A Preventive Treatment for Migrant Workers at High-risk of COVID-19
Status:
Completed
Trial end date:
2020-08-31
Target enrollment:
Participant gender:
Summary
In December 2019, a novel coronavirus, now called COVID-19, emerged as a global health threat
from Wuhan, China. Within weeks, the contagious virus spread within and between communities,
causing a lower respiratory tract infection dominated by symptoms of fever, cough and sore
throat. The incubation period was estimated at between 5 to 7 days, but could last as long as
14 days. Although COVID-19 causes a mostly mild and self-limiting disease, respiratory
involvement has been reported in about 5% of the population, requiring supplemental oxygen
and even ventilatory support to relieve hypoxia. Alveolar damage, fibrosis and consolidation
have been reported in radiologic and post-mortem studies. Existing data suggest a mortality
rate of COVID-19 is approximately 1-2%, higher among individuals with pre-existing
comorbidities and in healthcare systems with suboptimal access to ventilatory support.
Given its high transmissibility, COVID-19 has quickly spread across the globe within a short
interval. By 27 April 2020, over 3 million people around the world have been diagnosed with
COVID-19, and more 200,000 have succumbed to the disease. As a proportion of patients
manifest mild or no symptoms, these numbers are likely an underestimate of the actual number
of patients with COVID-19. More disconcertingly, patients are known to shed viruses despite
mild or no symptoms, making it essential that a collective approach against COVID-19
incorporate active pharmacological treatment to prevent or mitigate virus pathogenesis prior
to its potential evolution to cause respiratory distress. To date, clinical trials have
focused on the treatment of hospitalised patients diagnosed with COVID-19; only few have
examined the clinical benefits of pharmacological agents despite few compelling in vitro
data.
The relatively high transmission of COVID-19 in a closed dormitory environment of migrant
workers in Singapore presents a real-life scenario where a prophylaxis treatment could reduce
the impact of the disease. In Singapore, there are well grounded concerns an excess in cases
could pose the possibility of strain in healthcare system and mentally drain her workers. The
availability of an effective prophylaxis treatment is highly desirable to potentially reduce
this burden. Data from the current study could also have implications on how future outbreaks
in high-density areas should be managed, especially when residents are subjected to
quarantine and isolation.