Dr Gagandeep Kang, one of India’s most eminent medical scientists who played a critical role in the development of the indigenous rotavirus vaccine, says that things are within control right now, and will continue to be so till people follow the usual safety protocols and institutions invest in research. She also said about a new variant that some strains spread fast and some spread slowly. This one seems to spread a bit faster.
Q. How worried we should be about this new UK strain?
A. I think the biggest thing we need to do is to make sure that we have sequencing of the strain. This is being done for a few thousand isolates in India, but given that we have done more than 10 million, that’s not efficient. We should be trying to sequence while distributions happen on a regular basis, especially for travellers. That will give us a better answer about whether the strain is already here.
Q. Do you think that this virus spreads very quickly?
A. Some strains spread fast and some spread slowly. This one seems to spread a bit faster. It is circulating widely around the world. These things will happen in the future also. The principles for control are exactly the same still: wearing a mask, social distancing, and making sure that you don’t pass this infection to others.
Q. Do you think this can impact the line of treatment? Do we have tools to control ?
A. We are managing quite well now without vaccines. We will have better control once we have the vaccine available, but we shouldn’t think it’s an all-in-one solution. In the future, other strains might emerge where vaccines might not work. So, we should be prepared for a situation where we can make vaccines in six months, if needed. New strains don’t emerge in a day. They take time. All strains are vaccine-susceptible, but tomorrow they may not be. We have new technology but we need to do better on surveillance, tracking, vaccines, etc. But we have the tools for control now, we should be aware of that. We must be careful and continue to invest in science and in research and development. If we do that, we have nothing to worry about. But, if we ignore the threats, things can spiral out of control.
Q. The Imperial College of London says that according to data, this new strain tends to impact children and adults both. What would you say about this?
A. I think what they are referring to is that, in terms of impact, we are seeing the virus in children a little more than others. That is a factor of its infectiousness, not that it is more dangerous for children. Children are less affected by the virus in terms of the severity of the illness and the ability to spread among younger children. So, I don’t think that is changing at all. It’s just that because this virus seems to replicate at a higher level than other viruses, it may have an easier way to get inside the cells that will contribute to a higher viral load and its ability to spread more easily. I don’t think there is anything to worry about this being more dangerous for children—we have no evidence of that.
Q. Does this impact India›s vaccine roll-out in any way?
A. We don’t know that at the moment. There is no evidence to show that vaccines will not work. So, until we know that, why are we worrying about theoretical problems? 2-4 weeks is the time it will take for people to understand what the biological significance of this strain is. At that time, we will know. Based on the mutation, it doesn’t look likely that vaccines won’t work.
Q. When do we expect the vaccine roll-out to start in India?
A. I think a lot depends on the MHRA in the UK. If they licensed AstraZeneca vaccines, it might happen in the next week. If it does, then we will be looking at having vaccines in India shortly after. I don’t expect the regulator will take a long time to review the data because no Phase 3 efficacy study has been done in India so far. The Covaxin study is ongoing and we don’t have results. So, we must rely on other regulators to review the data from Phase 3 studies, and once they approve the vaccines, our regulator can look at their determination as well as evidence in India and take it from there.
Q. Which vaccine will India get first?
A. It will be the AstraZeneca vaccine because that is the one which has the most complete data package. Phase 1 and Phase 2 trials for safety and immunogenicity have been done in India. Phase 3 has been done outside India. Linking them together, we have enough information to tell us that we have a vaccine.
Q. Do you think that this virus can jump to other species?
A. Of course, it can. We have ample evidence of that happening among dogs, cats, tigers, mink and other kinds of animals. It can also come back into humans. We have evidence of that from the mink studies, where another variant cluster of five variants was seen when it went from humans to minks and back again.