New infectious wave

Is it worth expecting the next surge of Covid? Do I need to put on masks again? What vaccinations and how often should be vaccinated? Explains the molecular biologist

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In the Russian regions, a mask regime in hospitals and clinics is gradually introduced. Somewhere they directly say that this is connected with the new wave of Covid, somewhere they use euphemisms of SARS. Is Covid really returning whether we will have to sit on quarantine again in addition to everything, as often Kovid (if it is) will return, explains the molecular biologist Olga Matveeva .

- Olga, how much is this justified measure now - a mask regime? In Russia, it seems, they forgot that there was such a thing as a pandemic. Is she returning?

- Pandemia - it would be too loud now. Rather, we must talk about the danger of an infectious wave. This is not so global phenomenon, but also quite dangerous. An infectious wave can also take life, people can get sick with severe complications. Yes, we are now seeing a new wave of incidence of coronaviral infection. This coincided with the fact that the children went to schools.

- Cooked - or is a new wave spurled with the fact that the children went to schools?

- Children are mostly easy, but they often infect parents, so infection is spread through children. The current rise began a little in August, in September his pace began to increase. It is assumed that the beginning of the school year affected the acceleration of this wave.

- Is this happening all over the world or only in Russia? And in general-do these waves track in the world as closely as two or three years ago?

- Of course, in the USA and in many other countries they continue to monitor this. There are several parameters for this, one of them is the number of cases, but it is just difficult to track now, because many people are sick at home, do not contact doctors, such cases are not fixed anywhere. Nevertheless, there is still financing for measurements of hospitalizations. By the way, in Russia the number of hospitalizations with Covid is also now analyzed. But in the USA and some other countries there are additional methods of analyzing infectious outbreaks.

-You once talked about the analysis of sewage as the most reliable method.

- Yes, in some European countries, in the USA, in many states, wastewater analyzes the presence of the virus, and here the signal that a wave of incidence is rising is received earlier than hospitalization begins. Still, not everyone is hospitalized, only part of the people are seriously ill. It was on wastewater that in mid -August, a signal was recorded that the wave of the epidemic was coming up.

Then no one beat the alarm-it seemed that it was still summer, there was no special activity of respiratory viruses. But then it became clear that there were more and more cases, the wave went to the United States in almost all states where measurements were held, and in Europe, too.

- What was the US reaction in the USA? Some new vaccination campaign, maybe new warnings?

-They actually waited for this waves, prepared for it. And not only in the USA, but also in Russia too. Already in April, companies producing vaccines conducted research, trying to guess what the new version of the coronavirus will be. We conducted tests and began to prepare the vaccine already under the results. In parallel, measurements continued, because the strain could not be guessed, there was anxiety about this. Now a preprint has come out, from which it is clear that the option was determined correctly.

There is no one dominant strain now, there are several of them. The vaccine was checked for five main dominant variants of the virus. And they found out that the volunteers who participated in the tests of this vaccine have a very strong level of neutralizing antibodies, that is, those that can actually fight the virus.

- What kind of vaccines does this apply?

-We are talking about MRNC-vaccines. Unfortunately, in the United States, the Johnson and Johnson vaccine, similar to the Russian “satellite”, did not go. Adenovirus vaccines turned out to be somewhat worse in side effects, so they did not implement so well. Not only Johnson and Johnson, but also the European Astrazenka. They are behind them very powerful pharmaceutical companies, but they could not cope with the fear of people before side effects.

-That is, there are still side effects? In the Russian "satellite" they should be similar, given that all these vaccines on the same platform?

- Listen, I was very carefully versed in these side effects. These are several cases per million vaccinations. Covid gives thousands of times more risk.

- Is it possible to more precisely about the ratio of the number of deaths from Covid and side effects of the vaccine?

- In Russia, during the pandemic from Covid, approximately every hundredth, that is, 1% of the population died. And severe side effects from adenovirus vaccines are several cases per million.

Yes, they are, but their number is measured by one- or two-digit numbers per million. Why it scares people more than 1% of the probability of dying from Covid, I do not know.

- Maybe people simply do not believe that all severe side effects are recorded?

- In the USA, for example, they are fixed very well, because people receive compensation for this, that is, it is beneficial for them to apply for side effects and fix them all. The rules on this subject are very clear. And doctors in this side of the patients. All these cases are very well detected, because it is simply economically profitable. And quite a lot of money was paid to patients. I don’t know how the system of fixing the side effects in Russia works, but in the USA, vaccines are very well studied.

-As a result, MRNC-vaccines won the USA, it is they who are now “tuned” for new variants of the virus? Simply put, is it a “Pfizer” and “Modern”?

- That's right, this is the “PFAZER” and “MOSTERNA”. And the options for vaccines against new strains, I repeat, were ready in April. In the summer, the companies provided documentation in the FDA, but continued to monitor the situation to be sure that the strains were determined correctly. And on September 12, the quality control of food and medicines (FDA) approved new versions of vaccines for large -scale use, and it has already begun. However, mass vaccination will begin in October.

- Why only in October? Are the vaccines not ready or there is no need yet?

- It’s just that the vaccines have not yet entered the hospitals. The need is just, people are already calling to vaccinate. Moreover: they call for vaccinations to children from six months.

- So early?

- There are disputes on this occasion, and while I am keeping neutral here. And not only me, on this occasion, recommendations are different in the USA and in Europe. In the United States, it is recommended to vaccinate all over 6 months, that is, from infancy, and in Europe - only risk groups.

-From the very appearance of an Omicron Curian, if not earlier, we said that the children are already sick with a Covid and even die from him.

- And still there is a dilemma. The vaccine for children is relatively safe, but there is no statistics that says that the disease for children is more dangerous for vaccination. More precisely, there is data, but we do not know whether they are convincing enough. In the United States, on the basis of these data, recommendations are given to be vaccinated to everyone, but in Europe - no. If you have a choice, vaccinate a child or not to vaccinate, then in the USA or in Europe I would still advise the first.

- And in Russia?

- In Russia, the situation with the vaccine is very incomprehensible. All that I found about this about Russia is the words of Alexander Ginzburg ( head of the Gamaley Center, the developer of the "satellite". - I. T. ): back in July, he told the Vedomosti newspaper that their institute was ready for the new options for Omicron, they only wait for the state to give money for clinical trials. I don’t know if he is still waiting for money.

- Russia now has somewhat different priorities.

- In any case, I see that in Russia they are now urging the old version of the “satellite” and ... guess: what else?

- Really "Epivaccorone"?

- Yes, our beloved Epivaccoron rebelled from non -being, on September 13, the Ministry of Health extended her registration certificate.

-Maybe something “twisted” in this unfortunate product and now the vaccine will work against new options?

-No, no, my colleagues and I just looked at this moment. This is not a new version, but an extension of the registration certificate for the old one.

- And the old version will work against new options for the virus?

- I'm not sure. I'm just not sure. I can say for sure that if it works, it’s much worse than the updated vaccines. Will she work at all? Maybe risk groups should still be vaccinated at least by it, since there are no other options.

- So far, there are no special calls to be instilled in Russia, and there are especially no people who wish.

- The fact that there are no calls is probably fair, because for now, apparently, no one knows if the “satellite V” will now work.

- Do you need to monitor the test results?

- I’m afraid that the tests will be carried out too late, when the infectious wave will rage with might and main, they had to start much earlier. As far as I know, while at the Gamalei Institute, clinical trials have not even begun. The institute’s employee told me that the updated version was checked so far on animals. But the main thing is still the result of testing in public: whether the new variants of the virus neutralize those antibodies that occur after a new vaccine. Unfortunately, Russia is very far behind in terms of clinical trials, political lobbying plays too much role here. But what I'm sure of - this is in masked mode. Masks now I would very recommend to wear everyone, especially risk groups.

Although, of course, it would be better to do this to protect others from their possible infection. Masks are undoubted good.

- What are these new variants of the virus that you are talking about, what are they dangerous?

- The virus simply continues to evolve. And the most dangerous in these options is exactly the fact that they are new. And the fact that they appear so quickly that they run away from all vaccines. They also run away from immunity in ill people. The virus changes so quickly that immunity to it, which appeared in any way - “vaccine” or “natural”, is still working for a short time. This is the most unpleasant in the Omicron Curian and in general in this coronavirus: the huge speed of evolution and great contagiousness.

-We discussed different options for the virus, with different letters of the Greek alphabet, then reached Omcron, and then he somehow began to mutate so that all new “breeds” became Omcron’s options. Now these are also new options for Omicron or the virus further went "in alphabet"?

- Now these are all the options for Omicron. They are given different beautiful names, but I even stopped remembering them, because they have no important features, except for high contagiousness. That is, it cannot be said that there was some new terrible strain, from which everyone will die.

They are all approximately equivalent, if we talk about the likelihood of infection and the severity of the course of the disease. And in the immune layer, mortality from Omicron is still relatively small.

But infectious waves will be repeated. That is, there will be some intervals of time for which everything will forget about Covid, and then a new wave.

- So, after all, with the flu, we live like that?

- This is worse than the flu, if you focus on the number of excess deaths. Simply put, more people die. Although from Omicron still dies less than from previous options. Rather, it is better to say so: if there is an immune layer, that is, a certain number of vaccinated, then Omicron does not kill as many people as previous options - the first, “Ujansky”, delta and others.

- So this is a very important reservation: if there is an immune layer. We do not know if he would also kill, like a delta, less or more, a vaccine did not appear.

- Not only vaccines. A lot of people got ill and received immunity, so there is an immune layer. Apparently, recently she has “thinned out”, so a new wave has gone. If in Russia there were a good updated vaccine, I would very much advise people vaccinations. Both vaccinations and masks.

But while Russia is one of the worst countries in Europe and in terms of mortality from Covid, and in the percentage of vaccinated, that is, in two very important parameters.

- When the pandemic was recognized as completed, many publications began to appear: they say, all these elbows, masks and vaccines were a mistake, all fears are exaggerated, and so on. This is true?

- It’s good that you asked this question! I also see how influential politicians start such conversations: now we, they say, are investigating how it was all wrong. It was for such people that colleagues and I conducted an excess mortality study in different countries.

There is such an argument: it is not a matter of vaccination, but only in the wealth of the country and as its medicine. Like, medicine in the country is good - there was little people, and if the country is poor, and medicine is bad, then there were many people, and there was nothing to do with the vaccines.

-Actually, many people think so.

- Therefore, we conducted a study in two parameters: both in the GDP of countries and in the level of vaccination. After all, the wealth of the country often determined how many anti -epidemic measures were taken there and what these measures were. But vaccination may not be connected with this, that is, we investigated countries with approximately the same income, but we vaccinated little in some, in others - a lot.

We look at a sample of countries equally rich. And it turns out that mortality was not dependent on the level of GDP there, but it already depended only on the vaccination level.

We see this in both European countries and in the USA in different states. In America, there can be a huge difference between different states, because in the south there are many anti -Vaxes, people who, in principle, do not believe in science, they have their own religious education. And many political leaders there are forced to comply with voters. It is they who begin the conversation about investigations in the vaccines and so on. In such cases, I say: well, you believe in the plot of pharmaceutical companies. But here we compare two similar states with different levels of vaccination - and we see that where we did more vaccinations, there is less mortality. This does not depend on state wealth.

And Russia is also in this trend. Russia, where vaccination went badly, is similar to Serbia and Bulgaria in terms of mortality, there was also about every hundredth in the pandemic.

- I understand that mortality is associated with the level of vaccination. And with poverty?

- Of course, it is also connected. Much depends on what opportunities the medical system has. Vaccination - yes, but the ability to help people is also an important parameter, especially in poor countries.

- And if the country is poor, but it was well vaccinated? Or wasn't it?

-It was just one of these examples-Puerto Rico. This territory for GDP per capita is poorer than the poorest state of the US, but it was vaccinated at some kind of cosmic speed, vaccination reached a level of 70% by October 2021 along with the most prosperous states of the United States. The economy of this territory is very dependent on the tourism business, and in order for people to come to the hotels, everyone had to vaccinate everyone. As a result, there is extremely low mortality from Covid.

But I gave you one example, but there is a trend: in the poorest states, both vaccination and income level played a role. And when some level of well-being has been achieved, vaccination is already playing the maximum role.

- You mentioned that the GDP level influenced what anti -epidemic measures were taken by countries. In general, were these measures were needed by themselves or still not? Maybe it was necessary not to destroy the economy with these elbows, but just wait for the appearance of vaccines?

- We watched how quickly the first waves of incidence were extinguished in different countries.

Where more severe measures were taken, mortality was ultimately lower.

We ourselves did not specifically analyze each of these measures, mask regime, elbow, and so on, this is more difficult work. But there are such research too.

- There are already vaccines, there are enough of them, but you recommend a mask regime now. Why, if ideally, everyone should just get vaccinations?

-Well, firstly, the ideal is simply unattainable ...

- This is understandable, but what should you strive for? So that everyone is vaccinated or so that everyone is wore masks?

- It is necessary both. Suppose 90% of the population is vaccinated. It happens that even 65% of vaccinated to extinguish an infectious flash is enough. You can reach such a plateau when a large part of the population is vaccinated so that the outbreak does not develop. But the infection still smolders, even vaccinated people spread it. The virus is changing, and people are smaller in antibodies. All the same, you need to wear masks, because there are a lot of people around without immunity.

In addition, the vaccine protects against the severe course of the disease and from death, but in a mild form a person can get sick. And Covid is such a thing that it is better not to hurt them even in a mild form.

- Is it possible now a repetition of such measures as Locksuns, quarantines and everything that we saw in 2020?

- I think it is no longer required now. The mask regime will be, especially in the field of healthcare, it has already begun to introduce it now. Further, the medical authorities will look at the epidemiological situation and solve depending on it. On the other hand, we do not know how height this wave will be, while it only accelerates. When the number of hospitalizations and deaths goes to the plateau and goes down, no one knows this. Сейчас можно только сказать, что разгоняется волна быстро, и ее нужно вовремя погасить.

— Теперь человечество навсегда привязано к вакцинам от ковида?

- I think yes.

— Каждые полгода теперь всегда надо прививаться?

— Необязательно этот промежуток в полгода сохранится. Может быть, со временем будет год. Или два. Это не единственный коронавирус, есть еще четыре. Они гораздо слабее и возвращаются каждые 2–3 года, довольно сильно меняя обличье. Но проблема в том, что они уже были неопасными в то время, когда за ними начали следить, то есть они уже вызывали легкую простуду. Никто не знает, какими они были раньше, когда вирусы еще не изучали. Скажем, в конце XIX века была очень сильная эпидемия, ее приписали вирусу гриппа, но на самом деле никто не знает, что это было.

Может быть, эти коронавирусы вызывали раньше тяжелые эпидемии, просто их не выявляли, но потом они смягчились. Не исключено, что и этот вирус смягчится и станет приходить реже. На такой сценарий надеяться можно.

Мы это увидим по числу госпитализаций и людей, заболевших в тяжелой форме.

Все теперь кричат по поводу локдаунов и карантинов: зачем, мол, это было нужно? А это и нужно было именно для того, чтобы не переполнялась медицинская система, чтобы количество коек для госпитализаций и число врачей соответствовали числу пациентов, чтобы люди не умирали дома без медицинской помощи. Для этого нужно гасить волны. Поэтому здесь всегда последнее слово будет за врачами и за медицинскими администраторами, которые следят за тем, сколько людей госпитализировано. Если на протяжении двух, скажем, лет не будет сильных вспышек, они могут сказать, что вирус становится менее опасным. А может такого и не быть, могут вспышки случаться и дальше каждый год, два раза в год.

— Но пока мы обречены прививаться, а фармкомпании «обречены» получать доходы от обновленных вакцин?

— Фармкомпании в любом случае зависят от государства. В США фирмы тратят большие деньги на разработки и клинические испытания, но при этом они должны быть уверены, что государство у них вакцину купит. Так что это в любом случае взаимоотношения между фармацевтическими компаниями и государством. В России разработчики вакцин — просто государственные учреждения.

— И, как мы знаем по опыту «ЭпиВакКороны», далеко не всегда их доходы связаны с качеством вакцины.

— Вот это меня как раз очень тревожит. В России великолепные ученые — и вирусологи, и молекулярные биологи, и иммунологи — и вообще есть всё, что нужно, чтобы прогнозировать следующие вспышки, чтобы разрабатывать вакцины и другие биотехнологические препараты. Талантами бог страну точно не обидел. Но все эти таланты в России слишком зависят от чиновничества, которое все это регулирует. И все разработки в России будут упираться в это. И в совершенно другие приоритеты государства. Плюс и уменьшающееся взаимодействие лучших умов России с лучшими умами в мире, и нехватка англоязычной литературы, о которой уже говорят, что не нужна она российским ученым.

* Внесена в реестр «иноагентов».