welcome to another MedCram co19 update this is for Monday the 9th of March gear
in Orange mainland China's cases are leveling off the total recovered is
increasing mainly because of the numbers generated from mainland China but at
other locations we're starting to see things pick up as well if we look at the
country specific statistics we can see of course China at the top but
interestingly if we look at South Korea and Italy these are two very comparable
countries here in terms of total cases and if you look at their populations
total cases per 1 million they're also similar 145 versus 122 we know however
that South Korea has done aggressive testing close to 200,000 people have
been tested in that country
and so I believe what you're seeing here with close to 200,000 people being
tested this number is probably pretty close to people who are actually
infected in that country whereas in Italy this may represent more of a tip
of the iceberg and as a result of that we can see that potentially explained
here is the total deaths if the virus is having the same effect in both countries
and at the healthcare delivery systems in both countries are similar you would
expect the total deaths here to be similar and serious and critical that's
another category where there is a serious difference the big news in Italy
is that they are taking what they call exceptional measures to contain about 16
million Italians living in 14 provinces in the north of the country as well as
restrictive measures covering the whole of the country you can see here in those
areas we have travel being restricted gatherings all schools and universities
are closed all museums and places of Culture will be closed all religious
festival and events are suspended you can see cinemas pubs theaters etc etc
any places where people congregates are being severely restricted or closed in
the United States with more testing we're going to see an explosion here I
believe of people that are gonna be positive and you can see all of those
here listed at world ometer okay we've received a lot of questions about Cova
19 treatment possibilities that may be on the horizon medications like REM des
aver that we discussed in our video update 11 that have shown promising
results in a test tube and are in clinical trials with humans as we speak
here's a paper that was published on February 24th that gives more
information about how REM de severe actually works we will put a link in the
description below this medication had gone through phase 1 trials already had
gone through phase 2 trials where the looked at safety again except in a
larger population but when they did the phase three trials on Ebola it did not
work so even though you can get something that works in vitro it doesn't
always mean it's gonna work in vivo you have to go through those phase three
trials before the FDA will give it a label well the unfortunate thing about
this medication is it passed phase one and phase two so we know it's a
medication that's relatively safe and it's sitting on the shelf looking for a
job to do and now enter this kovat nineteen situation here at the beginning
of 2020 and now it's being put to work directly into a phase three trial so the
nice thing here is that it didn't have to go through phase one and two because
it already did that so before we continue to talk about REM de severe we
need to follow up on what is traded in our last video update 32 about how the
Czar's cove two virus that causes cove in nineteen actually hijacks or cells
and how something called RNA dependent RNA polymerase or r d RP for short is
essential for the replication of RNA viruses please go back and watch this
video so you have context so let's zoom in and look closely at the function of
our d RP because that's going to tell you why REM the severe may or may not
work so here's our RNA dependent RNA polymerase and here's our viral RNA and
you can see the nucleotides here a u g c g c-- you what RNA dependent RNA
polymerase is whenever they see an a on the first strand it will create a strand
that has a you whenever they see a u it will put in an a whenever they see a g
it will put in a c wherever it sees a see it will put in a g and so forth and
so forth and the way that this works is it always creates RNA from the five
prime end to the three prime end which means that it's reading the templates
RNA from the three prime end to the five prime end so here it's coming up to the
next nucleotide and there's these things floating around and they have three
phosphates on them all of them have three phosphates and so the way that
this is abbreviated as there floating around in the cytosol for
instance if this is an a this would be known as a adenosine tri phosphate or
ATP this one here would be known as UTP and what happens is as these nucleotides
which are just floating around in solution there's a spot that opens up
and because this is AG one of them that has a C on it and three phosphates will
nicely bind in here and it will form C and it will continue to go on I'm just
going to erase some of this here so that we can see it a little bit more clearly
the thing that's really interesting about this is when it comes to the time
when there is a you that opens up ATP should normally go in there REM de
severe as will abbreviate our DV with a three phosphate on the end of it
actually binds into this you state better than the a and so it will go in
there instead and here's the nice thing about our DV in the situation as soon as
our DV binds as this RNA molecule is being copied about three or four
nucleotides down the line it causes the RNA dependent RNA polymerase to stop it
arrests RNA dependent RNA polymerase and if you scroll down to the bottom you can
see that REM des aver triphosphate is very similar to adenosine triphosphate
look at the structure it's going to fit very well inside of that spot as the RNA
dependent RNA polymerase is going by but if you have a concentration of our DV T
P in the cytosol it will suck one of those in and arrest elongation if you
arrest all elongation of the RNA you can't make viruses and you stop the
infection in its tracks so you can see why this medication has a lot of promise
but again we have to do the randomized placebo-controlled trials and those are
underway as we speak I want to give a quick shout-out to everyone here at Meg
cram who is behind each and every one of these videos it takes a team to make it
happen includes Haley Alicia our video editor
David and our producer and co-founder Carl Allred you can help support us by
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we'll be back tomorrow for another update thanks for joining us