«SARS-CoV-2 is changing faster than we can react. You have to be aware that we are still chasing this virus »- admits prof. Agnieszka Szuster-Ciesielska, virologist and immunologist. However, as she adds, “it will end someday”. When and how? The expert answers these and many other questions about the epidemic, endemia and threats related to the spread of viruses in an interview with Medonet.
- Prof. Szuster-Ciesielska draws attention to the fact that although the coronavirus is still evolving, it will more and more often “collide with the wall” in the form of our immunity and awareness of health prevention
- SARS-CoV-2 will become endemic, but it won’t happen as soon as we want it to. Besides, even when this happens, it will not cease to be a threat, as it can take a heavy toll on a seasonal basis
- Even endemic diseases can be very dangerous. For example, malaria kills about 1,5-2,7 million people each year
- According to the expert, we should also be vigilant against threats related to other viruses that may “leak” from areas where they have been endemic so far. A good example is the monkey pox virus
- More information can be found on the Onet homepage
Paulina Wójtowicz, MedTvoiLokony: Professor, it seemed a moment ago that we have COVID-19 under control. Today we are witnessing another wave of infections. Will this pandemic ever end?
Prof. Agnieszka Szuster-Ciesielska: Of course, the pandemic will end sometime, it won’t last forever. The virus, even if it evolves, will more and more often collide with the wall of developing immunity and the growing awareness of preventive health care. It was scary at first because SARS-CoV-2 hit an virgin population that was susceptible to the virus. Now it will be more and more difficult for him to take over us.
However, the new sublines of the Omikron variant, primarily BA.4 and BA.5, are of concern.
Yes, because they differ significantly in the amount and quality of mutations, especially the spine, compared to the first BA.1 subline. The problem is not only their ability to move quickly, but also to run away from our immunity. This should not come as a surprise, because the vaccines are based on the original Wuhan strain. The virus has come a long way since then, and the current sublines are very different. Clearly, it’s time to adapt to the new situation. And we know it is already happening. Pfizer and Moderna announce that Omikron-specific booster doses will be available in the fall.
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Only then a new variant may surprise us.
Unfortunately, SARS-CoV-2 changes faster than we can react. You should be aware that we are still chasing this virus. But it will end sometime, there is light at the end of the tunnel. The virus will eventually become endemic, and after many years, it will likely cause a common cold like other common cold coronaviruses.
Much has been said about endemic in the context of COVID-19, but it seems that it was rather wishful thinking.
It takes many years for the virus to become endemic, milder. In addition, it is determined by many factors: the way a person behaves, vaccinations, compliance with sanitary rules, that is, everything that hinders the transmission of the virus in the environment. Ultimately, it causes the immune response to be stronger and the symptoms of any disease to be milder. This eventually makes the virus endemic. The coronavirus does not yet meet these conditions. It will take many years for it to develop into a cold form, although it may reach endemic earlier, because our behavior also determines it.
I have the impression that in the context of COVID-19, we treat endemia as a synonym of peace and security, while it is quite the opposite. Some endemic diseases pose a huge threat to the entire human population.
Indeed, there have been many misunderstandings on this point. Endemia is confused with an epidemic, and although its tone is milder, it does not indicate that there is no threat. Endemic diseases are those that persist in an area over an extended period of time. Endemic is not limited to one region and may not be developing all over the world at the same time. In those countries where vaccination coverage is high and social responsibility is high, endemia may occur sooner. In contrast, in countries where vaccination is very poorly performed, the virus will have more opportunities to transmit and evolve.
Please provide an example of such a non-obvious endemic disease.
HIV infection. This may be surprising, because HIV occurs all over the world, but the point is that infections with this virus have remained constant for years, and are not increasing. Next – malaria, which is the best example that an endemic disease can be very dangerous and, unfortunately, very deadly. Malaria occurs in the tropics of Africa and has a huge death toll. Every year between 300 and 500 million people suffer from it, of which 1,5-2,7 million die. These are really very large numbers. Another example is Burkitt’s lymphoma, which occurs in African children. The disease is caused by the Epstein-Barr virus, although there are suspicions that an auxiliary factor, the so-called malaria is a cofactor.
We are talking about Africa, and until recently it was the “cradle” of monkey pox – an endemic infectious disease that spread uncontrollably around the world on a previously unseen scale. Why right now?
Scientists suspect that the virus may have already circulated in Western society, but because it has changed, it has “escaped”. This is primarily about the symptoms of the infection. It turns out that the monkey pox virus does not have to cause obvious skin symptoms in the form of a rash all over the body. This rash may be limited to one or two eruptions which will not leave you in doubt and will not prompt you to see your doctor. And this is how the disease spreads.
Scientists have observed that the virus has recently accelerated evolution significantly. The monkey pox virus is a DNA virus, which means that it changes, mutates, much slower than RNA viruses, such as the coronavirus, for example. The difference is significant – DNA viruses mutate about 10. times slower than RNA. Recent research has shown that the monkey pox virus has recently changed from six to 12 times faster than the nature of its genetic material would suggest. And maybe that’s how it evolved towards better portability or milder symptoms.
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Should we be afraid that another, perhaps much more dangerous, virus will also “escape” this way?
The World Health Organization has several viruses under close surveillance, including Nipah and Hendra. Both are paramyxoviruses, found mainly in Asia, and are transmitted by bats. Until now, it was thought to be zoonoses, but it has been observed that to a very limited extent, but nonetheless, it can be transferred from one person to another.
Why are they dangerous?
The mortality rate is huge – 60-75 percent. This cannot be compared to the coronavirus. If they evolve in a more adaptive direction towards humans, they can pose a considerable threat. In fact, the entire group of coronaviruses present in bats as reservoirs is under observation, many of them in laboratory conditions are capable of infecting human cells, which shows their epidemic or even pandemic potential. In addition, other viruses are dangerous, for example, causing Lassa fever, yellow fever or dengue fever. The latter is currently considered the fastest spreading mosquito-borne viral disease. Nearly 50 percent are at risk of infection. world population.
Two and a half years ago, most of us were unaware not only of these threats, but of the existence of most of these viruses. For you as a virologist, this subject is daily bread. Has the COVID-19 pandemic changed anything you think about the field of science you deal with?
Not much, because virologists and epidemiologists have long known that epidemics, pandemics, threats of new viruses will appear. The way people live in the world, the increase in population and population density, travel, climate change, inequality of access to vaccines – all this together causes a huge polarization, which results, among other things, from the spread of viruses.
The relative novelty is perhaps a new version of this polarization – the division into people who trust science and agree that vaccinations are the greatest achievement of medicine, save lives and are needed, and those who say that they are a threat, an attack on freedom. . It also clearly showed the diversity of knowledge that people have about health and prevention in general.
We encourage you to listen to the latest episode of the RESET podcast. This time Kamila Wykrota, the resilience trainer, will tell us about what resilience is. How does the ability to adapt to changing circumstances and react to adversities affect our quality of life? You will find out by listening to the latest episode of our podcast.