More than a year has passed since the beginning of the COVID-19 pandemic, vaccines with proven efficacy have already appeared, but the SARS-CoV-2 virus still remains one of the main mysteries and misfortunes of our time. The number of infected on the planet is approaching 140 million people, the number of victims has exceeded 3 million. New strains reduce the effectiveness of existing vaccinations and the immune defense of those who have recovered. When will the pandemic end and what awaits the residents of Russia in the near future?
A person who is familiar with many viruses firsthand, has extensive experience of practical work and scientific research can better understand the current situation and make predictions more reasonably. The hero of the Komsomolskaya Pravda interview is Mikhail Ivanovich Mikhailov, Soviet and Russian scientist-virologist and epidemiologist, Doctor of Medical Sciences, Corresponding Member of the Russian Academy of Sciences.
He graduated from the 1st Moscow Medical Institute named after I.M.Sechenov, then worked at the D.I.Ivanovsky Research Institute of Virology. From 1980 to 2005 he headed the laboratory of the Research Institute of Microbiology and Epidemiology named after N.F. Gamaleya. 2006 to 2016 worked at the Chumakov Institute of Poliomyelitis and Viral Encephalitis, where he rose from the head of the department of viral hepatitis to the director of the institute.
Since 2009, he has headed the Department of Microbiology and Virology at the Peoples' Friendship University of Russia. Today Mikhail Ivanovich is the head of the laboratory of viral hepatitis at the Research Institute of Vaccines and Serums named after I.I. Mechnikov and Scientific Director of the Institute of Molecular and Personalized Medicine of the Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation. Professor Mikhailov investigated the patterns of the spread of viral hepatitis of various etiologies (hepatitis A, B, C, D, E, G and TT), and also participated in the development of vaccination programs against hepatitis A and B. Author of more than 300 scientific papers.
IN RUSSIA QUANTITY HAS NOT BEEN MADE TO QUALITY YET
– Mikhail Ivanovich, there is a stream of alarming news about the coronavirus from many foreign countries, we hear about the 3rd and even the 4th “wave” of the pandemic. Against this background, Russia looks like an island of prosperity and stability. How can this be explained, in your opinion?
– It is difficult to give an unambiguous answer. According to the indicators of official statistics in our country, today there really is no serious rise in the incidence, it is kept at about the same level. I would like to believe that, firstly, this is the result of the COVID-19 prevention measures that are used in Russia. Secondly, the British and other variants of the coronavirus, which are spreading much more intensively, now prevail abroad. We already have these strains, but so far there are not so many of them that it becomes quality.
Plus vaccination is in progress. Yes, its scale is relatively small, but it is very important that socially active people with the largest number of contacts are being vaccinated. Perhaps this also, to some extent, restrains the spread of the infection.
Although, I admit: there is no definitive explanation of the current situation yet.
THREE MEASURES THAT BEST IN CONTENTING INFECTION
– As for anti-epidemic measures, there is now a lot of controversy: what works and what is useless only creates an additional burden. In your many years of experience, what measures actually best help contain viral infections?
– First of all, it is a high level of use of diagnostic tests. It is necessary to identify people infected with the virus and isolate them in time. We have a large amount of testing in our country, including asymptomatic cases of the course of coronavirus infection. This allows you to isolate people who, without knowing it, can be the source of the spread of the disease.
Also, of course, mask mode plays a role. In Russia, it has not been canceled and while they do not plan to cancel it, it will continue to work. By the way, in Moscow, much more people wear masks than in other regions.
Of course, restrictions on holding mass events are also very important. It is necessary to realize that the further development of the epidemiological process will really depend on you and me. From this point of view, warm weather is dangerous. People will actively choose to relax in nature, contact each other. Easter is coming soon, another reason for mass gatherings. But if everyone adheres to personal hygiene measures and the protection of themselves and loved ones, to actively vaccinate, then we can avoid a sharp rise in the incidence.
“EXTINGUISHING THE FIRE IN THE APARTMENT”
– A South African strain of the coronavirus has already been imported to Russia, which is known to partially “escape” the antibodies of patients who have had previous covid variants. People are worried: what if the current vaccinations will not help against the mutant virus from South Africa?
– We must take this calmly, do not panic. Yes, the virus can change, and it does. But imagine the situation: an apartment starts to burn, a fire. We need to stop it. And we flood everything around with water. Vaccination is the water that can stop the massive spread of coronavirus. Some may say: what if water gets on electrical appliances? Yes, it is possible, but the fire must be stopped, it is better to flood it with water than to do nothing. So it is with vaccination. In theory, she herself can lead to the emergence of new strains that will elude the immune press, that is, antibodies will not protect. But at the moment, vaccination is the most effective measure to combat the spread of infection.
In addition, there are optimistic statements by scientists, including those from the Institute. N.F. Gamalei (developers of “Sputnik V” – Ed.) That they have already learned how to quickly change the composition of vaccines if necessary. By the way, do not forget that when vaccinated with current vaccinations, many antibodies are produced with high efficiency. They can provide good protection even with a partial decrease in efficacy when infected with new strains.
“IN BATTLE GOSSANEPIDNADZOR WILL STRENGTHEN”
– Now we have great progress in the study and prevention of coronavirus infection, but there are also a lot of problems, – says Professor Mikhailov. – Much could be done more efficiently if there were sufficient funding for basic research in virology. We could have had a better system. But until the thunder breaks out, the man does not cross himself. We crossed ourselves and are trying to debug this system. I hope that the lessons to be learned from the pandemic will allow us to return virological services to their previous level. As they say, the state sanitary and epidemiological supervision will get stronger in the battles. In the Soviet Union, this system was the best in the world, it has huge traditions.
By the way, the People's Republic of China, which, with the help of anti-epidemic measures, was able to contain the spread of the virus in Wuhan, has confirmed that the development path of such a service is correct. And we must use all of this.
– In the PRC, the Sanitary and Epidemiological Service is now working according to Soviet principles?
– When I was little, my parents worked in the PRC. And the entire bacteriological service and virological service were partially developed by our Soviet specialists. They introduced a system of state sanitary and epidemiological supervision in China. Now there is a powerful epidemiological school with vast experience. It employs many virologists and epidemiologists. And here, unfortunately, optimization has led to a decrease in the number of specialists. Now we have to restore all this, but with losses.
EVERY VACCINE IS GOOD IN ITS OWN
– The PRC was the first to develop vaccines against covid, and now we most often hear about Chinese whole virion vaccines. That is, based on a killed or weakened coronavirus. They are used in the United Arab Emirates, Turkey, Singapore, Malaysia, tested in Brazil, Argentina. One gets the impression that China has relied on this type of vaccine (in Russia, this type includes the development of the Chumakov Center). Why do you think?
– This is not entirely true. In China, there are not only whole-virion vaccines, but also adenovirus vaccines, for example, like our “Sputnik V”. There is a wide variety of designs, and rightly so. Different approaches provide room for maneuver. We have the same thing, we already have several vaccines and the development of new ones continues. It would seem that after the appearance of “Sputnik” one could say: guys, stop, let's not spend money on others. But that would be the wrong approach. Different vaccines have their own benefits. Genetically engineered (adenoviral, mRNA vaccines), for example, allow a large volume of production to be rapidly increased. Such drugs can be changed relatively easily and quickly so that they work effectively against mutant strains.
As for whole-virion vaccines, they are good because they contain the entire set of coronavirus antigens (that is, fragments by which the immunity should later recognize the covid pathogen – Ed.). This should provide the best protection against infection. But in the production of such vaccines, very serious control is required, especially for drugs based on an attenuated virus (there are no such developments in Russia now, they are in China, India). From history we remember the cases of the so-called vaccine-associated diseases. For example, they were caused by a live polio vaccine.
ABOUT VACCINATIONS AND DOLPHINS
– When there are several vaccines in a country, people inevitably have a question: which one is better to choose?
– Yes, I am often asked about this. Let's remember: how do we evaluate this or that event? Compare the pros and cons. Each drug has its own advantages and disadvantages. There may be complications after vaccination. On one side of the scale we put possible adverse events after vaccination, and on the other – the consequences of covid. Believe me, for those who have been ill, passed through the red zone, resuscitation, there is no question whether to get vaccinated or not. And those who were not sick say: let's wait.
This reminds me of the dolphin situation. At one time I was engaged in the study of hepatitis in them. And experts explained: many believe that dolphins are so good, they save people who are drowning. But they do not purposefully save people, but simply play with them like a ball. Some dolphins are pushing people to the shore. And the rescued tell us what kind of dolphins are good. And those who were pushed into the open sea will tell nothing.
The bottom line is that you need to soberly assess the situation. There can be only one answer to the question about vaccination: it is imperative to be vaccinated if you have no contraindications. Any available vaccine registered in the country. And if you have a choice, then only your doctor can make it right. It is now clear that vaccines are definitely a blessing in COVID-19. What will be the consequences in ten years? We do not know. Most likely, they will not be. But I assure you that even if there are some unpleasant things, we will learn to deal with it. And now we need to protect and save those people who can and must still be saved.
QUESTION IN THE TOPIC
When the pandemic dies down
– Mikhail Ivanovich, when do you think the current epidemic will end?
– Unfortunately, nobody knows. For example, the same Spanish flu ended after a year and a half. But in the case of the coronavirus, we will most likely be dealing with an infection that persists in the population. I would very much like to hope that covid will become the same as the relatively mild seasonal flu.
However, making predictions is extremely difficult. History shows that in most cases, nature is smarter than man. Nobel laureate Dr. Blamberg, who was awarded for the discovery of the surface antigen of the hepatitis B virus, shortly before his death said an amazing phrase: if one ever finds consciousness in viruses, the first person to have consciousness will be hepatitis B. I would now add: undoubtedly , the coronavirus also claims this role.
