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COMMENTARY: 19 months after COVID-19: Delta strain and more

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COVID-19 illustration

This illustration created by the Centers for Disease Control and Prevention shows what the coronavirus looks like when viewed through an electron microscope.

It has been 19 months since the emergence of COVID-19 in December 2019 in Wuhan, China. It has killed millions worldwide and still there is no light at the end of the dark tunnel.

The new Delta variant is freaking out everyone in the U.S. and other Western nations where vaccination is relatively more successful and where the vaccines are readily available. But most of the world population is still awaiting vaccines and it is possible that if they wait over six months, the current vaccines may not be as effective. Here, I reflect on what went wrong and what is yet to come? I will divide my comments into five different parts: 1) What did we do right? 2) What went wrong? 3) What is yet to come? 4) Why are children and youth relatively protected? And 5) What must we do and prepare for in the future?

1. What did we do right? As soon as the seriousness of the COVID-19 virus was recognized and people began to die, we implemented lockdown, and masks and social distancing, to reduce the spread of the virus. Travels were banned, and schools and universities went online. At the same time, a Turkish-born husband and wife couple in Germany made an amazing stride in development of a novel mRNA technology that can produce a large number of vaccine doses at a warp speed. It left big pharma in the dust.

Many companies began to adopt the same mRNA vaccine system to catch up and in a short time, we had vaccines. The Western nations developed a protocol to vaccinate. The nations with national health care systems superseded the U.S. and surpassed the number of vaccinated people.

2) What went wrong? There are so many things that went wrong. One of the worst things was the spread of false rumors that vaccines change a person’s DNA, make people infertile and other unbelievable, unscientific, nonsense rumors that I cannot put in this print media. This false news spread through social media on a global scale.

Every nation, even little towns in remote parts of developing nations, still believe that vaccines are engineered to change one’s DNA. What the media could have done is to counter the rumors with sensible, logical answers. Going in front of the TV and getting vaccine jabs was not the only answer. The power of false beliefs has misguided the human race throughout history, and now we see and recognize how dangerous those false beliefs are.

It should be noted that the emergence of the Delta strain and new more aggressive and possibly lethal variants was anticipated by many scientists. It is simply Darwinian evolution -- survival of the fittest. As infection spread globally, the virus changed its shape. It will keep on changing until one of few variants may bypass some of the vaccines! As you noticed, I stated some of the vaccines, not all the vaccines. Let me explain this point with an illustration.

If you close your eyes and imagine and make a fist with your left hand and then hold your fist with your open right hand, really tight, then it will be difficult to free your left hand fist. In my imaginary example, the “fist” represents the COVID-19 spike protein, where your right hand holding the fist represents the antibodies your body produced after the vaccination. These antibodies are holding the spike protein at bay. To refresh your memory, the spike protein is the one that binds your lung cells and your cells in your nasal cavity that sense smell. With the help of the spike protein, COVID-19 enters into your lung cells and your olfactory cells that give you smell, leading to breathlessness and loss of smell.

Now, suppose one lost three fingers on the left-hand “fist,” which represents the mutation in the spike protein. In this case, your antibodies against the spike protein may have difficulty recognizing the FIST (spike proteins). Any time COVID-19 infects an unvaccinated individual, that infected person produces billions or perhaps trillions of new viruses. Some of them mutate in a normal process when any living organism (including us) introduces new mutations (variants). Most of these variants die since they become incapable of further replication, but some thrive.

These thriving mutants, including the Delta variants, can infect people more readily and spread like dickens. The changes in the spike protein structure will continue to occur and the effectiveness of the vaccine may be less and less.

If most of the folks were vaccinated, it would have decreased the mutation rate, but these events (mutations and new variant formation) cannot be prevented since most of the people around the globe are still unvaccinated. These unvaccinated people will continue to a provide a continuous source of a potential super spreader until we reach global “herd Immunity.”

Now, let me clarify the question many are asking: Why are vaccinated people infected? To answer this legitimate question, let me explain.

COVID-19 has many proteins besides spike proteins. Many current vaccines available to the Western world contain ONLY the spike protein (example of FIST). However, the virus also has arms, legs, torso and so forth. It has 12 known proteins. If we would have prepared the vaccines using the whole virus, inactivated with radiation or formalin, our bodies would have antibodies against the whole virus and our bodies would have multiple protective antibodies. People vaccinated with the whole dead virus will be carrying antibodies against many proteins of the virus. Therefore, even if the spike proteins mutate, the other antibodies can hold the virus at check.

So, one may ask which country had the premonition that the spike protein vaccine may become less effective? Well, most of the Chinese-made vaccines are whole-virus vaccines. So why we did not develop that in the first place? The major hurdle was that it might have taken several months longer to test the whole-virus vaccines. The evidence of the better success of the whole-virus vaccines is that the recent data confirm that the whole-virus vaccines have much better protection against Delta and other viral variants.

There are numerous examples of whole microbes’ vaccines, either weakened live viruses (i.e., polio, measles, mumps, rubella, chicken pox) or inactivated whole viruses (i.e., polio, rabies, and hepatitis A). One interesting point to mention is that there are an estimated 35-65 million individuals who have been infected with COVID-19 in the U.S. Many were asymptomatic or mildly symptomatic, mostly young people. These individuals have immunity against the whole virus. According to a study published in Science Immunology, they only need to get one single shot of any of the currently available vaccines to be well-protected.

Now, let me explain why vaccinated people can be carrying COVID-19 and can be infectious to other unvaccinated people. Generally, we do not carry many antibodies in our nasopharynx and as time passes after the vaccination, the amount of antibodies wanes. Therefore, COVID-19 can easily attach itself to our nasopharynx. Since the virus cannot spread very far in the vaccinated folks, it will die in a few days. But it can jump to others who are vulnerable (i.e., unvaccinated). Of note, none of the current vaccines give 100% protection to 100% of the vaccinated individuals. Therefore, in rare cases, some vaccinated folks may get a full-fledged COVID disease.

3) What is yet to come? As I explained, the virus will continue to mutate and new variants will continue to emerge. The more the virus replicates in unvaccinated people, more new variants will emerge. As you noticed, the Delta variant came from India, but a majority of the world population is still unvaccinated and will remain so due to lack of resources, wars, and social and political instability.

Since no nation on earth has resources to vaccinate the rest of the earth, we must protect ourselves by mandating mask in all public and crowded places. We must normalize the mask for many years to come. Here, in our nation, we must advocate vaccination and vaccinate as many people as possible. We have lost over 600,000 people in our nation, but the blind, false notions have not opened the eyes of those who believe in falsehood.

4) Why are children and youth relatively protected? I am sure this question has come to your mind many times. It is well known that besides COVID-19, there are four other coronaviruses -- HCoV-NL63, HCoV-229E, HCoV-HKU1 and HCoV-OC43 -- that we encounter. These viruses are common among children and cause mild cold symptoms. It is believed that antibodies produced against these viruses may provide some protection against COVID-19.

Generally, the little kids get exposed to these viruses in daycare and in crowded school conditions. This immunity does not last very long, but it does provide some protection to our youngsters. Can a nasal spray containing these four viruses protect older folks? We do not know the answer yet.

5) What must we do and prepare for in the future? It is not a farfetched notion that there will be more pandemics. The gap between one pandemic and the next is rapidly decreasing. We had SARS-COV-1 in 2002-03 (mortality rate 9%), then MERS in 2012 (mortality rate 40-50%) and SARS-COV-2 (COVID-19) in 2019 (mortality rate 1-3%). During the last two decades, we had the Zika pandemic and Ebola, which almost became a pandemic. Before that, the major pandemic like the current one was the 1918-19 influenza that killed 3-5% of the world population (over 50 million people).

Due to climate change, global warming, deforestations, the rapid increase in world population, pollutions and many other earth-harming acts, it is certain that new, lethal, super-spreader germs, most likely new viruses, will emerge. So we should be constantly vigilant to make sure we do not contribute in killing our fellow citizens.

Not taking the vaccine is harmful to our own people. It is estimated that “one” unvaccinated person infects at least “three” other people. This is a slow-moving, nuclear chain reaction. We can stop this unnecessary death and misery.

Dr. Omar Bagasra, M.D., Ph.D., serves as professor of biology and the director of the South Carolina Center for Biotechnology at Claflin University.

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