Subtitles section Play video Print subtitles 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 visiting our website make cram comm subscribing to this YouTube channel and most importantly sharing these videos with friends and family we'll be back tomorrow for another update thanks for joining us
B1 rna rem polymerase phase dependent dv Coronavirus Epidemic Update 33: COVID-19 Medication Treatment Trials, Global Testing Remains Limited 5 0 林宜悉 posted on 2020/03/13 More Share Save Report Video vocabulary