- What is the current situation with the covid epidemic in Russia and the world?
- Hospitalizations have sharply decreased in Moscow. It's real, a lot of people talk about it. Temporary hospitals are being vacated, the number of beds is being reduced. And this is fully consistent with what we see in excess mortality. Omicron caused a large wave of infections and a notable outbreak of deaths. It can be seen that in February there was a peak of excess mortality, but in March it is two times less. In Europe, the peak was two weeks earlier, then everything went down sharply.
But in Russia there is asynchronization. As a rule, Moscow, St. Petersburg, large cities give the first outbreak. Where there are many contacts, people are the first to become infected. Then these waves go through the regions. If you look at the regions, then in them the excess mortality in February and March is exactly the same. That is, if the outbreak ended in Moscow in February, in Russia there were outbreaks by regions as early as March, which gave excess mortality. April data is about to appear.
After Omicron-1, there is a flash of Omicron-2 everywhere. It is a little weaker, but also gives a high peak. In Europe, in some countries there was a double peak - first there was Omicron-1 and then it turned into Omicron-2, and in some countries these peaks were with time intervals. In general, if we look at the European Union, we see one big peak and the second smaller one. Absolutely the same picture in Israel. Now Europe and Israel are calm, more and more restrictions are being lifted.
But there are exceptions. In Portugal, the death rate has not fallen and now there is an increase in infection.
- Unfortunately, statistics on infections (infections) have become much less accurate ...
- A lot of people measure it at home, as there are so many home tests for both antibodies and the virus. State testing has dropped dramatically in all countries, so you really need to look at hospitalizations and deaths, and they are delayed.
We have Portugal, where deaths are not decreasing, but infections are increasing.
Two more waves passed in South Africa: there was Omicron-1, Omicron-2, and then another Omicron 3 and 4. Does this mean that "Omicrons 3 and 4" will go back to Europe or they will not have time to get there - it is not clear. As they advance, their mortality and severe course of the disease decrease. But it is still difficult to distinguish whether these strains are lighter, or population immunity has begun to work. Herd immunity still appeared. For example, in South Africa, there are fewer vaccinated, but more recoveries. In countries where fewer people were vaccinated, this was offset by more people recovering from the disease. Therefore, now all new options fall on the cushion of herd immunity. Therefore, it is difficult to say here whether fewer hospitalizations and deaths are due to herd immunity or a milder variant of the strain.
But there is also bad news: new mutations hide them from immunity to previous variants. This immunity works, but all the time the evolution of the virus goes so as to elude the immune system. The bad thing is that in America, the second Omicron has just arrived in the eastern states and hospitalizations have doubled in a month. Since our testing has dropped sharply, we cannot now say anything about the tests. Hospitalizations rose in both New York and Massachusetts. America is out of sync just like Europe. Now there is an increase in infections in the eastern states, there are states where the number of infections is falling. Omicron-2 has not yet arrived there. If you look at the whole, there is a general growth.
- During the previous wave of diseases, there was a correlation between the number of diseases and electoral preferences. States that traditionally vote Republican have been hurting more and harder. Does this situation continue?
Yes, there was such a correlation. They got sicker, there were more deaths. I have seen these correlations. Now this should be smoothed out due to the fact that in the states where they vaccinated less, they got sick more. One way or another, herd immunity appears everywhere, but the price paid by countries or states in which a smaller percentage of vaccinated is higher - there are more deaths, more long-covid. In states and countries where fewer people are vaccinated, herd immunity is much more expensive.
People get sick more easily, but a large amount of “long-covid” persists, when it is more difficult for people to think, fog in the head, general weakness, and sleep is disturbed. Unfortunately, these complications give even mild options. Yes, they die less, they get sick more easily, maybe due to vaccination or a previous illness. This we do not know.
- Many countries are lifting sanitary restrictions. Is it possible to say that humanity has already “got used to” covid?
- I would like that very much. But there are several factors that influence what happens in the world. People are passionately tired of quarantines, businesses and the economy are suffering. Therefore, the fact that restrictions are being lifted, of course, there is a respite now. But even in places where a sharp increase in infections begins, no new restrictions are introduced. Moreover, in countries where there is an increase in diseases, restrictions are still removed. There is a strong political component to this. The governments of the countries understand that the party of opponents of masks and restrictions is becoming stronger and these measures are extremely unpopular. For example, here in Massachusetts, despite the fact that the situation is dangerous, there are only recommendations to wear masks indoors, but there are no special prohibitions. Over the past two years, state governors, with the growth of diseases, have had the right to announce requirements for wearing masks. The local authorities had the right to oblige everyone to wear masks, check compliance and punish those who violate this rule. Now there is a struggle in the Senate to deprive governors of the right to introduce a law on mandatory compliance with sanitary standards.
As a virologist, I would like that in public places, where there is a large crowd of people, with an increase in the incidence, wearing masks would be a mandatory norm. But all restrictive measures are strongly opposed by business. The voice of the doctors is getting quieter.
How have the vaccines performed?
- Different vaccines showed themselves in different ways. I have a good attitude towards the Russian Sputnik and consider it an effective vaccine. However, it also has problems. All vaccines must be tested in clinical trials, and here I have few complaints. Although the clinical trial of Sputnik was not fully completed, a sufficient number of confirmations of efficacy and a relatively small number of side effects have already been received, but further, when the vaccine receives permission for a large-scale study, an analysis of how the vaccine manifests itself in scaling, as with widespread use in production, protocols may change slightly. Or the vaccine quickly loses its effectiveness.
After the clinical trials are published, there should be a series of publications and further study of the vaccine. I know that the Moscow Department of Health collected statistics in the summer when there was a Delta strain, what was the number of cases among those vaccinated. How many people got sick in a severe form, a mild form, how many people who were not vaccinated fell ill. But, unfortunately, they classified this data. There was a huge outbreak of diseases in June-July last year. How did the vaccine perform? How did she protect the Muscovites? Unfortunately, all this information was not shown to anyone, but there were activists who worked in the department who simply took this data and leaked it to a group that was engaged in vaccine education. I got this information, my colleagues and I began to analyze it and saw that Sputnik works well, it is very effective. Far fewer people vaccinated with Sputnik get sick and very few die, although there are exceptions. We got great results, we published a preprint, but due to the fact that this is secret data, there is a problem that the database was obtained unofficially.
On the same database, we saw that the EpiVacCorona vaccine does not work at all. Moreover, we have obtained a negative efficiency - people who are vaccinated with it get sick more often. But we explain this by the fact that those who have chronic diseases are more likely to get vaccinated and therefore, in general, they get sick more often. Most likely, the vaccine has zero effectiveness, but we got a negative one.
Simultaneously with us, the St. Petersburg Independent University carried out the same work. They collected statistics themselves and also came to the conclusion that EpiVacCorona has a negative efficiency. Negative effectiveness is when people who are vaccinated get sick more often than those who are not vaccinated, and not less often. We believe that people with a large bouquet of chronic diseases rushed to be vaccinated, and healthy people who were less afraid of infection remained unvaccinated. We don't think the vaccine causes the disease.
- Nevertheless, this vaccine continues to be produced. But in August last year, Moscow refused to buy it - there was not a single batch in Moscow after August 2021 ...
- The third Russian vaccine, KoviVac, was produced in such a small amount that, unfortunately, no statistics could be made on it. They also did not publish clinical trials. But there are two similar vaccines in China. They very quickly received WHO approval, and many countries purchased it. It turned out that this vaccine is very weak, it works, but it expires very quickly.
Here you can make a bridge to China. China is now just doomsday - a huge crisis. The country that adopted the zero covid policy held up the best. When all countries suffered, they eliminated all the primary foci of covid - they went without masks, enjoyed life. Everything was fine until Omicron appeared. An outbreak began in Hong Kong, where there were a lot of elderly people who were not vaccinated. Mortality was colossal, much higher than what was in Europe. All hospitals are full. Hong Kong was isolated and the outbreak subsided. But the largest cities broke out - Beijing, Shanghai. They began to close half the city or the whole city. Now there is a complete lockdown. People are forbidden to leave their apartments, they just go crazy. The zero covid policy is very expensive for China. Despite the fact that cities have been blocked for many weeks, they still cannot extinguish the outbreak. All this is happening against the background of the fact that people are vaccinated, but with very poor vaccines. Unfortunately, we have reason to believe that KoviVak is no better. There are many indications that this vaccine, just like similar Chinese ones, is very little effective.
- How will the vaccination situation develop? What are the prospects?
- I think nasal vaccines are the future. They are simply instilled into the nose. This is what the institute is doing now. Gamaleya. The nasal vaccine induces immunity in the nasal and pharyngeal mucosa. Thus, as soon as the virus enters the nasopharynx, it is immediately inactivated by antibodies. That is, the vaccine closes the gate through which the virus enters the body. It is very important.
The conventional vaccine allows the virus to enter, and only when the virus has already entered and starts misbehaving is it seized by the antibodies from the injectable vaccines.
The problem with the nasal Sputnik is that there are no clinical trials in Russia. Whether the dose is right there, how it works in different age groups - we don’t know anything. The developers have checked something, but everyone else should just take their word for it. Logically, this should be a good vaccine, but, unfortunately, there are no publications about it.
I have a lot of hope that humanity will cope with the virus through nasal vaccines.
- Many Russians dreamed of being vaccinated with mRNA vaccines, Pfizer and Modern. What results did they show?
- They performed very well. I would say that these vaccines have the same efficiency as Sputnik. Unfortunately, we do not know the statistics on the side effects of Sputnik. They are rare, but possibly more than mRNA vaccines. We don't have data. The effectiveness is comparable, but we cannot say how much the frequency of side effects differs.
But all vaccines have one common problem - they lose their effectiveness. After six months, the vaccine barely works against a mild form of the disease. The vaccine continues to protect against serious illness and death for more than six months. The consensus is that people over fifty or sixty need a boost every six months.
- Should we wait for the next wave of covid infections? Or is it gradually fading away?
- Information in the press disappears. I think that a sharp decrease in contacts between Russians and foreign countries may turn out to be a positive factor. The fact that Russia was restricted in flights, in business contacts, in obtaining visas is bad for everything, but it is very good to reduce the spread of covid. Much fewer people began to travel, which has already affected the fact that the second wave of Omicron has passed throughout Europe, and in Russia it has not even begun. I hope the summer goes by smoothly. In autumn, unfortunately, all colds and viral infections begin to grow. So, you should not relax.