mid-day speaks to two international medical experts on issues ranging from COVID-19’s infectivity, its waves to tackling it in India’s rural areas
Dr Lieve Fransen and Dr Jay Levy
Special investigations editor for mid-day, Vinod Kumar Menon, chatted with two international experts — Dr Lieve Fransen and Dr Jay Levy. Dr Fransen is a medical doctor with a PhD in social policies and has extensive experience and credibility in global public health. She is a well-recognised policymaker at the senior management level in the EU in a range of different departments in the European Commission. Dr Levy is a virologist and professor of medicine at the University of California, San Francisco. His discovery of the HIV virus in 1981 was nominated for the Nobel Prize in 2008.
Edited excerpts from the interview:
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mid-day’s to Dr Fransen: Is the vaccine infectivity increasing over a period of time as the mutant strain spreads? Could live attenuated vaccines be the cause for the emergence of new variants?
The virus is adapting to survive. To survive, it needs to multiply in its hosts. Several variants have developed over time with increased infectivity. More variants will keep developing until the whole population is vaccinated. New variants must hold some advantage over the old ones if they are to become the dominant virus. That advantage can be won in many ways, but for a respiratory disease like Covid-19, one factor is transmissibility. The answer lies in vaccinating everyone.
Could children be more susceptible to this variant? Is there a likelihood of a Delta variant changing its pathogenicity rendering kids more susceptible to serious disease?
I do not think kids are more susceptible to the Delta variant. But the variant is more transmissible. As this age group is not vaccinated yet, they may be susceptible. When they get infected, most often they do not get seriously ill. Only some do.
Also read: ‘US to support India’s vaccination efforts with USD 25 million’
Do you think developing countries like India and South Asian countries should build tele-medicines infrastructure to reach the rural areas, with the help of trained ASHA workers, who can tackle future pandemics?
I think all countries can benefit from telehealth. In low-income countries, there is lesser resistance to telehealth — it could make a major difference in India.
Covid has adversely impacted the fertility rate of the world, including India. How could this impact highly populated countries like China and India?
Pregnant women with Covid-19 were more likely to deliver preterm compared to pregnant women without Covid. Babies born to mothers with Covid are more likely to be admitted to the neonatal unit. Data shows Covid has prompted short-term fertility decline in many countries. In developing countries, the pandemic has interrupted the supply chain and access to family planning services, therefore increasing the risk of unwanted pregnancies. So we may have a mixed picture worldwide.
mid-day to Dr Levy: Covid variants have been evolving. Where and when do you think these mutations will stop?
Delta variant is passing rapidly through the world, and its presence in the US is dominant. One needs to get ahead and vaccinate individuals so this variant is blocked by all our immune systems.
Vinod Kumar Menon
Do you think the third wave would impact children across the globe? Is this likely to be the last wave?
The Delta variant is able to affect kids, it has a better chance of attaching to receptors on cells in kids to infect and replicate. Will this be the last wave? One can’t tell but certainly, the only way we can prevent it is to get a large number of people vaccinated so that new variants will not form and cause a new wave.
Do you see the vaccine becoming an annual feature for the world, especially now that the new variants are emerging so rapidly?
We are very fortunate in having vaccines as they are preventing infections in over 90 per cent of people. It looks to me that these vaccines will have their effect for at least two years and some maybe for five years.
The Delta variant is causing 80 per cent of the new Covid cases in the USA. Do you foresee a similar trend happening in India?
Because it can attach more readily to cells, the variant has become dominating in the USA. It looks like it will be dominated in India as well. Except, there will be an early response by the population because of the genetic makeup of people in India. However, India needs to continue to monitor the types of viruses, so that it can stay on top of this epidemic.
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