The coronavirus is going to stay longer with humanity and the world has to be prepared to live with the virus. The goal needs to be a controlled scenario with maximum vaccinations, better drugs and surveillance, says Dr Soumya Swaminathan, chief scientist, World Health Organisation (WHO).

"We will not be able to eradicate it soon. This virus infects animals, like in the case of many domestic pets, and so it is very difficult to eradicate a virus that goes into animals and again comes back to humans. Even vaccinated people are getting infected. Therefore, what can be achieved or the ideal goal should be a controlled scenario where the virus stays with us, but not affecting our lives or causing deaths", she tells in an exclusive interview with Fortune India.

Like influenza—which kills about 300,000 to 600,000 people a year worldwide but still we are yet to find an effective vaccine for the disease—the world has to accept the coronavirus like so many other infections, where the virus circulates in the community and most people get a mild infection, get cold and cough and only the most vulnerable people getting severe infection.

"Today we are very confident with the vaccines developed and what we need is a break between hospitalisation and infection. Like what happened in the U.K., where there is a very high rate of vaccination and testing, countries which are testing a lot are getting a lot of cases, but their hospitals are not filling up and deaths are at a reasonably low level," she states.

Fortunately, most of the current vaccines available give some amount of protection. Better treatments and antiviral drugs are being developed and will be available in the near future. The developing world should get affordable oral antiviral drugs and treatments and thus early diagnosis can prevent and control this infection, she elucidates. "Every country now has to think what is acceptable to them, how to keep the virus under control and what mechanisms need to be put in place without sacrificing all of the other healthcare services".

Dr Soumya Swaminathan, appointed as WHO's first Chief Scientist since March 2019, tells that the big question now is on the waning of immunity and what it means. Many reports talk about waning of immunity and antibody levels dropping after six months or nine months. That was expected and what has happened side-by-side is that the protection has not dropped to that extent. That is, vaccinated people are protected against severe disease, even if they get 'breakthrough' infections. The 'delta variant' of the virus can infect vaccinated people, but rarely those infections become severe.

"Some data shows people who recovered from any variant are protected even 8-9 months down the line from re-infection. Breakthrough infections in people already infected are also rare. In vaccinated people it seems more, but are mild infections", she avers.

Commenting on fears of the virus becoming resistant to vaccines, she tells we may or may not get a variant which is resistant to antibodies, which is impossible to predict at this point of time. Now the delta variant constitutes 97%-98% of all viruses worldwide. Some studies show it is partially resistant to vaccines and needs a higher level of antibodies to fight it. To make the current vaccines ineffective, the virus has to mutate further both in terms of resistance to antibodies and increase in transmissibility. It can happen, but the chances of a virus becoming completely resistant is very rare. The current vaccines can elicit a broad immune response and one or two mutations cannot completely transform the virus to become resistant, she adds.

The mutated Alpha variant was seen in November last year and then, very quickly, other variants of concerns with different properties like beta, gamma and the delta in 2021 were identified. The mutations make the virus more efficient in transmission or evading the antibodies as the virus was adapting for its survival. This can continue and likely to continue. The delta variant is the most infectious, and a step above the previous variants in terms of its efficiency in transmission, which is why we saw horrible waves, including in India, she says.

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