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WHO interview: ‘If our behaviour returns to normal Europe risks new waves of Covid-19’

The Local sat down with the man at the forefront of the World Health Organisation's quest for a coronavirus treatment to ask whether reopening our societies will create a second wave and what happens when populism meets science.

WHO interview: 'If our behaviour returns to normal Europe risks new waves of Covid-19'
"Social distancing is not very social" . AFP

In the world of science, John-Arne Røttingen is somewhat of an international superstar. 

In 2015, the Norwegian epidemiologist led the steering group of the groundbreaking study that helped produce a vaccine for Ebola at record speed.

If the stakes were high back then, they are even higher now.

Røttingen, who heads the Norwegian Research Council, is directing the WHO's international study into Covid-19 treatments and an eventual vaccine.

The study, Solidarity, is a clinical trial in multiple countries to achieve a treatment for Covid-19 as rapidly as possible.

Four different drugs – hydroxychloroquine, remdesivir (previously used to treat Ebola), lopinavir/ritonavir (a licensed treatment for HIV) and and lopinavir/ritonavir + interferon – are being tested on 3,500 hospitalised patients in 17 countries simultaneously. 

It is a massive international effort to try and compress years of work into months, to find a solution to the highly contagious virus Covid-19 which has killed nearly 400,000 people worldwide, pushing countries into an economic turmoil that could have long-lasting and devastating impact.

The Local: European countries are easing restrictions on social distancing, reopening societies slowly. Are we risking new waves of infection?

Røttingen: We are very vulnerable to new rounds of infection. To achieve herd immunity, at least 50 percent of the population in a country needs to have had the virus. No European country has those levels yet.

The “R” (virus reproduction rate) is important. If we manage to keep it below 1, we will avoid a resurgence. 

The Local: We’ve seen European countries taking different measures to contain the virus. Sweden kept things largely as normal, while southern European countries like France, Italy and Spain imposed strict nationwide lockdowns. What’s the best option?

Røttingen: It's a misunderstanding that Sweden did nothing to limit the spread of the virus. The population followed a lot of health precautions even if they didn't go into lockdown.

But our societies need to be prepared to impose restrictive measures earlier than they did last time. 

It would be better to begin with the measures that are less harmful for the economy and the society at large. We know that closing schools is very expensive, but probably not very efficient in reducing the spread of the virus. 

The Local: It seems like we here in the south of Europe are struggling more than people further north to keep up with these social distancing rules. 

Røttingen: Yes, in Nordic countries we sometimes joke that, when they told us that we can stop having to keep two metres between each other, we said “phew, finally, we can go back to our usual five metres”.

In France, the doctor Didier Raoult (on the picture) has been distributing hydroxychloroquine as a coronavirus treatment to patients in his hospital in the French southern city Marseille. Photo: AFP

The Local: What are the most efficient steps countries can take to stem the spread of the virus?

Røttingen: Social distancing. Reducing use of public transport and avoiding large gatherings. 

If our behaviours return to normal I believe that we will see new waves and will need new rounds of restrictions. It's an important balance to strike between resuming social life and taking health precautions.

The Local: So basically we can keep working and going to school but we have to stop everything that’s fun?

Røttingen: Yes, social distancing is not very social is it.

This is why testing is so crucial. We need to continue our efforts to develop a vaccine, continue testing and contact tracing, and we need to keep up social distancing and general hygienic measures. 

The Local: Will we ever get a vaccine and, if so, when?

Røttingen: There is a big, global race to get a coronavirus vaccine going on with more than 100 drugs being tested right now.

In a best-case scenario, we get a vaccine approved early 2021. Then we need to produce the quantity to begin to vaccinate people, which means we are quickly moving into late 2021, early 2022. 

But all this depends on decisions that are being made right now.

The Local: What kind of decisions?

Røttingen: You might have seen the initiative by the WHO together with French President Emmanuel Macron, German Chancellor Angela Merkel and other state leaders, which works to set up a large-scale development, production and distribution of vaccines.

If we manage to set this up now, we will be able to begin to vaccinate earlier than we usually would.

The Local: What kind of vaccine are we talking about? Will it be a one-time vaccine that will make you immune against the coronavirus for years, or a short-term vaccine that we’ll need to take again and again?

Røttingen: That’s difficult to say because how long an immunity lasts depends depends partly on how quickly and how much the virus is changing and partly on the properties of the vaccine.

Chances are we will see new outbreaks, perhaps not every year, but every two-three years. But right now it's too early to say.

 

Head of Norwegian Research Council John-Arne Røttingen is directing the WHO's international study into Covid-19 treatments and an eventual vaccine.. Photo: WHO

 
The Local: Tell us about the WHO study into possible treatments. What kind of results are you seeing?

Røttingen: We ourselves are not allowed to check the results. There is an independent committee overseeing the process, and analysing the results in intervals as they come.

We will stop the study as soon as we know that a drug is efficient – or as soon as we see that it is either not having the wanted effect or that other, unwanted side effects emerge. 

The Local: Hydroxychloroquine, one of the drugs you are testing, has been hailed as a miracle cure by some, while others claim its proponents are charlatans.

Røttingen: We have seen that several leaders including US president Donald Trump and Brazil’s President Jair Bolsonaro, have spoken out in favour of hydroxychloroquine. 

One big question about hydroxychloroquine has been whether it has serious side effects or not.

A study in The Lancet, (which concluded that hydroxychloroquine had dangerous side effects, before doubt was cast on it) had some methodological weaknesses and potential failures in their dataset. 

We were very unsure whether we should stop the branch of hydroxychloroquine or not, but we decided to put the brakes on it until we had analysed our data. We have now made the decision to resume the hydroxychloroquine arm of the study after our independent data and safety committee advised continuing.

The Local: Is it dangerous that populism is interfering with science?

Røttingen: Yes. It’s a shame that these kind of scientific questions become political.

In South America patients are often being offered the drug as a treatment even though it isn’t approved as an efficient treatment for Covid-19 yet. This complicates things for us because we can’t include patients who have already been taking one of the treatments into our study. 

The Local: What role does WHO play in all this?

Røttingen: The WHO plays a crucial role as a neutral and normative actor, which always stands on the shoulders of science. All its guidance are based on neutrality and independent data. 

But we know that the WHO is suffering from political pressure, and member states use the institution to push their own agendas. I have argued for separating science from politics in the WHO, to protect its scientific role. 

The pandemic shows us how much we need this kind of scientific, global institution. 

 

Member comments

  1. Brought to you by the same guys who said on January 14th that there was no sign of human-to-human transmission, praised the Chinese for their transparency, and touted the Imperial College Model used to justify the lockdown. If there are no big spikes in America this week, then all bets are off as far as the experts are concerned.

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COVID-19

Austria in shock over doctor’s suicide following anti-vax abuse

Austrians expressed shock and anger this week over the suicide of doctor who had been the target of a torrent of abuse and threats from anti-vaccination protesters.

Austria in shock over doctor's suicide following anti-vax abuse

The bells of Vienna’s St. Stephen’s Cathedral rang out in memory of Lisa-Maria Kellermayr on Monday, and hundreds of people held a candle vigil outside, after the 36-year-old doctor was found dead at her practice on July 29.

She had long been the target of death threats because of her criticism of the widespread anti-lockdown protests of 2021.

An autopsy later confirmed that Kellermayr had taken her own life.

Austria has found itself deeply polarised over coronavirus restrictions and in particular a government policy –subsequently dropped — of making vaccination against the coronavirus compulsory.

Kellermayr — whose practice was in the region of Upper Austria where immunisation rates are particularly low — had frequently complained of the menace.

“For more than seven months, we have been receiving… death threats from those opposed to coronavirus measures and vaccinations,” she wrote at the time, sharing a message from one internet user who said they would pose as a patient in order to attack her and her staff.

She described how she had “invested more than 100,000 euros” ($102,000) in measures to ensure her patients’ safety and was on the brink of bankruptcy.

Then, at the end of June, Kellermayr announced on her professional website that she would not be seeing patients until further notice.

Daniel Landau, who organised a memorial vigil for her in Vienna, said that Kellermayr had become a virtual recluse for several weeks. “She didn’t dare to leave” her office, Landau told AFP.

Fanning the aggression

On Saturday, the head of Austria’s doctors’ association, Johannes Steinhart, said that while aggressive behaviour towards medical staff was not new, it had been “fired up and noticeably aggravated” by the debate over Covid-19 and vaccines.

The police, who had previously suggested Kellermayr was exploiting the situation for attention, insist they did everything to protect her. The local prosecutor’s office also rejected suggestions it could have done more.

“As soon as we received the police report (identifying one of the suspects), we sent it over to the relevant authorities in Germany,” spokesman Christoph Weber said.

On Friday, prosecutors in the neighbouring German state of Bavaria said a 59-year-old suspect was being investigated by a specialist hate speech unit.

At the beginning of the week, Austrian President Alexander Van der Bellen visited the small town of Seewalchen where Kellermayr lived to lay flowers in her memory.

After news of her death broke, he had appealed to Austrians to “put an end to intimidation and fear”.

‘They’re gagging us’

But on some Telegram groups, the hateful messages continue.

“Some people are celebrating her death; others believe the vaccine killed her,” said Ingrid Brodnig, a journalist and author who investigates online disinformation.

“Stricts laws exist” already against online hate, but not enough is done to implement them, Brodnig said.

One government minister has floated the idea of a separate prosecutor’s office to target such cases. Doctors and researchers have also been targeted elsewhere.

French infectious disease specialist, Karine Lacombe, described how she had been vilified for her work as part of a collective of doctors combatting coronavirus-related disinformation.

She, too, complained that the response from the authorities in the face of threats was not robust enough, and has scaled down her public appearances this year.

“You end up thinking that the risk isn’t worth it,” she told AFP. “In that sense (the aggressors) have won, they are gagging us,” she said.

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