"As is the case with other coronaviruses, SARS-CoV-2 will be endemic, and I am sure that it will live with us. Vaccines are our best weapon against it, even in the event of new variants emerging. Nonetheless, this virus's ability to mutate is less than that of the flu. Annual vaccination of the elderly will likely be necessary again, but vaccinating younger people and those with weakened immune systems may be less frequent," Professor Justin Stebbing, world-renowned oncologist from Imperial College London, author of over 600 papers published in the most widely recognized academic journals, involved in the making of the AstraZeneca vaccine, said in his email interview with Kurir. The interview was made possible through the assistance of The Flexitarian Society Foundation.
Is there reason to fear that the dominant Delta strain will soon be replaced with an even more dangerous variant?
"There are 24 letters in the Greek alphabet. We really don't know. It is not very likely that a new strain will emerge that the vaccine will not respond to. I assume that locally there will be many new outbreaks and multiple variants, but I think that Delta will remain dominant in the foreseeable future. Having said that, the dumbest virus is smarter than the most intelligent of immunologists, and the virus has outsmarted us before as well."
You said jokingly that the Greek alphabet, which the WHO uses to name coronavirus variants, has as many as 24 letters. Do we have to go through them all in order to be rid of the coronavirus?
"We really do not have enough data. We don't know."
Breaking through the immune system defences is a problem that the entire world is faced with. Still, vaccines do ameliorate clinical presentations and reduce mortality rates, even if they don't stop the spread of the Delta variant?
"The most important thing is that vaccines reduce hospitalizations and mortality rates. They probably also stop the spread of the disease but, as is the case with everything else, they are nowhere near being able to stop it 100 percent. Two doses are very important."
The third dose of the vaccine – the same as the first two or combined?
"We don't know for sure whether another amplifier may be better, but what we do know from a number of studies is that it is safe to take any vaccine. For the main vaccines that have been approved – two viral vector ones (Astra Zeneca, Johnson & Johnson) and two mRNA ones (Pfizer and Moderna), each combination appears to be appropriate. I recommend the third dose to the elderly, the vulnerable, or immunosuppressed people, such as oncological patients who receive chemotherapy. We know that the combination of the Delta variant and the vaccine causes a robust immune response, but in clinical terms we still don't know how long it lasts, but we can assume."
Vaccinating young people is a big problem that the whole world faces. Do you have an idea as to how to motivate them to take the vaccine, as without them there can be no herd immunity?
"I think that the Israeli experience demonstrates that herd immunity will be hard to achieve. They have vaccinated almost all their adults, but now we are observing epidemic outbreaks among children. I think that with children it could be a snowball effect – seeing that your friends' children have been vaccinated, one friend's, and then another's – and it is precisely this that can be a great motivator, on top of being safe and protecting the entire family."
Children usually fare well dealing with the coronavirus, but can they avoid long Covid? Research conducted in the US has shown that the pandemic has resulted in an increase in paediatric obesity. Are children becoming easy targets for Covid, given that obesity is one of the great risk factors in Covid?
"Children nonetheless get ill more rarely, and new studies have shown that they rarely get more severe forms of Covid, which is very important. However, it is true that obese children are at a higher risk of complications."
What are the most severe effects of Covid on the body, and what is the most common long-term condition/damage the body sustains?
"Developing a more severe form of Covid-19 which requires hospitalization may affect multiple organs and cause long-term problems, e.g. long-term lung scarring. In fact, any organ can be affected."
The flu was nearly entirely absent last year. Should we brace ourselves for a stronger impact this fall and the flu joining hands with the coronavirus?
"It's very hard to say. All these viruses, including the RSV (respiratory syncytial virus), coexist, and they all have an impact on certain communities, or environments, in waves."
There are many medications used in treating Covid-19, and you yourself have worked on developing them. Which therapy is the best?
"I like to recommend Baricitinib, as it is a very ordinary sort of pill, taken once a day, inexpensive, has few interactions with other medications, a short half-life, and acts in a safe way. Most important of all, this medication provides the greatest benefits in preventing mortality in any randomized study, and has a double antiviral effect and an effect against cytokines."
MULTIPLE DEATHS IN ONCOLOGICAL PATIENTS DUE TO LATE TREATMENT
How much have oncological patients suffered since the start of the pandemic, and is a significant increase in the number of oncological patients likely?
"There is no doubt that the effects of the pandemic on many conditions, from oncological to cardiovascular, have been significant. There has also been an increase in deaths resulting from late diagnostics and treatment of oncological patients. I think that in the upcoming period there won't be a significant increase in the number of these patients."
Kurir.rs/Jelena S. Spasić