Huang Zhihuan, a White House consulting expert and a professor at the RAND Corporation's Down China Policy Chair. Photo/Courtesy of respondent
Text | Xiao Longping, an interviewer at Xinjing Think Tank
Golden sentences
The COVID-19 pandemic will not suddenly disappear, and the symptoms caused by the new crown may slowly become as long-lasting as a cold and continue to evolve.
From the perspective of global vaccine supply, many Americans believe that what the U.S. government has done so far does not match its status as a global "leader."
The Omiljung strain is similar to other new coronaviruses, that is, the impact on the elderly is relatively large, and the symptoms caused by infection will be more serious.
Most of the two or three doses of vaccines have basically no serious illness after infection with the Olmikron strain, or the symptoms are very mild.
According to the World Health Organization, on January 25, there were 218,400 new confirmed cases of new coronary pneumonia in the United States, less than one-fifth of the five days ago, which was 16.34% of the highest value on January 12; 552 deaths, which was 13.9% of the highest value on January 23.
In South Africa, where the new coronavirus variant strain Amy Kerong was first discovered, there were only 1,332 new confirmed cases on January 25, 3.5% of the highest value on December 13, 2021; 88 deaths, which was 15.97% of the highest value on January 7, 2022.
Voices that "the global COVID-19 'pandemic' will end" began to prevail. However, Jennifer Huang Bouey, a White House consultant and chair of the Department of International Health at Georgetown University, a White House consultant and chair of the Department of International Health at Georgetown University, told the New Beijing think tank that if the epidemic caused by the Olmitchon strain may weaken to a flattening in the United States in February and March, the new crown epidemic will not disappear, but may gradually become as long as a cold.
Professor Huang Zhihuan is an epidemiologist who studied at Peking University School of Medicine and received his Ph.D. degree. In the early days of the 2020 COVID-19 outbreak, Huang Zhihuan called for the United States and China and the world to strengthen cooperation again, "because this is a battle between the virus and humans, not between people, nor between countries." ”
Huang Zhihuan said that from SARS, H5N1, H1N1, H7N9, to influenza, to the Ebola virus and other infectious disease outbreak responses, the United States and China have carried out good communication and cooperation, and have made great contributions to the progress of human health.
So, when the COVID-19 pandemic is not yet clearly over, what cooperation projects can China and the United States jointly carry out in the fight against COVID-19? Why do the United States, the United Kingdom and other developed countries have a rapid increase in the number of confirmed cases in this wave of Theomikron strain epidemic? Why is the Olmikharong strain "poor and rich" pandemic in developed countries? On January 25, Xinjing Think Tank interviewed Professor Huang Zhihuan for this purpose.
The Omiljun strain has an immune escape function
Xinjing Think Tank: Since mid-December 2021, the new crown epidemic in the United States, the United Kingdom and other European and American countries has reached a record number of daily confirmed cases under the influence of the Omilon strain. What do you think is the main reason?
Huang Zhihuan: Mainly because the Aomi Kerong strain has an escape function. The immune system provides several "protective layers" for people, such as the first layer of protection is antibody protection. This is an antibody formed after a person has had a certain type of disease in the past, or after vaccination, but this antibody is generally less sensitive. The antibodies failed to recognize the Omikeron strain, so they escaped.
Of course, this is not to say that the body's immune system is completely unresponsive, and the defense of the second layer of the immune system (that is, T-cell immunity) is still useful. Therefore, although the Omiljung strain has infected many people, it has caused few severe diseases, and many people have basically no symptoms.
Xinjing Think Tank: Does this have a lot to do with the fact that the northern hemisphere is in winter?
Huang Zhihuan: From an epidemiological point of view, the source, host and environment constitute an "epidemiological triangle". Therefore, the "environment" has a certain impact, but how much impact it has, for example, in winter, everyone may be more likely to gather indoors, rather than outdoors, if the ventilation is not good, etc. will have an impact. But I think the main thing is because the Omikejong strain has an immune escape function.
Xinjing Think Tank: Some scholars say that the Omiljung strain affects the upper respiratory tract more than the lungs, so it is more contagious but also milder. What do you think of this "new" judgment?
Huang Zhihuan: Yes. There are Scholars from Hong Kong and Japan who have done similar research. Among them, Hong Kong researchers have done relevant experiments with different tissue cells in vitro with the Omiljun strain, and the results confirmed that the Omiljun strain is more likely to infect upper respiratory tract cells than lower respiratory tract (i.e., lung) cells.
Xinjing Think Tank: In other words, the new crown vaccine can also prevent the severe disease caused by the infection of the Olmi kerong strain, but it has little effect on preventing transmission?
Huang Zhihuan: Yes, most of the two or three doses of vaccines have basically no serious illness after infection with the Omilon strain, or the symptoms are very mild. Of course, there are individual exceptions, if there is an underlying disease, there will still be a phenomenon of severe illness, but the overall rate of severe illness is much lower than that of people without vaccination.
The COVID-19 pandemic will not end in February and March
Xinjing Think Tank: There are views that the epidemic in developed countries such as the United States and the United Kingdom has played an amplified effect in the global epidemic.
Huang Zhihuan: As a public health researcher, I hope that the more data, the better, because it is conducive to more accurate study of viruses. The United States is now more mature than two years ago, and now that so many confirmed cases can be reported, it does mean that there are many cases. The current confirmed case data is basically confirmed by PCR testing, but there are still many people at home with rapid detection equipment to detect, so the current public data may not be complete enough, and many people without symptoms may not do testing, therefore, the current number of confirmed cases can only be used as a rough reference. However, this is still very consistent with what we have seen, including the degree of congestion in the hospital or the positive rate detected by the people around us, which is indeed quite a lot.
▲ People line up at the new crown testing points on the streets of New York, USA, waiting for testing. Photo by Xinhua News Agency reporter Wang Ying
As a result, health systems are strained in all parts of the country, especially where there are not many vaccinated people. Although vaccination rates in the United States are 68 per cent and 95 per cent of people over the age of 65 receive their first dose, the distribution is uneven across places, with some places, especially young people, still not vaccinated. Current data show that if an unvaccinated person is infected with the Omiljun strain, the hospitalization rate is 5-10 times that of the vaccinated population (the older the patient and the more un-vaccinated and infected with the Omiljun strain, the more likely it is to be hospitalized).
Xinjing Think Tank: WHO data show that since the winter of 2021 in the United States and the United Kingdom, the number of confirmed cases per day has been several times that of the previous peak, but the number of deaths has not shown a corresponding proportion of growth, and the United Kingdom is still less. Why is that? Does this mean that the case fatality rate caused by the Aomi kerong strain has become lower?
Huang Zhihuan: First of all, the virus itself is not easy to affect lung cells, and it is less lethal to the lungs. At the same time, many people already have T cell immunity, so although it can escape antibody immunity, T cells still have about 80% protection. These two factors determine that the Aumechjong strain is less severely ill. Fortunately, otherwise the death toll of this wave of the epidemic would be very high.
Xinjing Think Tank: Some virologists in Europe and the United States believe that Omi Kerong is the "terminator" of the new crown virus, predicting that the new crown epidemic may end in February and March 2022. What do you think?
Huang Zhihuan: If the epidemic caused by the Omikejong strain may weaken to a flat level in the United States in February and March, the new crown epidemic will not disappear, but it may gradually become as long-term as a cold. There are currently seven common coronaviruses, four of which cause the common cold, and three other coronaviruses – SARS, Middle East Respiratory Syndrome (MERS) and COVID-19 – that have caused large-scale outbreaks.
Historically, the Spanish flu of 1918 and SARS in 2003 seem to have suddenly disappeared. But our research found that after the 1918 flu, the virus (H1N1) actually circulated several times in the form of avian influenza, but humans have tolerated it, so it did not cause the economic and social impact of the 1918 influenza pandemic."
Judging from the current situation, the new crown virus cannot suddenly disappear, it will certainly continue to exist, and may produce new mutations to cause a re-epidemic, but because more and more people are multi-layered immune to it, regular vaccination may no longer affect travel and daily life.
Don't think that infectious diseases are no longer a threat
Xinjing Think Tank: If the performance of the United States and the United Kingdom in the prevention and control of the new crown epidemic is 10 points, how many points will you give?
Huang Zhihuan: Not very good at scoring. However, the outbreak of COVID-19 has revealed the strengths and weaknesses of different countries. For the United States, its strengths are, such as the development of vaccines, american researchers can quickly develop innovative vaccines, quickly pass the FDA (Us Food and Drug Administration) inspection and approval, mass production, and then distribute to the people who need it, but whether the population wants to fight or not is another matter.
From the perspective of global vaccine supply, many Americans believe that what the U.S. government has done so far does not match its status as a global "leader." At the same time, the epidemic has also exposed some problems in the domestic public health system in the United States, such as insufficient interaction between the public health department and the public, and many people do not know who to listen to. For another example, the relationship between the US government and the private sector has also exposed the need to further strengthen the cooperative relationship between the two sides in the face of this epidemic, and the phenomenon that the government has made corresponding commitments but has not been fulfilled.
Xinjing Think Tank: As the first South African to discover the Omiljung strain, the number of new confirmed cases on January 25 has dropped to more than 1,000. Some European and American countries continue to increase confirmed cases, so there are views that the Olmikron strain is "poor and loves the rich". What do you think?
Huang Zhihuan: The age structure of European and American countries is a factor, most countries are mainly elderly, And South Africa and other African countries, including India, have an average age that is younger than that of European and American countries. The Omiljung strain is similar to other new coronaviruses, that is, the impact on the elderly is relatively large, and the symptoms caused by infection will be more serious.
▲ London, England under the epidemic. Photo by Xinhua News Agency reporter Li Ying
Xinjing Think Tank: In this wave of the new crown epidemic, the death toll in the United States and the United Kingdom is relatively large. What do you think is the reason? What does this teach for public health efforts?
Huang Zhihuan: I think all countries should be careful not to think that infectious diseases are no longer dominant, so they focus on the treatment of chronic diseases and then tilt the funds to the treatment of chronic diseases. In the United States, for example, there have been no corresponding combat exercises for many years, because there has been basically no large-scale serious respiratory epidemic in the United States for 100 years. All in all, no matter which country it is, don't think that infectious diseases are no longer a threat.
U.S.-China cooperation should not be limited to the national level
Xinjing Think Tank: You have done research on Sino-US cooperation in the field of public health, and the Chinese government has learned a lot of experience from the public health work of the United States in the past. Judging from the results of this epidemic, what experience do you think the United States, the United Kingdom and other developed countries can learn from China's new crown epidemic prevention and control work?
Huang Zhihuan: There are indeed many experiences to learn, such as doing a good job in educating the public to wear masks in winter, the Chinese government's assistance to vaccines in other developing countries, and using big data technologies such as health codes to respond to the epidemic. The problem is that the timing of the COVID-19 outbreak is very inappropriate, just when the US-China relationship is in a trough, and the COVID-19 epidemic has also exacerbated the deterioration of relations between the two countries to some extent. Therefore, at this time, it is very unlikely that the US government will learn from the Chinese government's experience in epidemic prevention and control. Now the U.S. government will talk about learning from The experience of Japan, South Korea, and even Vietnam, but it will not say learning from China's experience.
Of course, American politics has a national level, a state level, a city level, and many other types, such as civil society organizations, scientist organizations, and even fund organizations, laboratories, etc., which are basically not affected by the national level politics of the United States. So, I think whether it's health or climate and energy, cooperation in these areas may be carried out at different levels, rather than from the national level, which is really difficult now.
A medical worker prepares for COVID-19 vaccination at a clinic in Texas, USA. Photo: Xinhua News Agency
Xinjing Think Tank: In the global response to the new crown epidemic, what role do you think China and the United States can play, and what needs to be promoted together?
Huang Zhihuan: I think there are quite a few projects that can be worked together, such as vaccine research and development. For developing countries (regions), especially low-income countries (regions), even if vaccines can sometimes be transported there, how to transport vaccines to various places where they are needed, how to store them, how to provide medical capacity, so that people can get vaccines, these are all big issues, and the United States has its own advantages.
At the same time, the United States has done a good job in antiviral drug treatment, but if you want to make the global new crown epidemic end as soon as possible, you can't rely only on a few companies in the United States to produce antiviral drugs, but also have to dig out the global production capacity of the company and give technical support. The United States and China can cooperate in these efforts, but they do not necessarily require the cooperation of the two governments of the United States and China, but the two countries support the third-party organization to carry it out. For example, the Gates Foundation or a foundation in China.
Finally, the challenge that in the past was that the medium of transmission that should be targeted in the prevention and treatment of infectious diseases was water and food, is that airborne transmission can also lead to major outbreaks of infectious diseases with significant impacts. Therefore, how to control and improve the sanitary quality of the air is becoming more and more important now, and there will be a lot of international cooperation in this regard in the future, and the scientific research institutions of the United States and China can also carry out a lot of corresponding cooperation.
Edit | Zhang Xiaoyuan
Proofreading | Liu Jun