The CSIC virologist Margarita del Val (Madrid, 1959) has probably been the voice of our conscience throughout the last year and a half. PhD in Chemistry for the specialty of Biochemistry and Molecular Biology in the Autonomous University of Madrid, De Val soon became one of the most authoritative voices when it came to analyzing the drift of this pandemic, but also in one of the most conservative.
Every time someone tried to launch the bells to the flight, she lowered expectations and convinced us that there was still a long way to go to relax and endanger our elders, the most vulnerable in the face of a ghost that has already taken over. millions of lives around the world. Precisely for this reason, when it finally seems that the main indicators begin to show us the light at the end of the tunnel, its diagnosis is more important if possible.
Question: Spain has managed to enter low risk of first-time incidence in more than 14 months and it is not the only indicator found in control parameters. Let me try to pass the cotton test on to this data with your help… This is good news, right?
Answer: Right now we are in a situation that looks very favorable. We have been lowering the number of cases for a long time. This wave has been the best of all, because we already had a good part of the population vaccinated when it started and now it is even more favorable, because we have more people vaccinated and, above all, 98% of those over 60 years of age, which is where you really have to focus, because 19 out of 20 deaths during the entire pandemic belong to this group. It is true that we are beginning the autumn and, as soon as human beings begin to feel cold, we begin to change our behavior, to go indoors in the afternoons, to not ventilate well … And the number of infections begins to rise. However, now we no longer care about the number of cases, but whether there are waves of serious people, because the elderly are already vaccinated and mortality or, at least, serious disease will drop significantly.
Q: I understand, therefore, that, although new waves come, they will be less worrisome …
R: They will be less worrisome because there will be fewer serious people. In addition, we have in our favor that we know better how to protect ourselves. The most vulnerable population knows that they will have to wear a mask when they go to a more crowded place. On the other hand, we have a fantastic weapon that I want us to apply: we can buy antigen tests in pharmacies. If we are going to meet with the grandparents, then we all do an antigen test and if there is one that tests positive, then the rest of us go. Before we had to do a PCR, which was much more expensive, and we had to go to a special place, but now it is much easier. We have many more weapons. However, it must also be remembered that vaccines are not infallible: they protect 95%, which means that 5 out of 100 may still have a serious disease. So, we have to gradually recover normality, but do not lose heart.
Q: Are we then prepared to live with the virus?
R: We have almost 2% of those over 60 who have not been vaccinated and, for that, the most important thing is to get them vaccinated, because until we are free from being able to end up infecting these people, we have to be careful. Among the elderly there is a problem, which is fear. There are older people who say … ‘Ugh, I’m very crushed, I have many chronic diseases and let’s see if the vaccine makes me feel bad’. What will be fatal to you is if you become infected and, since the virus is going to stay with us, you cannot afford not to be vaccinated. So, in order to live with the virus, we need to vaccinate these people and now is the best time to get them out of the general fear that those who have been confined at home have. They are very few, but we always meet someone directly who does not dare to go out. Well, now there is a very low incidence, the sun is still at noon, we are very many vaccinated … That they dare to go out, nothing is happening out there.
Q: Will we have to take more doses or even get vaccinated every year?
R: I do not believe it. The big problem with this pandemic has not been that the virus is the most powerful and infectious enemy we have ever had, but that we have no defenses. We had not passed it when we were little, that is the difference. There are many infectious diseases that we pass on as children, when we have a very powerful immune system, and then we have immune memory for a lifetime. Vaccines have made up for having spent it as children. Therefore, it is one more infection. We do not know if it will stay like a cold like those caused by other coronaviruses or if it will stay like the flu, which causes some 15,000 deaths each year, but of course it will no longer be what it has been until now. And get vaccinated every year, I think not. I can’t say yet, but this year you certainly don’t need a third dose. No age bracket, and neither in the residences.
P: So you are not in favor of inoculating a third dose to those over 65 years of age?
R: It is that there is no evidence to support that it is necessary. The protection that the elders of the residences have right now is the same as they had when they were newly vaccinated. The effectiveness of the vaccines has not decreased at all. There are no more serious cases among them than those who had just been vaccinated.
P: But there are several studies that confirm a loss of antibodies …
R: But at this point we do not know that antibodies are not markers of protection? For nine months we have been talking about new variants that do not seem to be neutralized well by the antibodies of vaccinated people, and yet we see that all these variants that had scared us so much are controlled very well at the population level. There is no major clinic associated with the variants. Protection against beta is the same as against alpha and is the same if we are newly vaccinated as if we are infected months later. The immune system is much more complete than just antibodies, what happens is that it is the only easy thing to measure, but stop fooling us. We are surrounded by infectious diseases. If against all infectious diseases we had the same amount of antibodies as the month we were infected, the blood would be full of antibodies and it would be practically solid. That is not a protection measure. Protection is stable since we started to get vaccinated. What’s more … Of all the vaccinations, can you tell me which ones we get regularly every year?
P: Only the flu that I know of….
R: Effectively. No other. We do not get the vaccines that we get as children again because they are very powerful vaccines, very good and they protect us for life or enough so that if we get a second infection we will not find out. There is an exception for one vaccine, which is weaker than all the others, which is the flu vaccine. And there is a virus that varies more than some of those viruses, and that varies 10 times more than the coronavirus, which is the flu. That is why those vaccines are repeated every year, but these four coronavirus four vaccines are very good and powerful, and the virus is easier to control than we tend to think. Therefore, there is no reason to believe that a third dose will be needed, or that we will have to vaccinate every year.
Q: You have always been very cautious – pessimistic some will say – and now, however, one has the feeling of great optimism.
R: For those vaccinated, my level of optimism is very high, but I am exactly as pessimistic as before for people who have not been vaccinated. It should be borne in mind that the vaccine only protects the person who is vaccinated. The vaccine may make it somewhat less likely that the virus will reach someone who has not been vaccinated, but we still do not know how much less likely, because we can also infect. For this reason, the risk of the person who has not been vaccinated, his personal risk, is exactly the same as it was six months ago, twelve or eighteen months ago. So for those people I’m not optimistic at all. Those people have to get vaccinated. We have vaccinated almost 40 million Spaniards. If something very serious happened, it could not be hidden.
Q: The problem is that among these people there are not only people who are afraid. There are also large anti-vaccine groups …
R: I think they are afraid too. They need total certainty and we will never have it in life. Neither is science going to give it to him, nor is it going to give him knowledge. And we are not going to have it at all. Not for the coronavirus, not for anything else. That is why they take refuge in absolute atrocities. Now they feel more animated, they are more active, but I believe that deep down they are afraid and we have to get them out of that loop they are in. You have to understand them, not attack them, but let no one hide behind the fact that this is a matter of the pharmaceutical companies, which are making money. For me, make money selling a sandwich, a Coke, a movie ticket, a trip or a vaccine, but I am seeing the benefit of the vaccine, I am seeing it clearly. Do I pay for it? Yes of course. Do not look for three feet to the cat. People who are vaccinated are not only healthy, we are not only protected, but we are calmer. Many ghosts of the ones we had have left us and we finally have a future. We are making plans that we weren’t doing before we vaccinated.
Q: These vaccines have worked so well that it seems that we have already forgotten about the Spanish antidotes that are being developed at the CSIC. Mariano Esteban seemed to be about to start human trials, but Health decided to paralyze them. And there seems to be no news about the Enjuanes and Vicente Larraga vaccines …
R: Now we go more calmly, but they continue forward. We need more vaccines. The vaccines that we have at the moment are the fastest and simplest vaccines, but we have to make other more complete ones and the important thing is no longer going to be speed, but to achieve really powerful second and third generation vaccines that are sterilizing . That is, they protect against infection and prevent transmission.
Q: That’s precisely what the Rinse vaccine would do, right?
R: Probably. Until they prove it, we will not be certain, but they start from a starting point that is much more favorable to probably be sterilizing. Imagine that every person vaccinated since we started last winter was a person who could be happy and said goodbye to all restrictions. The vaccinated have continued to wear a mask and we have continued to maintain certain measures because we can infect. If we had sterilizing vaccines, the pandemic would be something else socially. Not only personally, that we are already safe with these four vaccines, but at the level of society. We would have advanced much faster. Vaccinated person, person who can go dancing at the disco. That is why we need more vaccines. We no longer need it. I, with this vaccine, even if it infects me in the future, that will be a reinforcement of my immune memory. Hopefully it infects me every 6 or 7 years and strengthens me throughout my life. But there are countries where vaccines have not yet reached. So we have to move on. I see it clearly and the rest of the world sees it too.
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