“Morocco must indeed be worried”

The natural process of SARS-CoV-2 gives rise to variants, which are constantly mutating.

The Delta variant, reputed to be very contagious, is present on the national territory.

Interview with Dr Tayeb Hamdi, researcher in health policies and systems and vice-president of the National Health Federation.

Interview by Ibtissam Z.

Finances News Weekly: Alpha, Beta, Delta, Gama …, the variants of the initial Sars-CoV-2 virus are multiplying. Currently, the Delta (Indian) variant is on the rise. How can we explain it?

Dr Tayeb Hamdi : Since the outbreak of the pandemic, we have had the classic strain and of course the other variants. Towards the end of 2020, there was the appearance of the Alpha variant detected in Britain, Beta in South Africa, and Gama in Brazil. The name has been changed by the WHO so as not to stigmatize countries. The Delta variant, detected in India last April, is progressing, and this is completely normal.

When we have a variant which is more transmissible, it is obvious that it dethrones the other variants. Alpha, the British variant, is 40-70% more transmissible, so it ended up replacing the classic strain in Europe and many other countries. As far as Delta is concerned, it is much more transmissible than Alpha by 60%. So, whenever there is an introduction of the Delta variant in a country, it will automatically end up taking the place of the previous variants. It will be the most dominant, unless there is an appearance of a new variant (mutant) which would be more transmissible than the Delta.

FNH: Classified as worrying, the Delta Plus has worried the scientific community in recent days. It would be even more aggressive than the Delta variant. What is it?

T. H. : Indeed, the Delta Plus variant is worrying, but what we know today is data provided by the Indian Ministry of Health, which has classified this variant as being of concern, “variant of concern”. They believe that Delta Plus spreads faster compared to Delta. It might be more virulent, or could thwart the effect of the immunity acquired by vaccination and that conferred by a former infection due to Covid-19. It should be noted that the World Health Organization (WHO) has not yet classified the sub-line of Sars-CoV-2 Delta Plus, as being of concern.

The scientific data on this mutated Delta variant are scarce; there are no in-depth studies in this direction yet. However, the scientific community is taking into consideration the statement of the Indian health authorities pending data and scientific studies which demonstrate that Delta Plus would be more transmissible and more virulent than the Delta in question. But it is indeed a mutation in the mutation of the Delta.

F.NH: The Delta variant raises fears of a resumption of the epidemic in Europe, as was the case for Great Britain and Russia. What about Morocco? Should we be worried, especially since we are seeing a relaxation of barrier measures?

T. H. : The introduction of the Delta variant on European soil was detected early in Great Britain, before spreading to practically all other countries. There is has just over 80 countries that are affected by the Delta variant. Since its introduction, it has steadily gained ground, replacing the dominant British variant Alpha. For example, in England, 96% of new cases are due to the Delta variant. If we take into account the data published on the international site for the sharing of genomic sequencing (GISAID), over the last 4 weeks, 77% of the sequencing carried out in Portugal show that it is indeed the Delta .

For Spain, we see 10%, about 8% in Italy, and 30% in the United States, revealed only a few days ago. This spread of the Indian variant is the cause of the epidemic resumption in Great Britain, Portugal, Russia, South Africa, and it will be the case for other countries, it is obvious. At the end of August, the Delta variant is expected to permanently replace the Alpha in Europe, which means that a resumption of the epidemic is possible. There is talk of a 4th wave in Europe towards the end of the summer season. An epidemic recovery means more positive cases for Covid19, but not necessarily severe cases that require hospitalization in intensive care or outright lead to death. Vaccination plays an important role in preventing severe cases of the disease.

It’s a race against time to vaccinate as many people as possible. Regarding Morocco, indeed, we must be concerned. Who says presence of disturbing variants on the territory, says rapid transmission. There is a considerable relaxation of barrier measures. The finding is alarming: as soon as there is a relaxation, health measures are no longer respected. Unfortunately, the people deduce that we won the battle, when that is completely wrong. We are still in a vulnerable phase. For internal or foreign travel, there is always a risk of a resumption of the epidemic. The only way to keep the epidemiological situation under control in order to counter the virus is to further strengthen respect for individual and collective barrier measures.

In Morocco, we risk seeing an upsurge in new cases in the coming weeks because of the release and the Delta variant. If the population respects individual and collective barrier measures and people over 40 who had missed their vaccination appointment catch up, then there will be a slight to medium recrudescence of new positive cases, without influence on serious cases. , and deaths would remain low and under control. Otherwise, there will be a sharp upsurge in new cases, with more hospitalizations, and serious, even critical cases among unvaccinated people over 40, suffering from chronic illness, but also among young people. Therefore, more restrictive measures would be necessary.

FNH: The variants will continue to mutate. How can you imagine the coming months with Delta, Alpha. What approach should you follow?

T. H. : Mutations are part of the very nature of the virus. Every Once we advance in the pandemic and in the vaccination, we will have mutations that will be more and more worrying and serious. This is called immune pressure. We do not have a planetary population (8 billion) which has virological virginity compared to Sars-Cov-2. That is, initially, no one had the antibodies against this virus. On the other hand, with the persistence of the pandemic, there have been hundreds of millions of people who have caught the virus and who, as a result, have developed antibodies.

Of course, there have been deaths all over the world, but over 99% of the population is doing well, so they keep the antibodies. The other point to raise is the vaccination which is advancing. We currently have hundreds of millions of people around the world who are vaccinated and develop antibodies. It is true that the virus knows mutations; and these mutations, in the presence of antibodies or immunity, divert that immunity which is acquired either by the vaccine or by the disease. The process of natural selection means that we will end up with more and more mutations, which will deflect immunity and the effects of antibodies, which means that we will have more variants said to be “disturbing”. There, we are talking on the scale of the pandemic over one, two or three years of evolution of the virus and its mutations. In the long run, vaccination and immunity eventually overcome the virus; the latter weakens and becomes a virus like any other, like the flu or the common cold. This is what brings us to talk about vaccine injustice. India has it very well

demonstrated, and there are many countries where the virus circulates freely. A virus that circulates continuously mutates and, therefore, these mutations will be even more serious. England, for example, has vaccinated a large part of its population, and today it finds itself held hostage by Indian variants. This is where the whole problem lies. We have no other alternatives, we must vaccinate the maximum possible of the population and respect health measures to slow down mutations. Likewise, it is important to reduce and manage gatherings, it is the only solution to break the chain of the virus.

FNH: The detected cases of the coronavirus linked to the Delta variant, recorded in recent days in vaccinated people, are really worrying. Are these Delta variant contaminations after vaccination normal?

T. H. : Unfortunately, the Delta variant weakens the effectiveness of vaccines that are currently available. Indeed, studies have shown that people who have already contracted the covid-19 virus with other strains, classic, Alpha, Beta, Gama, are more at risk of reinfection with Delta. Especially people who have been infected with the coronavirus due to the South African and Brazilian variants: they are more likely to catch the disease again. For those who have been carriers of the virus (classic strain and Alpha), the risk is lower compared to Beta and Gama.

Regarding vaccines, a study carried out in Great Britain found that for people who have been vaccinated with AstraZeneca and Pfizer, the effectiveness of the vaccines is reduced to 50% when it comes to the Alpha variant, and considerably reduced to 31 % concerning the Delta variant. This means that 70% of people who have received only one vaccine dose are at risk of having the disease again. However, there are glimmers of hope, with this good news highlighted by studies. These have shown that for people who have completed their vaccinations (2 doses), the efficacy is estimated between 80 to 90%, with practically the same success rate against the other variants, and even more than 94% against the severe forms. .

FNH: The virus replicates and mutates. Would it be possible to counter it by causing it to “mutate to death”, in a process that scientists commonly call “lethal mutagenesis”?

T. H. : Indeed, it is a line of research. Lethal mutagenesis is a scientific notion that does not date from today with the advent of covid-19, because it has been around for more than 3 decades. Researchers and scientists are working on this hypothesis, which consists in using certain characteristics of the virus’ mutation for the benefit of science. Scientists believe that we could push these viruses to make a lot of mutations, so that they are no longer able to reproduce, and therefore no longer be able to secrete proteins that allow them to multiply and spread. Drugs, especially antivirals that cause lethal mutagenesis, have already been tested against other viruses.

It is an avenue to explore. But this technique is more of a search for the future, but not an immediate solution for the coronavirus. There is another branch, the one that we tend to forget: it is about drugs against the coronavirus to treat people who have already caught the virus. If we can find an effective treatment, it will be an excellent thing to achieve a good combination of vaccines and drugs. Currently, we must remain vigilant, administer the vaccine and respect barrier gestures to protect ourselves while awaiting collective immunity.

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