Dialogue with American immunology professor: If this is done, the new crown may no longer constitute a global health emergency
In 2023, the new crown epidemic has entered its fourth year.
At the beginning of 2022, the Omicron variant strain was detected and began to spread around the world, leading to a surge in cases in many places around the world. A year later, a mutant strain of the Omecron subtype, XBB.1.5, broke into the public eye with its high infectivity.
XBB.1.5 was first discovered on October 22, 2022, and then spread rapidly in the United States. According to the World Health Organization (WHO), XBB.1.5 is by far the most contagious variant of the Aomecron subtype.
On January 10, a reporter from the Beijing News had a conversation with Andrew Pekosz, a professor of molecular microbiology and immunology at the Johns Hopkins University Bloomberg School of Public Health. The mutation in XBB.1.5 allows it to bind more tightly to cells, Pecos said, which means that although the body only inhales a small amount of virus, there is a high probability that these viruses will attach and enter the cell, and a small amount of virus can cause infection.
According to Reuters, WHO spokesperson Carla Drysdale (Carla Drysdale) announced at a press conference a few days ago that the WHO Emergency Committee will meet on January 27, local time, to discuss whether the new crown pandemic Still constitutes a “global health emergency”. Pecos pointed out that one of the important criteria for measuring whether the new crown pandemic is a “global health emergency” is whether there are several surges in cases each year. No longer constitutes a global health emergency.”
Pecos said that countries must make good use of the tools used to limit the new crown virus and effectively prevent the growth of cases. “I believe that the end of the new crown epidemic is really completely in the hands of mankind.”
Earth Connection｜Interview with Andrew Pekosz, Professor of Molecular Microbiology and Immunology, Johns Hopkins University Bloomberg School of Public Health
The XBB.1.5 mutation makes it easier to attach cells
Small amount of virus can cause infection
Beijing News:In your opinion, how did the XBB variant of the Omecron subtype originate in the first place? On the whole, what are the common characteristics of subtype variant XBB and its sublineages?
Pecos:XBB is what we call a recombinant virus, which means it has segments from two different Omicron variants. Currently, the most likely scenario for XBB to occur is when a person is infected with two different omecriron variants. The virus now has the ability to evade many of the immunities that come with infection or vaccination, which is what is most worrisome about XBB. Now that we are concerned that XBB and its sublineages can invade the immune system and spread more easily, scientists around the world are testing them.
On January 10, a reporter from the Beijing News connected with Andrew Pekosz, a professor of molecular microbiology and immunology at the Johns Hopkins University Bloomberg School of Public Health.Earth Connection video screenshot
Beijing News:What allowed XBB.1.5 to prevail over other Omicron subtypes and spread rapidly in the United States?
Pecos:The mutation that allows XBB.1.5 to bind more tightly to human cells is a unique mutation that is rarely seen in new coronavirus variants. Laboratory results have shown that this mutation causes the virus to bind more tightly to cells, and we suspect that this feature makes the virus more transmissible, which means that although the human body only inhales a small amount of virus, the possibility of these viruses attaching and entering cells High, so a small amount of virus can trigger an infection.
Beijing News:According to the WHO, XBB.1.5 is by far the most contagious variant of the Aomecron subtype. However, there is currently no indication that the pathogenicity of XBB.1.5 is significantly enhanced. At this stage, do you think it is very likely that mutant strains with enhanced pathogenicity will appear in the future?
Pecos:The current situation is that the new coronavirus is acting more and more like influenza. It can carry mutations, can spread around the world, and can reinfect humans after a certain period of time. So the new coronavirus is obviously going to be with us, like other (flu) viruses, it accumulates mutations every year and keeps changing. We hope it doesn’t increase potential pathogenicity, but it almost certainly becomes easier to evade vaccines and immunity from previous infections. So we have to find a way to deal with it every year because it doesn’t seem like it’s going away.
Vaccination booster still effective in preventing severe illness
The relationship between XBB.1.5 and the increase in the number of cases needs to be further determined
Beijing News:In this case, how effective is the vaccine for the public? What is the significance of booster vaccination?
Pecos:Booster injections are still very important and will provide protection, especially to prevent serious illness and hospitalization. The large number of mutations in XBB.1.5 may mean that the vaccine can no longer prevent infection, but it will still be effective in preventing severe disease, which is one of the important meanings of the vaccine.
Data map: New coronavirus XBB.1.5.Figure/Visual China
Beijing News:Since the outbreak of the new crown epidemic, people have experienced many mutant strains from Alpha to Omicron. What is the reason why XBB.1.5 has caused concern in many parts of the world this time? What impact did XBB.1.5 have in the areas where it spread?
Pecos:The reason for concern is that when XBB.1.5 first appeared in the US, it spread at a very fast pace. Now some of the data has been adjusted, and while the infection numbers are still growing, the growth rate is not as fast as we thought a week or two ago. It now appears that the transmission ability of XBB.1.5 is indeed higher than that of other mutant strains, but it is not as contagious as when Omicron first entered the human population, which is good news to some extent.
In terms of its impact, we saw a slight increase in the number of hospitalizations, as well as the total number of cases, where XBB.1.5 was detected. But it’s unclear what’s driving the trend. The United States has just ended a series of holidays such as Thanksgiving and Christmas, and there are many travel and gathering activities. Perhaps this is one of the reasons for the increase in cases. So in the next one to two weeks, we need to make a judgment on whether the increase in these cases is caused by XBB.1.5 or the expected increase in cases in the original holiday season.
Countries must develop optimal strategies for booster vaccinations
Symptoms of ‘coronavirus’ and its treatment are still being studied
Beijing News:In your opinion, will XBB.1.5 be the next major global epidemic strain? Does it have potential implications for global public health? How should people respond?
Pecos:XBB.1.5 does seem to be the most dominant mutant strain at the moment. Of course, if new strains appear in the next one to two months, the situation may change. As far as the current situation is concerned, the strains of the XBB family have become the dominant strains in almost all the places where it is popular, and XBB.1.5 has more advantages than the original XBB. Therefore, I expect that wherever XBB.1.5 appears, it will likely end up being the dominant strain.
In the face of any strain, basic public health interventions such as wearing masks and avoiding crowds (especially indoors) are still effective. Booster shots also protect the body from severe illness, especially in high-risk groups such as the elderly. In addition, some antiviral drugs have been shown to be protective in many countries. We have developed many tools around the world in response to the new crown epidemic, and people must use these tools more effectively to prevent serious diseases.
On January 4, 2023 local time, in London, England, commuters wear masks on the subway.Figure/Visual China
Beijing News:The global epidemic prevention has entered a new stage. What should be the focus of the current epidemic prevention? Where should medical resources be tilted?
Pecos:People still have to deal with spikes, and I would have expected to see only one spike per year so far, but the reality is that there seems to be a spike in infections every few months. We must think carefully about vaccination and determine the best strategy for booster administration. We can’t get a booster shot every 3 months, it’s not feasible, we have to come up with a strategy to boost herd immunity through vaccines to deal with the emergence of serious infections.
Beijing News:What information do we have about the “long crown” at present? What is the latest research?
Pecos:“Coronavirus” is indeed a very important disease, and it is also one of the scientific research priorities of the American medical community. Several studies released in the past few weeks have shown that even relatively mild symptoms of COVID-19 patients may develop symptoms of “covid-19”. The symptoms of “long new crown” may last for 4 weeks, 2 months, 6 months or even longer.
But we don’t yet know what the best way to treat people with “long crown” is, and now everyone is trying to understand what this “long crown” is, which itself includes many different symptoms, and may be different “versions” of ” Long crown”. For example, there may be some that affect the lungs more, some that affect the kidneys more, and others that cause brain fog — a cognitive confusion. Right now, researchers are focusing on figuring out all the symptoms of COVID-19, and until we fully understand which ones are interconnected, it will be difficult to find accurate treatments and determine what causes them.
If there is only one surge in cases in a year
The new crown epidemic may no longer constitute a global health emergency
Beijing News:Now into its fourth year, where are we currently in the pandemic?
Pecos:I believe that the end of COVID-19 is truly in the hands of humanity. We have the tools to limit disease, and as a group we must do a better job of disseminating these tools globally so that vaccines and antivirals are effectively available to different countries.
Knowing that public health interventions can slow the spread of COVID-19 and how to reduce case numbers and hospitalizations, countries must make better use of these tools and emphasize their importance to their populations.
Beijing News:What are the characteristics of the new crown epidemic in the future that we will no longer call it a “global health emergency”?
Pecos:The most important criterion is that if instead of seeing multiple spikes in a year, we deal with one surge a year, like the flu, then maybe it’s more safe to say that it’s no longer constitute a global health emergency.
For this to happen, vaccines and antiviral drugs must be widely distributed around the world. They must be distributed to all countries of the world so that everyone can reach and use them. We may be moving in this direction, but the new crown epidemic has not yet shown this feature, and there are multiple surges in cases every year.
Data map: The new crown vaccine is in the hands of researchers. A female doctor holds a syringe and a vial of vaccine for the treatment of coronavirus.Figure/Visual China
Beijing News:After China adjusted its epidemic prevention and control measures, some countries introduced entry restrictions for Chinese tourists. What do you think of these restrictions only for Chinese tourists?
Pecos:There are two main types of these restrictions, the first is the need for testing, which may go some way to prevent people who are infected with the new crown from traveling and infecting others, but in fact, there are so many cases worldwide that it is very difficult for China. The number of cases in any country the tourist travels to will have only a small impact. I don’t think the travel ban is going to help, even though there was a travel ban before, it didn’t stop the virus from spreading everywhere, so it’s less effective.
Most restrictions don’t really achieve the end goal of letting us learn more about the new variants that are emerging and quickly identify them. What I would like to see is a greater effort by countries to begin to sequence more of the virus, which is the most important information for us. By sequencing more viruses, we can discover new variants earlier, which is applicable to viruses that appear in various countries, so detection combined with sequencing may be a better method.
Beijing News reporter Luan Ruoxi Liu Jingyu
Edited by Zhang Lei, proofread by Wu Xingfa
