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Virologist Luis Enjuanes: “The situation in China is worrying and will have a cascading effect on the rest of the world” | International

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Three years after the start of the coronavirus pandemic, the world has once again become concerned about China. The explosion of cases that the Asian giant recorded after him abruptly ended the zero-Covid policy, in force since 2020, worries many governments. The question is how an uncontrolled rise in infections in a country of more than 1.4 billion people will affect the rest of the world. Luis Enjuanes, director of the coronavirus laboratory of the Spanish National Center for Biotechnology (CNB-CSIC), is a leading international expert on such situations.

Question: What’s happening in China?

Reply. Well, there was no middle ground. They went from isolating all residents of a building because of a [single] positive case at almost let the virus spread in a poorly immunized population.

Q And it is not advised.

A. No. The result is that, according to some sources. About 35 million people are infected every day. This is a huge number, which can only be explained if we take into account two things. The first is that the restrictions [that China has] Imposed over the past three years means very few people have spread the disease naturally. The second is that China’s vaccination coverage rates are lower than those [they are] in Europe… and their vaccines are also less effective. All this means that the population is poorly protected against the virus. As a country, China should have done what the rest of the world did: gradually reopen as the population of vaccinated people grew and maintain some restrictions. [in place] as long as necessary. [China] went from one extreme to the other.

Q Applied the zero covid policy for so long essentially meant that China had postponed when the country had to seriously confront Covid-19?

A. Yes.

Q But it was not difficult for a foreigner. China is also a scientific power. Haven’t the country’s experts warned that this could happen?

A. China is also an authoritarian regime, a country that strictly disciplines a population accustomed to obey. At the start of the pandemic, the Chinese government retaliated against doctors; this is what happened in the famous case of an ophthalmologist who, with the best intentions in the world, simply warned that a new virus was spreading. This is how dictatorships are, and the lack of freedom always works against the people.

Q How worrying is all this for the rest of the world?

A. It’s worrying.

Q As worrying as three years ago?

A. We are much better prepared [now]. There are a lot of contagions, which means there will be a lot more mutations, and new variants will emerge. This will have a cascading effect on the rest of the world. More infections always lead to more serious cases and more deaths, which implies additional risks. However, it is also true that newer variants tend to be milder forms of the virus.

Q Why is this the case?

A. If the virus kills you or makes you very sick, they bury you or isolate you and the virus can no longer spread. On the other hand, if you can continue to lead a relatively normal life, you will spread [the virus] all over. It is a natural process; on a large scale, this means that eventually the most attenuated forms [of the virus]that cause milder cases, always end up spreading further. The Omicron variant causes less severe cases than Alpha or Beta.

Q Wasn’t Omicron softer because of the effect of vaccines?

A. Yes. The protection of a population against a virus depends on many cumulative factors. In Europe we have seen that [happen] with the Omicron variant. It was generally milder than Alpha or Beta, but still caused many serious cases and deaths among the unvaccinated and immunocompromised population.

Q But there are viruses that do not subside over time, such as meat and smallpox.

A. These viruses are DNA; [they’re] larger and more stable. They mutate much less and cause a different type of systemic infection. This is why being vaccinated or having had the disease once means that you are protected for life. I was vaccinated against smallpox more than 60 years ago and I am still protected from it. Coronaviruses and influenza viruses are RNA and mutate much more.

Q You said the tens of millions of infections in China are going to have a cascading effect on the rest of the world.

A. Yes, and again we have vaccines to thank [for protection]. New [vaccines] have a dual function. They protect us against the first forms of the virus, which is necessary because [the earlier strains] would reappear otherwise. Vaccines too [protect] against recent [variants], like the new forms of Omicron. This is necessary because we know that protection against serious diseases from the first doses decreases over time, especially in the elderly and those with weakened immune systems. That’s why these new booster doses are so important. It’s like a race.

Q What do you mean?

A. The body develops antibodies and T cells against the form of the virus that infects it or the vaccine it receives. These defenses are extremely effective at first, but over time and as new variants appear, they lose this efficiency. And then comes the time when the virus infects you again. And then you develop new antibodies… And so on.

Q The virus is supposed to subside and eventually it will feel like a cold.

A. Not necessarily. It could be like the flu, which for many people is not mild, and every year they have to get vaccinated again. There are things we don’t know yet.

Q Is it wise to require negative Covid-19 (PCR) test results from travelers from China, as some countries doeven when the virus continues to spread around the world?

A. Yes, it is a standard public health measure that is taken in uncertain situations. You don’t impose a quarantine or ban people from crossing the border, but you have some control in a situation where you don’t know much about what’s going on in China or you’re not sure tell you everything.

Q Beyond China, what is the biggest challenge currently posed by the virus?

A. Long Covid. Studies in the United States indicate that up to 20% of people suffer from some kind of disease that does not go away after their infection. According to studies conducted in other countries, the percentages are lower but still significant. This is a huge challenge that countries will have to face.

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