Tegan Taylor: So Norman, last week we revealed to our listeners that we are no longer in an exclusive relationship with the new coronavirus, we are experimenting with other viruses. And in light of that, they gave us some ideas for new names for the podcast.
Norman Swan: One person says Monkeycast. Not bad.
Tegan Taylor: I like Monkeycast. Another says Pandemonium, which we could also use as an opportunity to talk about pandas, which I like.
Norman Swan: Yes. One of them is Epidemicast.
Tegan Taylor: I like it. There is also Pandemicast, which seems to be the most obvious. But I don’t know, Norman, there’s something I’ll always like about Coronacast.
Norman Swan: I have more for you, Neuroticast.
Tegan Taylor: Definitely … I feel like it fits in at least for your side of our conversations.
Norman Swan: It’s me who’s neurotic, not anyone else. Well, let’s get to it.
Tegan Taylor: Yes, I’m health reporter Tegan Taylor.
Norman Swan: I’m a doctor and journalist, Dr. Norman Swan. It’s Wednesday, June 1, 2022, and this is Coronacast.
Tegan Taylor: And we’ve heard a lot about the various Omicron subvariants, the new variant that hit the scene late last year, and now it seems to be branching out. But we’ve already talked about the fitness of viruses, Norman, and that there will probably be one who can balance others because it will have some benefits that others don’t. And I like to think it’s like the real Omicron. And now there is enough evidence to pit subvariants against each other, as someone with a much larger number of brain cells than we put together. What do they say about which subvariant looks like it will win?
Norman Swan: Well, there can be two real Omicrons. So this comes from Trevor Bedford, who runs a viral evolution lab in Seattle, and has written very coherently and well about viral evolution since the beginning of the pandemic. If they gather all the evidence and they’re tracking the viral genomes now since the beginning of the pandemic, and what he says is that basically when you look at BA4 and BA5, these are the newest cousins of Omicron, the first Omicron. , which was BA1, so they’re all under an Omicron umbrella. They are a little more contagious, so they are starting to disappear … at a low level, but they are starting to push out other Omicron subvariants, especially 2 and subvariant 2. It’s getting very complicated, 2.12.1. And now there is an indication that the reason, or at least one, of the reasons why BA4 and BA5 displace the BA2 subvariant is that they are more immune evasive, so there is only a smaller antibody response to these BA4s in the body. BA5 subvariants, and that could be why they’re starting to push BA2. So it’s early, but it looks like they’re slowly taking over the government, that would be a prediction.
Tegan Taylor: So if they’re more immune evasive … I know it’s not easy, but would it be an easy way to get around it, to create vaccines specific to these variants?
Norman Swan: Well, it could be, but before we get to that, the consequence of being more immune to avoid is that you could actually get reinfected with BA4 and BA5 if you had a previous Omicron, and about that. there is a lot of talk. about reinfections, so there isn’t much strong evidence for reinfection with Omicron, in fact there was some evidence that you didn’t get reinfection, but Trevor Bedford suggests that you might start to see this in BA4 and BA5.
The question of vaccines is really important, it just shows you how difficult it is. So what are you making a vaccine against? Can you create a type of Mr. Omicron vaccine that will cover all the variants in the Omicron family? This may be quite difficult to do if there are subvariants such as 4 and 5 that are resistant to the vaccine. So if you created a vaccine against BA2, it would not work very well or less well, it would work worse against BA4 and BA5. So it really emphasizes that we need to get this second generation of vaccines, and there are a lot of them around, and hopefully they’re more effective across potential variants.
Tegan Taylor: So these second-generation vaccines try to provide a broader immune response, they don’t necessarily target just the most prominent peak of the spike protein, but they track other parts of the virus that may not change. easily as the end of the spike protein.
Norman Swan: And one place that could be is what is called the receptor binding domain targeted by the Doherty Institute, their vaccine, and they anticipate that at the very, very pointed end, there are fewer variations you want if, the tip where it anchors with the body. They bet it’s probably less variable than some other parts of the tip.
Tegan Taylor: So you’re saying that instead of just updating Pfizer or Moderna, we should look for completely new vaccine technologies.
Norman Swan: Yes, it just depends on whether they exist and whether they come out. An interesting article from China about the COVID-19 nasal vaccine, so instead of injecting it into your nose, you will use the flu as a carrier for this vaccine. And unfortunately it was not very effective. So there are a lot of things that try to make a vaccine more effective or easier to apply, but we haven’t cracked it yet or they haven’t cracked it yet.
Tegan Taylor: It’s very exciting from a scientific point of view, but what time frames would we be talking about here?
Norman Swan: I think the Melbourne vaccines are going on trial, or at least the first trials, which I understand, and I’m sure it’s happening overseas. So we haven’t been given the light we had for desperation with Pfizer and Modern and Astra, but we should start to see something come up, I hope, by the end of this year in terms of new vaccines, perhaps for 2023.
Tegan Taylor: So let’s ask ourselves some questions, our viewers sent them as usual to abc.net.au/coronacast. And Brett says; with the size of the Omicron epidemic in New Zealand … oh, are we receiving questions from the New Zealanders?
Norman Swan: All right.
Tegan Taylor: We’ll make an exception for Brett. He says; it is almost inconceivable that I have not personally been exposed to the SARS-Cov-2 virus more than once. Brett is triple annoyed by Pfizer, while Basque, if appropriate, has not had Covid or tested positive, so he assumes the vaccine has done its job and his immune system has defended itself against the virus. So he wonders, meaning his immune system is now even better prepared for any future exposure and is even less likely to get Covid.
Norman Swan: I wish that were true. The fact is, Brett, your behavior is good at the moment because you’re completely crazy and wearing a mask when appropriate, so you’re trying to protect yourself from any viruses around you, including COVID-19, so good thing and this the behavior itself will protect you from the new versions of COVID-19 that may appear, but it does not guarantee that we will unfortunately move forward.
There’s another question we often get, and I thought it was where you were going, Brette, that everyone around me had… a typical question is; everyone around me had COVID-19 and I didn’t have it, am I exceptional and am I resistant to that? In fact, I had that interview with Patricia Karvelas last Monday before my studies, and she talked about how she would never get it, and then the next day she didn’t have a job with COVID-19, so she got it wrong. But there is a lot of research going into this. And there is no doubt that if you take any virus, there is probably someone or people with genetic variation in the body that gives the virus some resistance. It can be at any time, it can be resistant to the infection process, it can be resistant to the spread of the virus in your body and so on. So a lot of different things are happening. It is almost certain that there are people who are truly resistant to COVID-19, as this is true of other viruses, and if they are the cause, it will almost certainly be genetic, provided that their behavior is the same as anyone else’s. Brett’s behavior is very protective of Covid, and that’s probably why he’s protected himself so far.
Tegan Taylor: Well, Brett, I hope you continue to dodge Covid. And we have a question from another listener who says; Can you please provide us with up-to-date information on mysterious cases of hepatitis that occur in children? I’m worried about my kids.
Norman Swan: Well, the WHO has recently reported the latest number of cases, there are about 650 cases in about 33 different countries, it still shows a relatively high severity, some children need an acute liver transplant. They haven’t gotten to the cause yet, so a theory about adenovirus has emerged that is still possible, it may be an adenovirus next to COVID-19, that’s a possibility, but it doesn’t seem to. So they really are still not sure what is causing this virus. But if you have 650 cases in the world’s multi-billion population, it’s not very common, although it will be underdiagnosed. There are almost certainly children with a milder form of hepatitis that they will lack. But at this stage, it’s not the order of the day. So while you may be worried about your own children, there is nothing to keep you up at night, at least at this stage.
Tegan Taylor: In a country like Australia, once it is identified, is it possible to treat it well in a hospital?
Norman Swan: Well, acute hepatitis is very difficult to treat, and you rely on supporting a child or adult with acute hepatitis, and the treatment is mostly because you can’t give medication if you don’t know what you’re treating. It’s mostly about supporting the person, make sure he is well hydrated and if he needs to be in intensive care. But if the liver eventually starts to fail, you really have very few options and a liver transplant is about it. You certainly want to avoid drugs like paracetamol, which can damage the liver, but there is no evidence that these children take paracetamol more often than others.
Tegan Taylor: It’s really disturbing. We can take comfort in the fact that it is rare, even if it is not very pleasant for the people who are affected.
Anyway, that’s all we have time for today at Coronacast. You can continue to send questions or comments at abc.net.au/coronacast, whatever, we are happy to read them all.
Norman Swan: And I’ll see you next week.
Tegan Taylor: I’ll see you then.
#subvariant #True #Omicron #ABC