New Delhi: It may take three years for the whole world to get vaccinated against Covid-19, and when it comes to the development of the much awaited vaccine, accuracy and not speed is important, said Dr Faheem Younus, Chief of Infectious Diseases at the University of Maryland Upper Chesapeake Health, US.
Speaking to ThePrint’s Editor-in-Chief Shekhar Gupta during a virtual Off the Cuff interaction, Younus stressed that there are many variables to consider when developing a vaccine.
“The understanding is that the vaccine may start getting approval by the end of this year to early next year, then will come to the first responders or your high-risk populations. By the time it reaches you and me, it may be another year, it maybe eight months or 18 months. And by the time you vaccinate the whole world, that maybe three years,” said Younus, who is known for busting myths about Covid-19 on Twitter.
According to him, the “large timeline” enhances the value of the three available strategies against Covid — masking, washing hands and avoiding crowd.
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‘Safe and effective vaccine will win’
Till date, only one vaccine candidate, Russia’s Sputnik V, has been approved for use. Nine out of 10 vaccines are still in the third phase of trials, including the vaccine being developed by the Beijing Institute of Biotechnology that has been approved for military use in China.
“I think being first is not important here. This is not trying to put a man on the Moon. The difference here is being accurate is important,” said Younus.
He added that though Russia and China seem to be hurtling towards the finish line, “the vaccine that’s safe, and that’s effective, ultimately is going to win”.
He was also optimistic about how long Covid antibodies will remain in our body. “What we do know is it typically will last much longer than natural infection. The question is how much longer natural infection lasts, we don’t know that either. Studies are showing that the antibodies trail off within three to four months but that’s misleading information.”
“You have T cell immunity and B cell immunity, human bodies are smart. They can’t be fooled so easily,” explained Younus, adding that vaccine-induced immunity is likely to last for one or two years.
“I personally believe that this is enough to crush this virus in this pandemic,” he said.
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What we’ve learned so far
Younus also disagreed with the assumption that there has not been much progress in the treatments developed against Covid-19.
“I think there is an immense amount of progress made on treatments. If I look back to 8 March when I treated my first patient, we treated her completely wrong. We did not know how to treat her. Back then we thought that everyone should get on the ventilator quickly,” said Younus.
He added that after Italy, Spain, and US’ Seattle, doctors now know that they should use anticoagulants — drugs that prevent clots — since the “virus causes blood clots”.
“We use dexamethasone because the registry trial from the UK shows that if you use that on patients who need oxygen, then their chances of survival increases. It’s also cheap and available,” he said.
Younus also advocated the use of remdesivir, an intravenous antiviral drug, which he said shortens the illness and immunoglobulin.
On plasma therapy, he pointed to the conflicting data and said, “I personally believe it will work, we just don’t know the right patient, the right time and the right amount of antibodies.”
Younus noted that ICU mortalities have gone down by 30-40 per cent in recent months.
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On South Asia’s Covid response
The doctor gave a measured view of the Covid situation in Pakistan. The number of cases in India is 22 times more than the cases in Pakistan. In terms of fatalities too, India’s numbers are higher.
Younus said even if there seems to be a semblance of success in Pakistan’s model, one should “be humble” about it.
“You know, when you have fog on the road, what do you do? You slow down, right? Because you will stop your car somewhere… There is no point being arrogant,” he said. “The moment you speed up and you think that oh my God, we won, you don’t know, you may end up with a second wave.”
Younus noted that there may be two reasons as to why South Asia and Southeast Asia have recorded much lower fatalities than the rest of the world.
“It’s possible that the genetic determinants of people living in that part of the world provide them some strength against this virus,” he said, highlighting that previous viral infections could have made South Asians more immune.
However, a second possibility is that many cases aren’t being measured. “The not so optimistic side is we are not testing enough. So unless you test millions of people, you really don’t know,” he said.
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