PETER PIOT

We can avoid new lockdowns

An interview with Peter Piot, special adviser to the President of the European Commission on Covid-19

we-can-avoid-new-lockdowns

Lockdowns can still be avoided in Europe, the noted virologist Peter Piot tells Kathimerini. In an exclusive interview a few days before he speaks at the Athens Health Summit that Kathimerini is organizing, Piot emphasizes that the only way that the nightmare of the previous winter can be avoided, however, is a combination of faster vaccination, compulsory use of masks indoors and the widest possible application of telework mandates. “If this does not happen, new lockdowns will be unavoidable,” he warns.

On vaccination, he says priority should be given to boosters for the older population – “above 60, 65, 70 years, the jury is still out” – and to those with weak immune systems. “At this point we don’t have enough scientific evidence leading to the conclusion that vaccine-induced immunity wanes for everyone after six months,” he notes. He adds that heterologous vaccination (a third jab with a different vaccine than the first two doses) has been shown to offer stronger protection, and that this is also the case for those with a prior infection who then get vaccinated.

The same is “very likely” true if the sequence is reversed (vaccination followed by breakthrough infection), he says, “though it’s too soon to know this for sure.” Piot also argues that – if it’s shown to be safe – vaccination should be extended even to children under 5 (the European Medicines Agency is expected to rule next week on vaccinating children aged 5-11).

The Belgian veteran virologist, one of the scientists credited with the discovery of Ebola and the first head of UNAIDS, says that the first-generation vaccines still work “well enough,” even against the Delta variant: “We should be clear about the main aim of vaccination: preventing hospitalizations and deaths. We hoped that the vaccines would also stop transmission, but this will not happen.” He highlights the need for constant vigilance in case a “nasty variant” emerges which will require amending the vaccines.

Piot also calls the arrival of anti-viral pills on the market “very good news” and a “game-changer.” The European Commission, he says, is already negotiating purchase agreements for the pills with drugmakers on behalf of the member-states. He predicts they will be widely available in Europe well before the spring.

Elusive target

Piot last spoke to Kathimerini in mid-April, just as the vaccination campaign was ramping up in the EU. What do we know now that we didn’t know then about herd immunity? How can a country like Belgium, where 75% of the total population is fully vaccinated and which has already recorded more than 1.5 million infections, still be getting a daily average of more than 11,000 cases?

“Delta has changed a lot regarding the level of vaccination and natural infection needed to get to herd immunity. That percentage has now risen to perhaps around 90%, when in the beginning we thought it would be around 70%. I think it’s striking that countries with lower case rates – Portugal, Spain, Italy – combine very high levels of vaccination coverage with an insistence on public health measures like mask-wearing. Friends in Spain and Italy are telling me that masking has become second nature there. Belgium is an interesting case: Brussels has a lower vaccination rate than Flanders, but Flanders right now has more new infections – because there they decided back in September to drop all restrictions. When we spoke seven months ago, I was more optimistic about the impact of the vaccines. There’s no doubt they have made a big difference – but they are not enough on their own to defeat the virus.”

Piot foresees that, gradually, over the next few years, Covid will become a seasonal disease: “Each winter we will get a wave of some kind. My hope is that with each passing year it will be less deadly,” he explains. Indoor masking, he believes, will be needed for years to come.

‘Black swan eventuality’

Are there projections about how often the virus will mutate and how frequently we will need to be vaccinated against it? “We know it mutates at a slower pace than influenza. Nevertheless, we may require an annual booster.” The black swan eventuality is the emergence of a variant so different that it will be like dealing with a whole new virus – “and then we will really be in trouble.”

Despite the failure of similar efforts relating to influenza, he says there is a “realistic” possibility that researchers can find the holy grail – a universal coronavirus vaccine. “The pharma companies did not have the incentive to invest what was needed for a universal flu vaccine; we would only have to get that vaccine once or twice, instead of every year,” he points out. “But now there is a lot of research going on for a universal coronavirus vaccine.”