Will the COVID-19 pandemic ever end? What will our lives look like from here on? Should we be sending children to school? And do we know where the virus came from?
These were only some of the volley of questions that Gagandeep Kang, Professor of Microbiology at Christian Medical College, Vellore, Tamil Nadu, answered at an ‘Ask me anything’ session at the Bangalore Literature Festival (BLF), which opened at the Bangalore International Centre here on Saturday.
When asked if there is an end in sight for COVID-19, the virologist said, “Polio was much harder to get rid of in India. But with a lot of effort, we got to a point where we said there is no polio in our country. Why was it possible with polio and not with SARS-CoV-2? Polio only affects humans. SARS-CoV-2 infects both humans and animals. When you have a virus which is asymptomatic, and can cross the species barrier, that makes it impossible to get rid of.”
She added that this is also an RNA virus. “Some of those mutations don’t matter, some do and give the virus abilities that it didn’t have before. When we start to think about all the variants that are being described, these are viruses that have acquired new characteristics. The evolution for SARS-CoV-2 is actually very slow. The reason we are seeing this so quickly is because it is multiplying so much. Every time it replicates, there’s chance for it to mutate. There will be many more mutations,” she said.
In this backdrop, how do we live? “We are encountering a virus we haven’t seen before. We have to build our experience with the virus. It is a natural process that happens. If you look among the three coronaviruses, this one is the weakest. At what stage is it OK for us to be out and about with some level of precaution? It’s a bit like dressing for the weather; when it’s raining, carry an umbrella, when it’s cold, wear a sweater. When you see lots of cases, cut down activities, when they are fewer, expand them. We can’t live without interaction. We have to learn what are the risk tolerances,” she said. This would mean calibrating your own risks. Masks, ventilation, and limiting the number of unknown people work as we know, she added.
About the newest variant – Omicron – Dr. Kang said unlike last year, when we didn’t have vaccination or an infection history, we now have a better chance of scenarios. “Omicron is very transmissive. Think about double masking, limiting crowds, ventilation. Ensure everyone you know and are interacting with are double vaccinated. Booster dose is a policy decision. We don’t know yet whether reinfections in vaccinated people will result in severe cases. It doesn’t seem to be causing severe disease like it did last year,” she said, adding that we need to make sure we have plans for the older and vulnerable populations.
Responding to a particular question on data sharing by the government, she said even after 1.3 billion doses being administered and 11 months, data available for vaccine effectiveness is for less than half a million.
“While there is data available on deaths among vaccinated, unvaccinated, and those with one or two doses by age, it doesn’t tell you which vaccine they took, where, and if they were individuals with comorbidities. All this information is presented as percentages…we will be living with this virus. Vaccines are going to change. We’ve never had the potential opportunity to use so many different vaccines. Wouldn’t you want to know which is best for different categories? You can get this information by doing real world vaccine efficacy study. If we had access to it, we could do it,” she said.
On the looming question of vaccinating children and sending them to schools, she said sit would be best to do this “carefully with the best, safest vaccines.”
“With everything, you have to do a risk benefit assessment. It differs for each vaccine. We know from disease data in other parts of the world that risk of severe disease for adolescents is very low. I would like to vaccinate children when I know which vaccine is the best. I would like to see a solid data set that have received these vaccines and come down in a stepwise fashion with monitoring.” But she urged parents to send children to school, with masks, and by ensuring that they understand that they need to be careful. “It’s really important for children to be in school. The risks to children are very low,” she said.