As the race to finding a cure for COVID-19 intensifies, online search trends can shed light on what is catching the public eye and help in debunking misinformation that could lead to self-medication.

By Anuja Venkatachalam

Looking at the most googled treatments for COVID-19, we highlight the difference between Chloroquine which is not approved in India, and its derivative Hydroxychloroquine which is approved for critical cases; and the lack of any clinical evidence for Ivermectin – an anti-parasitic drug that has got the public’s attention.

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While there is no medication for preventing and curing coronavirus, there is definitely public interest in drugs that have been approved for critical cases and treatments that are under research and development.

An analysis of Google Trends data globally over a period of one month from 4 April to 4 May shows that Vaccine is the most searched treatment for COVID-19, followed by Favipiravir and Chloroquine.

Plasma Therapy and Hydroxychloroquine have garnered the most interest in India, and Ivermectin saw a spike in interest on 4 April, after a laboratory assessment indicated its effectiveness in inhibiting coronavirus.

We bring you the latest on the most searched treatments online.

Vaccine for COVID-19

The road to developing a vaccine is uncertain and long. It involves six stages from research and development to supply which typically takes 12-18 months.

On 16 April 2020, the World Health Organization (WHO) announced a Research and Development (R&D) Blueprint to co-ordinate and expedite the development of a vaccination for coronavirus. 132 governments and organizations across the world are official signatories of the blueprint engaged in vaccine development.

Six vaccines are currently in the third stage – i.e., the clinical-stage wherein the vaccine is tested on humans, starting from small groups to groups with specific characteristics, and finally to larger groups of people.

Favipiravir

Favipiravir is an antiviral drug used to treat influenzas A, B, and C. It became the first drug to be approved by the Chinese government for treating COVID-19. The Chinese Clinical Trial Registry shows seven ongoing trials studying the efficacy of Favipiravir for treating COVID-19, some looking at specific groups of patients, and others comparing Favipiravir to other anti-viral drugs.

Similar trials are being conducted in the US, UK, Italy, and India. In India, Glenmark Pharmaceuticals, a Mumbai-based company has received approval from the Drug Controller General of India (DCGI) to conduct trials testing the efficacy of the drug for the treatment of COVID-19.

Chloroquine & Hydroxychloroquine

Chloroquine & Hydroxychloroquine unfortunately became catchwords after their promotion as a one-size-fits-all solution for COVID-19 by political leaders. Data shows a huge spike in the reported prescriptions of these drugs after US President Donald Trump’s espousal of the drugs as having a definitive impact on COVID-19 patients. Brazilian President Jair Bolsonar made similar claims in a video that was taken down by Facebook on grounds of misinformation.

Chloroquine and Hydroxychloroquine are distinctive drugs used for treating certain types of malaria. Chloroquine is also used to treat amebiasis, whereas Hydroxychloroquine, a derivative of chloroquine is used to treat lupus and rheumatoid arthritis.

There are at present,106 research articles on the use of these drugs for treating COVID-19 patients; however, there is no conclusive evidence as yet.

The US Food & Drug Administration (FDA) has approved the use of chloroquine and hydroxychloroquine for treating COVID-19 patients under stringent guidelines. On 24 April, the FDA issued a safety concern addressing the liberal prescription of these drugs for outpatients and cautioned medical practitioners of the serious heart rhythm problems that were reported in COVID-19 patients being treated with these drugs in combination with other medications.

In India, the Indian Council for Medical Research (ICMR) has approved the use of Hydroxychloroquine (and not Chloroquine) for asymptomatic healthcare workers working on suspected or confirmed COVID-19 cases and asymptomatic household contacts of laboratory-confirmed COVID-19 patients under stringent guidelines.

Due to insufficient backing from rigorous randomized controlled trials, the potential effects of these drugs on patients with varying conditions is unknown. They must, therefore, only be administered by a certified medical professional under the guidelines issued by health authorities.

Plasma Therapy

Plasma is the fluid in a blood vessel that transports blood cells and platelets throughout the body. It also contains antibodies, and has therefore been used to treat illnesses through a procedure called “Convalescent Plasma Therapy”.

In the context of COVID-19, plasma from a recovered COVID-19 patient is used to boost the immunity of a critically ill patient, as a recovered patient showing no further symptoms for a period of time after treatment is expected to have built the antibodies to fight the virus.

Plasma Therapy is one of the several interventions under trial for COVID-19. On 12 April, ICMR invited hospitals to participate in randomized controlled trials to assess the safety and efficacy of Convalescent Plasma Therapy in treating COVID-19. Selected hospitals from India have received approval from ICMR and DCGI to participate in the trial.

Plasma Therapy is therefore not an approved treatment for COVID-19 and is currently only being used in experimental conditions for the purpose of the trial.

Famotidine

Famotidine is an antacid that is under trial in the US after anecdotal reports from doctors in China indicated that COVID-19 positive patients who routinely took the antacid were at lower risk of progressing to more critical stages of the virus.

Famotidine has not been approved for testing in India as of 5 May 2020. However, a recent news report suggests that the government is taking stock of the production and availability of the drug after reports of shortages in the US, following its inclusion in the list of potential treatments for COVID-19.

Remdesivir

Remdesivir is an anti-viral drug that has been approved by the US FDA for the treatment of critically ill COVID-19 patients. The drug is reported to have expedited recovery in an unpublished clinical trial led by the US with more than 1,000 participants. An earlier trial in China with 237 participants reported the reduction in recovery days was not statistically significant. However, the US-led trial with larger sample size and participants across three continents also showed a 3.6% lower mortality rate in the treatment group as compared to the placebo group.

The drug is set to be tested for efficacy in India as part of the World Health Organization’s “Solidarity” clinical trial for COVID-19 treatments.

Ivermectin

An anti-parasitic drug called, “Ivermectin” received mainstream coverage after a study published in Science Direct found that in laboratory settings, Ivermectin showed the ability to inhibit the coronavirus.

The medication has not been tested on COVID-19 patients, and there are therefore no case reports or clinical trials to back the efficacy of the drug.

On 10 April, the US FDA had to issue a public safety notification cautioning against potential cases of self-medication with Ivermectin used for animals, after it was touted as a cure for COVID-19 by some news outlets.