A scientist’s view of the Covid-19 pandemic

FIFI PETERS: South Africa’s race to beat the Covid-19 pandemic is being spearheaded by many individuals. Considered one of them is Dr Glenda Grey. She chaired the analysis committee on Covid-19 and is amongst these working tirelessly to make sure South Africans get vaccines in order that we are able to get our lives again to regular. However Covid-19 isn’t the one pandemic she’s at warfare with. She has spent a big a part of her profession combating HIV/Aids and is revered worldwide for her analysis in stopping the unfold of the virus from moms to their infants.

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Dr Glenda Grey, president and CEO of the South African Medical Analysis Council, joins the SAfm market replace. Dr Grey, thanks a lot to your time. How are you recently?

Prof GLENDA GRAY: It’s a double-edged query. I feel that as a healthcare employee, as a researcher and as a scientist we’ve spent the final one-and-a-half years or 18 months being fairly frenetic and dashing from disaster to disaster and resolution to resolution. It’s been a rollercoaster experience, these final 18 months, however an exhilarating rollercoaster experience, I ought to say.

FIFI PETERS: For most individuals Covid-19 is the virus that turned their world the wrong way up, that value them their family members, that value them their livelihoods even. However as a scientist, what is that this factor known as – the Covid-19 pandemic?

Prof GLENDA GRAY: Effectively, I feel it’s every thing. Like most individuals, I’ve additionally misplaced colleagues, family and friends members to Covid-19. So it’s affected all of us. So we really feel as affected, and that’s additionally why there’s an pressing want to search out options.

However the Covid-19 pandemic was brought on by a virus known as SARS-CoV-2, and this virus has circulated internationally. Initially we thought it was fairly a secure virus and wouldn’t evolve. However in the direction of the top of final yr we noticed that the virus had developed in some components of the world. After which once more, this yr, simply while you assume the virus isn’t going to evolve any additional, the Delta variant emerges, which is way extra transmissible than the earlier variants of concern.

And so what now we have is a pandemic with a virus that’s evolving. On the identical time now we have vaccines that do work, however at a world stage we haven’t given sufficient individuals the vaccine, notably in decrease to middle-income nation settings. So now we have a pandemic, now we have vaccines that work, and simply not sufficient going into the arms to assist attempt to start to regulate this pandemic.

FIFI PETERS: I keep in mind that earlier than the vaccines have been even discovered world leaders, particularly these on the continent, have been warning in opposition to vaccine nationalism, but right here we’re: as you rightly say, solely a fraction of the jabs which were administered worldwide have been on the continent, in comparison with what we’re seeing in different places, in additional developed international locations. How did we get right here?

Prof GLENDA GRAY: It’s true that we must always keep away from the vaccine nationalism, however at one stage the high-resource international locations did make a plan and so they both funded vaccine improvement, which secured their entry, or they purchased up provides, both earlier than they have been accessible or as they turned accessible. So (these) international locations sorted their residents and I suppose poor international locations, as a result of they don’t find the money for and so they have fragile well being techniques, have been unable to take care of their residents and didn’t in time purchase vaccines from producers or perhaps thought that the Covax facility would assist the rollout in these sort of settings. And so at a world stage poor international locations have been let down.

I might additionally say that poor international locations additionally must take care of their residents and poor international locations must also be in a state of affairs the place they’re placing their cash up entrance and ensuring they’re additionally first within the queue. We are able to’t anticipate handouts and we have to take much more accountability for our personal well being. We’ve the cash, notably in South Africa, and we must always have made certain that we had entry to vaccines a lot earlier on.

Possibly there’s serendipity about not getting access to vaccines early on, as a result of clearly we have to ensure that the vaccines we use are efficient in opposition to our variant. Generally vaccine selection is impacted by the variant that’s circulating. Dashing out would have helped in some cases, however could not have helped in different cases. However all in all, the query on the continent of Africa is why we weren’t first in line. What did we have to do to be first in line, and the way will we stop that sooner or later?

The one means we current that sooner or later is to ensure that we’re vaccine producers, and we take the manufacturing into our personal fingers.

FIFI PETERS: I suppose all now we have at this stage is the good thing about hindsight. We solely hope that we be taught from it and our leaders will be taught from it.

Dr Grey, there’s a whole lot of hesitancy across the vaccine, and in some instances I suppose this may impede the race to herd immunity. Why ought to individuals not be afraid to take the job?

Prof GLENDA GRAY: The vaccine has particular person well being advantages, and the vaccine at the start will defend you in opposition to loss of life and hospitalisation. I feel that’s a very powerful factor. The vaccine will get our kids again to highschool, get our lecturers within the classroom and get our waiters and our eating places open. So the vaccine has advantages. It’ll assist us get our lives and our economic system collectively. So individuals who don’t need to be vaccinated are impeding the progress to opening up our economic system and are impeding our capability to have a society that may interact at an financial stage. I feel it’s vital to attempt to perceive what vaccine hesitancy is, why persons are scared. Folks give vaccines to youngsters, so why are they so hesitant to take vaccines as adults?

FIFI PETERS: One other problem that the pandemic has launched is that it has made us take our eye off the ball of different viruses and illnesses that proceed to value lives on the continent. Have you ever seen an under-investment or a scarcity of consideration in your area, within the medical fraternity, to different viruses like HIV/Aids or malaria previously 17 to 18 months once we’ve had our deal with the pandemic?

Prof GLENDA GRAY: At a laboratory stage, we’ve seen a discount within the quantity of TB diagnoses being made, and the quantity of individuals coming for his or her CB4 or viral hundreds, which implies that persons are not being monitored and might not be accessing antiretroviral remedy. Folks might not be going as a result of they’re petrified of going to a well being system as a result of the well being system is being reorientated in the direction of the pandemic.

So undoubtedly we’re going to see a fallout not solely with HIV and TB and different infectious illnesses; we’ve seen fallout of childhood immunisations, we’ve seen a fallout within the care of pregnant lady and supply. And so each a part of the well being system has been weakened by the Covid pandemic.

FIFI PETERS: And are you assured that as quickly as we get the pandemic underneath management we’ll see a refocus, a fast refocus on these areas – and what may the potential value of not rapidly refocusing on them be?

Prof GLENDA GRAY: Effectively, we want a extra resilient healthcare system. We want a healthcare system that may handle the power illnesses, in addition to handle emergencies or disasters. And definitely now we have to have a extra expansive well being system in order that nothing budges, even within the face of a catastrophe or emergency. We’ve to work in the direction of that. We’ve to search out different methods of giving care, now we have to search out methods of giving care outdoors the well being techniques. And now we have to search out methods of restructuring well being techniques, taking a look at digital know-how, TeleMATs (MAT= mediation assisted remedy) and fashionable procurement strategies and interventions that guarantee individuals get care, even when there’s a pandemic. And so we have to take a look at the fourth industrial revolution and attempt to discover methods of modernising our well being system in order that we take this in our stride no matter occurs sooner or later.

FIFI PETERS: Simply taking a step again from the Covid-19 pandemic, as a result of you will have spent fairly a big a part of your profession doing analysis round HIV, which pandemic has been more durable to combat for you – Covid-19 or HIV?

Prof GLENDA GRAY: I feel each, in numerous methods. The lucky factor about Covid-19 is that we have been capable of finding vaccines in underneath a yr. The pathogen was recognized in January and by November we had a vaccine. And so the pace at which a vaccine was discovered was sensible, and we haven’t been capable of finding a vaccine for HIV. In order that’s a distinction. That’s what has made HIV so tough – that now we have been unable to know the immunology of HIV sufficient to have the ability to design a vaccine that may defend individuals in opposition to HIV, whereas with Covid we have been in a position to do it faster.

The opposite factor is, I suppose, with HIV when you get contaminated it should take you 5 to 6 years with out remedy to turn into sick and die, whereas with Covid you [could] die inside days or perhaps weeks of getting it. So simply the pace at which individuals can die is completely different for Covid in comparison with HIV. However, in contrast to HIV, Covid has no remedy, there’s no remedy. So when you get Covid at this second in time, we don’t have an anti-viral that may inactivate Covid like now we have with HIV. HIV has received triple remedy, three antiretrovirals may help management the replication of HIV in our physique.

The distinction with Covid and HIV, as effectively, is I suppose individuals can get better from Covid, whereas with HIV you may’t get better. So I feel there are a whole lot of variations in the way you handle it. Covid is airborne and HIV is sexually transmitted, or from mom to little one. And so the completely different modes of transmission put completely different individuals in danger in comparison with HIV once we take a look at Covid-19.

FIFI PETERS: Do you assume the business, the medical fraternity, will ever discover a vaccine for HIV on this lifetime?

Prof GLENDA GRAY: In my lifetime, hopefully. We’ve discovered a monoclonal antibody which will defend in opposition to HIV; perhaps there we can provide cocktails of those monoclonal antibodies, and perhaps that’ll be a method. So perhaps we are able to use passive immunity to guard in opposition to HIV. We’ve to proceed to attempt to discover a vaccine. I’ve devoted my life to discovering an HIV vaccine – and located it simpler to discover a Covid vaccine than an HIV vaccine. However I’ll proceed in my profession to work within the HIV vaccine discipline.

FIFI PETERS: And we’ll proceed watching the developments that you simply make, Dr Grey. We’ll go away it there for now. That was Dr Glenda Grey, president and CEO of the SA Medical Analysis Council.

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