Filenews 28 February 2021 - by Xenia Turki
In the middle of last December, the big bet of vaccinations against Covid-19 began for humanity. Hope for all to return to normality. Most countries pay a very high price for the pandemic. The human losses are many, the economic cost enormous and that is why the pressure to stop the spread of the disease is enormous. Now a light begins to emerge at the end of the tunnel, that the nightmare will end in the next few months. Research shows that vaccinations are effective and therefore the big bet now is to remove barriers so that as many people as possible can be vaccinated without delay.
The message that if the measures are properly observed and that if most people rush to get vaccinated is probably the only way to end the pandemic, they send two doctors who are at the forefront of tackling the disease in Britain, speaking to the Liberal, who are at the forefront of tackling the disease in Britain: Paul Hunter, professor of Medical Microbiology at East Anglia University, and Vassilis Vassiliou, associate professor of Cardiology at the same university. In their interview, the two experts stressed anyway the aim of vaccination is to reduce the risk of serious disease and death, rather than to completely eradicate the virus, which is almost impossible because of the multiple mutations it presents.
No one can say for sure when the coveted wall will be built, since there is still much to be done under the microscope of the competent authorities and researchers. However, the two experts are confident that in the next period we will see a reduction in hospital admissions as well as a reduction in the number of people who lose their lives to Covid-19. The concern about mutations may be understandable, but what we need to bear in mind is that vaccines protect against serious disease and help prevent hospitals and health systems from being over-loaded. The message from Paul Hunter (B.C.) and Vassilis Vassiliou (B.B.) is extremely encouraging: We will defeat the crown, even if we still have to fight with him for a long time.
-How much longer does it take for mass vaccinations to have a tangible effect on the general immunity of the population? What role do you think each country will play in pursuing a different programme?
P.X.- Complete immunity of the population will never be achieved, as both natural infection and vaccines do not adequately prevent re-infection, even when they prevent serious manifestations and complications of the disease. The aim of vaccination is to reduce the risk of serious disease and death, not to eradicate the virus.
B.B. - Unfortunately, as with other viruses, the new coronavirus has multiple mutations, which "escape" from general immunity. For this, universal immunity is very difficult to achieve. However, there is room for optimism. Speaking generally I would say that an island that is more flexible at its entry points can more easily control the spread of the virus and a good example is New Zealand. For this reason a combination of mass vaccination, repeated every year to all citizens who meet the criteria, with a strong tracking system can help Cyprus keep low levels of SARS-COV-2 infection and allow it to return to the normality it seeks.
-Under the circumstances you describe at what rate do people need to be vaccinated in order to confirm the protection of the general population?
B.C.- The answer is complicated, as there are many factors that affect general population immunity. This will depend on the impact of virus mutations, age and geographical distribution, density and seasonality of a country's population.
B.B.- It is also important to indicate that even people who are vaccinated do not have 100% protection against the virus, and moreover they may be able to transmit it. Therefore, social distance measures, good hygiene and masks will continue to be part of life until Covid-19 reaches the point where it is no longer a threat.
- Do you think that the vaccination targets set in the first place were achievable or were simply the result of our desire to achieve the coveted immunity?
B.B. -Expectations are high, but I think the objectives set were relatively achievable. The big question, of course, is how long it will take to achieve them, as the limiting factor that is currently putting obstacles in the way of production, namely the lack of rapid production of vaccines in sufficient doses.
- If we could plan the issue of mass vaccinations from the beginning, would you plan something different? What have we learned so far from the process that has been going on for about three months?
B.C. - Speaking of Britain, I would say that the situation here is progressing very well, as the vaccination programme is under way and more and more people are being vaccinated. On the other hand, the European Union is facing problems because it seems to have given more importance to procedural matters than to focusing on protecting its population.
B.B.- I agree that Britain has a success on the issue of vaccines. The bottom line is we need fast and mass vaccination. Israel is perhaps the best example and the other countries should be exemplified by this.
- How worried are you about the mutations the virus presents? Is it really a threat or are we just terrified without real cause for concern?
B.B.- First of all, it must be said that the new mutations are not a surprise. It is common for viruses to mutate and give new strains. New mutations can be a problem if they are more contagious (so they can transmit the virus to more people) or more infectious (so they can cause more serious diseases and have more hospitalizations and deaths). Unfortunately, several of the new mutations have shown similar characteristics and led to an increasing number of patients being infected and ending up in hospital for hospitalization, with several of them even losing their lives. The other big concern is vaccinations.
- Do you think, therefore, that there will be an impact on those who have already been vaccinated by virus mutations?
B.B. - This is something that we need to see separately for each mutation and for every type of vaccine that is on the market and we cannot speak generally. There is, of course, concern that vaccines may have limited protection against certain mutations. That's exactly what we see happening with the South African mutation. On the other hand, however, we must not overlook that vaccines protect against serious disease and this is just as important. Any new variant presented must be evaluated. Here too, it is important to mention that all vaccines can be modified to act against new mutations. However, this is a process that takes at least six months. In addition, this assumes that those who have already been vaccinated will be vaccinated again with the new modified vaccines.
-Covid-19 didn't turn out to be a simple flu, as many have claimed. What does your experience show you about its long-term consequences?
B.B.- We see that many people who got sick during the first wave of the disease have symptoms for some time afterwards. They suffer from chronic fatigue, shortness of breath, chest pains, insomnia, headaches, poor memory and concentration, a syndrome that experts call long Covid ie Covid long duration. We have fellow doctors and nurses who were unable to return to work several months after they got sick because they could not cope with their duties. Therefore, the only way to prevent mortality and morbidity associated with Covid-19 infection is to aim for a complete eradication of the disease.
If we don't have a state with a healthy population, the economy will suffer anyway.
- The pressure to start traveling is great. Do you support the idea that there should be a 'vaccination passport' for travel purposes and beyond?
B.C. - I'm sure we're not going to achieve complete general immunity. Once the most vulnerable are vaccinated, I believe that travel restrictions should be lifted.
B.B.- It is difficult at the moment to make such a decision. Moving forward, in my opinion the safest thing we can do is to ask for a negative coronavirus test for all those travelling 72 hours before their journey and to conduct a rapid test upon arrival at the airport of a foreign country. However, what we need to understand is that the more people are vaccinated, the safer travel will become.
- How do you assess the last 14 months when humanity has been living in the shadow of the pandemic? What successes were recorded and what failures?
B.B. - How uniquely unusual has the last year been. We've seen many organisms work together to zero in on the effect of the virus. The role of science and medicine has been at the heart of it and once again the most important successes belong to the medical field. Through appropriate collaborations, clinical trials were set up very quickly, which allowed the identification of treatments such as dexamethasone (a steroid) that saved human lives. In addition, science and medicine used their years of experience and were able to develop safe and effective vaccines in record time. On the other hand, not everything was rosy, of course. The fact that we didn't appreciate how quickly the new coronavirus attacks can be considered a failure. This has led us to a situation where critical decisions have been taken, without having full data in front of us, and that is why many governments have been slow to take decisive action in time. I will refer again to the example of New Zealand where the government of the country imposed early lockdown, strict border controls and established an effective tracking system, which has now allowed it to have zero cases. What I'm trying to say is that we've learned that when the virus is on the rise, no other measure can stop it from full lockdown.
-Speaking of lockdown the debate about their effectiveness has been lit up for good. On the one face, they seem to be saving lives, but is the price we pay for them, financial, mental health issues, isolation, really too great?
B.B.- That's right. Lockdown is not a pleasant thing and causes a lot of problems. That is why most governments try any other measure before finally implementing them. In the end, the economy and health are put on the scale in order to decide on the implementation of a lockdown. The timing is also extremely important, i.e. when and for how long it will be implemented. We now know that the outbreak of Covid-19 cases cannot be stopped in any other way. So if it has to be implemented, it may have to be done before the situation reaches the inexcusable, so that it has a shorter duration.
It is important, however, to add that economics and health are interrelated concepts and not necessarily rivals. In other words, if we do not have a state with a healthy population, the economy will suffer anyway. Lockdowns aren't the only ones affecting the economy. The blow to the economy will probably be much bigger if the epidemic is not controlled with a lockdown. Burdened morbidity and mortality, not only due to coronavirus but due to the overs saturation of health systems, will result in additional predictable deaths, weakened labour and depleted health resources with longer-term greater consequences for the wider community.
I couldn't help but agree that lockdown is hard and that isolation is a difficult process for everyone and that can exacerbate mental health problems. That's why it's important for all of us to try to stand together and stand by our neighbours, friends, family members. We're going to beat Covid-19, but this is going to take a little longer than we'd like.
Protect ourselves with any vaccine available
- Will we ever get to the point where vaccines against Covid-19 will now be unnecessary?
B.C. - It's too early to make such an assessment. But seeing how the situation is now, I believe that for at least the next five to ten years people will need to be vaccinated against Covid-19. We will be called to learn to live with the virus and survive its infections, aided by vaccines.
-What happens if one region, country or continent achieves a better vaccination rate than another? What are the risks if, for example, Europe vaccinates most of its population and Africa does not?
B.C. - It's a risk that the different vaccination rate brings, and that's something we have to deal with.
B.B.- I agree, the different degree of vaccination is an issue of concern to the medical community and this is an undesirable scenario, which will allow the virus to exist, as well as its mutations.
-As more vaccines are approved and marketed, do you think that either citizens or government authorities should have the right to decide which formulation to use?
B.C. - It's a difficult issue. However, the World Health Organisation has already issued some directives and what it mainly wants to achieve is that all countries will have sufficient quantities of vaccines.
-Is it safe to administer the AstraZeneca vaccine to people over 65?
B.B.- Both the European Medicines Agency and the World Health Organization argue that AstraZeneca's formulation can be administered to people aged 65 and over. The most important thing is that we all protect ourselves with whatever vaccine is available, regardless of which company has manufactured them.
Compatibility and doses
- Are vaccines compatible with each other? For example for a two-dose vaccine, can someone get the first from the AstraZeneca formulation and the second from that of BioNTech and Pfizer?
B.C.-I'm pretty sure about the compatibility of vaccines, but it's something that needs to be scientifically proven. An investigation is currently under way in Britain, which just wants to ascertain what is going on with this issue.
-What is your view of two-dose vaccines in relation to those of one dose?
B.B.- Britain has sparked heated debate by delaying the second dose from six to 12 weeks in order to vaccinate more people, as there were not enough doses available. There are indications that the AstraZeneca vaccine is safe and offers better protection. We are waiting for Pfizer and BioNTech vaccine data but in theory, the same principle applies. Therefore, it makes sense to delay the second dose if it means more vaccinations. As far as single-dose vaccines such as Johnson & Johnson are concerned, compared to those that are two such as AstraZeneca or Pfizer and BioNTech, there is no difference in their effectiveness.
