– Vitaly Vasilyevich, as we already know, the exit from the regime of self-isolation should be gradual. Scientists and authorities are developing an appropriate roadmap. Have an understanding of what it will be?
– Exit from isolation will not mean that on May 11 we will all go outside. The exit will be gradual. Based on the experience of other countries, probably, first of all, it is necessary to establish the education of children, especially high school students. This is a contingent that practically does not get coronavirus. For younger schoolchildren, so that they remain under supervision after school, one must probably organize a system of summer school camps – an extension.
Another priority: it is necessary to establish a normal patient care system. I’m not talking about infected people for whom isolation will continue, but there are people with chronic diseases who have spent a month and a half in self-isolation and have not added to their health. Their problems did not go anywhere, but only worsened, because apart from the lack of walks, they did not receive routine medical care for a long time.
I think in the first days we will open parks – not for mass walks, but for individual walks. It will be necessary to somehow organize an exit on the street of elderly people. Maybe it’s worth allotting certain hours, days for this, so that they can walk.
– Which small business representatives will be the first to start working?
– First of all, it would be advisable to start the work of small shops where people can buy something from clothes, household goods, because people live not only with food.
– All these measures to weaken the regime will occur throughout Russia immediately?
– All that I have listed is for Moscow. In other regions, it may not be possible to do this yet, because the epidemic, where they later connected to self-isolation, is now in full swing. On the other hand, there are many cities and regions where people do not live as crowded as in megacities, so there the process of overcoming self-isolation, if it was introduced there at all, will be even faster and easier than ours.
– When going out into the street, should healthy people use any protective equipment?
– We will be required to wear masks. But this must be done with meaning. For example, on a street where people are dispersed and the possibility of infection is small, wearing them is pointless. Moreover, in children and the elderly due to the constant wearing of masks, breathing difficulties may occur. This ultimately only hurts. Therefore, it is advisable to hide behind masks from the virus only in the subway, in stores, in a word, only where there is a crowd of people.
– Is it worth wearing silicone gloves, which for many have already become a mandatory attribute of the wardrobe?
– They do not make much sense, because the virus most actively spreads by airborne droplets.
– Do you need to drink some drugs or bury them in your nose?
– It is possible that prophylactic drugs that will maintain the immune system at a high enough level should be drunk, but all these immunomodulators should be prescribed by a doctor. After all, every vitamin, I’m not talking about antiviral agents that promote the release of interferon, have their own form and play a role in the biochemical cycles of the body. Their excess, as well as a lack, can have its side effects.
– There are people with strong innate immunity. Are they guaranteed protection against COVID-19?
– It is known that the most protected from coronavirus are children, with the exception of those who have an impaired immune system. Their sufficiently strong innate immunity, which they inherited from their parents, is helped by the so-called thymus gland (it works actively until about 5 years). In this gland, the former stem cells coming from the bone marrow into the immune system are converted to T-lymphocytes that can fight infections.
Once in the children’s body, the genome of the virus is powerless before ideal protection, as, indeed, in the body of young people. But over the years, innate immunity in a person weakens a little. If the body by this time is still weakened by diseases and bad habits, it becomes more accessible to the effects of infection. It is known that when SARS-CoV-2 coronavirus (it causes COVID-19 – Auth.) Enters the body, it encodes several proteins in the body with a weakened immune system that affect the innate immune response system.
– The second wave of COVID-19, according to Chinese scientists, is waiting for us in November …
– I do not think that in its strength it will be the same wave as now. Still, a certain percentage of people have already been ill, and after a few months, provided that everyone behaves correctly, we will get only a slight increase in the incidence. We need to understand that COVID-19 will stay with us forever, like the flu, like HIV, like viral hepatitis. Destroying it completely will not be easy. The whole world has been fighting smallpox for 20 (!) Years, measles and polio have not yet been defeated …
– What will contribute to the increase in the incidence in the autumn period – a decrease in temperature?
– In the autumn-winter period there is an increase in all viral diseases. And this is due not only to temperature. There is a whole range of factors. This is a lack of vitamin D in the body due to a decrease in sunny days, and a large crowding of people who returned after the holidays.
– By November, we will not have a vaccine against COVID-19. What will we defend ourselves with?
– Many countries in the situation of the unpreparedness of specific vaccines for the epidemic of a disease use the so-called “quick vaccines”. They stimulate the innate natural response of the body to any pathogen and cope with it in a few days. Protection is short-term, but almost one hundred percent.
– In our country there is a “quick vaccine”, which is produced on an industrial scale?
– Our institute at one time created such a tool, it successfully passed all clinical trials, but then, with the change of a higher management, the work was slowed down. Now we have remembered her again, clinicians have already begun her trial, she received support at the RAS, but we are unlikely to have time to provide her with Muscovites for the upcoming fall season.
“What is it based on?”
– These are special proteins of four bacteria, the so-called pathogen-associated molecular complexes. They provide the synthesis of protective cytokine molecules with a strong anti-inflammatory effect. When introduced into the body, such a vaccine blocks the development of the virus and protects cells from it.
– Is it injected intramuscularly?
– There are two options for administration – subcutaneously and in the form of nasal drops.
– How many days did she protect the body after administration?
– For each kind of disease, it has its own application scheme. For example, against acute respiratory viral infections, we add drops to the nasopharynx not once, but during a certain period, for example, within two weeks with a certain interval. You know, there are very often sick children who cannot even take planned vaccination activities because of constant coughing and snot. So, with our vaccine, we kept the kids from colds for a year and, against the background of vaccination with a fast vaccine, made routine vaccinations against other infections.
Now the big problem is nosocomial viral infections. The patient undergoes a unique operation, and then he dies from pneumonia … If such people are given a “quick vaccine”, then we can protect them from concomitant infections. It also makes sense to use such a vaccine if the person has contacted the patient and is afraid to get sick.
– And if he still managed to “catch” the pathogenic virus, but the disease has not yet manifested itself?
– Even if I “caught”, the vaccine’s effectiveness will be lower, but it will still be. By the way, now for such an emergency effect on the skin or mucous membrane in the nasopharynx with our vaccine, we are developing its variety in the form of a spray. Squirted in the throat before a trip on transport, before work, and – forward.
– If you say that by the fall your quick vaccine will not be available for Muscovites yet, what should be protected?
– I think other institutions have begun to develop similar tools. Maybe someone will put their production on stream faster than us. And so I would recommend to lead a healthy lifestyle, to observe sanitary rules: try not to contact with a large number of people, still keep a social distance.
– By the way, something with the coronavirus completely forgot about the flu. But autumn is a time when everyone is vaccinated precisely from this infectious disease. So you need to get vaccinated against flu this year?
– Of course! Because he has not gone anywhere.
– But no one says anything about him, as if he weren’t …
– It’s just that this year it is not enough, the isolation regime helped many to avoid not only infection with coronavirus, but also other respiratory infections. Although a month ago in the US, data were published on 35-40 thousand deaths from influenza.
– Do you have such data for Russia?
– It should be, but so far no one is publishing them.
– Theoretically, a flu vaccine can at least partially protect against COVID-19 coronavirus?
– Any vaccine to some extent can stimulate one or another type of immunity, but no one can say how much the influenza vaccine will be effective against coronavirus.
– Scientists have already clarified the question of concern to many about secondary infection with coronavirus?
– There is no one recorded repeated case of COVID-19. Only a few cases are described when the virus did not disappear from the body for a long time after recovery, and then gave a second round of the disease with all the previous symptoms. But how often and with whom this can happen, we do not know yet. Basically, the cured people no longer became ill, because they formed antibodies to this virus.
– And for how long will the immunity of patients who have been ill remain, can I say now?
– As far as I know, antibodies to SARS after people had SARS did not disappear for 10 years, to MERS – 5 years. To even older types of coronaviruses, immunity lasted for a year or a little more. How much the desired titer (frequency) of antibodies to COVID-19 will be retained is not yet known. If we assume that this will be 2-3 years, then we can hope that in 3-4 years we will transfer this infection from life-threatening to the category of ordinary SARS.