Virologist Christian Drosten: “The pandemic will only really start now”

WNM | Sep 23, 2020 at 10:44 AM
Detlev Ganten (right) and Christian Drosten (left) (Source: World Health Summit/S. Kugler)

BERLIN, 23. September (WNM/World Health Summit/Daniela Levy) – In an interview, Christian Drosten, Director of the Institute of Virology at Charité, speaks with Detlev Ganten, President and Founder of the World Health Summit.

Professor Drosten, Professor Ganten, what was the biggest surprise for you regarding COVID-19?

Christian Drosten: I would not have expected at all that this virus is so easily transmissible. For me it was clear very quickly that this is a SARS virus. Namely the species, the same type of virus that I have known for 17 years. But I never thought that this one would behave so completely differently. This is due to a tiny detail in the surface protein of the virus.

Detlev Ganten: For me, the biggest surprise was right at the beginning, when the virus was still far away. Suddenly, the rapid spread of the virus began - these were not individual cases but clusters. I would never have thought that the virus spread so quickly and that the systems would be so overwhelmed with all the catastrophic consequences. After all, we had seen severe waves of influenza, but they were all controllable.

What is most important in the fight against COVID-19?

Detlev Ganten: Very clearly: Transparency, cooperation, communication and: education! It is crucial that the population is well and clearly informed, so that precautionary measures are understood and followed and no myths are spread. "Education is the best vaccination." An educated society can deal with such things better, even with false reports circulating. I think it is a huge disaster that the educational infrastructure in Germany is not very modern. Even worse than the fact that the health authorities have been neglected in the past.

Christian Drosten: Things have to change in science, too: In Germany, for example, medical research is very cancer-oriented. Infectious diseases are extremely important in medicine, and we are not just noticing this now. We need much more research in this area. Antibiotic resistance is the next big issue. This also affects us in high-performance medicine. We can see how it takes its revenge if we neglect fields of activity that apparently do not affect us. But really only apparently.

How can we get COVID-19 under control in the countries of the global south?

Christian Drosten: From our western perspective one would say, we need a vaccination. But that is not so simple if one thinks of the global south. The clock is ticking. The spread in such countries is not slow. And we have no idea how many people are infected there.

However, it seems that there are relatively few deaths in African countries. There are perhaps obvious reasons for this: One is the age profile - the population is simply younger. And for another, the immune system is used to many infections. There, worm infections, for example, are universally spread. They influence the immune system. Although we do not know the exact effect on this particular COVID-19 viral disease, it could be an explanation.

Germany currently holds the EU presidency - what role can Germany and Europe play in the global fight against the pandemic?

Detlev Ganten: In the current situation, in the increasingly bipolar world with the blocks by the USA and China, Europe has a decisive role to play. The most important thing is international, multilateral cooperation, especially with countries that have not always been cooperative in the past.

So what is the key to improving global health care?

Detlev Ganten: Viruses and other health threats to people know no national borders. Therefore: International structures must be strengthened. We can only act together - with courage, good ideas and across all borders. That also applies to science.

How can we ensure that everyone in the world has access to a vaccine?

Christian Drosten: You have to use existing structures: There are international organizations and programs that are experienced in supplying countries of the global south with vaccines.

Detlev Ganten: And the WHO must be strengthened. Europe and Germany are doing this in an exemplary manner. And there is another thing I think is important: international, moral pressure from the scientific community. The academies of science, which advise their respective governments and are heard by the public, are particularly good at this. If individual countries then fail to join in, they will ultimately be unable to resist the public pressure.

Do you think that in the future more attention will be paid to science?

Christian Drosten: The credibility of science is currently high, but that can change quickly. At the moment, nobody knows exactly how the epidemic will continue. There is the possibility that the whole thing is not so easy to control despite scientific explanations and that science has simply been too slow, for example with the availability of vaccines. We will only know in the end how science has fared. Because this pandemic is not a scientific phenomenon, it is a natural disaster.

Detlev Ganten: Science is asked if it is credible. It must therefore take a holistic view of the whole event, i.e. the big picture, and also take an interdisciplinary view: in other words, not only the virological aspects, but also the economic, social and political aspects of a pandemic, for example. No one can predict with precision what will happen. Science must take a critical and self-critical approach to problems. And then communicate it in the same way. Christian Drosten does this in an exemplary manner.

What is the most important lesson we can learn for the future?

Christian Drosten: The pandemic will only really start now. Also here in Germany. We can only speak of lessons from the first wave in Europe. There alone we see huge differences. But what we can already say in any case is that it is relatively important to inform the population well and comprehensively. It can cause great harm if politicians use the dynamics of a pandemic for political messages. This is very difficult - the virus immediately serves the bill. You can see what it does in the USA. In Germany, too, we see the consequences.

Detlev Ganten: The message for me is very clear: health is the most important thing for the individual and it is the basis for a functioning society. The economy, culture and all that simply does not work if what we consider guaranteed is no longer there. I am not sure whether everyone is really aware of this.

Christian Drosten: I do not think so.

If you could wish for something - what would it be?

Christian Drosten: We have to change things to control the situation in the coming months. We need pragmatic decisions. There are already speeches being held praising the German success, but it is not quite clear where it came from. This success came simply because we reacted about four weeks earlier than other countries. We reacted with exactly the same means as others. We did not do anything particularly well. We just did it earlier. That is why we were successful. We were not successful because our health authorities were better than the French, or because our hospitals are better equipped than the Italian ones. If you carry this over into the fall, you must of course realize that we continue to do nothing better than others.

What does that mean?

Christian Drosten: In Argentina, for example, the spread is very difficult to control despite measures - it's winter there. In Germany, we should look abroad in a much more differentiated and precise way. We must stop talking about things like soccer stadiums. That really is completely misleading.

Detlev Ganten: Of course, I would like to have an effective therapy and a vaccine.

But I also think it is very important that it finally becomes clear how vital international and multilateral cooperation is. And I repeat: education, education, education. An educated society understands necessary measures, behaves rationally and does not run into the arms of rat catchers.

When can we say that we have done it and can shake hands again?

Christian Drosten: What does "we have done it" mean? Probably when the spread following an epidemic pattern has been broken. That is, when there is no longer a free wave of infection running over the population, but only localized outbreaks that can be controlled. This situation will be reached in different countries at different times. In countries of the global south, this could be the case earlier because the age structure is different. In our case, of course, it depends on when there are enough vaccines for the risk groups.

So risk groups should be prioritized?

Christian Drosten: Yes, then we do not need 50 million vaccine doses in Germany. Apart from the expected competition for distribution, it is not so easy to fill so many vaccine doses into bottles and then administer them. Even if the vaccine is there. Even if one or two approved vaccines are available in January, it will all have to be bottled and people will need to be vaccinated.

Detlev Ganten: A vaccine and an effective therapy would indeed be a huge step forward. But one thing must not be forgotten: the other diseases are still there, the many avoidable deaths, for example cardiovascular diseases or infectious diseases that cannot be controlled when antibiotics are no longer effective. I hope that the lesson we have learned from this Covid-19 pandemic is that we will have to be better prepared for challenges of this kind in the future. Prevention may cost money - but not being prepared can have dramatic consequences.

Source: World Health Summit