrible experience. You’re very lonely. You don’t have any friends or family there so you don’t have that emotional, personal support you rely on in your hardest times.’ 

But he warned that recovery can take six to eight weeks. ‘There’s people who have been on those ventilators for a lot longer and they’ve come out and lived to tell the tale. There’s quite a few of us getting clapped out of the hospital that prove you can get back to normal,’ he said.

‘There’s still a long road of recovery, it takes about six to eight weeks, but you can sit here and tell the tale and fight this.’



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