China started the second wave of infection of the coronavirus, which is from the beginning predicted by experts. For the first time since the beginning of April, the country began again to identify COVID – 19 from local residents. It happened in several provinces of China, including in the Wuhan, went through the world of the new coronavirus. Should I wait for the second wave in other countries, including in Russia? Where they are more likely in countries with strict quarantine or with its absence. These questions observer “MK” said the Director of the Institute for medical Parasitology, tropical and vector-borne diseases to them. E. I. martynovskogo sechenovskiy University Alexander Lukashev.
According to media reports, in Wuhan identified five new patients with COVID, and they all lived in the same apartment complex. The coronavirus found in the city of Shulan, which is on the border with Russia and North Korea. The next day the city imposed quarantine. The level of risk of power raised to the level “high”.
– Alexander, now many virologists say that strict quarantine guarantees the arrival of the second wave. Is that so?
– No guarantees, but creates conditions. On the other hand, if no action were taken, it would lead to a dramatic increase in illnesses. Judging by the experience of cruise ships, where the virus acted in a confined space in a short time, it would affect 20 percent of the population
– Why are formed a second wave of infections?
– According to the General rules of infection go waves, waves are a common phenomenon. First comes a surge in the incidence, then it weakens, recover from their immunity is formed. And then children are born without immunity – and again there is a wave. The infection breaks out when a non-immune stratum, which is, for example, 5-10% of the population. And this non-immune stratum hurts. And then the virus takes several months or years. But this is familiar to mankind infections: influenza, SARS, Rota – and enteroviruses, and others. These infections form soft waves, because they affect a minority of the population. In the case of new coronavirus infection immune stratum at the time of its appearance in the world was 0%.
– Some experts say the real figures of infection in Moscow today, about 2 million people. Do you agree with these grades?
– It would be too optimistic, because he speaks about the formation of a good immune layer. I rather agree with the assessment voiced by Sergey Sobyanin: now infected approximately 3% of the population. Of course, the number of patients is higher than registered, but not dozens of times. In new York recently published the results of the study the population for the antibody: it has shown that immunity to the new coronavirus has 20% of residents and 13% in the state. There was a large sample, and the difference in the proportion of people with immunity consistent with differences in the registered morbidity.
– Recent studies on the antibodies in CAO among physicians outpatient segment revealed no immunity none of the 167 doctors who are constantly working with COVID. It’s already supposed to happen a certain “preimenovanje”?
– Such a phenomenon exists, but the importance of practicing infectious disease specialists tend to exaggerate. On the other hand, the results are strange and look realistic enough. I have many friends and the doctors ill.
– Returning to the theme of the relationship between quarantine and the second wave – whether it is possible to say that the Swedish experience still correct?
— We don’t know what kind of experience is correct. There are several options: each has its own pros and cons, and each has a very expensive price. Out of this history without losses is impossible, and different countries choose their own path minimize losses. Today this path has cost Sweden two thousand lives. On the other hand, they will have a faster immune layer is formed, and the probability of a second wave in severe form is significantly reduced.
Unfortunately, the elimination of the virus at this point impossible. And we don’t seem to go the way of most European countries, which quickly reduces the incidence to zero. We follow the way of the US and the UK, who came out on a plateau and for a long time “sitting” – with minimal reduction in the number of new cases. But now they reduce economic losses, and they have no desire to quickly eradicate the disease. The cons of this route: there will be more victims, and pros: it’s immune stratum. But when the vaccine is not clear, and natural immune stratum will contain the virus. And she doesn’t have to be 60 or 80%; the presence of 20% of the survivors will prevent a rapid spread of infection. Such performance has now reached new York, but it cost him 20 thousand lives, and it is even less than in Moscow.
— By the way, have you any ideas why the mortality rate in Russia is strikingly low?
We cannot exclude that the real extent underestimated, although I don’t know how to do it in such quantities. On the other hand, to save we, too, have learned this fact. Besides, Russia is one of the biggest delays mortality from morbidity. I’ve seen expert assessment: the gap between identification of cases and mortality is on average 17 days since dying patients mainly from 14 to 21 days of illness. We identify infected people earlier and therefore there is a big gap between the increase in morbidity and mortality. In other countries this period ranges from several days up to 14 days in Germany.
We come to this?
– Yes, most likely, the mortality rate will rise, but not to the levels of Italy, for example. We do a lot of tests and I think asymptomatic patients. And I repeat: we have learned to treat and not overload the medical system. Learned how to pull patients by heparins and interleukin blockers. Now is the only thing that really works. But these are medicines that are very qualified doctor should prescribe individually, and there is no universal scheme. This is one of the problems.
– What about the use of plasma?
– It can work, but have not yet received wide distribution. While her contribution to the statistics is unknown.
– What forecast you can make on China?
Is no longer epidemiological, and social and organizational forecast. I think they will wait for the vaccine and the vaccinated population. But it is important that the vaccine was safe. But the main problem with developing a vaccine is that their security is not yet possible to confirm the research. Exaggerating, we can say that if you take twenty young people and infect COVID, that most of the disease will be asymptomatic, have smaller parts, most likely in the form of light – and on its face such an experience with a wild type virus can be secure. This, of course, a joke, but roughly the same thing can happen with the vaccine. The most dangerous complications of failed vaccines not happen at vaccination, and at the time when vaccinated with the virus is found, especially when the immune system slightly decreased, you may experience problems, for example, 2-3 years. If you can not vaccinate a thousand people, the possible problems raised units. This is acceptable. But if you vaccinate a billion, and the problem will be a million – it is unacceptable. For example, against SARS coronavirus developed 38 vaccines, but today it became known that 28 of them were potentially dangerous. Of course, now these errors will take into account, however, to understand the vaccine is dangerous or not requires a few years. And the fact that the production of vaccine are going to deploy already the new year, the accelerated scheme is a big risk. Incidentally, among the professionals engaged in coronaviruses, there is little who takes part in the development of vaccines – they know all too well about the pitfalls. Most of the development are biotechnology.
– Want to understand Chinese quarantine – an example to follow or did he?
Today, China’s probability of hard second wave are higher than in many other countries. But on the other hand, the Chinese have shown that they can effectively resist the virus and won a month for all of us. They will have to find some solution, they can’t live forever. But in countries where there was severe outbreak, the second wave will be less likely and easier.
– And the third wave will be?
Yes. And fourth, too. These waves may become an annual event.