THE race against time!

The time frame of the coming weeks will decide on our getting through this pandemic.

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Dear readers,

It feels like a marathon, but without an end in sight.

Indeed, we are still at the beginning of this pandemic, since just 1.4 % of the global population was found to be infected. For Germany, this number is around 3 %, and the dark figures are just that, in the dark, because in Germany, testing numbers declined significantly starting December. This pandemic seems to get worse, the further it continues. Bad news are piling up. However, we are not helpless. In our last posts we had outlined a strategy to curb viral infections. The virus will not disappear, even when it had been eradicated from humans, since it has the opportunity to withdraw into an animal reservoir, from where it might re-emerge anytime.

But first, we need to reach that point, where infection numbers reach zero. This means to get a grip and to pull ourselves together for a couple more months, avoiding personal contacts of any kind, even during summer time.

Mobilize your powers and your fighting spirits.

Since we are all, all countries in one boat, it is possible to defy this pandemic together. This is a challenge. Otherwise, it might be necessary to lock up affected hotspot regions – without exceptions. Exceptions like people relevant for safety, or medical support, would need a daily on-site test at the border to avoid counterfeit tests.

Controls are necessary for those parts of the population, that are always trying to circumvent protective measures, and thus annulling the goals and reason for these measures. However, we do not want any police state, surveillance society, or dictatorship. It should be feasible for a progressive, intelligent, and enlightened populace to pull together.

We DO HAVE means against this virus. It just means to use all the tools in a strategically clever way. For good reasons, we are advocating a ZERO virus strategy, since each infection is one too many, enabling “the ember to flare up and become a starting point of a forest fire”, which may get out of control any time. It makes sense, insofar, as to close off a metropolis after just one positive SARS-CoV-2 test and to put it under quarantine until the area has tested negative.

Some of our politicians are of the opinion it is feasible to ride the devil or a demon.

This will fail. Such hubris will have consequences. The tendency of our governors and some ministers to dance on a blade, and thus to expose the population to a blade, is known, but is too dangerous in this pandemic. Thus, we again are advocating a ZERO virus strategy, which is feasible, if we act in time with the few tools we have at hand after one year, with some to become available soon. Our strategy is different from a similar one published recently, using “green zones”, a feat hardly realistic for several reasons.

Our strategy includes (!) timely vaccinating the population. All the vaccines approved by the EMA are well tolerated, while protecting from severe COVID-19 disease and death. Any doubts we can refute and to the laments by people, who experience so called “side effects”, we must say, they might not have any experience in vaccination. Such reactions, like fever, are a normal reaction after vaccination. Many of the younger people, including those in health care settings, seem not to know immune reactions, maybe, because they were never before vaccinated. In Europe, there had been a trend for decades towards less and less vaccinations. Even to us it happened, that a German doctor refused to administer an annual Influenza vaccine. German medics, after approbation, are not obliged to keep up their training, and are allowed to voice alternative or outdated views and opinions. This sometimes makes problems.

The currently available vaccines are a great tool against this virus.

Should the population refuse vaccination, this will be decisive to the outcome, with all its consequences.

You might remember successful vaccination campaigns against the smallpox if you were born in the 70s. Oral polio vaccine was administered then as well. A combined vaccine against Mumps, Measles, and Rubella (MMR) is excellent. There are vaccines against seasonal influenza, against German measles, parainfluenza, TBE (a tickborne virus causing encephalitis), or HPV (causing cervix carcinoma), against hepatitis A and B viruses. All these vaccines may result in some side effects, that now are experienced with the SARS-CoV-2 vaccines as well. These include fever, headache, fatigue. All these effects vanish within 24-48 hours. The worries voiced by some people, the vaccine might change your own genome are nonsense.

There are some infectious diseases that CANNOT be vaccinated against. Among theses are HIV/AIDS, hepatitis C virus, hepatitis E virus (which is currently spread worldwide through seafood and raw meat) or malaria (caused by a single celled parasite), as well as other viruses, or parasites that are notoriously resistant to treatment.

Globally the biggest killers have been HIV/AIDS, Malaria, Tuberculosis, but there are more, like Hepatitis C virus, Influenza (such as the Spanish Flu), Smallpox (which killed 30-50 million in the 20th century alone), as well as the medieval plague which ravaged in several decades-long waves.

Now we are hoping the vaccines against SARS-CoV-2 will stay effective for a while, since it is only a question of time for variants to emerge, that escape vaccine protection. Therefore, you should not wait until the effects are being dodged by new mutants. Numbers of new infections need to be reduced dramatically as fast as possible.

In England it has been reported that a second “British” variant of the virus (dubbed B.1.535) is circulating, which shows similar changes as the South African and the Brazilian ones. In the meantime, the AstraZeneca vaccine does only provide minimal protection against the South African variant. Interesting is an observation made in the US, where there is enhanced spread of seven independently arisen new variants with similar characteristics. This news reached us today. Meanwhile, we also know that one of the viral proteins (an enzyme) which was thought to give the viral genome some stability, in fact is leading to enhanced changes and thus is leading to major combinations of diverse mutations.

Another worrisome observation is made with one patient, who had had contracted SARS-CoV-2 and recovered in the fall. In December, the patient contracted the South African variant and now is in critical condition in an ICU. While this is a single case, it is making one important point: Even after recovery from a disease with a fully replicating wildtype virus, which triggers antibody and T cell responses against many viral compounds, this does not protect from a new variant. This is alarming, since the vaccines approved in Europe unfortunately only are aimed at one viral protein, the spike. Thus, with time, viral variants will be emerging that escape vaccine-mediated protection.

The race against time has started now!

Some of the mutants will take hold globally. Two days ago, our Minister of Health, Jens Spahn, mentioned the “British” variant (B 1.1.7) has increased from 6 % to 22 % of tested cases within two weeks. A doubling time of one week is called exponential growth. All virologists familiar with their topic should start to feel queasy now.

We are again pointing to our two previous blog posts dealing with the strategy for 2021.

Please, read all the points again and please put them into effect as good as possible. Give 130 % every day. It is worth it in order to get out of this viral mess with a lasting effect, if you do not want to see infection numbers explode, leading to countless deaths, triage, and medical personnel close to breaking down, with people suffering from long-term disease, unable to work.

The coronavirus home tests still controversially discussed in Germany indeed are a necessary tool to identify contagious individuals – best via self-testing at home. This would suppress new infections. The more infected people know to stay in quarantine, the slower the viral spread.

Therefore, individuals should perform a test before leaving their home, daily.

These tests need to be approved as quickly as possible. We were under the impression this had already happened months ago. We do not approve the high pricing, since these are cent-articles in production. And no trained medical personnel is needed. These kinds of tests are in use in many areas, such as pregnancy tests or tests for the urine composition and many others.

Time is critical.

The decision makers’ course of action needs to be faster, coherent, and braver, now! Mistakes happen. Take a chance. To do nothing is not an option. We cannot allow this virus to have more room for new infections. The outdated strategy by German politicians to adhere to incidences of 50 or 35 infected people per 100 000 per week is obsolete. The virus is changing too fast, we are too slow in reacting. Throw everything at this virus you have at hand to shorten the time of pandemic.

An “antiviral task force (AVTF)” would be helpful now.

In addition, we are advising an Antiviral Task Force (AVTF, similar to the one mentioned in media recently), that can use its strength to reach goals. This includes coordination and broad organization with all groups and authorities involved. This competence leverage is necessary. It includes an immediate development of a long-term strategy, expertise, the power to persuade, assertiveness, coordination and cooperation with politicians, national and international authorities, purchasing of material, management on European level, adjustments of vaccine strategies, if necessary the consideration of border controls, but most importantly concentrating on the fight against the virus and the protection of the populace. We can imagine that. It would relieve the politicians and give people a boost, knowing that the fight against the pandemic is being performed efficiently. It needs a long-term strategy with the necessary competence in democratic hands. This includes information, communication, and education. All these points need to be improved, at the moment it is too chaotic, inefficient, without proper coordination, and thus resulting in a lack of trust by the people. There is a lack of expert competence, the decision-making processes are to slow and nontransparent at the same time.

Mankind has experienced many epidemics and pandemics. This pandemic is meeting our immune system fully naïve, it will become worn down by repeated infections. Unfortunately, mankind has not learned how to deal with pandemics.

This opinion is not shared by all. Especially among people out of their specific area of knowledge, such as sociologists, economists, writers, careerists this view is not being shared, because they simply don’t know better. They are using their range of influence to unsettle people, or simply for a chance to see their face in the media, self-centered and narcistic. The two of us had learned that qualified people know when to contain oneself, because they are no experts in this specific field.

The good ones know they may do a lot of damage with their reach and their influence, and since are behaving professionally in a constructive way.

For 600 years, our politicians have been making the same mistakes, over and over again, in the case of epidemics. The major error is to listen to incompetent, out of their area of expertise, yet influential people. These include merchants, today named economists, lawyers, who without expert know-how aim to stop measures against the virus using legal articles. Courts are reacting to the currently seen situation. In a pandemic, however, prevention is needed, which is including the avoidance of situations, in this case infections.

In the end lives are lost, and infection numbers will increase, with the result of new mutants emerging: A pandemic within a pandemic within a pandemic. These mutations will dismantle tool after tool: The immune system which has overcome one infection, and the vaccines. This will trigger secondary damage in economy, society, and politics. Mutations are game changers.

In summary: We are in need of hands-on tests, in copious amounts as soon as possible. Time is critical. A more courageous action by the decision-makers is necessary. It cannot be that decision-makers are not up to date with current developments of this pandemic, as seen with some of the German governors in recent interviews.

To now discuss a lifting of protective measures is out of place. We are insistently warning against this! There is no place for opportunistic decision and to serve all interest groups at the same time. This is impossible in such a pandemic. Do that, and we will experience new mutations that will force new lockdowns and produce a lot of harm. One of these may be a “German” one that may emerge here to spread. This you will trigger, dear governors!

The German Constitution is making it clear that the individual’s right to health is not up for discussion.

Our assessment: We know viruses, our expertise is in virology. For 25 years now, we are studying interactions of viruses with their host cells and the immune system. HIV is a master of change, as well as Influenza, and many other viruses that are more or less dangerous to human beings.

This virus is different from other coronaviruses. We do have a lot of respect of this one. Never underestimate your enemy or the threat. This might end fatally.

Our appeal: We all need to do better. We all need to pull together. The aim is to stay healthy – everything else is secondary in a pandemic of this scale. The aim is to obtain new tools against this virus and to follow a long-term strategy.

Use your imagination in the one and the other direction. How do you want to see the year 2021 end? Make a decision. Sometimes, this is the way to find reason.

We want to close 2021 with the lowest possible damage. This is our goal, and we are happy to consult and accompany you through this pandemic. This is all we can do momentarily. If you want it, we shall play a part in it, and you will profit.

Successful strategies are based on attacking and resolving a problem, and NOT in treatment of symptoms, or ignorance combined with wishful thinking.

The way out of the pandemic, by Dr. Sabine Breun and Dr. Jörg Baumann, use of this figure is permitted with authors’ names exclusively! (To zoom in please press CTRL+).

Yours, Sabine and Jörg

SAJO is consulting all around infectious diseases. We are applying our know-how, that we have acquired in more than 20 years. We do what we can to fight this pandemic.

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