Coronavirus: The Tide Is Coming for Medicinal Cannabis
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By Zulfikar Abbany
The search for a vaccine for the new coronavirus, SARS-CoV-2, or indeed a medicinal drug to cure it, has taken researchers down both traditional and less traditional avenues.
They have looked at existing drug candidates, such as remdesivir, which was original developed to treat Ebola. In Germany, the first clinical trials for a coronavirus vaccine are based on a candidate developed for cancer immunology.
There's a study out of France that suggests nicotine — typically ingested via the often-lethal pastime of smoking — may protect people against the novel coronavirus, itself a potentially fatal lung infection.
And, now, preliminary research is emerging out of Canada that certain strains of the psychoactive drug cannabis may also increase resistance to the coronavirus. If the study, which is not yet peer reviewed, can be verified, it would appear that cannabis works in a similar way to nicotine.
"The results on COVID-19 came from our studies on arthritis, Crohn's disease, cancer and others," said Dr. Igor Kovalchuck, a professor of Biological Sciences at the University of Lethbridge, in an email to DW.
As with the research into nicotine's effect on the coronavirus, it is thought that some strains of cannabis reduce the virus' ability to enter the lungs, where it takes hold, reproduces and spreads.
In a paper on preprints.org, where scientists can publish non-peer-reviewed results, Kovalchuck and colleagues write that their specially developed strains of cannabis effectively stop the virus from entering the human body.
The study is one of many papers globally that have been shared on preprint websites, including preprints.org, in a bid to disseminate preliminary findings into potential COVID-19 treatments that have yet to undergo rigorous peer review.
The coronavirus needs a "receptor" to enter a human host. That receptor is known as an "angiotensin-converting enzyme II," or ACE2.
ACE2 is found in lung tissue, in oral and nasal mucus, in the kidneys, testes, and gastrointestinal tracts, they write.
And the theory is that by modulating ACE2 levels in those "gateways" to the human host, it may be possible to lower our susceptibility, or vulnerability, to the virus. It could basically reduce our risk of infection.
"If there's no ACE2 on tissues, the virus will not enter," said Kovalchuck.
No Common or Garden Cannabis
Some in the science community say medicinal cannabis may help to treat a range of conditions from nausea to dementia. But medicinal cannabis is not the same as what you might call recreational cannabis.
Those more "common or garden varieties" of cannabis — or street cannabis — are known for their Tetrahydrocannabinol (THC) content. That's the main psychoactive agent in the drug.
The Alberta-based researchers, meanwhile, have focused on strains of the plant, Cannabis sativa, that are high in an anti-inflammatory cannabinoid, cannabidiol (CBD) — one of the other main chemicals in cannabis, aside from THC.
They have developed more than 800 new Cannabis sativa variants, with high levels of CBD, and identified 13 extracts which they say modulate ACE2 levels in those humans gateways.
"Our varieties are high in CBD, or balanced CBD/THC, because you can give a higher dose and people will not be impaired due to the psychoactive properties of THC," said Kovalchuck.
Low Funding, Low Knowledge
Kovalchuck also heads a company called Inplanta BioTechnology, with Dr. Darryl Hudson, who has a PHD from the University of Guelph — another Canadian institute where research is ongoing into the use of cannabinoids in medicine.
But funding for cannabinoid research is "still hard," he said. And that's the case in other countries, too.
Some researchers in the UK say that may be because there are misconceptions among the general public and politicians about medicinal cannabis, perhaps even a fear that people will become addicted or try to self-medicate, using just any old form of cannabis they can find.
Those researchers say themselves that it is vital to be clear about the information and to avoid sensationalism.
"Researchers have to be particularly careful when disseminating their results given the socio-political volatility of medicinal cannabis use," said Chris Albertyn, a Research Portfolio Lead at King's College London, and an expert on cannabinoids and dementia.
The best way to get through that, says Albertyn, is to implement open, transparent research methods.
"In this instance, the current research from Canada has just unveiled a potential therapeutic 'mechanism of action' but that would need to be validated and tested in well-designed, robust clinical trials before any meaningful clinical conclusions can be drawn," he said.
That would include pre-registering clinical protocols and analysis methods, publishing in open access journals, double-blind placebo controlled trials, and strict, independent peer review by the clinical academic community, said Albertyn.
A turning tide
The problem is that without sufficient funding and further research, there is too little knowledge about cannabinoids — whether it's positive or negative research results — some say we just won't know until we do the research.
"But there is ENORMOUS interest now," said Kovalchuk in his email. And that's his emphasis. "The tide is coming."
While he and his co-authors say even their most effective extracts require large-scale validation, they say they may be a "safe addition" to the treatment of COVID-19. An addition, mind, alongside other treatments.
So, large-scale verification pending, medicinal cannabis could be developed into "easy-to-use preventative treatments," such as a mouthwash or a throat gargle in both clinical and home use.
Reposted with permission from Deutsche Welle.
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By Joni Sweet
If you get a call from a number you don't recognize, don't hit decline — it might be a contact tracer calling to let you know that someone you've been near has tested positive for the coronavirus.
Interviews With Contact Tracers<p>Contact tracing is a public health strategy that involves identifying everyone who may have been in contact with a person who has the coronavirus. Contact tracers collect information and provide guidance to help contain the transmission of disease.</p><p>It's been used during outbreaks of sexually transmitted infections (STIs), Ebola, measles, and now the coronavirus that causes COVID-19.</p><p>It starts when the local department of health gets a report of a confirmed case of the coronavirus in its community and gives that person a call. The contact tracer usually provides information on how to isolate and when to get treatment, then tries to figure out who else the person may have exposed.</p><p>"We ask who they've been in contact with in the 48 hours prior to symptom onset, or 2 days before the date of their positive test if they don't have symptoms," said <a href="https://case.edu/medicine/healthintegration/people/heidi-gullett" target="_blank">Dr. Heidi Gullett</a>, associate director of the Center for Community Health Integration at the Case Western Reserve University School of Medicine and medical director of the Cuyahoga County Board of Health in Ohio.</p>
“You’ve Been Exposed”<p>After the case interview, contact tracers will get to work calling the folks who may have been exposed to the coronavirus by the person who tested positive.</p><p>"We give them recommendations about quarantining or isolating, getting tested, and what to do if they become sick. If they're not already sick, we still want them to self-quarantine so that they don't spread the disease to anyone else if they were to become sick," said Labus.</p><p>Generally, the contact tracer won't ask for additional contacts unless they happen to call someone who is sick or has a confirmed case of the virus. They will help ensure the contact has the resources they need to isolate themselves, if necessary. The contact tracer may continue to stay in touch with that person over the next 14 days.</p><p>"We follow the percentage of people that were contacts, then converted into being actual cases of the virus. It's an important marker to help us understand what kind of transmission happens in our community and how to control the virus," said Gullett.</p>
Why You Should Participate (and What Happens If You Don’t)<p>A <a href="https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30457-6/fulltext" target="_blank">Lancet study</a> from June 16, which looked at data from more than 40,000 people, found that COVID-19 transmission could be reduced by 64 percent through isolating those who have the coronavirus, quarantining their household, and contacting the people they may have exposed.</p><p>The combination strategy was significantly more effective than mass random testing or just isolating the sick person and members of their household.</p><p>However, contact tracing is only as effective as people's willingness to participate, and a small number of people who've contracted the coronavirus or were potentially exposed are reluctant to talk.</p><p>"Contact tracers have all been hung up on, cussed at, yelled at," said Gullet.</p><p>The hesitation to talk to contact tracers often stems from concerns over privacy — a serious issue in healthcare.</p>
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Climate Explained is a collaboration between The Conversation, Stuff and the New Zealand Science Media Centre to answer your questions about climate change.
If you have a question you'd like an expert to answer, please send it to firstname.lastname@example.org
What was the climate and sea level like at times in Earth’s history when carbon dioxide in the atmosphere was at 400ppm?<p>The last time global carbon dioxide levels were consistently at or above 400 parts per million (ppm) was around <a href="https://www.nature.com/articles/nature14145" target="_blank">four million years ago</a> during a geological period known as the <a href="http://www.geologypage.com/2014/05/pliocene-epoch.html" target="_blank">Pliocene Era</a> (between 5.3 million and 2.6 million years ago). The world was about 3℃ warmer and sea levels were higher than today.</p><p>We know how much carbon dioxide the atmosphere contained in the past by studying ice cores from Greenland and Antarctica. As compacted snow gradually changes to ice, it traps air in bubbles that contain <a href="https://www.cambridge.org/core/journals/annals-of-glaciology/article/enclosure-of-air-during-metamorphosis-of-dry-firn-to-ice/09D9C60A8DA412D16645E6E6ABC1892F" target="_blank">samples of the atmosphere at the time</a>. We can sample ice cores to reconstruct past concentrations of carbon dioxide, but this record only takes us back about a million years.</p><p>Beyond a million years, we don't have any direct measurements of the composition of ancient atmospheres, but we can use several methods to estimate past levels of carbon dioxide. One method uses the relationship between plant pores, known as stomata, that regulate gas exchange in and out of the plant. The density of these stomata is <a href="https://journals.sagepub.com/doi/abs/10.1177/095968369200200109" target="_blank">related to atmospheric carbon dioxide</a>, and fossil plants are a good indicator of concentrations in the past.</p><p>Another technique is to examine sediment cores from the ocean floor. The sediments build up year after year as the bodies and shells of dead plankton and other organisms rain down on the seafloor. We can use isotopes (chemically identical atoms that differ only in atomic weight) of boron taken from the shells of the dead plankton to reconstruct changes in the acidity of seawater. From this we can work out the level of carbon dioxide in the ocean.</p><p>The data from four-million-year-old sediments suggest that <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2010PA002055" target="_blank">carbon dioxide was at 400ppm back then</a>.</p>
Sea Levels and Changes in Antarctica<p>During colder periods in Earth's history, ice caps and glaciers grow and sea levels drop. In the recent geological past, during the most recent ice age about 20,000 years ago, sea levels were at least <a href="https://science.sciencemag.org/content/292/5517/679.abstract" target="_blank">120 meters lower</a> than they are today.</p><p><span></span>Sea-level changes are calculated from changes in isotopes of oxygen in the shells of marine organisms. For the Pliocene Era, <a href="https://agupubs.onlinelibrary.wiley.com/doi/full/10.1029/2004PA001071" target="_blank">research</a> shows the sea-level change between cooler and warmer periods was around 30-40 meters and sea level was higher than today. Also during the Pliocene, we know the West Antarctic Ice Sheet was <a href="https://www.nature.com/articles/nature07867" target="_blank">significantly smaller</a> and global average temperatures were about 3℃ warmer than today. Summer temperatures in high northern latitudes were up to 14℃ warmer.</p><p>This may seem like a lot but modern observations show strong <a href="https://journals.ametsoc.org/jcli/article/23/14/3888/32547" target="_blank">polar amplification</a> of warming: a 1℃ increase at the equator may raise temperatures at the poles by 6-7℃. It is one of the reasons why Arctic sea ice is disappearing.</p>
Impacts in New Zealand and Australia<p>In the Australian region, there was no Great Barrier Reef, but there may have been <a href="https://link.springer.com/content/pdf/10.1007/BF02537376.pdf" target="_blank">smaller reefs along the northeast coast of Australia</a>. For New Zealand, the partial melting of the West Antarctic Ice Sheet is probably the most critical point.</p><p>One of the key features of New Zealand's current climate is that Antarctica is cut off from global circulation during the winter because of the big <a href="https://www.tandfonline.com/doi/abs/10.3402/tellusa.v54i5.12161" target="_blank">temperature contrast</a> between Antarctica and the Southern Ocean. When it comes back into circulation in springtime, New Zealand gets strong storms. Stormier winters and significantly warmer summers were likely in the mid-Pliocene because of a weaker polar vortex and a warmer Antarctica.</p><p>It will take more than a few years or decades of carbon dioxide concentrations at 400ppm to trigger a significant shrinking of the West Antarctic Ice Sheet. But recent studies show that <a href="http://nora.nerc.ac.uk/id/eprint/521027/" target="_blank">West Antarctica is already melting</a>.</p><p>Sea-level rise from a partial melting of West Antarctica could easily exceed a meter or more by 2100. In fact, if the whole of the West Antarctic melted it could <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.695.7239&rep=rep1&type=pdf" target="_blank">raise sea levels by about 3.5 meters</a>. Even smaller increases raise the risk of <a href="https://www.pce.parliament.nz/publications/preparing-new-zealand-for-rising-seas-certainty-and-uncertainty" target="_blank">flooding in low-lying cities</a> including Auckland, Christchurch and Wellington.</p>
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