New Delhi, November 12
AIIMS director Randeep Guleria in an interview with IANS said that we could reach a stage in the future where we could have a good amount of immunity, and people could feel that there is good immunity now and that the usefulness of the vaccine is not there. He added that if the virus does not mutate or cause changes, people may not think about getting vaccinated again and then there will be less use of the vaccine in the future.
Excerpts from the interview:
Q: If a vaccine is available ready-to-use in early 2022 or late 2021 for ordinary people, would they not have achieved immunity against this viral infection, or perhaps the Covid-19 scenario improved by then? People can treat this viral infection like the common cold and cough, which has no adverse health impact.
A: There are two issues: one is the immediate availability of the vaccine to reduce and prevent the pandemic. So if there is a vaccine available, if you can give it to the high risk group and to those who have a higher probability of contracting the infection as a priority, we could immediately decrease the number of cases and also decrease the number of deaths.
But, we can get to a stage on the line where we can have a good amount of immunity and people feel that now there is good immunity, the usefulness of the vaccine does not exist. And, if the virus does not mutate or cause changes that may require you to be vaccinated again, because you can become re-infected, then there will be less use of the vaccine in the future.
One problem is how the virus changes and what is the possibility of reinfection and, if that is a major problem, then we must get vaccinated to prevent reinfection. We are learning how the virus behaves over the next several months and based on that, a decision will be made on how often the vaccine is required. If we have good herd immunity, whether it is necessary or not, this is a big challenge because a lot of money is invested in vaccine doses and manufacturing and sometimes the vaccine industry is very concerned that it could have a drop in demand. .
Q: Have you mentioned that people have long-term side effects after their recovery from Covid-19? If Covid-19 belongs to the coronavirus family, why do patients develop medical complications that can have long-lasting effects on health or a prolonged illness?
A: Most of the previous viral infection we had is due to other viruses such as influenza. Coronavirus, we have almost seven other viruses in subsets of this coronavirus family. Four of them only cause flu-like symptoms, which are very mild. The other three we have, one was SARS, which was controlled and did not cause a pandemic. We also have the MERS coronavirus, which is not that contagious, so we have small outbreaks.
This is the first pandemic of this magnitude with coronavirus, the previous pandemic was with influenza viruses. What we are realizing with this coronavirus, which is a new virus, and is of bat origin. This virus, although it causes a respiratory tract infection, also has a systemic effect. The virus attaches itself to receptors that are present in many organs of the body, the ACE2 receptor. It causes swelling of the blood vessels and if these blood vessels are in the heart, it can cause myocardial damage to the heart muscles. It leads to higher chances of clotting and this leads to strokes. This virus can cause what we call Long Covid. Post-shriek from Covid, which is not anticipated to be a serious problem, as most viral infections tend to recover and people have post-viral effects that last for a few days and then recover.
The government is working vigorously to develop post-Covid-19 clinics at all levels, this could be at the district level and in medical schools, and to provide comprehensive support to these people. Many of them need supportive treatment, which could also be meditation, yoga, so a comprehensive plan is sought: allopathic, yoga and Ayurvedic medicines.
Q: There is data showing that BCG protects against viral infections. Can a booster dose boost the immune system and protect against Covid-19?
A: There is controversial data when it comes to BCG. There is in vitro data from laboratories, which suggests that the BCG vaccine gives some degree of immune response, which also has an anti-viral effect. A retrospective study from Israel showed no benefit for people who received the BCG vaccine. But there is another study from the Netherlands, which looked at people who got the BCG vaccine five years ago for some other trial, and found that they had some degree of protection, as far as Covid-19 is concerned.
The recent trial under the ICMR tends to show that there may be some benefit, but currently some vaccinated in the older age group are small. There are two ongoing trials in India, which are multicenter: one is the BCG vaccine in the elderly and the other is the BCG vaccine in younger age groups with comorbidities. Theoretically it may be more beneficial, but we need more data to say that vaccinating all the elderly with booster doses of BCG is worthwhile.
IANS
