Like tuberculosis, Covid may continue to come

DR FAHEEM YOUNUS, The person responsible for infectious diseases at the University of Maryland is on a mission to combat disinformation. In an exclusive interview, Younus expresses his concerns about how a pandemic can widen the gap between those who have and those who don’t. excerpt:

Please tell us about the situation of Covid in the United States.

I think we couldn’t handle it well in 2020. In 2021, it was treated better. Now it’s a combination. Not only is the virus receding, we are handling it better. In other words, everything is going in our favor. That is, we have a vaccine and we have all the cures. The government is mailing quick inspections to people at home, which is a big step forward. At the end of the winter months and holiday season, people weren’t so crowded, and the Omicron surge actually plummeted by about 90 percent in most states of the country. So we are in much better condition.

How do you deal with incorrect information?

This is the most purposeful job in my career. Even if people feel they can’t get out of the forefront and discuss the issue reasonably, they are abused. But I think good information saves lives.

So how do I do that? Multiple methods. You have to look again. Everyone has their own fears. You need to understand where they are coming from. You have to start from a standpoint of empathy.

When it comes to medical research, African-Americans have a long history of being limited and not treated fairly. Therefore, their distrust is rooted in history. When I talk to the African-American community, I associate them with one of the inventors of the Moderna vaccine, an African-American doctor. And I make them aware that it is one of their own daughters who is at the forefront of the development of this vaccine.

I give them the data. You see, this vaccine allergy is not closely reactive with food allergies. So what I mean is that I can’t exaggerate everyone. Not everyone is a conspiracy theorist. Some people have good reasons, and you get involved with them on those good subjects.

How dangerous is the BA.2 variant?

I don’t think it’s wise to say it’s more dangerous than BA.1 or Omicron. Because, as of today, we know it will spread rapidly. What we don’t know is whether it avoids vaccine-based immunity beyond Omicron. I don’t think there is evidence. And will it cause a significant number of reinfections in people who have recovered from Delta or Omicron? I don’t think there is any proof of that. Of course, rare cases occur.

So it feels like the jury hasn’t come out yet. The numbers indicate that they are likely to be as unchanged as BA.1.

Have you reached the stage of endemic disease?

Some places, yes. Somewhere, no. Endemic species are not a sign of victory. When we say it’s endemic, we’re saying we can’t really kill you. Let’s shake hands.

That’s what we are saying. Ideally, smallpox and polio are not endemic. They have been eradicated. That is victory. Endemic is like the flu. We accept that it comes every year and kill 20,000 to 30,000 Americans. I don’t know what that number is in India.

If another variant comes, it can be catastrophic.

What are your biggest concerns about Covid 19?

In general I am an optimistic person. I usually don’t think much about fear.One of the fears I have is that Covid may continue to come [back] Like tuberculosis (TB). This means a disease that kills more than a million people each year, but is almost forgotten because it dies in poor countries. And developed countries continue to gain more control over viruses and more options to keep their economies open. While it’s still a big problem for some, I’m afraid the world may go on.

What lessons did you learn during the pandemic? How did you deal with the virus?

I learned a lot. I think this pandemic was a humble experience. First of all, we learned that no one can win this war. We are all interdependent.

Vaccination would have taken 10 to 15 years without the huge amount of money to speed things up. This kind of process cannot be achieved quickly unless regulatory agencies speed things up, give prompt, appropriate and safe approval, and eliminate bureaucracy.

This pandemic cannot be predicted solely for basic research or frontline clinicians. We need a mathematician, statistician, and modeler who can predict where this pandemic is heading in 6 to 12 months. You cannot decide whether to open or close the economy. Because we need an economist who can see the big picture and explain the risks and benefits. These are the risks of viruses and the risks of closing the economy. etc.

How much do you know about Long Covid?

Not so much. I feel there is hundreds of studies on this subject, but there is still no long unified definition of Covid. There are no specific lab tests. You have been using Covid for a long time, as if this test was positive. It’s all based on history and symptoms. And they vary from study to study. Therefore, it is very difficult to compare. There are about 200 symptoms there. If you say you have any of these symptoms after recovering from Covid for a few weeks, you are considered a long Covid. It’s very vague. It does not mean that it does not exist. It’s absolutely real. It also occurs with other viral infections. A subset of patients have long-term side effects.

What should we do? Those who are currently suffering should probably go to a specialized center. Not everyone can handle those cases. Wherever you have a specialized center, you have more experience and they can receive empathic and timely care. Symptom management, even if nothing else. But at the same time, a prospective, double-blind study with clear and concrete definitions and criteria is needed. And only then will we know.

Some people seem to be immune to Covid. How would you explain this?

It’s hard to say. I don’t think some people will ever get Covid. We do not perform high-dose serum tests. It can only be said that everyone was taking the test.

About 30% of people are asymptomatic, remain asymptomatic, or have very mild symptoms. Therefore, some people may have a milder illness than others.

At the same time, there are genetic determinants. I have had an HIV patient who has not been treated for 20 years and it does not get worse. Therefore, it is also known for other viruses. But at this stage, you know that there are genetic determinants. However, without extensive serum studies, it is not known if anyone is truly immune to the virus.

Some experts believe that mRNA vaccines are superior to DNA vaccines. What are your thoughts?

It’s hard to say because I haven’t seen a direct trial between the two. Here’s why we keep talking about mRNA vaccines: The first was the first vaccine to be launched in large quantities with FDA approval. More than 2, 1 billion people have received them so far. Therefore, we know that they are widely used. Third, many subgroup analyzes of mRNA that are not yet available in DNA vaccines are open to the public.

We are aware of the effects of mRNA vaccines and their healthcare providers. We studied pregnant women, fertility, breastfeeding, and people with weakened immunity. Therefore, RNA vaccines and their subgroup analysis and published data are now very large. There is a higher level of comfort. More safety data is available.

As more and more data are released, DNA vaccines will be better positioned.

Do vaccines provide better immunity than real infections?

Natural infections can inhale 1000 virus particles or 1 million virus particles. not sure. The degree of exposure is not my control. It happens randomly by chance.

Whether I’m wearing a mask, whether others are wearing masks, all of this determines the amount of virus I’m inhaling. As a result, I may get different levels of immunity. Vaccines can be used to obtain exactly the same doses given to thousands of people in measured clinical trials. Therefore, there is a measurable response. The action response is more measured. So you can feel that I will get reliable protection as it has been tested. Therefore, it increases predictability. And then there is the follow-up. You are immunized with a natural infection, but it is difficult to measure. Therefore, I think you are a kind of flying blind person.

How would you rate India’s reaction to a pandemic?

I think people living in India judge it better. Seen from a distance, India, like the United States, was struggling at first. The first wave was a really terrible blow. But I am very happy to see that many countries, including India, are increasing their vaccinations.

Disinformation has decreased a little. Overall, I think most countries are catching up.