Frustration boiled over as traffic management staff at the Avondale testing centre threatened to call the police on people angry they had been pushed to the back of the queue after an hour-long wait in line. Video / Adam Pearse
While most of the world is focused on getting as many people vaccinated as quickly as possible as new Covid-19 variants wreak havoc, such as the Delta strain has in Sydney, there is a renewed focus on developing effective treatments overseas.
And now there is burgeoning hope that "game changing" medication is on the way.
Because many health experts are coming to realise that while vaccination is the most important way to protect people from the coronavirus, it's not the only way we can fight back.
There's also still a huge number of unvaccinated people around the world for various reasons including lack of supply or young age, and this can create a playing field for mutations.
A medical syringe seen displayed in front of the Israeli flag. Photo / AP
That's why in Israel, companies are focused on developing medications that could prove invaluable in the fight against the virus.
Indeed, Australia's chief medical officer Paul Kelly says lessons can be learned in places such as Israel and the UK, where outbreaks have surged but hospitalisations and deaths have been limited.
Kelly said: "[There are] lots of lessons; when the UK decided to open up, they did have an increase in cases but not an increase in any great extent in deaths or in hospitalisations or ICU except in some small pockets of the population, particularly in the Midlands, where they had lower than the national average vaccination rates.
"They have actually done what we are proposing to do at that around 80 per cent rate of vaccination.
"Israel similarly, they recently have seen an increase in cases but the death rates in hospitalisation rates have not increased the great extent.
A health worker prepares a booster dose of the Pfizer-BioNTech Covid-19 vaccine. Photo / AP
"We've absolutely looked at those [countries] every day and every week and are learning from their experiences."
Israel has fully vaccinated just under 80 per cent of its adult population – the same target set for New South Wales to be able to open up – but the country registered 7600 new infections overnight.
According to Israel's Ministry of Health: "The vast majority of those infected are unvaccinated children. There are also vaccinated individuals [and] the severe cases are among older adults 60 years of age and older."
So what can be done for those groups? Three weeks ago, the country started offering a third vaccine shot to the elderly, and those working in health care. And despite the increase in cases, their death rate is comparatively low.
During Israel's peak outbreak they were seeing a seven-day average of 65 daily deaths, while that number is 19 as at August 17.
Even so, it's becoming clear that Israel is working on boosting its options to minimise the damage from Covid-19, now it has been unable to eliminate it completely. Hope for Israel - and potentially eventually the world - could also lie in experimental drugs, such as EXO-CD24 and Allocetra by Enlivex Therapeutics.
Prof Nadir Arber invented the drug EXO-CD24. Photo / Tel Aviv Sourasky Medical Center
EXO-CD24
EXO-CD24 is an experimental "precision" medication for inhalation, developed by Professor Nadir Arber at Tel Aviv Sourasky Medical Center.
Its aim is to halt the "cytokine storm" that affects the lungs of approximately 5-7 per cent of covid-affected patients. This occurs when the immune system starts attacking healthy cells with extra cytokine cells.
Arber developed the medicine by using a molecule, CD24, that he had spent 25 years researching in the hope it would help cancer patients.
He now believes it could soon help numerous Covid-19 patients.
"Even if the vaccines perform their function, and even if no new mutations are produced, then still in one way or another the corona will remain with us," said Arber of the ongoing need for the medicine.
On how it works, he explains: "We are not suppressing or altering the immune system [like with steroids], but rather restoring it to normality by controlling the aspect of the system that causes the cytokine storm, the over-reaction of the immune system that is often the cause of serious covid illness."
An image of cytokine-secreting cells. The green markers indicate the more productive cells. Photo / Centre of Excellence for Nanoscale BioPhotonics
The drug's Phase I trial produced impressive results, with all 30 patients treated with it recovering, and 29 of which left the hospital within 3-5 days after receiving it.
More good news came earlier this month, with reports from the Phase II clinical trial showing 90-93 per cent of seriously ill Covid-19 patients, who were treated in several Greek hospitals, were discharged within 5 days. This phase was conducted by Dr. Sotiris Tsiodras, Greece's national coronavirus commissioner.
"Doctors reported good responses, and this is very encouraging and supports our hope that this drug could be a game-changer," Arber told the Times of Israel.
There were no deaths, and no patients needed to be intubated and placed on ventilators.
"Patients selected had moderate to high severity disease, and you would expect some would be intubated or stay in hospital for longer," said Arber.
"We are optimistic."
However, he did caution that the next step of the trial is essential, where some patients are placed on placebos for comparison.
News of the medicine has been greeted with cautious enthusiasm from many.
One social media user wrote: "EXO-CD24, there is a cure out there …"
Another said: "EXO-CD24 might be the lifesaving miracle the world has been searching for."
A third wrote: "Israel were first to get heavily vaccinated. They as the US are finding vaccines don't cover Delta strain. So their people are getting; spreading and dying from covid. They're working on treatments like EXO-CD24 and MesenCure as this is more long term than vaccine. Australia pay attention!"
And another: "The EXO-CD24 inhaler is being heralded as a 'miracle drug' against #Covid-19, in a recent Tel Aviv study. Originally designed to fight ovarian cancer, it resolved moderate to severe covid cases within 5 days of use (just once a day)."
Allocetra by Enlivex Therapeutics
Shai Novik is the executive chairman of Enlivex Therapeutics, an immunotherapy company who is developing another treatment for Covid-19 in Israel. He says that there has been renewed interest in treatments for the coronavirus once people realised that, while hugely important, vaccines weren't going to spell the end for the virus.
"Just two months ago, interest in covid therapeutics was done," Novik said.
Vaccines are so important, along with new treatments to help those with severe symptoms. Photo / Getty Images
"Everyone thought it was over because the vaccines were working well. And then Delta came along."
Which means there's now an urgent need for "a slew of therapeutics for mild, moderate, severe and critical cases of Covid-19", he told Israel21c.
That's because patients can respond differently to the virus and also to different drugs.
Enlivex chief scientist and medical officer Dr Dror Mevorach undertook research that paved the way for trials of Allocetra, which is given once through an IV infusion to severely ill patients and works by reprogramming malfunctioning immune cells.
"It's agnostic to the strain of the variant, which could be Delta today, Epsilon tomorrow," Novik said.
So it doesn't target the virus itself, but instead the side effects of the virus such as organ failure including the lungs.
"To date, we've treated 10 critical and 11 severe Covid-19 patients.
"The results were encouraging. We did not see any issue with safety and tolerability. Nineteen of the 21 patients were released from the hospital in 5.6 days, on average, after receiving our drug product — less time than you'd expect at this level of illness."
The Israeli Ministry of Health has reviewed the company's phase II trial data, and authorised a phase IIb clinic trial involving 152 patients in Israel and Europe. Half will get Allocetra, and half a placebo.
If the data is supportive, the company will seek approval for it to go on the market.
