“Sore throat and runny nose.” How does the new “micron” manifest itself?

– Pavel Yuryevich, now we are again in the vector of a rising wave of coronavirus infections, 12 thousand infected per day are detected. Is it already the crest of the wave or not yet?

“I think we are on a gradually rising shoulder.

I suspect that the maximum values ​​will be in September-October, because for the spread of the infection a lot of activity is needed and it is impossible without children and adolescents.

Kindergartens, schools and universities will start working in September. Also, by September-October, antibody titers will drop in those who were sick at the beginning of the year.

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Pavel Volchkov

From personal archive

– What are the main symptoms of COVID-19 caused by the latest versions of Omicron?

– Swelling, redness and prolonged sore throat, severe runny nose. All these symptoms are easily explained by the characteristics of the new variants of the “omicron”. After all, these strains do not descend into the lungs, but are localized in the place where the infection occurred. This is the oropharynx and the nasopharynx – now all the events unfold here. A runny nose is required to physically wash away the virus that enters with the reverse current. As part of the mucus released from the nose, there will be many dead neutrophils with the formation of neutrophil networks (neutrophils are a subgroup of cells that are part of innate immunity. Their main function is to capture and digest pathogenic microorganisms – viruses, bacteria, fungi, protozoa – and their decay products body tissues. – “socialbites.ca”). This is the job of the immune system.

In most cases, what we think of as a disease is actually the work of the “human body’s air defense”.

– Why does immunity not always protect, even if a person is infected with the same “micron”?

– The immune system does not work on the “black and white” principle and in principle cannot 100% prevent any re-infection. It all depends on the specific conditions of acquiring the virus, its amount (viral load), concomitant diseases and the age of the person. And this is specifically the answer to the question: will there be fatal consequences with these relatively mild variants of “omicron”? Yes they will. However, it will be substantially less than “delta”, as only a small number of cases develop pneumonia.

– If you look at the graphs of the number of infections in different countries, and especially in Russia, you get the impression that the worst was in January-February 2022. Really?

– Not this way. However, if we take Russia, the most difficult period was associated with the delta strain. Fatal outcomes and hospitalization level are incomparable with “micron”. This happened because the “micron” changed its dominant way of penetrating into cells, using endosomes (membrane vesicles). This was a turning point for the pandemic.

Because of this, the “omicron” began to be infected in significantly smaller quantities. Previously, 1000 viral particles per unit volume were conditionally required, now the virus needs almost an order of magnitude, maybe even two. It does not need to get into the lungs, but you can fly into the epithelium of the upper respiratory tract. In fact, this has caused people to tolerate “omicron” much more easily. So, as they once said, “omicron” can be called a natural vaccine.

– And which is better – a natural vaccine or a medicine?

– Medicine is actually a good thing, but in terms of protection, the vaccine will never be compared to a natural viral infection.

— According to Rospotrebnadzor data, omicron BA.4, BA.5 lines dominate in Russia. Together they account for 75% of all infection cases. Should patients try to figure out which version of “micron” they have?

– It’s not worth it. They are not much different from each other inside, not far enough from each other to have a competitive advantage.

– Where might the next strain come from that will cause not only interest but also concern from WHO?

– If you “cross” India with the immune-deficient southern part of Africa, something might work there. But this takes time. “Centaur” is gaining momentum in India now, but it still has a long way to go before it becomes a separate letter of the Greek alphabet.

– In the scientific literature, there are studies that try to answer the question of how long the protection lasts on average after the initial infection. Some articles say that this type of protection takes about 14 months.

– It looks real. And here it is important to understand that the severity of the secondary disease is incomparable with the first. And

There is another clear pattern: if you are seriously ill then you have made a lot of antibodies, your defenses will work better and longer.

If the initial infection is easy, the protection is worse.

The analogy is this: If you had a full-scale, long-term invasion that penetrated deep into your territory – you had a real war there – it is clear that you will remember this war for a long time. The immune system responds in a dose-dependent manner.

– Therefore, protection against “omicron” – say, if a person was infected during the January wave – should be worse than “delta”?

— Yes, because Omicron does not cause major systemic lesions.

This does not mean that you are no longer protected, just that the protection is improved in proportion to the infection that has occurred, no more, no less. From the biology point of view this is an effective answer, why give an exaggerated answer? Thus, the immune system is regulated.

– There are also many scientific articles that say that the third and fourth vaccines protect against “omicron”. Would you recommend getting vaccinated now?

– It’s not about the third and fourth. Ideally, each individual should be considered individually, a personalized approach is needed. If a person has “delta” and has symptoms when “omicron” comes in, and they have also been vaccinated, it is not worth doing anything now. If we look at the history of people who have recently been vaccinated and have never been sick, the decision should be made based on the date of the last vaccination. If it’s much earlier than six months, I recommend getting them vaccinated on the eve of the autumn season.

– Who needs to be vaccinated in the first place now?

– Those who are not sick and have not been vaccinated before. But it is precisely these people who will most likely not go and get vaccinated because they hadn’t already done so in the previous years of the pandemic…

Should children be vaccinated?

– Yes. We have a vaccine for children, and during that time quite a number of children have matured and moved into the category that can be vaccinated. I encourage kids to get vaccinated against COVID-19, especially as the fall school season approaches.

– What about the elderly?

– In anticipation of a possible epidemic in the autumn, I recommend that people who have been vaccinated for a long time, especially the elderly, be vaccinated again.

The immune system also ages, so a booster would make sense for them. If anyone has an increased death toll, it’s the elderly. This is where the “overshoot” factor comes into play.

– Do you need the flu?

“We need more from the flu than COVID-19 because we haven’t had the flu for very long. And a large layer of kids has formed who have never had the flu. It’s a big layer that can quickly reinfect their parents. Parents don’t get the flu for a long time either, so most of us have antibody titers.” already low.

“What about monkey flower?” Recently, more than a thousand infected people a day were detected in the United States …

– Monkeypox is more like a “media issue” after all. It is clear that we are very susceptible to any viral infection during the COVID-19 pandemic, but the virus is potentially incomparable to SARS-CoV-2.

Monkeypox is transmitted through sexual contact, bodily fluids and microtrauma. It is comparable to the human immunodeficiency virus, but HIV has a long latency period – people may not know they are infected for years and can spread the viral infection. This is not the case with smallpox. Therefore, it is quite easy to control this virus if you set such a target.

Should the country have a monkeypox vaccine? Does it need to be done now?

– If I were a representative of a pharmaceutical company or an institute affiliated with a state company, I would set out to make such a vaccine. Let it be. But first of all, I would evaluate the possible market for its sale. Of course, it can also be applied in African countries. Potentially, this has a political meaning – establishing contacts with West and Central African countries. For Russia, I personally rate the likelihood of a wide spread of the monkeypox virus as small.