Professor David Olaleye, a virologist, at the University of Ibadan, in this interview by SADE OGUNTOLA, says irrespective of the variants, the virus also needs weak immunity and supportive environment to thrive and so Nigerians should lay emphasis on the protective preventive measures as use of face masks and washing of hands.
HOW worried should Nigerians be about the proliferation of the COVID-19 variants, particularly the Indian variants?
The few Indian variant cases identified in Nigeria so far are from people that returned from India and tested positive for the virus. Basically, all viruses undergo changes, the commonest of which is mutation; so we will always have variants when it comes to the virus. But, it is the degree of change that occurs especially when it translates into more severe disease or cases of deaths that is important.
Also, of importance is whether the available vaccines are still protective against new strains or if the virus is able to bypass the protective ability of the vaccine in a person that is vaccinated. Currently, as many as a dozen
COVID-19 variants are known to be circulating worldwide. Among them are B.1.1.7 and B.1.351, the highly transmissible strains that originated in the UK and South Africa, respectively as well as the strain circulating in India.
Now, the assumption that the Indian strain is the most virulent strain because of the current deaths reported in India has not been established scientifically. It is a highly transmissible strain, the same as the UK and the South African strains, so it spreads very fast but there is no reports on its pathogenicity yet.
How about the pandemic in India and the Indian strain?
What is happening in India has to be related to the virus, the immunity of individuals and also the environment. All these variables come together in the causation of any disease-causing organisms called pathogens. The factors are particularly important in viral infections and diseases. For instance, why do we have the same virus infecting 10 people, and then probably only two or three developing the severe form of the disease or dying while the others end up with the mild infection? That is part of the effect of the host.
Also, we have factors of gender or age. There are viruses that the presence of some hormones in the body encourages their faster multiplication. Similarly, in the presence of a suitable environment, some organisms will spread and grow faster.
In the case of India, the situation points more towards a combination of the three factors, the host immunity, the weak health system (environment) and less of different pathogenicity of the virus. Although many people are placing more emphasis on the virus, the virus also needs weak immunity and a supportive environment to thrive. What is happening in Brazil and some other South American countries now are very close to what is happening in India.
Any resemblance in these variants in terms of havoc it causes?
We see this every time and so it is not just about the virus but also the role of the host, the host’s immunity and how the host is able to respond to the infection. Even in Africa, the response to the virus may not be totally the same in a group of people because of such factors as the presence of other underlying medical conditions (comorbidities), nutrition, and deficiency of some micronutrients and so on.
So, it is not just enough to point at the virus alone, we need to look for and track what the variants translate into in terms of the clinical disease. Do you have a more severe disease and deaths? If the answer is yes, what is the mechanism in the body and what is responsible for this?
For instance, the first report on blood clotting in the lungs and other organs were reported at the early stage of the pandemic in Spain. Now, we know that this is a major factor in the pathogenesis of the infection. So you will find some cases of blood clots in the vessels to the lung, causing stroke or heart attack.
Recently, a report talked about blood clot as a problem with the infection and with the vaccines, how is this so?
Just recently, researchers in Europe described as an extremely rare clotting, mainly a type of blood clot called cerebral venous sinus thrombosis (CVST), that was seen in combination with low levels of blood platelets called thrombocytopenia even with both the AstraZeneca and J&J vaccines. Nonetheless, people shouldn’t look, get worried or scared that one strain of the virus is deadlier than the other. We know this is not the case. But it is the work of the scientists to track changes in the virus with time and to study what it translates into especially in relation to the design of vaccines. Now, UK just reported on Sunday that the AstraZeneca vaccine protects clearly against the Indian strain.
So what really is the problem in India?
So if you go back to India to investigate what epidemiologically led to the unfortunate serious micro epidemic within the India region despite the initial control of the pandemic and vaccination, it might be linked to the religious festivals going based on what we see across the media.
Several thousand and thousands of people were there. And big gatherings are super spreaders, so it was an opportunity to spread the virus because of the closeness without the use of protective face masks and physical distancing.
Also, across the media, if you look at the way they take care of the sick in their hospitals; such a highly infectious disease can easily spread. You find a lot of relations having to take care of the patients in the hospitals because the health system is overwhelmed.
At the end of the day, all those people caring for patients in the hospitals will return home with new infections in buses, trains and so on, and then large population of their major cities also gets exposed to this respiratory virus that spreads very fast in such an environment.
So it is not because there is one particular strain killing people more than the other, it is because there is a combination of factors that are leading to the unfortunate situation that they are experiencing right now in India.
The good sides of the situation so far is that the same methods of prevention, that is the use of masks, proper handwashing with detergents or medicated soap under running water and physical distancing will protect against all the variants of the virus be it the Indian, the South African variant or the UK variant.
In the United States of America, they have identified many variants that they really don’t talk about variants routinely again, it is essentially the same virus. We can only get worried or disturbed if the available vaccines cannot protect against the variants.
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