Coronavirus: "We have to be patient"

We all feel the effects of the pandemic caused by the novel coronavirus SARS-CoV-2. Schools, playgrounds, restaurants and most stores are closed; the government puts restrictions on the freedom of its citizens. Professor Lars Dölken, head of the Department of Virology at the University of Würzburg, believes that these radical measures are justified.

Lars Dölken: "From a virological and epidemiological point of view, the timing and the severity of the measures introduced were just right. If they had been adopted earlier, they would probably have led to disproportionate economic consequences and wouldn't have had sufficient approval from the public. At this moment, however, they were absolutely necessary. But we will have to wait until the end of March to see whether the measures are actually working since many people also in Würzburg were still in close contact with others until recently with groups of people gathering on the banks of the River Main, for example. So if the numbers of Covid-19 cases and deaths continue to rise steeply over the next two weeks, this does not mean that the measures aren't working. They will work! We just need to have some patience.

What is your advice in this situation?

Lars Dölken: Every single one of us must now make all efforts to curb the spread of the virus. The actions and behaviour of every individual in and around Würzburg, our ability to efficiently protect vulnerable groups, such as the elderly or people with an underlying health condition, and our compliance with the measures will all be decisive for the death toll we will have in one year. Most people will only show mild symptoms if they contract the disease. Therefore, it is paramount that any case of the flu over the coming weeks is taken seriously and that those infected will do everything in their power to avoid transmission to others, regardless of whether it is the coronavirus or any other virus.

Note: The University of Würzburg has set up a website with information and guidelines related to the coronavirus pandemic for its students and staff: https://www.uni-wuerzburg.de/en/novel-coronavirus/

Every so often, you hear people say that all the measures are useless anyway and that case numbers will skyrocket again once the measures are eased.

Lars Dölken: This is not at all the case. In two to three weeks' time, important trials on potential Covid-19 drug treatments will be completed. The combination of chloroquine, a traditional anti-malarial drug, and azithromycin appears to be effective against the virus. The antiviral drug remdesivir is another highly promising candidate. Originally developed against Ebola, it is also effective against the two coronaviruses that were responsible for the SARS and MERS epidemics. So chances are good that we will have some means to fight the virus in three to six weeks' time. Until then, we must continue to live with restrictions. Afterwards the government-imposed measures could be lifted step by step, allowing the controlled spread of the virus among the population. Coronavirus causes mild disease in 95 percent of those infected. These people don't need treatment and shouldn't get any to minimise the risk of virus resistance. We will then get the coronavirus outbreak under control and prevent further casualties.

And what about a vaccine?

Lars Dölken: The first vaccines could be ready by autumn, however, there won't be enough doses for everybody. By this time, we will also know when a vaccine will be available for a large-scale rollout. Experts around the world are currently working on a vaccine for Covid-19 backed by massive funding. Based on virological and immunological data, we can assume that the vaccines will be effective.

The flu vaccine developed every year does not prevent all infections. Why should this be different with a Covid-19 vaccine?

Lars Dölken: It is true that the seasonal influenza vaccination prevents only about 60 percent of all infections on average. This is because there are many different types of influenza virus around and it is difficult to predict which ones exactly will be the most common in the upcoming season. For this reason, not all virus types are covered by the vaccine. But as far as Covid-19 is concerned, we know exactly which virus we are up against. The vaccines will be very effective for the vast majority of people. The large-scale vaccination of the population will then result in herd immunity which will increase the protection of those few people for whom the vaccination has not been successful.

And then the virus will disappear forever?

The virus itself is likely to stick around; we will have to plan with it in the long term. Over the next three to four years, around two thirds of the global population will either be infected with the virus or be immunised through vaccination. Professor Christian Drosten from the Charité Hospital in Berlin provided an excellent description of this process in his daily podcast on NDR. I can highly recommend these podcasts as a scientifically sound and very accessible resource!

NDR podcast with Christian Drosten: https://www.ndr.de/nachrichten/info/Coronavirus-Virologe-Drosten-im-NDR-Info-Podcast,podcastcoronavirus100.html

It will remain to be seen for how long coronavirus immunity will provide full protection. People will likely have to get boosters every three, five or ten years. Future infections will probably be much less severe and not lead to the kind of social upheaval we are currently experiencing.

What will happen next?

Lars Dölken: The next two to three weeks will be decisive. Based on the gradually increasing number of people tested in combination with the strict government-imposed lockdown measures, we will soon know what the situation in and around Würzburg is really like. The longer we keep control, the more resources will flow into our hospitals and health authorities and the better we will be positioned to brave the pandemic. This reduces the risk of having a situation similar to the one in Italy. The behaviour of each individual will have a direct impact on the Covid-19 situation in Würzburg. It is up to every single one of us to take responsibility.

Vita

Born in 1977, Professor Lars Dölken has directed the Department of Virology at the University of Würzburg since 2015. In 2017, he was awarded an ERC Consolidator Grant from the European Research Council for his work worth two million euros.