Albert Rizvanov: ‘The pandemic will unlikely be widespread by spring and summer’

A KFU doctor on forecasts of the epidemic, a third wave of COVID-19 and a race of vaccines

“The majority of the population will have antibodies to COVID-19 by spring 2021 either if a person catches a disease or receives a vaccine. Clearly, it is much safer to receive the vaccine than to get infected. COVID-19 is a terrible disease that can cause long-term severe consequences. We all will have immunity to novel coronavirus. But we can get it in a good or bad way. The good way is to receive a vaccine, the bad way is to get infected. This is why it is up to everyone,” Realnoe Vremya was told by Director of the Centre for Precision and Regenerative Medicine at the Institute of Fundamental Medicine and Biology of Kazan Federal University, correspondent member of the Academy of Sciences of the Republic of Tatarstan, Doctor of Biological Studies Albert Rizvanov. The professor also guessed when the novel coronavirus infection would disappear, who would win the race of vaccines and explained how often one should receive a vaccine against COVID-19.

“The pandemic will likely end in 2021”

Mr Rizvanov, when do you think all this will end? Can we expect that the COVID-19 pandemic will go down in 2021 or stop threatening us?

The pandemic will likely end in 2021. Though there are several factors that can influence it. If we have a look at the experience of other seasonal viral respiratory infections, we see a rise in the incidence in autumn and winter and a fall in spring and summer. This is why there is hope that the COVID-19 pandemic will have the same scenario and will stop being widespread by spring and summer 2021. This is linked with seasonal changes and the fact that more people contract COVID-19 and create herd immunity.

On the other hand, the end of the pandemic will greatly depend on vaccination terms, on how fast states can provide the public with doses of vaccines, which is the most effective way of creating herd immunity. Though some experts claim that the novel coronavirus infection might turn into seasonal. We can add the facts of secondary infections of COVID-19 to this. It isn’t like chickenpox that one has once in a lifetime and will never contract it.

According to the experience of other infectious diseases, immunity stays for around a year. Now there is research demonstrating that the level of antibodies significantly reduces in 5-6 months already. Though scientists stress that despite a reduction, this level is anyway enough to protect from the new infection. Fortunately, though there are cases of secondary infection, they aren’t widespread — there is less than one per cent of people who recovered from novel coronavirus and contracted it again around the world.

Taking into consideration all the pros and cons, we can forecast that the pandemic will unlikely be so widespread in spring and summer 2021. New Year holidays are a serious risk factor of infection. People met with each other — new contacts appeared with friends, relatives, which considerably expanded communication. This can add fuel to the fire of the pandemic.

The end of the pandemic will greatly depend on vaccination terms, on how fast states can provide the public with doses of vaccines, which is the most effective way of creating herd immunity

“Coronavirus vaccines will maybe be added to the vaccination schedule

Won’t the pandemic gain in power after spring and summer 2021?

As the flu and viral respiratory infections come back every year, coronavirus can come back too. There is a rise in viral respiratory infections in autumn and winter every year. And people don’t have only one disease every year, for instance, only flu or cold. Several viruses always circulate in the population at the same time. The case is that we will see that novel coronavirus will join the family of viruses that annually attack us.

But as there develops herd immunity and there are vaccines, a mass COVID-19 incidence is unlike by next summer and autumn. While the epidemiological situation in winter and early spring 2021 will still be tense.

Not all experts believe that the concept of herd immunity is applicable to COVID-19...

There won’t be a hundred per cent immunity. Quite a big amount of people who are resistant to the disease will anyway appear to prevent a serious incidence from spreading. Coronavirus vaccines will maybe be added to the vaccination schedule, we will regularly be vaccinated in high seasons.

When do you think the mask regime will disappear? Precisely by spring and summer 2021?

Highly likely. But it will depend on the epidemiological situation. Clearly, nobody will cancel the mask regime unless the epidemic goes down to an acceptable level.

There won’t be a hundred per cent immunity. Quite a big amount of people who are resistant to the disease will anyway appear to prevent a serious incidence from spreading

“Everybody will win the race of vaccines”

We can say there is a race of vaccines now. Who do you think will win it?

Everybody will win it because there aren’t simply enough vaccines. All vaccines announced in Russia now — Sputnik V, EpiVacCorona and the Chumakov Centre’s vaccine — are created on various technological platforms and require different production. Production capacities are anyway limited. So all these vaccines are necessary to fill the market. Moreover, all the vaccines work a bit differently, which will boost the protection of the population in general.

The same is happening around the world. The demand for vaccines is measured in billions of doses. While existing capacities are ready to provide only hundreds of millions of doses. Anyway there is a gap between demand and production capacities.

When will production capacities reach such a level to vaccinate the majority of the population and diffuse the issue?

They can never be reached because it is a pharmaceutical business. There is a term overbooking when more tickets than a plane has are sold. This is done to completely fill the plane. The same happens to production.

It is profitable for companies if a plant runs a hundred per cent. It is unprofitable for them to build with room so that capacities are half full. This is why all this is in the hands of commercial companies now, there will always be underproduction: they need to sell everything that was made. If they make more and don’t use the capacities fully, they will lose money. While pharmaceutical companies are, first of all, a big business, they know how to count money very well.

The demand for vaccines is measured in billions of doses. While existing capacities are ready to provide only hundreds of millions of doses. Anyway there is a gap between demand and production capacities

“People will be happy to receive any vaccine

When will it be possible to complete the mass vaccination against COVID-19 in Russia?

I think next spring. The main problem now isn’t even the availability of vaccines but the availability of production capacities. Nowadays it is merrily reported that Sputnik V has been delivered to all Russia’s regions, but when we look at the amounts, while it is several thousands of doses per region at times, is a drop in the ocean. This will make no difference. We aren’t talking about mass production of Sputnik V. It is an absolutely new vaccine, a new technology, so there simply weren’t such plants — they have to be created literally from scratch.

What approach among producers of Russian vaccines is the closest to you? Which one would you receive personally?

The available one. A spoon is dear when lunchtime is near, one should receive the vaccine that is available. In general there will be seen a shortage of vaccines soon. People will be happy to receive any vaccine. It’s like vaccines against the flu.

There are different vaccines — some work a bit better, but for a small number of strains, other work a bit worse but for a large number of strains. But doctors for infectious diseases anyway claim that the eggs are the same, only in profile. That’s to say, a vaccine can be better at something but worse at another thing. But in totality, they are all approximately equally effective.

Does it mean we can hope that the majority of Russia’s population will have antibodies against COVID-19 by spring 2021?

Yes, the majority of the population will either contract the disease or receive a vaccine. Herd immunity precisely consists of two factors. In fact, formed immunity is an immune response, antibodies and killer cells that are specific to the virus. They appear in two cases — if a person catches a disease or receives a vaccine. Clearly, it is much safer to receive the vaccine than to get infected. COVID-19 is a terrible disease that can cause long-term severe consequences. We all will have immunity to novel coronavirus. But we can get it in a good or bad way. The good way is to receive a vaccine, the bad way is to get infected. This is why it is up to everyone.

I would choose vaccination, without doubt. However, I already managed to contract COVID-19 with 28% lung damage. This is why I can’t receive the vaccine now, as I have antibodies. In general, any vaccines have side effects. But they are tiny compared to the negative effects of the disease itself.

We all will have immunity to novel coronavirus. But we can get it in a good or bad way. The good way is to receive a vaccine, the bad way is to get infected. This is why it is up to everyone

“This pandemic questioned humanity’s security in front of bioterrorism”

Speaking globally, when will it become possible to vaccinate most of the people?

Hard to say. I think the dynamics will be approximately the same as in Russia, at least in civilised countries. While the developing world will, unfortunately, be vaccinated last. Now all countries are hogging the blanket, especially the USA.

Won’t developing countries and anti-vaccination campaigners create big problems to get global herd immunity?

Unfortunately, developing countries will create immunity by infecting a big amount of people. And probably with tougher economic consequences. While anti-vaccination campaigners have always existed. The case is that now society is so that people, first of all, think about themselves and don’t realise that refusing a vaccine they not only make their own choice but also impose this choice on people around. They say: “It is my health, I do whatever I want.” And this is wrong.

Anti-vaccination campaigners pose a threat to the health of people around. Here a very subtle balance should be kept between the individual freedom and responsibility towards society.

Will people who received a vaccine get to have sterilising immunity?

Unlikely. It will likely be protective immunity that will protect from a severe case of the infection. All the vaccines that are applied today don’t create immunity in mucous membrane the virus gets through. But only the experience of use of vaccines can show how effectively they protect from a perspective of sterilising immunity. But it has already been proven that they are effective in protecting the organism from serious infections.

But will one have to receive the vaccine every season like against the flu?

Yes, the vaccination against COVID-19 will likely be added to the vaccination schedule.

Many experts say that COVID-19 isn’t the last pandemic for humanity. And we can wait for more terrible ones. Do you wait for them?

Yes, without doubt. All humanity’s history, even contemporary history shows that some pest comes about and causes inconveniences for us every 5-10 years. So COVID-19 is certainly not the last example. I am convinced that COVID-19 is a virus of natural origin. But this pandemic questioned humanity’s security in front of bioterrorism. Countries aren’t interested in such a biological weapon because it is too untargeted and hits everybody. While terrorists don’t care. The most important thing for them is to do the greatest damage as possible.

From a perspective of biological weapon, such viruses aren’t effective. While from the point of view of terrorism, I have some fears that we might face bioterrorism in the future. Such viruses can be created with the help of technology. And it is much cheaper than nuclear programmes.

All humanity’s history, even contemporary history shows that some pest comes about and causes inconveniences for us every 5-10 years. So COVID-19 is certainly not the last example

“All doctors talked about the high effectiveness of plasma transfusion”

How is KFU’s project on preparation of plasma of people who had COVID-19 going?

At this moment, there aren’t medicines that would influence the coronavirus itself. All medicines either reduce inflammation or make the blood thinner to avoid the process of making clots. In other words, all medicines influence the consequence, not the cause, the virus itself. The only treatment that influences the virus itself is either a vaccine or plasma transfusion from the blood of people who had COVID-19 because plasma contains antibodies that can bind to the virus and neutralise it. In Tatarstan, the republic’s Ministry of Health launched a project to prepare plasma of people who had coronavirus as early as in April on Kazan Federal University’s initiative.

Now at KFU, we provide the service when a person who had COVID-19 can save the plasma personally for himself in case of secondary infection or for his relatives, friends. It is a kind of biological insurance. A person pays around 30,000 rubles but owns this plasma and it can be used only by his consent.

Do you have data on the effectiveness of plasma treatment?

There aren’t official statistics. But the procedure was approved around the world, including the USA and European Union. During a recent meeting in the Tatarstan Health Care Ministry, all doctors of COVID-19 hospitals of the republic talked about the high effectiveness of this procedure and asked to increase the amounts of plasma. It is in a very high demand.

By Kristina Ivanova
Tatarstan