INTERVIEW: HOW SHOULD EUROPE FIGHT THE CORONA PANDEMIC?

Dr Jonas Schmidt-Chanasit is the Deputy Head of the WHO Collaborating Centre for Arbovirus and Haemorrhagic Fever Reference and Research at Bernhard Nocht Institute for Tropical Medicine in Hamburg. He is one of the most requested virologists in Germany when it comes to an assessment of the current coronavirus situation. The Vice President of the European Senate of Economy and Technology, Benedikt Gruetz, spoke with him about how Europe should fight the coronavirus and gained some exciting insights.

Q1. The coronavirus pandemic is not only a European issue; it affects the whole world. What is your current assessment of the global coronavirus situation?

That is an exciting question. I agree with the opinion of the World Health Organization (WHO) here. The coronavirus is a wake-up call on the question of how we want to live in the future. Do we want to continue to live as we do now, accepting the destruction of habitats and thus displacing thousands of species or destroying their livelihoods? Because by doing this, we create the conditions under which epidemics and pandemics can become more severe.

I have witnessed this myself in the countries of the Global South, especially in Brazil, where I worked for several years. I have witnessed how rainforests are cut down and how yellow fever virus or dengue virus epidemics have developed. In addition, COVID-19 has further increased inequality in the world. Those most at risk have become even more vulnerable. We see this here in Germany and across Europe. The inequalities in access to healthcare have been ruthlessly exposed, and they need to be worked on diligently.

Q2. What exactly needs to be done about healthcare?

We need to invest more in healthcare and thus, also in pandemic and epidemic control. We are willing to invest billions annually in military build-up for a war that we hope will never happen, and in comparison, we have invested almost nothing in pandemic and epidemic prevention. But now, of all things, a virus has brought many countries to their knees.

Q3. What should follow from this realisation?

What follows from this is that international cooperation is very important. We have to realise that pure individualism will not get us anywhere. We have to work together against a pandemic. Asian countries in particular are showing us how to do this because their understanding of community and society is different from ours in Europe. That is why multinational organisations, such as the WHO and the European Centre for Disease Control (ECDC), must be strengthened. These, especially the WHO, have been bled dry financially in recent years, but we urgently need these organisations in order to be able to better support the countries of the Global South in particular.

Q4. Are you also referring to the supply of medicines and vaccines?

Yes. Vaccines, which are the way out of not only this pandemic but also all the epidemics and pandemics to come, need to be distributed more equitably to protect the most vulnerable people around the world, not just locally. For COVID-19 in particular, those are the elderly and those with pre-existing conditions. It is almost bizarre that here in Germany, teachers are fighting with the over-80s for the vaccine.

There can be no such discussion in Somalia because there is no vaccine at all. But also, these people see, of course, the discussions that we have here in the West. And all of us should ask ourselves whether after us, our own children and the 20-year-olds in our country should be vaccinated first, or whether these vaccine doses should be used for the older people and the patients and nursing staff in Somalia.

Q5. What should we derive from this?

It is important that we all have one goal – namely, to maintain or improve the health of all of us in this pandemic. And that health is much more than just preventing physical damage; it also includes mental well-being. In this respect, we should take a very broad view of the strategies that we develop here at home, and we have not done that well in recent months. We see sectoral collateral damage that will be with us for years to come and will have negative consequences, especially for the youngest, who ultimately have done without a lot compared to everyone else.

Q6. We just talked briefly about vaccines. What is the real problem with vaccine manufacturing?

Vaccine manufacturing is not fundamentally a problem in this pandemic. There is the challenge that there may be problems in production, but this is completely normal. We know all about this from rabies, polio or yellow fever vaccination, where in the past there have always been bottlenecks and then you have had to fractionate. It is a proven method for yellow fever to make more vaccine doses out of one vaccine ampoule than originally planned, as is currently being done. It is not something that is specific to COVID-19 but a general challenge that exists in the highly complex process of vaccine production.

Q7. People are always talking about vaccines. Don’t we also need drugs that are acutely effective against the virus?

The development of drugs, antiviral agents, is very important and needs to be advanced. However, it is often difficult to develop such antiviral agents for acute, i.e., nonpersistent, infections or chronic infections because they are often an overreaction of the immune system to a pathogen that is perhaps no longer in the body. We have to make a clear distinction between therapies against HIV, hepatitis C and hepatitis B, which are persistent infections, and coronavirus, which is an acute infection, which we either survive or die from.

Q8. What is the best possible strategy for you right now against COVID-19?

I’ve just touched on a lot of things. It’s ultimately a mix of different building blocks. Vaccination is very important. The rapid tests must be used in parallel to safeguard the path to herd immunity induced by vaccination, and in addition, the usual applicable measures, such as distance, hygiene and protective masks must be observed. This is also perfectly sufficient to get through the pandemic now. Then we end up with a situation like we have with influenza and other viruses.

Q9. What technologies will help us fight and suppress the pandemic?

Technologies are already helping us massively today. We can detect new pathogens relatively quickly and also reliably. In diagnostics, “next generation sequencing” is the buzzword here. In metagenome sequencing, we also have very good companies in Europe, such as Oxford Nanopore, a spin-off from Oxford University. Globally, large companies such as Illumina have also advanced these technologies, which allow us to identify all pathogens in a sample, even without suspicion of a specific pathogen, in a very short time.

This is the technology of the 21st century. Speed is absolutely the key here. We will not be able to prevent the spread of zoonotic agents from animals to humans because, as mentioned above, the habitats will be narrowed and destroyed. The transmissions of zoonotic pathogens from animals to humans will continue to happen, and what we can work on now is the responsiveness to these transmissions. That means rapid containment, rapid counter-response and rapid vaccine development. It has to be said that, for example, mRNA technology is a milestone in vaccine history that will take us significantly forward in the future for other pathogens as well.

Q10. How can European companies provide concrete support in fighting the pandemic?

In this transitional phase in which we currently find ourselves, the regular testing of employees is important to, for example, keep production lines running and avoid further slumps and breakdowns there. Rapid testing and the PCR process are both established. But actually, this should only be a transitional phase because in an estimated few months, the critical areas should be vaccinated, and those who have not yet been vaccinated by then should either have come through the disease or not be placed in critical areas for the time being so that there are no production slumps. That to me is a very realistic scenario for the next six weeks.

Q11. Will all of our lives possibly change permanently?

As already mentioned, it is to be hoped that we have learned to be more considerate of natural habitats and species and to not displace and constrict them, because this inevitably leads to more pathogens jumping from animals to humans. It is important to create these natural spaces and to preserve them. A good coexistence between humans, farm animals and wild animals is very important.

However, it is also important that climatic conditions are maintained in such a way that there is no deterioration, i.e., that it does not get warmer, because this is also a decisive driver for epidemics and pandemics. Especially with mosquito-borne pathogens such as Zika or dengue, warmth plays a decisive role, and the warmer it gets, the more critical the situation becomes with these pathogens as well. We must all take care to live in a climate-friendly way. Thank you very much for your comments.

Dr. Jonas Schmidt-Chanasit
M.D. – Head Department of Arbovirology,
University of Hamburg.