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RIO – The virologist Eurico Arruda, from the USP School of Medicine in Ribeirão Preto, is a staunch critic of the proposal to create an “immunity passport” for cured covid-19 patients. He is also skeptical that the widespread spread of the disease could create “collective immunity,” in which most former patients would protect a minority of uninfected people. He cautions that if he follows his “family’s” behavior, the new infectious agent that has spread from China to the world may not generate lasting immunity, unlike diseases like measles, for example, that they immunize for life. Therefore, there would only be immunization with a vaccine that does not yet exist.
“I pray I am wrong, so that next year we will discover that everyone who had SARS in 2020 will no longer have SARS. But this is a novelty for coronaviruses,” he says, in an interview with State.
The researcher says that covid-19 is, like other coronaviruses that emerged in the 21st century, aggressive and “different”, causing unexpected complications for the patient, for example, strokes in young people and kidney, brain and pressure problems. He believes that Brazil lost time since the virus appeared in China and spread in Europe. But he is optimistic about the possibility that a vaccine will reach the population quickly, which, according to him, should occur in early 2012.
Below are the main excerpts from Arruda’s interview with State.
For some time, there was hope regarding covid-19, which was even cited even by politicians, that there would be an immunity passport, a document so that anyone who had already had the disease could return to activities, because they would be immunized. You have criticized the idea. Why
Totally, because that idea does not exist. There’s no such thing. This virus belongs to the same family as other viruses that jumped from animals to humans and adapted for decades and circulate among people endemically. That is why we have been studying these viruses for some time. Therefore, it has been known for a long time that these coronaviruses do not induce, I am talking about the previous ancient coronaviruses, they do not induce a lasting and protective immunity. So much so that there are classic experiments carried out in England in which the individual is experimentally infected with the coronavirus, therefore, he is sure that he inoculated him, because the virus dripped into his nose. Develops a respiratory infection, in the case of a cold. Then it is cured, then it is tested and you see that the individual has antibodies, has antibodies, has antibodies … After a year, they went there and dripped the virus into the individual’s nose. And the individual contracted the virus again.
Is it a great possibility that a person has a coronavirus and does not immunize them?
Immunity, in viral diseases, for some of the viruses, is permanent. Measles is one of those (viruses) in which immunity is permanent. Measles, chicken pox, mumps … Those diseases that you only have once. But there are all the respiratory viruses, it is a list, they are more than fifteen. In fact, if you consider that each of them has several types … And adding more than 150 types of rhinoviruses, you get more than 250 different types of respiratory viruses. And they have no cross immunity. That is why you spend your whole life, you live 80 years, you have colds. You are not immunized for them. Well, the coronaviruses, the old coronaviruses, let’s call it that, the endemics … I prefer to call them endemics. because they are no longer epidemic, but they have become endemic. So there are OC-43, 229-E, NL-63 and HKU-1. They are the four known human coronaviruses. They circulate normally and immunity against them sucks. It is not protective and can re-infect these coronaviruses once again throughout their lives. Here comes the 21st century, and three different coronaviruses emerge, leaping from bat species to humans. Some came from bats directly to man, others came from bats that passed through other animal species. What are they? SARS-1, MERS, Middle Eastern, and now SARS-2. These three are the 21st century coronaviruses, let’s call it that. All of them produced very serious epidemic outbreaks. Of course, nothing compares to this one because SARS-1 and MERS were somewhat restricted to Asia. So now this third party, which is SARS-2, has appeared. It is a virus with tremendous propagation capacity. It spread in the world in a fantastic way, because from December to March the virus was on all continents.
But what is your criticism?
When we tested the serological test, the pharmacy test, there are so many HIV positive people there that I’m not even sure if that’s exactly positive for SARS-2. Because these tests have not been validated. And I’m not here criticizing anyone. Because a pandemic has arisen, each investigator runs away to help do something. They made the virus antigen, a virus protein, put it on that tape to capture antibodies, and they all go there to test the tape. But that test has not been validated. In other words, it has never been adequately studied if it has a cross-action with other coronaviruses, if the antibodies produced by other coronaviruses also react with this SARS-2 protein in that test. That is, they would be false positives. On the other hand, people go to the pharmacy, for example, and celebrate. I’ve even seen it on television, the person takes his finger out of the car window, does the test, the result comes out: “Oh, it was negative.” The person jumps for joy because he does not have the virus. And this is wrong. The person may have the virus and the serology in the blood is negative because there has not yet been time to produce the antibodies. We had to invest in detecting the virus in secretion, by PCR or by antigen research, but in respiratory secretion. Looking for the antibody in the blood … that’s for later. What we need now is to save lives, to save people. To save people, you must look for the virus in the secretion.
Is it possible to do this in bulk? Or is it too expensive?
Germany did it almost throughout Germany. So they did massive tests and separated people with the virus from people without the virus. But you can’t do that with serology. Look, you say I’m a great critic of openness. I really am, because there is no way to separate the wheat from the chaff now.
Another argument that was also raised is that there would be a “collective immunity” problem, that is, a large number of people, 70% of society, would have the disease and be immune. From what you say, it doesn’t work as well, at least in relation to coronaviruses.
Exactly. You just asked the key question. Is there herd immunity? There is But it is half crazy for some viruses and very good for others. Collective immunity against measles: If the population of any country has a measles vaccination coverage of 90%, what does it mean? This degree of immunization against measles is sufficient herd immunity to protect the entire population. Now, in these respiratory viruses, where immunity is partial, it is not a protective immunity for life … So I might even be wrong, I pray to be wrong. So next year, 2021, we’ll find out that everyone who had SARS in 2020 will no longer have SARS in 2021. But this is a first for coronaviruses. If you follow family rules, that immunity may be partial.
An impression, too, from a layman, is that new and surprising information about the covid-19 appears every day. Now, a problem has been discovered involving younger patients who have a stroke due to the virus. Why does this new coronavirus look so different from the others or not?
No, he is different. He is diferent.
What differentiates coronavirus from other viruses?
These three new ones, these three from the 21st century, let’s say, that are still epidemic, have not become endemic, they are much more aggressive viruses. So we can call various components to explain this. For example, the input receptor for this virus is an enzyme, which is the angiotensin-converting enzyme, which interferes with various organ systems, including blood pressure control. So you can imagine the consequences for a cell of a virus that called at the place where the one that should call would be a blood pressure controller. So there will be a change in blood pressure. This receptor is rich in endothelial cells, that is, it is well expressed in blood vessels. The virus will now infect the blood vessels. And it will start to cause disseminated intravascular coagulation, there is a high degree of fibrin deposits in the lungs. In fact, the lack of oxygen in the blood of patients is surprisingly low, the oxygen content … If it was another disease, with that oxygen saturation content of 50% or less, people are dying. And sometimes, with this virus, the person is already less than 50% saturated and is not yet dying. He will die later … He (the virus) is bringing some news, like this one, under clinical observation. Including kidney damage, brain damage … So it’s a different virus. You got me into this: I can’t reason with bringing everything you knew about endemic coronaviruses to these as if they were the same, because they are not. Those are much more serious.
We have had very bad figures in relation to the pandemic in Brazil, including alarming figures. What do these numbers indicate as of now? Because these data confirm what was said, that from the end of April to May there would be an acceleration …
Would there be an acceleration because what is being seen? I do not want to politicize the debate, I do not want to express political positions here. However, there are a few things to say. When it started in December in China, and we saw that in early January it was already in Europe, in Italy, and in February, in early February, it was already booming, we knew we were going to get here. So, it’s not about ‘Ah, I hope you don’t get here’, I’m going to sit on the couch hoping it doesn’t. I was going to arrive. Therefore, it was necessary to take action from January.
Did we waste time?
We lost a lot of time. We wasted time. Of course, there was no cure or vaccine, but we could have provided better conditions for treating patients. More beds, more ICU, more respirator, more mask …
How do you see this pressure, by some authorities, to loosen the quarantine? There are people who accuse scientists of being dominant, for not considering the whole, the economy. How do you see this
It is funny. (Em) A country that goes years and years without adequate funding for science, that dismantles research and science, is suddenly the fault of scientists who are alarmists? My dear, you have a nightly duty to bury a corpse in Manaus. Do you think this is an invention? It is a very serious disease, a new disease. We needed to be united against it.
But what the authorities, especially the federal authorities, argue is that Brazil is a very large and very diverse country, so the pandemic does not follow the same pattern in the regions. Doesn’t that matter, this regional difference?
Look, when they asked me, in the interviews I gave at the beginning of January, they asked me what I expected, I said: the only thing I really want is for this virus not to like the heat. Because respiratory viruses are usually cold weather viruses. In fact, in China, where it started, it was very cold. Germany was cold, Europe was cold … But then you look at what is happening in Manaus, and it is surprising and shocking. There is no place hotter than Manaus. So the virus is there, pumping. So, I think that the arrival of this virus to places where it has not yet reached is a matter of time. They are people who travel, spread out, etc.
So the only way out is the vaccine?
The only way out, yes. For almost any disease, with rare exceptions, you ask me, the way out is a vaccine. I think we will have a vaccine. This vaccine from the Chinese and the British, I think it will work.
Isn’t it too far to reach people?
It is an inactivated virus vaccine, the world manages to organize itself to produce an inactivated virus vaccine, in a whole hemisphere, in a period of five months. For the flu, I’m talking. So if we apply the reasoning that this installed capacity to produce this flu vaccine takes five months to produce for the southern hemisphere and then five months to produce for the northern hemisphere, we are talking about a space there of about ten months to produce for everyone. We are only in the midst of a pandemic in which there are several vaccine factories that can be activated. So, I have the impression that we can shorten this time. Even Brazil is a candidate (to produce the vaccine), because we have an important vaccine production plant that is Butantã.
That would point to when? Early 2021?
And over there.
For the vaccine to reach people?
For the vaccine to reach people.
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