WHO staff will consider Covids, vaccines, and mistakes made

TThe Covid-19 pandemic is in its third year, the end is unseen, and the world is fed up with gills. A new and more contagious variant, Omicron has been enthusiastic about holiday gatherings over the past few weeks. Some infected people have been vaccinated three times.

Believe it or not, early 2022 may be even more disturbing than early 2020.

As we have Several times Over the past few years, STAT has turned to Mike Ryan, Head of Health Emergency Program at the World Health Organization, for insights into where we are and where we are heading. He and his team first learned that a new virus would appear to be prevalent in Hubei, China, during the decline of 2019, and since then the world has survived the worst pandemic of the century. I have been trying to support you.

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We ask Ryan if he expects the pandemic to last as long as it lasts, who should renew the Covid vaccine, and what he considers to be the main mistake the world has made. I did.

“The most shocking thing about this pandemic was the lack or loss of trust,” he said of those who refused to follow the advice of public health leaders and the containment policies set by the government. rice field.

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The conversation transcript has been edited for length and clarity.

Given what you knew about a pandemic in this, are you surprised that this is still in full swing after two years?

I was disappointed, but in a way I wasn’t surprised. That is, we have experienced one before. It was 2009. It took two years to operate the system.

However, the pandemic of the H1N1 flu was much milder and did not last for two years everywhere. It was in a clear wave.

When dealing with highly contagious respiratory viruses, the virus is expected to pass multiple waves. It was unclear how these waves would develop in terms of geography, temperature, seasonality, and everything else. However, the history of respiratory epidemics is that they tend to pass through those wave-like transmissions.

Then adding the fact that each wave is driven by different variants actually processes the evolving virus and presents new challenges to the immune system.

It is expected that immunity will decline over time. If the virus continues to evolve, there is double pain.

At the same time, if the vaccine is not very effective in preventing infection or reducing serious illness [in the face of a new variant], Then you really retreated with respect to your control over the virus. It’s a snake and a ladder, right? You made a big trip down the scoreboard.

Where do you think you will go next year?

It’s very, very, very difficult to predict. Many thought the delta variant was the most appropriate and fastest. It is highly adapted and highly evolved. For many, if you get a variant that beats it, Several Mutant. And we may be on the verge of having it.

I think much of this depends on how much protection the current vaccine provides. And if you need to switch the composition of the vaccine, how quickly can it be done? There are many factors that depend on each other. You can’t think in predictions, you can only think in scenarios. There are so many variables that affect the results in extreme ways.

If you need to renew your vaccine and it is determined that you need an Omicron-specific vaccine, do you think wealthy countries will buy another booster for their fourth vaccination? That would mean that developing countries still waiting to vaccinate most of their people would have to wait longer.

Yes, there is a possibility. That’s what happened last time. Currently, there is no big difference in how the world is approaching it.

And another issue you have to consider is that you may get a booster or another vaccine for Omicron that protects you from Omicron but not from Delta infections. This virus was completely different and there is no guarantee.

It’s a big decision to move that production to a whole new variant. Therefore, there is a lot of debate about how it happens, what is the best sequence to use, and what is the best virus to use to build it. And there is a question mark as to whether two types of production should continue. Whether it is necessary to combine vaccines. Whether you need to set the sequence somewhere between Omicron and other Omicrons in the third way. And there are so many unknowns and so many lab tests and trials that need to be done to get their answers.

We believe these are big decisions and have real consequences. They need to be done quickly, but they also need to be done carefully.

It’s very difficult to come up with the right answer. Therefore, there must be some collective wisdom to drive this. “Well, this is what we make and this is what you buy” is not purely a manufacturer’s decision.

Do you feel that manufacturers are taking the lead in this?

The question is, are they partners in this process or are they masters?

It should be done together. It should be centered in the best interests of the world’s population, with science and evidence driving that decision.

I’m neither their keeper nor master, whether or not the manufacturers agree with it. Neither is WHO. We only claim that there are some big unknowns here, and we are all trying to get those answers. At this point, you need to focus on putting together the best possible data, the best evidence, and making the right decisions.

If it’s left to a purely commercial decision, I’m not sure if that decision is necessarily the best decision.

Have you ever wanted to do something different from jumping in the world? Where did we make the biggest mistake?

This interview may continue for some time.

The biggest collective failure is that we have underestimated this microorganism. We have always assumed the best scenario to make our decisions. And I’m not the one who assumes the worst scenario as a trick. Otherwise, it can hurt society. But on every occasion, we seem to adopt the best scenario as the basis for our policy. And I think this virus is exploiting it one after another.

After all, the virus has no brain. It only takes advantage of opportunities from an evolutionary perspective. And we seem to have consistently and permanently given it an opportunity.

There was tremendous social, economic and political pressure to return to normal.

Over and over again, the government tried to return to normal and overtook the runway by opening too soon. The restriction is lifted too soon. They do not really persuade or empower people to continue these basic measures to reduce the risk of infection. I think it was a problem throughout the pandemic.

It does not mean to remove the blockage. For me, the blockade was almost always a last resort. Many eastern countries have managed to abandon the blockade. However, they maintain very strict measures in terms of wearing masks, crowds, tests, etc. That’s why they adopt a much more comprehensive and layered strategy. They have maintained the strength of the control means without completely blocking it or opening it completely. They took corners with or without understeer. They made people accept the idea that it would take a long time, and that it would have to be a sustainable endeavor. If everyone did, I think we would be in a better place.

But as a public health doctor, I think the biggest tragedy is the issue of vaccine fairness. That was really scary. That’s horrible.. The world has never agreed with the fact that first vaccination of the most vulnerable people was a better bet, not only epidemiologically but also in terms of impartiality.

Consistency, coordination and solidarity ideas — these are all nice words. However, it is very difficult to achieve it in a society that does not trust the government. [don’t buy into] That social contract, its inherent trust that the community should have in its government to say, “Yes, you are there to protect me.”

What shocked me most about this pandemic was its absence or loss of trust.

It’s amazing to read about public health workers who quit their jobs after being threatened with murder during a pandemic. They face hatred and Vitriol from the people they are trying to protect.

It’s tragic. And it’s tragic to think that there are millions of people in the Northern Hemisphere who aren’t currently vaccinated because they don’t believe in government. Whatever the reason, historians, whether it is insufficient for the government to build its credibility, or because it has been actively weakened by false information or other things. And social historians talk about it for decades.

If you’re looking to prepare for a future pandemic, it’s not all about technology, ping machines, surveillance systems, AI, and so on. We need a social solution to future pandemics rather than a technical solution. Because we are dealing with a destroyed world, a destroyed community. We are dealing with breach of trust and long-term collapse.

I tremble when I think of a more serious pandemic with that level of community distrust. It really negatively affected people’s awareness and willingness to maintain countermeasures. What’s happening is hurting them because they’re always telling them that a government conspiracy is happening because they can always find a lot of material and why they don’t do what they’re asked for. ..