Why the oropharynx and nasopharynx have become springboards for new variants of the “omicron”, how long the protection against infection lasts, in what cases it is necessary to vaccinate (including flu and monkeypox) and where a new terrible strain of coronavirus may come from, in an interview with Gazeta .Ru,” said Pavel Volchkov, head of the MIPT Laboratory of Genomic Engineering, virologist.
– Pavel Yuryevich, now we are again on the vector of a rising wave of coronavirus infections, 12 thousand infected are detected per day. Is it already the peak of the wave or not yet?
“I think we’re on a slowly rising shoulder. I suspect that the maximum values will be in September-October, because a lot of activity is needed for the spread of the infection, and it is impossible without children and adolescents.
Kindergartens, schools and universities will start working in September. In addition, by September-October, antibody titers will drop in those who had been ill at the beginning of the year.
– What are the main symptoms of COVID-19 caused by the latest versions of Omicron?
– Swelling, redness and prolonged sore throat, severe runny nose. All these symptoms can be easily explained by the peculiarities of the new variants of “omicron”. After all, these strains do not descend into the lungs, but are localized in the place where the infection occurred.
This is the oropharynx and nasopharynx – now all events are unfolding here. A runny nose is needed to physically wash out the virus that has entered with a reverse current.
As part of the mucus released from the nose, there will be many dead neutrophils, with the formation of neutrophil networks (neutrophils are a subgroup of cells that are part of innate immunity. Their main function is to capture and digest pathogenic microorganisms – viruses, bacteria, fungi, protozoa – and decay products body tissues. – “Gazeta.Ru”). This is the job of the immune system.
What we in most cases take for a disease is actually the work of the “air defense of the human body.”
– Why does immunity not always protect, even if a person was infected with the same “micron”?
– The immune system does not work on the principle of “black and white” and cannot 100% prevent any re-infection in principle. It all depends on the specific circumstances of obtaining the virus, its amount (viral load), concomitant diseases, and the age of the person.
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And this, in particular, is the answer to the question: will there be lethal outcomes with these relatively light variants of “omicron”? Yes, they will. But they will be largely less than with the “delta”, if only because pneumonia develops in a small number of cases.
– If you look at the graphs of the number of infections in different countries, and in particular in Russia, you get the impression that the worst was in January-February 2022. Is it so?
– Not this way. Still, the most difficult period, if we take Russia, was associated with the delta strain. Lethal outcomes and the level of hospitalization are incommensurable with the “omicron”. This happened because “omicron” changed the dominant way of penetration into cells, he began to use endosomes (membrane vesicles). This was a turning point for the pandemic.
It is due to this that “omicron” began to infect in significantly smaller quantities. If earlier it was necessary, conditionally, 1000 viral particles per unit volume, now the virus needs almost an order of magnitude less, maybe two orders of magnitude.
He does not need to make his way into the lungs, but you can simply fly to the epithelium of the upper respiratory tract. In fact, this has led to the fact that people tolerate “omicron” much easier.
That is, as they once said, “omicron” can be called a natural vaccine.
– And what is better – a natural vaccine or a drug?
The drug is actually a good thing, but in terms of the level of protection, the vaccine will never be compared with a natural viral infection.
— According to Rospotrebnadzor data, omicron BA.4, BA.5 lines now prevail in Russia. Together, they account for 75% of all cases of infection. Should the sick try to understand what version of “omicron” they have?
— Not worth it. They do not differ much from each other inside, they have not gone so far from each other that they have competitive advantages.
– Where can the next strain come from, which will cause not only interest, but also concern for WHO?
– If you “cross” India with the immunodeficient southern part of Africa, something might work out there. But this takes time. “Centaur” is now gaining momentum in India, but it still has a long way to go to become a separate letter of the Greek alphabet.
– In the scientific literature, there are studies that try to answer the question: how long does the protection work on average after the initial infection. Some articles say that such protection lasts approximately 14 months.
– It looks like the truth. And here it is important to understand that the severity of the secondary disease is incommensurable with the first. Moreover, there is another clear pattern: if you were seriously ill, then you have formed a lot of antibodies, your defense works better and longer.
If the first infection was easy, then the protection is worse.
The analogy is this: if you have a full-scale, long-term invasion with a deep penetration into your territory – you had a real war there – it is clear that you will remember this war for a long time. The immune system reacts in a dose-dependent manner.
– Therefore, protection against “omicron” – if, say, a person was infected during the January wave – should be worse than from “delta”?
— Yes, because Omicron does not cause large systemic lesions.
This does not mean that after it you are not protected, just protection is developed in proportion to the infection that has occurred, no more, no less. From the point of view of biology, this is an effective answer, why answer hyperbolically? Thus, the immune system is regulated.
– There are also a lot of scientific articles that say that the third and fourth vaccinations protect against the “omicron”. Would you recommend getting vaccinated now?
– It’s not about the third and fourth. Ideally, each specific individual should be considered separately, a personalized approach is needed. If a person had been ill with “delta” and had symptoms when “omicron” came, in addition, he was also vaccinated, now it’s not worth doing anything.
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If we consider the history of people who have recently been vaccinated and have never been ill, then a decision must be made depending on the date of the last vaccination. If it was much earlier than six months ago, on the eve of the autumn season, I would recommend that they be vaccinated.
– Who needs to be vaccinated now in the first place?
– Those who have not been ill and have not been vaccinated before. But it is these people who most likely will not go and get vaccinated, because they already did not do this in previous years of the pandemic …
Should children be vaccinated?
– Yes. We have a vaccine for children, and during this time a fairly large number of children have matured and moved into the category when they can already be vaccinated. Especially in the run-up to the fall school season, I would encourage children to get vaccinated against COVID-19.
– In anticipation of a possible outbreak in the fall, I would recommend that people, especially the elderly, who have been vaccinated for a long time, get revaccinated.
The immune system also ages, so a booster would make sense for them. If anyone has an increased number of deaths, it is in the elderly. This is where the “overshoot” factor comes into play.
– Do you need the flu?
“We need even more from the flu than from COVID-19, because we haven’t had the flu for a very long time. And a large stratum of children has formed who have never had the flu. This is a large layer that is able to quickly re-infect its parents. Parents also haven’t had the flu for quite a long time, antibody titers in most of us are already low.
“What about monkeypox?” Recently, more than a thousand infected people were detected in the United States in one day …
– Monkeypox, it’s more like a “media topic” after all. It is clear that we are very sensitive to any viral infection during the COVID-19 pandemic, but the virus is not comparable in potential to SARS-CoV-2.
Monkeypox is transmitted through sexual contact, bodily fluids and microtrauma. It could be compared to the human immunodeficiency virus, but HIV has a long latency period – people may not know they are infected for years and spread the viral infection. This is not the case with smallpox. Therefore, this virus is quite easy to control if you set such a goal.
Should there be a monkeypox vaccine in the country? Does it need to be done now?
– If I were a representative of a pharmaceutical company or an institute affiliated with a state company, I would set out to make such a vaccine. Let it be. But first of all, I would evaluate the possible market for its sale. Of course, it can be applied in African countries. Potentially, there is some political meaning in this – establishing contacts with the countries of West and Central Africa. For Russia, I personally assess the likelihood of a wide spread of the monkeypox virus as small.
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