COVID-19: NICE updates guideline as Sanofi announces vaccine development

As the number of deaths in the UK more than doubled over the weekend, The National Institute for Health and Care Excellence (NICE) has updated its rapid COVID-19 critical care guideline.

The organisation previously said that all adults on admission to hospital, irrespective of COVID-19 status, should be assessed for frailty using the Clinical Frailty Scale (CFS) and that comorbidities and underlying health conditions should be considered.

It also said that the risks and benefits and likely outcomes should be discussed with patients, carers or advocates and families using decision support tools (where available) so that they can make informed decisions about their treatment wherever possible.

Further, decisions about admission to critical care should be made on the basis of medical benefit, taking into account the likelihood that the person will recover to an outcome that is acceptable to them and within a period of time consistent with the diagnosis.

Because of this, patient groups and representatives were concerned that applying the score to people with learning disabilities, autism and other stable long-term disabilities, would put them at a disadvantage when decisions were made about admission to critical care in this time of intense pressure.

Because of these concerns, NICE has updated the guideline to include a clarification that the tool should not be used in certain groups, including those with learning disabilities or with stable long-term disabilities such as cerebral palsy.

As a result, the new guidance reflects these clarifications and emphasises the need to consider additional patient factors when interpreting the CFS score.

As more pharmaceutical companies race to find a vaccine to the growing pandemic, Sanofi is the latest to offer its services in the form of a collaboration with Translate Bio to develop an mRNA vaccine.

The French pharma giant announced that the partnership will use Translate Bio's mRNA platform to discover, design and manufacture a number of SARS-CoV-2 vaccine candidates, with Sanofi advancing them for further development.

"We are committed to leveraging different ways to address the COVID-19 public health crisis by testing treatments, as well as two vaccines using different platforms. We believe the more approaches we explore, the better our likelihood of success in achieving this goal," commented David Loew, global head of vaccines at Sanofi.

In addition to Sanofi, Vertex has revealed its plans to keep clinical trials going during the unstable time, working with trial sites to enable "virtual clinic visits" and home delivery of study drugs to ensure that ongoing trials continue as planned with the correct monitoring and procedures in place.

The outbreak "will require unprecedented utilisation of healthcare resources that we expect will have an impact on our clinical trials" explained chief executive officer Jeffrey Leiden, adding "given the rapidly evolving pandemic, it is too early to precisely determine the long-term effects of the outbreak on trial timelines."

The World Health Organisation (WHO) urges the public to stay aware of the latest information on the COVID-19 outbreak, with information available through your national and local public health authority.

Wash your hands frequently:

Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.

Maintain social distancing:

Maintain at least one metre (three feet) distance between yourself and anyone who is coughing or sneezing.

If you have fever, cough and difficulty breathing, seek medical care early:

Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.

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