A year and a half of pandemic, various types of vaccines developed with efficacy and safety, a very high percentage of the European population vaccinated … And, despite everything, they are already more than four million dead in the world and this is not over.
Why? The fundamental reason why the nightmare continues lies in a key fact: the transmission has not been slowed down.
Regardless of the fact that this virus already emerged with many ballots to be difficult to eradicate, there are three circumstances that concur in this pandemic that pose serious problems to tackle it. Two of them have a solution, although they require the will, the means and the effective direction of the control measures by those who know the most (who, unfortunately, do not usually coincide with those who have the most power).
The third is the real threat.
First problem: vaccination progresses very slowly
Vaccination progresses very slowly. In this regard, it is not enough to assess the data provided by Western countries. The virus does not understand borders or income per capita and there are many countries where vaccination is testimonial (not to say non-existent). We must remember that we are facing a pandemic that affects the entire planet. If its advance is slowed down on one side but expanded on others, little is achieved globally.
How do we solve this first problem? Implementing the necessary measures for the industrial production of vaccines, ensuring that their distribution and administration is done in a homogeneous way throughout the planet and giving biosanitary priority to mass vaccination.
Second problem: vaccines do not prevent contagion
Vaccines currently approved and marketed protect us in a very effective way against COVID-19, that is, against the effects derived from infection by SARS-CoV-2. But nevertheless they do not protect us from contagion al 100%.
What does this mean? Well, we can contract the virus despite being vaccinated and, although we do not become seriously ill, we will continue to be vectors of transmission.
In this regard, the commercialization of one of the Spanish vaccines that the National Center for Biotechnology (CNB-CSIC) hopes to release by the beginning of next year is eagerly awaited.
Unlike the vaccines approved so far, the one that will come out of the hands (and the brains) of the team led by Dr. Luis Enjuanes, from the CSIC, will have the advantage of being administered by the nasal route, that is, it will fight the virus from the airways themselves, intercepting their natural path of entry. In addition, it will provide a second even more hopeful biotechnological virtue: as it is a molecule derived from the SARS-CoV-2 RNA itself (what is called a replicon), it will be self-powered. In other words, the dose of vaccine (RNA) that will be administered to each person can be multiplied up to 5,000 times within the body itself. In this way, those who receive this vaccine will enjoy sterilizing immunity, that is, not only will they not get sick, but they will not become infected or, what is more important at the pandemic level, they will not transmit the virus.
While this vaccine arrives, how do we solve this second problem?
Well, maintaining security measures despite being vaccinated, listening to scientists and, why not say it, ignoring politicians who put the electoral revenue of a news item not sufficiently contrasted to the biosanitary interest of the population.
In a Article that the WHO has just published, we find the best updated information to know the most advisable public health measures in the different scenarios.
Third problem: the virus mutates
The virus, like any biological entity, is subject to the action of mutagenic agents and, consequently, evolves generating new variants.
In this regard, it is important to clarify that we tend (very wrongly) to consider that any new variant is more infective, more virulent (that is, with a greater capacity to generate pathologies) and more contagious than the previous ones. That is radically false. Viruses, especially those in the SARS-CoV-2 group, are especially negligent in making copies of their genetic material or, what is the same, they mutate a lot.
However, the vast majority of these mutations either end up being lethal to the virus itself or do not pose an additional danger to our species. The problem is that, since the virus is so extraordinarily widespread and has such a high replication rate, the possibilities that among the immensity of variants that are generated there is one that is especially dangerous for our species, they multiply exponentially.
The last appeared genomic variants of SARS-CoV-2 are updated the ECDC (European Center for Disease Prevention and Control). He grouped them into four categories:
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Worrisome variants (VOC, of variant of concern), where the best known are located, the two subtypes of Alpha (United Kingdom), Beta (South Africa), Gamma (Brazil) and the especially worrying Delta variant (India). Its genomic properties, epidemiological evidence and / or data obtained in vitro have had a significant impact on the transmissibility of the virus, its severity and / or the immunity acquired by the administration of vaccines prior to its appearance.
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Variants of interest (YOU, de variant of interest), where the variants Eta (Nigeria) Theta (Philippines), the three subtypes of Kappa (India) and Lambda (Peru) are located. These variants could suppose a negative impact but the data is still insufficient to affirm it in a resounding way
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Variants under supervision. There are a total of 21 variants whose recent description makes it premature to provide relevant data on their characteristics.
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Discontinued variants. The two subtypes of the Epsilon (USA) variant have been included in this category as they are no longer circulating, have been circulating for a long time without any impact on the general epidemiological situation, and / or are not associated with any property of concern.
Variation problems
The continuous appearance of variants poses two very different and very worrying types of problems:
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Problems at the individual level. VOCs carry a significant impact on the severity of pathologies developed by the unvaccinated infected. Fortunately, in the majority of those vaccinated, the infections are mild or asymptomatic, although with persistent symptoms. Therefore, and in this regard, the message to the population remains the same: you have to get vaccinated yes or yes.
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Problems at the population level. These variants also imply a significant impact on transmissibility, which is a serious setback to stop the spread of the virus and control the epidemiological situation. To this is added the fact that not all types of vaccines protect in the same way against different types of variants, so we may find ourselves in a situation of constant revaccination until the definitive way to tackle SARS is found- CoV-2.
In any case, it is essential to have an idea of how the virus is changing because, as stated by Massimo Palmarini, director of the Medical Research Council – University of Glasgow Center for Virus Research, the integration of epidemiological data with experimental data obtained in laboratories It will be key to being able to predict what the virus will do and being able to anticipate its actions.
In the meantime, we’ll have to get used to being a bit like Bill Murray in Caught in time, although substituting that cute marmotita for this hideous and tiresome virus.
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