Russian-speaking FDA employee: 'Coronavirus is not very harmful, mortality can be overestimated'
Why the virus turned out to be less dangerous than expected, and whether it is worth phasing out strict quarantine measures in an interview To the browser said Doctor of Biological Sciences, deputy director for science of the vaccines department of the Administration for the Control over the Quality of Medicines and Food in the United States (Fod and Drug Administration) Professor Konstantin Chumakov.
In fact, the number of patients with coronavirus infection in the world can reach 100 million people, which means that the mortality rate from it is much lower. This is very good news, which means: coronavirus is not at all as evil as it first seemed. Most viruses, spreading to other populations, weaken over time. In addition, trials of new drugs are continuing at a frantic pace - not only vaccines, but also finished drugs.
Is coronavirus really so scary for humanity or is it exaggerated by a worldwide panic?
There are many coronaviruses themselves, they have been known for a long time, most of them cause just mild colds. Many viruses can skip animals from humans, in which they may not cause big problems.
All human viruses once arose in an animal reservoir, and then passed on to humans. And if there is no immunity in the human population, the virus spreads easily - like fire on dry hay. When a significant part of people becomes ill, it is already difficult for him to spread. People have a population immunity, and the virus itself is not very dangerous.
The SARS-CoV-2 virus, which causes COVID-19 disease, is also not very harmful. Data begins to appear, how many people actually became infected, sick and died - it turns out that mortality is less than 1%. Official figures say 2 to 5%. In Italy, even more. But this is due to the fact that we do not have good statistics regarding the exact number of cases and infections. It’s difficult to miss a dead person, and getting sick is easy, not to mention those who have become infected and have no symptoms.
But what about those who sought medical help?
By definition, these are already difficult cases. If you just cough, then you won’t go to the hospital, which means you will remain outside the statistics. Now methods have appeared that allow you to see the presence of protective antibodies in a person’s blood. It turned out that the number of those who have them is about 50 to 80 times more than the official statistics on sick people say. This is very good news. It means: the virus is not at all as evil as it seemed at first. Even now, despite the fact that the epidemic has been raging for two months, in the same USA the number of deaths is still less than that of seasonal flu. So the scale of the pandemic needs to be considered in comparison.
I do not want to downplay the importance of all quarantine measures and dangers. Again, this virus is new, it has not yet adapted ... And in general, all viruses, having switched to a new population, are at first more dangerous, but gradually become sparing. If the virus kills its owner or sends him to the hospital, it already falls out of circulation and cannot be transferred to another. And only those viruses are transmitted that do not kill their master, so that he can continue to infect other people. Therefore, any new virus is gradually becoming less dangerous. This is a fundamental biological law.
If the virus is not so dangerous, why are so many countries quarantined?
These measures were taken at the very beginning, when it was not clear what we were dealing with. After all, a pandemic could kill not 3%, as the current imperfect statistics show, but all 30%. Then it would be a complete disaster. During the plague of the 30th century, 50% of Europeans died out. The Spanish flu killed between 100 and XNUMX million people during World War II. That disease is a good example of "mitigating" new viruses, it emerged and disappeared pretty quickly without any vaccines or drugs. Because there was a variant of the virus that stopped killing a person - the Spanish flu turned into an ordinary seasonal flu. It's unpleasant, but no one is scared anymore.
Therefore, quarantine measures are justified. If they were not accepted, then all hospitals would be overwhelmed. An uncontrolled development of the epidemic with large population losses would begin. Quarantine smoothed out the epidemic. Even in New York, the US virus distribution center, hospitals were not crowded, and the number of new infections was gradually declining.
Another thing is that it is time to gradually release this quarantine, especially where there is no large incidence or it has been proven to decline.
Europe is also beginning to open. It is right?
Absolutely. For example, Germany, Switzerland have already passed the peak, there are about 10-20 times fewer new cases than at the highest point. But Sweden and the UK have not yet reached it in part because of their wrong strategy. Sweden decided not to close anything. They believed that population immunity would develop faster. But this comes at the cost of the deaths of many citizens. It seems to me that this is wrong even from a moral and ethical point of view.
WHO says the virus will move towards Eastern Europe, Africa, Central and South America.
It is possible, but not obvious. There is a very clear correlation between incidence and national income. The richer the country, the more sick it is. In poor and undeveloped countries, there is no or very little coronavirus. Africa just belongs to this category. In different areas, different dynamics.
By the way, why?
There are different theories. For example, in low-income countries, the incidence of tuberculosis is traditionally high, which is why BCG vaccine is used there. It causes a non-specific protective effect against various other diseases. This is a known fact. According to one theory, that is why such countries are protected from coronavirus. Another theory claims that people there are quite dirty and often susceptible to bacterial and viral infections, as a result of which their innate immunity is constantly trained.
Another factor - in poor countries, a completely different age structure of the population. Most are young, but they are ill little and easily. In affluent countries, older people predominate; they get sick more often. In addition, rich countries are much more open, and the population itself is more mobile and dynamic.
And of course, they test more for coronavirus there, so the statistics there are more reliable. In fact, in Ukraine the incidence is lower than in New York per capita.
In general, in Eastern Europe, the incidence is also much lower than in Western.
Experts are worried about the situation in Russia, where the number of cases is growing rapidly, the Russians themselves will soon begin to infect the Chinese. Plus, the Russian Federation can submit biased data on the number of infected.
Now the statistics are bad everywhere. For objective reasons, it is very difficult to collect all the information; there are not enough test kits. I don’t know why, but now the incidence in Russia is three times higher than in Ukraine.
There is also Belarus where there are no quarantine measures.
Yes, their situation will be worse than in Russia. Maybe because they are closer to Europe or because they do not introduce strict quarantine measures.
Do you think China has not reduced the number of infected and fatal cases?
China could also manipulate unpleasant data. Countries with an authoritarian regime are always inclined to distort information about their problems. Surely, there were many unaccounted cases, although we do not know the exact facts. But whether it was a state strategy - I do not know. For top management, this is the height of idiocy - to underestimate the impending threat.
How many infected in the world?
There are no clear data yet, but at least the official statistics are underestimated by 10 times. According to research at Stanford University, the difference can reach up to 80 times. In the state of New York, 260 thousand people are infected, but it is estimated that 3 million people already have antibodies to this virus. So they were already infected. The difference is 10-12 times. If such a proportion is worldwide, I won’t be surprised that about 100 million people have already become familiar with the virus.
Is it possible to say that a certain collective immunity among humanity has already been formed?
It is just starting to form, and this is very good news. Studies on the number of antibodies to the virus show us that everything is not as scary as it might have seemed at first. The figure for the dead is quite comparable to seasonal flu mortality. I heard in New York that if a person was dying and had respiratory symptoms, he was recorded in the statistics of coronavirus deaths even when no tests were done. I do not exclude that mortality may be overstated. We need to wait until reliable numbers are given to us, otherwise any theory can be built.
Is the peak of the pandemic in the world passed, or are we only approaching it?
Judging by the published data, not yet passed. Perhaps we are at the peak. It’s hard for me to judge, I take information from publicly available sources. But in every country they collect it in different ways - somewhere they hide it, somewhere they inflate it, somewhere they don’t test people.
If summer becomes a respite, then what will happen in autumn and winter? The second wave is more dangerous than the first?
We know almost nothing about this virus. Those who say the second wave will be in winter are based on information about the flu. It is really seasonal and activates in the autumn-winter period. This is due to the weather, the general stability of the body, with the migration of birds that can carry it. But other viruses have seasonality, which is often very strange, epidemiologists can not always explain it. There are viruses that come every two, three years, and there are repeats every year. And how to explain it?
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What will happen in the fall or next year is unknown. But you need to prepare, of course. If there is no second wave, this is only good.
As I understand it, you adhere to an optimistic point of view - will the virus become weaker?
The history of viruses proves that this always happens. From the point of view of evolution, it cannot be otherwise. Viruses circulate and change very quickly: both for the better and for the worse. This is a fundamental biological law. If the body has not left offspring, then it disappears.
In so many countries, they started looking for a vaccine against coronavirus. Can it be ready by the end of the year for example?
Hardly. Tests are already underway, but the vaccine can be called only when it is proved that it is safe and protects against the disease. And this process is very long. First, the drug should be given to a small number of volunteers, and if everything is fine, give to more people and see if it protects or not.
A huge number of people need to be vaccinated in order to statistically notice the difference in incidence among those who received the vaccine and did not receive it.
The incidence of coronavirus in the world is not very large. Every day, only a few new cases are recorded per 100 thousand of the population, or even not a single one (depending on the country). To conduct such a test in such conditions is simply impossible. If a million people are vaccinated, then in such a control group, only 10 cases can be expected. If the effectiveness of the vaccine is 50%, then it is very difficult to notice the difference between 10 cases and five - statistically this is unreliable. It often happens that when the vaccine created is conducted through the first phase of a safety test, then the second phase begins, and when they go to the third one to test the effectiveness in terms of protection against the disease, the epidemic has already passed.
But this does not mean that the case is hopeless. If the wave of the epidemic passes, it will be possible to test the drug in animals and prove safety for humans.
It usually takes years to create a vaccine. Now, when the whole world and scientists are working tirelessly, when everyone wants this vaccine, she will be given a green street, but still this is not a matter of months, but a year or more.
There is another complication that makes us take this very carefully. There are situations in which the vaccine does not help, but only makes it worse. Examples were: for healthy people, the drug is safe, but not for patients. We need to go step by step, and so far we have not figured out how to do everything quickly.
Maybe people will learn how to control the virus?
Only quarantine measures. But then the whole economy will collapse. There is an idea - to use some non-specific protective effect that many live vaccines give due to the stimulation of innate immunity. For example, the anti-tuberculosis that is being tested. We offer a trial of a live polio vaccine that works well against influenza. They need to be checked, but these are ready-made drugs with proven safety that can be used even today. We hope this will be the solution to the problem until reliable vaccines are created that give permanent immunity. But for now, this is just an idea. To prove it, tests are needed.
The same applies to the use of BCG?
To an even greater extent. The polio vaccine is completely safe, but BCG is not very safe. Especially for people with impaired immune systems, there can be very unpleasant complications. Everyone in the Soviet Union was vaccinated, but the vaccine we received in childhood, most likely, will not work. Congenital immunity is gradually reduced. This does not mean that having made BCG once, you will not be ill anymore. Just in the coming months you will have greater resistance to other viruses and bacteria. But reckoning that a childhood vaccine will protect you from the coronavirus is naive.
I often read that after 10 years, mankind is waiting for a new virus, much more deadly than this.
We will never get rid of the threat of viral infections. See how many new diseases have occurred even in the last 100 years. Tick-borne encephalitis, Ebola, SARS, SARS-2, MERS, influenza pandemics ... People live in the world of viruses, they are the masters on this earth, not us. There are many more in the world. But people already know a lot about them, a whole biotechnological and vaccine industry has arisen. I assure you that in a year we will have an effective cure for coronavirus. Maybe there will be no vaccine, but if there is an effective medicine in our hands, then we can completely relax.
By the way, drug trials seem to be successful.
Hard to say. According to chloroquin, an antimalarial drug, the data so far are contradictory. But there are new tools developed based on knowledge of the molecular biology of viruses, they are already being tested. There will be medicines. Recently, there has been a huge boom in the field of antiviral drugs. People have learned to treat hepatitis C, which before that was generally incurable. And now, recovery is 99% of the time. It is enough to drink pills for 2-3 months - and that’s all. And they could not create a vaccine against this disease, it is very difficult. There is not even an idea how to create it, but there is already a pill.
There are already 60 candidate antiviral drugs that have been shown to be effective in vitro, it remains to be tested in humans. One or two of them will definitely reach the finish line.
The interview reflects exclusively the position of Konstantin Chumakov as a scientist in the viral vaccine industry, and not as a representative of the FDA (Food and Drug Administration) and is not an official position of this structure.
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