‘It will be very hard to go back to the pre-pandemic situation even with large scale vaccinations’

In March last year, Dr Bijon Sil and his team from Gonoshasthaya Kendra announced an antigen and antibody research kit. Three months later, the findings of the BSMMU showed that the antibody kit was effective in 70 percent of cases. 

Gonoshasthaya Kendra and Dr Shil improved the consistency of the kit to a greater degree as per FDA umbrella guidelines. However, the kit could not be distributed after Dr Shil left Bangladesh due to his E-visa not being issued, even though he had given all necessary documents and information.

The Business Standard recently took an interview of this acclaimed scientist in Singapore. Here is an excerpt of that interview for our readers.

At the moment some trials of Moderna Covid vaccine show 95 percent effectiveness. Many people are looking forward to the vaccine but will this change the rising numbers of Covid patients in the short term?

It's an interesting question; the results from the FDA have gone through rigorous examination with numerous data. The data have to be correct in a pandemic situation for the vaccination to protect people. However, it is a slightly complicated situation for people to get vaccines in case they have antibodies due to silent infection. In a case where you already have antibodies, it is not advisable to inject the vaccine. 

So we have to remember, for the vaccine's effectiveness we should also consider the people who will be vaccinated. For example, if from a vaccinated group of 500 people 300 people have antibodies, there will be a problem. But we are in an emergency now, and we are trying to get results as soon as possible. At present, it's rather a rush-game than a scientific method.

What will Herd immunity look like when a mass vaccination program is implemented?

Generally if you want to protect any population, at least 70 percent herd immunity should be achieved and that could be possible through the coverage of 90 percent vaccination. That means at least 90 percent of the whole population of the world has to be vaccinated, which is no small feat.

Do you think there is a possibility of going back to the pre-pandemic situation? 

It is possible but will be very hard to go back to the pre-pandemic situation even with large scale vaccinations. If a second strain of the virus emerges like that in the UK and Africa, that could be a potential threat for herd immunity because of people's exposure to the new strain of the virus and/or the vaccination itself. At this moment we know very little whether the vaccines will be able to fight against the mutations or not, so it's advised to take at least 14 days to determine how the health situation is. We must get more information from the Vaccine manufacturers on whether the vaccines can fight against the mutated coronavirus strains or not. If coordination is possible, we might be able to go back to the pre-pandemic situation.

What will be the new normal with the vaccine, and what does Bangladesh need to do to ensure the vaccine's best outcome?

Bangladesh has been trying to get the Oxford- AstraZeneca' and vaccines from other sources. At the moment, they are planning to reach 30 million doses. That is one-fifth of the population. So far, they have prioritized the front line workers, policemen, high-risk group of people, civil servants, garment and pharmaceutical workers. This will also help the economy to get back on track with people beginning to leave home.

I think Dhaka has already achieved a good level of herd immunity as cases are dropping by 80 percent compared to June/July.  However, in rural areas, there is still less herd immunity. With less public gatherings and cautious steps, the next few months could be utilised to perform the vaccination and eliminate the virus.

It is important to note that any virus that can jump from species to species poses a grave threat. That is what happened in Europe when a virus was exposed to mink and back to the human host.  So before that happens, we must eliminate the virus.

What is the limitation of the Vaccine?

Some people are developing allergic reactions following vaccination, in particular to mRNA vaccines. . It is almost essential to note that people who are allergic to cosmetic products which contain PEG as thickener might also be allergic to mRNA vaccine.

The Oxford-AstraZeneca vaccine uses a gene that carries a vector like Adenovirus which can grow in the human host following vaccination and initiate antibody development. This vaccine could have less allergic reactions. Also quite promising yet not verified by the FDA, Novavax is a peptide vaccine just like a Hepatitis B vaccine, so it is very safe but expensive. Then the Pfizer vaccine is an intermediate genetic material which can translate in human host cells following vaccination and produce desired protein to develop immunity against SARSCoV2. 

The biggest problem will be from fake vaccine manufacturers. As long as the FDA and other regulatory bodies remain vigilant to give only the effective vaccines green light, there will be fewer problems. However, there are people who try to develop fake vaccines to meet up the huge gaps caused by high demands. Both regulatory bodies and individual government agencies should have to give special attention to control it through regular evaluation of safety and efficiency of vaccines prior to vaccination. 

What are your recommendations to people who will get vaccinated in the new normal?

First, always check if the vaccine is authentic. Wait for at least 30 mins after vaccination, check if there are any adverse reactions and if you need medical care. The adverse effects of the vaccine are severe and still have to be taken under condensation. Wear a face mask, observe social distancing and hand-hygiene practices, it is still possible to spread the virus even though you are vaccinated.

You have seen the catastrophe of SARSCoV1, will the world and especially South Asia be ready for the next epidemic?

If vaccines work, then we can go back to a pre-pandemic state at some point. We also eliminated SARSCoV1 through massive quarantine and case management. However, after nine years it reappeared in the middle eastern countries in the form of MERSCoV simply because we did not develop any good vaccine against SARSCoV1. After  17 long years, once COVID-19 had appeared, WHO thought that the outbreak could be controlled like SARCoV1 and MERSCoV but in reality it did not happen. It is an excellent lesson to learn that we should never forget the emergence of a new virus and always be prepared. If the Emergency preparedness was in place after SARSCoVs, we could easily have handled this pandemic and the world would not see the destruction caused by this tiny entity.