Fiocruz builds new hospital center and invests in clinical trials with WHO

The Foundation started the construction, in Rio de Janeiro, of the Hospital Center for the Covid-19 Pandemic - National Institute of Infectious Diseases, which will assist the state and municipal governments in fighting the disease. The rapid assembly hospital unit will have 200 beds exclusive for intensive and semi-intensive treatment of critical patients infected with the novel coronavirus (Sars-CoV-2). Check out a 3D view here.

Built in partnership with the Brazilian Ministry of Health (MoH), the initiative will also have a diagnostic support system for all necessary tests, including imaging, such as computed tomography. The hospital will be coordinated by the National Institute of Infectious Diseases Evandro Chagas (INI/Fiocruz), the reference unit of the Foundation for ​​clinical research and specialized care in infectious diseases, which already acts as reference for Covid-19 severely ill patients.

“The moment is critical in relation to the Covid-19 pandemic and our main goal is to save lives and to protect the Brazilian National Health System” said Nísia Trindade Lima. Lima recalled that, in addition to the new coronavirus, other diseases will continue to pose serious problems for the public health system, especially in a continental country that has immense social inequalities and in which many people live in places of great agglomeration and demographic density.

Nísia recalled that Fiocruz, which turns 120 years old this year, has its history dedicated to facing health and infectious emergencies. “Our goal is to minimize the effects of the pandemic as much as possible. We are working on all fronts to combat the novel coronavirus”.

In order to speed up its implementation in the short term, the construction of the Center will take place in two stages. The first module will take 40 days to build and will have 100 beds, 50 for intensive treatment and 50 for semi-intensive. The expectation is that, at the end of two months, the entire work, with a total of 200 beds, is already completed. To meet the deadline, the construction site will operate 24 hours a day.

Global clinical trial

The new space will also hold the Solidarity clinical trial of the World Health Organization (WHO), led in Brazil by Fiocruz. Launched by WHO last Friday (March 20), the initiative aims to investigate the effectiveness of four treatments for Covid-19 and will be implemented in 18 hospitals in 12 states in Brazil with the support of the Department of Science and Technology of MoH and coordination by INI/Fiocruz. Solidarity is a global joint effort to provide a quick answer on which drugs are effective in treating Covid-19 and which are ineffective and should not be used.

The study was launched by WHO director general, Tedros Adhanom Ghebreyesus. During his speech, Tedros emphasized solidarity as a key condition to face the pandemic and the importance of concentrating efforts so that the study can generate robust and high-quality evidence as quick as possible.

 “Studies with a limited number of patients, and without adequate control, as most of the studies registered to date, may take a long time to get an answer, or not even reach it”, explains Valdiléa Veloso, INI´s director. “The Ministry of Health instructed us to include research centers in all regions of the country in the study and to contribute with the largest possible number of patients. Thus, it collaborates with the global effort to have a quick and applicable response to the Brazilian population”. According to the researcher, at first, chloroquine, Remdesivir, the combination of liponavir and ritonavir, will be tested, alone or combined with Interferon Beta 1a.

Despite having four established treatment lines, one of the premises of the study is that it is adaptable, that is, if new evidence emerges, the lines may be adequate, with discontinuation of drugs that prove to be ineffective and incorporation of other promising drugs. In this kind of study, a central committee has access to all data and performs analyzes along the process, preventing patients from being exposed to ineffective or highly toxic drugs.

The goal of Solidarity is to reach the largest number of patients in the shortest possible time. With this in mind, the study was planned to be executed at a time when everyone is dedicated to caring for critically ill inpatients. The research will include only hospitalized patients, to meet the most urgent demand, which is to offer treatment to patients with more severe conditions.