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</v:shape><![endif]--><![if !vml]><img width=673 height=664 src="cid:image001.jpg@01D67165.432852C0" align=left hspace=12 v:shapes="Picture_x0020_2"><![endif]><b><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Explained: What is RLF-100 or Aviptadil, the 1970 drug being explored for Covid-19 treatment<o:p></o:p></span></b></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Preliminary studies have shown that the drug RLF-100 protects alveolar type II cells that are responsible for oxygen exchange in lungs.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>An old drug formulation — RLF-100 — is being probed to treat Covid-19 patients after initial studies have shown that the drug is able to halt SARS-CoV-2 virus replication in lungs. In Mumbai, doctors have begun prescribing this drug although it is not available in India.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>What does RLF-100 do?<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>RLF-100, also called Aviptadil, is a formulation of synthetic human Vasoactive Intestinal Polypeptide (VIP). VIP is released throughout the body, but remains mostly concentrated in lungs. It is produced by immune cells and nerve endings and acts as a neurotransmitter. It helps improve muscle activity and blood flow in gastrointestinal tract.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>But it also plays another important function. Studies have shown VIP has anti-inflammatory and anti-cytokine activity properties. Preliminary studies have shown this protects alveolar type II cells that are responsible for oxygen exchange in lungs. Since coronavirus attacks lungs and the alveolar cells, the drug may be helpful in preventing SARS-CoV-2 onslaught in alveolar cell and limit damage in lung.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Houston Methodist Hospital was first to report recovery in a 54-year-old man who developed Covid-19 and became critical. The man had undergone a double lung transplant and later contracted Covid-19 infection. Doctors administered RLF-100 under emergency use and the patient could be weaned off ventilator in four days. “He received three infusions of RLF-100 under an FDA-approved emergency use IND (Investigational New Drug). Within 24 hours of the third infusion, substantial improvement in oxygen saturation and radiographic improvement in characteristic COVID-19 pneumonitis was noted. He was discharged from intensive care at that point and returned home at 1 week on room air,” a multi-author article by doctors stated. This article is however not yet peer reviewed.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>The clinical trial<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>RLF-100 has been granted “Orphan Drug Designation” by the US Food and Drug Administration (FDA) for Acute Respiratory Distress Syndrome and chronic lung diseases, drug maker NeuroRx said. On June 8, NeuroRx and Relief Therapeutics announced a phase 2/3 clinical trial to treat critical Covid-19 patients. The trial will have 144 participants. The drug will be targeted on those requiring high flow nasal oxygen, and those on non-invasive or invasive ventilator support. Doses for three successive days will be given to patients.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>In a press statement earlier this month, CEO of NeuroRx Prof Jonathan Javitt said, “We are conducting placebo-controlled trials to see whether the observations made in the case-control and open-label studies will be confirmed for less ill patients with COVID-19-related respiratory failure. Our independent Data Monitoring Committee will be conducting an interim analysis of these data later this month.”<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>RLF-100 is not a new finding. It was discovered in 1970 by Dr Sami Said, a pulmonary medicine specialist. In 2001, US FDA gave RLF-100 an orphan drug designation to treat acute respiratory distress syndrome, and in 2006 for acute lung injury. US FDA also granted investigational new drug (IND) licenses for human trials of Aviptadil. But it has not shown significant progress in those trials in treating lung diseases.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>There are still no well-designed clinical trials that have found optimistic findings for RLF-100 and research into its use to treat Covid-19 is in nascent stages. The manufacturer claims rapid clearance of pneumonia and improvement in oxygen levels in patients this drug was used on emergency basis.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>In Mumbai, Breach Candy Hospital has prescribed this drug to a critically ill patient. The drug is currently not available in India. Kin of patient are trying to procure it from USA, treating doctors said.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Dr Rahul Pandit, intensivist in Fortis hospital, however warned. “There is very little known. For us to prescribe a drug, we need to wait for scientific evidence,” he said.<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><b><span style='font-family:"Verdana",sans-serif;background:white'>Zimbabwe COVID19 Update</span></b><b><span style='font-family:"Verdana",sans-serif'><o:p></o:p></span></b></p><p class=MsoNormal><b><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-family:"Verdana",sans-serif'>Frontline Health Workers follow WHO IPC guidelines as they provide care for Covid-19 patients </span></b><span style='font-family:"Verdana",sans-serif'><o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>The first day Princess Zengeya and Vongai Mafunga, where seconded as COVID-19 front liner care givers, they were extremely frightened about their safety, recalls Nomazulu Dlodlo, nurse in charge at Thorngrove Hospital in Bulawayo.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><img width=680 height=380 id="Picture_x0020_3" src="cid:image002.jpg@01D672D8.062CF3C0" alt="Frontline Health Workers follow WHO IPC guidelines as they provide care for Covid-19 patients"></span><span style='font-family:"Verdana",sans-serif'><o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>With the increased infection rate of COVID-19 frontline workers in Bulawayo, Princess and Vongai were not sure if they could conduct their duties without exposing themselves to the virus.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>A week into their duties as primary care givers of COVID-19 positive patients in isolation with moderate symptoms such as dry coughs, Princess and Vongai received a three-day comprehensive training for front line workers.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'> <o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>The exercise focused on issues such as use of Personal Protective Equipment (PPE); management of waste produced during the care of patients; hand and respiratory hygiene. Including contact and droplet precautions as stipulated by WHO’s Infectious Prevention Control (IPC) guidelines for health care workers when providing care for COVID-19 patients.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Although Princess and Vongai were scared at first, receiving training was extremely empowering to them. It provided them with a practical lesson on donning and doffing amongst many things. Describing her initial experience as a COVID-l9 frontline worker, Princess says she was extremely anxious.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>“I won’t lie l was extremely nervous. l was just seconded here without any knowledge or training on caring for COVID-19 patients,” says Princess.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Because of the training, she learnt that donning is the process of putting on PPE while doffing is the procedure of removing it. Learning about the best IPC measures for Princess was extremely important.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'> <o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>“Now I know how to handle a patient with COVID-19 and how to protect myself. I am also aware of WHO donning and doffing guidelines which l follow everyday as l look after the COVID-19 patients,” explains Princess.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>The two COVID-19 frontline workers say they both learnt of the proper use of appropriate PPE such as medical mask, eye protection (googles) or facial protection (face shield) to avoid contamination, clean, nonsterile, long-sleeved gown, and medical gloves. The frontline workers were also educated on the hand hygiene they should follow before putting on and after removing PPE.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Princess further narrates the kind of care she provides to the patients in the isolation room.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>“The patients’ l look after are brave and inspire me. They communicate well, and tell me how they feel. l regularly check-up on them after a few hours. I am always there when they need me and just offer them with emotional support as well. I assist some of them with bathing, feed them as well as clean their rooms,” Princess reveals.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Despite the growing myth and stigma within their community of health care workers spreading COVID-19 in Bulawayo, Vongai has remained resolute.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>“People run away from us all the time even public transport drivers leave us behind because of fear of being infected,” notes Vongai.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'> <o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Princess and Vongai started working at Margret Hospital at the same time. They both had similar fears on what to do when providing care to COVID-19 patients. By the time of writing, Thorngrove Hospital had admitted 23 COVID-19 patients.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Princess and Vongai are currently looking after one patient and are practicing what they have learned.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>“Doffing is a critical part because that is when l am contaminated. Therefore, following the right IPC measures as recommended by WHO is extremely important in protecting myself and those around me,” says Vongai.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Thus, the exercise taught Princess and Vongai how the correct use of PPE reduces exposure to COVID-19.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>The training also taught Vongai of the critical elements- which an isolation room or ward should have. As well as the symptoms to look out for when caring for patients with moderate symptoms. Moreover, the exercise showed her what to do if their conditions become critical.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>“For instance, l learnt that l should always observe patients all the time and check if they can breathe normally,” adds Vongai.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>The Ministry of Health and Child Care (MoHCC) facilitated the training at Montgomery Gardens with all new front liners care givers at Thorngrove Hospital. The material used during the training was steered by WHO IPC guidelines. Thanks to the generous funding from Department for International Development (DFID). WHO has been able to offer technical support to MoHCC in translating national guidance on IPC into practices by frontline health workers through training, mentoring and supportive supervision.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Thorngrove Hospital was one of the health facilities WHO visited during their two weeks support visit to the City of Bulawayo’s COVID-19 response. WHO also visited Ekusileni Medical Centre and Mpilo Hospital.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'> <o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>WHO’s visit was necessitated by the drastic increase in COVID-19 cases in Bulawayo. Bulawayo has the second highest number of Covid-19 positive cases standing at 1161 as of August 14 2020.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Throughout the visit, WHO took time to identify areas they will support to strengthen Bulawayo’s COVID-19 response efforts further. Moreover, WHO continues to work very closely with technical partners supporting the COVID-19 response pillars in Zimbabwe including NGOs, professional associations and other UN agencies.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'>Tatenda Chimbwanda is a communications officer at WHO Zimbabwe Country office</span><span style='font-family:"Verdana",sans-serif'><o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p><p class=MsoNormal style='background:white'><i><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Invest Wisely!</span></i><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Bulls n Bears </span><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'> <o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Telephone: <a href="tel:%2B263%204%202927658" target="_blank"><span style='color:windowtext'>+263 4 2927658</span></a><o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Cellphone: <a href="tel:%2B263%2077%20344%201674" target="_blank"><span style='color:windowtext'>+263 77 344 1674</span></a><o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Alt. Email: <a href="mailto:info@bulls.co.zw"><span style='color:windowtext'>info@bulls.co.zw</span></a> <o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Website: <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.bulls.co.zw&sa=D&sntz=1&usg=AFQjCNH8LYgdY55h-XKseuM8Kpr-JKdfhQ" target="_blank"><span style='color:windowtext'>www.bulls.co.zw</span></a> <o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Blog: <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.bulls.co.zw%2Fblog&sa=D&sntz=1&usg=AFQjCNFoIy6F9IXAiYnSoPSgWDYsr8Sqtw" target="_blank"><span style='color:windowtext'>www.bulls.co.zw/blog</span></a><o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Twitter: @bullsbears2010<o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>LinkedIn: Bulls n Bears Zimbabwe<o:p></o:p></span></p><p class=MsoNormal style='background:white'><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Facebook: <a href="http://www.google.com/url?q=http%3A%2F%2Fwww.facebook.com%2FBullsBearsZimbabwe&sa=D&sntz=1&usg=AFQjCNGhb_A5rp4biV1dGHbgiAhUxQqBXA" target="_blank"><span style='color:windowtext'>www.facebook.com/BullsBearsZimbabwe</span></a><o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'>Skype: Bulls.Bears <o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif;mso-fareast-language:EN-ZW'><img border=0 width=210 height=101 id="Picture_x0020_1" src="cid:image005.jpg@01D67165.432852C0" alt="cid:image012.jpg@01D0BFE7.544DF490"><o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Verdana",sans-serif'><o:p> </o:p></span></p></div></body></html>