In the midst of the pandemic, virologists have become the go-to people of interest to answer our burning questions on the virus that tipped our lives upside down.
As Emeritus Professor of Virology, University College London, in Paul Griffiths we found the perfect person to ask those all-important questions as we edge away from Covid-19.
Verity Craig speaks to Professor Paul Griffiths.
Paul, here in the UK we first heard about Covid-19 in the beginning of 2020. As a Professor of Virology, did you hear about it prior to then? And what were your initial thoughts upon first hearing about this ‘new virus’ that had emerged in Wuhan?
I teach a 3-month module entitled “global eradication of viruses.” In my introductory lecture on 14 January 2020, I mentioned a new virus emerging in China that the students should follow. My default position assumed that quarantine and isolation would control it in the same way SARS was controlled in 2003. It’s important to distinguish between the virus SARS-CoV-2 that causes the disease Covid-19.
Behind-the-scenes in your career as a virologist, was this moment something that you and your colleagues had spent years preparing for? And was it how you had imagined?
It was inevitable that another pandemic would occur at some point, but we didn’t know what year, or which virus. We support the plans of the international organisation CEPI (Coalition for Epidemic Preparedness Innovations) to prepare antiviral drugs and vaccines against the 6 most likely candidates. One of these is a coronavirus.
What for you, was the most shocking thing about the virus Covid-19?
I was surprised the government didn’t follow the successful way that NHS and university labs collaborated in 2009 using existing expertise and resources to diagnose pandemic influenza. Instead, they set up a new parallel system using private companies to form ‘Test and Trace.’ Please don’t call it “NHS Test and Trace” because it’s outside the NHS.
“we could decide to eradicate it from the globe, as we’ve done for smallpox and polioviruses 2 and 3,”
Do you think that the initial process of how Covid-19 was handled could have been better?
This is a subject for an inquiry to decide, judging politicians on what was known at the time, not on what we know now. I thought they were slow to recognise that SARS- CoV-2 was spreading widely and rapidly and were too slow to lock down. The Imperial modelling paper was published on 16 March 2020.
What makes Covid-19 different to other Coronaviruses and viruses such as SARS, Ebola etc?
The 4 coronaviruses that infect humans were joined in 2003 by SARS coronavirus and, in 2012, by MERS coronavirus. These were not very transmissible but had a high mortality ie more difficult to catch, but if you do, death is more likely. SARS-CoV-2 is more transmissible and kills 2% of the people it infects. A major difference is that SARS-CoV-2 transmits before people show any symptoms.
Why is Covid-19 more deadly to the elderly, and less to babies and children?
SARS-CoV-2 doesn’t spread easily among children, possibly because the receptor on cell surfaces becomes more prominent after adolescence. A high viral load (the quantity of virus you produce) is associated with worse disease. Also, elderly immune systems do not control viruses very well and tend to trigger inflammation in organs when they do. It’s this inflammation that kills people.
Why do some people have no symptoms, but can still carry Covid-19?
This happens with all viruses. Many people become infected but only some become ill. What they carry is the virus, SARS-CoV-2; nobody can carry Covid-19 (the disease). Thus, when news broadcasts say “Covid has spread around the country” they are incorrect; SARS-CoV-2 has spread and some people have become ill and developed the disease (Covid-19).
Can some people have anti-bodies against the virus without having actually had it?
No. You must have encountered the virus in order to develop true antibodies. However, people may receive a false positive lab result. They may also have antibodies from other coronaviruses that cross-react with SARS-CoV-2 to give a biological false-positive result. It’s the role of the virology lab to devise assays that don’t give these false-positive results.
“We may need boosters of the initial vaccine or boosters with vaccines against variant viruses,”
Do you believe the weather has impact upon viruses? For example, is it a fact that they are worse in the cooler winter months in the UK?
The weather definitely affects transmission of viruses. Some are easily destroyed by sunlight. In the summer, we spend time outdoors in fresh air, while in the winter we huddle indoors with windows closed, breathing air from others. Also, some viruses persist in delicate aerosols if the humidity and temperature are just right.
As we start to ebb away from the pandemic, do you think this is as ‘clear of it’ as we will ever be, and that it is a virus we will simply have to now live with (but more like flu for example)?
It’s too early to say. It could be with us forever, or we could decide to eradicate it from the globe, as we’ve done for smallpox and polioviruses 2 and 3. I prefer the latter, because it would have the added advantage of getting politicians around the world to collaborate with each other for the common good.
Anyone reading this may be surprised that it could even be possible to ‘eradicate it from the globe.’ Could you explain this please?
Eradication is an option if the vaccine could be delivered to all parts of the world, because there is no major animal reservoir.
Influenza could never be eradicated because it is common in birds (they act as a reservoir). SARS-CoV-2 can infect cats and mink, but only after contact with humans, so they are not a reservoir for us.
A problem is that infections disappear off the political radar after a year or two, whereas eradication requires continuous efforts (and funding) for many years.
I think we need to build on the current polio initiative, add in measles (the next on WHO’s eradication list) and add in SARS-CoV-2. Given the cost of the pandemic, I wouldn’t be surprised to see WHO agree to go after SARS-CoV-2 next; it would be easier to achieve than measles (R value 17 compared to 3 for SARS-CoV-2).
“The new results (of the vaccine) are so spectacular in terms of safety and efficacy that these methods will become the first choice for future vaccines,”
Now we have vaccinations in circulation that have helped life to move forward again. What would you say to anyone reading this who is nervous about having the vaccination? Or who has read dangerous facts online about any of the vaccinations?
To a patient, I’d explain why the vaccines are safe and effective in a calm, professional manner. I would explore the reasons behind their reticence and answer questions to help them make an informed decision.
To a friend I’d shout, “if you don’t take a vaccine that’s proven to be safe and save lives during a pandemic, then you need your head examined.”
Is it correct that the ingredients used in all of the current vaccinations in circulation have already been used for other diseases for some years?
All components of vaccines licensed before 2020 are well established. The two vaccines against SARS-CoV-2 use different methods that were progressing slowly to the Phase 3 trials necessary for licensure. The new results are so spectacular in terms of safety and efficacy that these methods will become the first choice for future vaccines.
What are your thoughts on young women who have not yet had the vaccine due to future fertility concerns? And in your opinion, could future pregnancies of babies be affected?
There’s no connection between these vaccines and pregnancy or fertility. A vaccine can only be licensed for pregnant women if it’s been studied on them. Pregnant women weren’t recruited into the trials, so it can’t legally be recommended to them. However, women can request either vaccine “off-label” if at risk of contracting SARS-CoV-2.
What are your thoughts on children having the vaccination?
A clinical trial is underway to assess safety in children. We should be able to interrupt transmission of SARS-CoV-2 by immunising adults. If this is not the case, the vaccine could be offered to adolescents. If this is still not sufficient, the vaccine could be offered to younger children.
Do you think we will have to have the vaccination each year to keep it at bay?
It’s too early to say and will depend on how long antibodies and T-cells specific for the virus last. It also depends on how many variant viruses emerge which may have reduced sensitivity to existing vaccines. We may need boosters of the initial vaccine or boosters with vaccines against variant viruses.
Some experts have suggested that Covid-19 won’t be the last pandemic in our lifetimes. What are your thoughts?
It’s inevitable that new pandemics will emerge, but we can’t predict when, or with which virus. We should support international collaboration through CEPI to make antiviral drugs and vaccines against the likely candidates. We should also stop destroying our environment, because this makes wild animals seek shelter closer to humans, bringing viruses with them which then transmit to humans.
“We need to continue simple elements of social distancing as part of our ‘new normal.'”
What advice would you give to people who are now too nervous to go outside or socialise again?
I’d encourage them to be vaccinated so they can get outside to meet friends in the fresh air and sunshine. The risks of getting severe Covid-19 under these circumstances are now virtually zero.
What is the biggest preventative of catching viruses and diseases in general?
Persuading workplaces that employees who feel unwell should stay at home rather than commuting to share virus with their colleagues. We need to ensure that no-one would suffer financially from following this guidance. Also, people should wash hands frequently and try not to touch their eyes, mouth or nose.
And finally, did putting everyone in to lockdown extinct any other viruses or diseases?
Yes, it did. The expected annual influenza epidemic did not occur in the Southern hemisphere or in our Northern hemisphere this year. Cases of the common cold were also reduced. We need to continue simple elements of social distancing as part of our ‘new normal.’
*Legal disclaimer: Please note that views and opinions expressed in this article should not be taken as medical advice.