The Victorian Premier Daniel Andrews has cautiously welcomed a “promising” drop in the number of coronavirus cases, but it comes as authorities say the virus-stricken state could still see many more deaths in the week ahead.
Deputy chief medical officer Professor Michael Kidd has also noted the fall in case numbers but with an added warning to Australians to prepare for a grim future.
Victoria recorded 322 new coronavirus cases in the 24 hours to Monday and 19 people died from the virus – the state’s worst daily death toll since the pandemic began. Fourteen of the deaths were linked to aged care facilities.
Sunday was the state‘s second worst day for deaths with 17 more fatalities and 394 new cases.
Australia’s coronavirus death toll has surged from 200 to more than 300 in just nine days.
While calling the drop in cases in Victoria “promising”, Prof Kidd said deaths usually follow around seven to 10 days after someone is first diagnosed with the virus.
“We are seeing the first promising signs of a reduction in daily numbers of cases, but it is too early to be certain,” Prof Kidd said, claiming officials will be “following the numbers very closely” over the coming week.
“We are now at the end of the first week of these stage four restrictions in Victoria.
“And so what we hope we will see over the coming week is the number of new infections each day will continue to decline hopefully.
“There is a 7- 10 day lag between the daily reports in numbers of cases and people dying, some people sadly die very early in the course of COVID-19, but for many people it is a week or more after they have been infected that we see people who are gravely unwell.”
He said despite the good news so far Australia’s death toll was certain to rise.
“While it’s heartening to see the declining number of cases being reported each day from Victoria – and we have seen that over the past five days – while we still have hundreds of cases being reported each day, we will continue to have people admitted to hospital and people becoming gravely unwell. And sadly some of those people will die.
It came as new ads were aired across Victoria in a bid to get residents to comply with the stage four lockdown.
The ads tell the confronting stories of people who caught the virus, including middle-aged woman June who thought she would die.
US President Donald Trump says he has started taking an anti-malaria drug that researchers say should not be used to combat coronavirus and has the potential to cause serious side effects.
Studies from the US, France and China have concluded that hydroxychloroquine is not effective for treating COVID-19, and in April the US Food and Drug Administration warned its use could cause heart problems.
Despite that, Mr Trump has called the drug a “game changer” in the fight against COVID-19, and now says he has been taking it for more than a week.
In Australia, hydroxychloroquine has been spruiked by Clive Palmer, who took out back-to-back full-page newspaper advertisements to claim his foundation had bought 32,900,000 doses of it.
Here’s what we know about hydroxychloroquine
What is hydroxychloroquine?
It is usually in tablet form and regulates the activity of the immune system.
It has mostly been prescribed to treat malaria, lupus and rheumatoid arthritis.
Hydroxychloroquine has also been used for years to dampen the immune system in people with autoimmune conditions.
In clinical trials, hydroxychloroquine has been shown to stop coronavirus from entering cells.
But that doesn’t mean it would work outside lab conditions as a treatment.
“One of the key things is that a lot of these drugs we find are going to be effective against the virus just in cells, [and] probably won’t be that effective in the disease setting,” Dr Larisa Labzin, an immunologist at the University of Queensland, said.
“Really what we’re looking for is not just that these drugs inhibit the virus replicating in people, but also that the people who get sick with the virus actually do better.”
Because hydroxychloroquine is already used in treatments for other conditions it can be fast-tracked in development to go straight to large human trials, unlike other drugs that would need to go through more tests first.
In March, there was a surged in demand for hydroxychloroquine, driven by claims about its potential as a coronavirus treatment.
That led to pharmacists being told to stop dispensing it so there would be enough supply for those who needed it as part of treatment for rheumatoid arthritis and malaria.
Does it work for coronavirus?
Several prominent doctors say they are worried that people could decide to take hydroxychloroquine because of Mr Trump’s actions.
“There is no evidence that hydroxychloroquine is effective for the treatment or the prevention of COVID-19,” said Dr Patrice Harris, president of the American Medical Association.
“The results to date are not promising.”
International research efforts have not yet found any benefits of taking the drug for those with coronavirus.
A study from France concluded the drug did not significantly reduce admission to intensive care or deaths among patients with severe cases.
A randomised clinical trial from China showed no improvement for patients with mild or moderate symptoms who were prescribed hydroxychloroquine.
The drug made no difference in rates of clearing the virus and did not reduce the duration of symptoms, but did cause side effects.
Two earlier large observational studies, each involving around 1,400 patients in New York, found no benefit from hydroxychloroquine.
Going even further, two studies published last week in the leading medical journal BMJ concluded that hydroxychloroquine should not be used in the treatment of coronavirus.
What are the possible side effects?
The USFDA has released emergency-use guidelines for hydroxychloroquine outlining warnings for its potential side effects.
Dangerously rapid heart rate
Abnormal heart rhythms
Problems with the heart muscle properly recharging between beats
Issues with the heart’s ability to pump blood around the body
Rupturing of red blood cells
Low counts for platelets and red and white blood cells
Increased risk of seizures
What is the Australian connection?
The Australian Defence Force is testing Chloroquine, from which hydroxychloroquine is derived, on its personnel as a potential preventative measure against COVID-19.
So far, 42 personnel have enrolled and started the 14-week trial, and Defence is seeking up to 700 civilian and ADF frontline healthcare workers to volunteer.
Associate Professor Jane Quinn, a pharmacology researcher at Charles Sturt University’s School of Veterinary Sciences, said she did not think there was currently enough international evidence of efficacy to justify the ADF trial.
“Chloroquine is a drug that’s been used for a very long time in the prevention and treatment for malaria and over time it’s become increasingly out of favour particularly for having quite a significant side-effect profile,” she said.
“That’s what makes it a little bit surprising that Chloroquine, particularly, is being suggested for use in this ADF trial.”
Which other drugs are being looked at?
The experimental antiviral drug remdesivir, which belongs to a group used to treat HIV and hepatitis C, has shown some promise in the lab for treating SARS, MERS and coronavirus.
Mr Trump has said he wants the USFDA to approve the drug “as quickly as they can”.
But early studies of its use have been criticised for lacking proper control measures, and two trials in China were suspended.
Scientists are now waiting for the results of large randomised controlled trials in the US and Europe.
The US National Institute of Allergy and Infectious Diseases (NIAID) has been giving the drug to some patients hospitalised with COVID-19 and lung complications.
Preliminary results released in late April showed patients recovered 31 per cent faster with remdesivir than with a placebo.
However, with conflicting data coming from a range of experiments, experts have urged caution.
Remdesivir, which failed as a treatment for Ebola, is designed to disable the mechanism by which certain viruses, including coronavirus, make copies of themselves and potentially overwhelm their hosts’ immune system.