'No matter how much you fast track, you cannot say here is a highly efficient vaccine even by the middle of next year or the end of next year.'
In the first part of his interview with Shobha Warrier/Rediff.com, Dr Rakesh Mishra, director, Centre for Cellular and Molecular Biology, said it was inevitable that the coronavirus will come back in more waves.
Asked by Shobha, "Does that mean 2021 also will be like 2020?", Dr Mishra replies in the concluding part of the interview, "Maybe there will be less panic in society as we know how to live with the virus! When we understand the virus, we will be able to avoid the spread of the virus, unlike in 2020."
While Europe and the UK are talking about a second wave, India, the US and Brazil are still experiencing the first wave and the cases are only going up. When will there be in dip in the numbers?
Yes, we have to reach the peak of the first wave for the cases to start coming down.
To reach the peak, we have to test as many people as possible. But we have to go a long way.
One way of knowing whether you are testing enough is, when the positivity is 2%-3%, that is, when you test 100 people, you will get 2-3 positive people. Then you can say, you are testing enough.
But our numbers are 15%-20%. It clearly shows we are not testing enough.
This is where we have to bring in new ways and new logistics.
Another thing is, whether you are tested or not, if people observe self-discipline, we can bring down the numbers.
So, the two important things are, large number of testing and self-discipline.
Yes, it is easier said than done.
When can we expect a second and third wave in India?
It is very uncertain as we are still in the first wave, and we do not know when it will come down.
A second wave might be two months or three months away depending upon how we manage.
And the second wave also depends on the behaviour of the people. Like in Europe, it matched with the opening up of pubs and restaurants and beaches.
Here also, if people start freely going to cinema halls, beaches, restaurants and malls, and city buses start operating, it may probably lead to a second wave.
A crude guess is, it may take another 3-4 months or more for the second wave to happen. Hopefully, the second wave will be a smaller one and will taper off faster.
Remember, what I am saying is not based on scientific data.
The last time when we spoke, you had said that generally it would take 5-6 years of intense study for a vaccine to be used among people.
But this time, all the countries are fast tracking and trying to come out with a vaccine in 3-4 months's time. In Russia, they did not even do a Phase 3 trial.
What kind of repercussions will this have on people who get vaccinated?
It is like declaring that you have a vaccine, feel good about it and make money out of it. But the fact is, a vaccine will not be there unless it is tested.
When I told you last time that it would take five-six years's time for a vaccine to be used, I meant only then we would know how good or bad or how effective a vaccine would be.
We get to know only that after a few years of using the vaccine on many people.
No matter how much you fast track, you cannot say, here is a highly efficient vaccine against COVID-19 even by the middle of next year or the end of next year.
That's because you have to vaccinate a large number of people first, and it will take several months to know how it works like whether it really prevented the person from getting infected.
That's why we do the trials, to see whether the vaccine protects the person from getting infected or not.
Somebody may announce that he has come out with a vaccine that works. But he will not be able to guarantee that this is the vaccine that will ensure you will not get infected after six months or one year. Or, that it will work for all the people. It will take time to get all this information.
To have a proper good vaccine, it will take at least two-three years. Yes, we may have some candidates which people may assume as a vaccine.
It may give you 50% protection, but 50% protection is meaningless for a large country like India when it has 50 crore (500 million) people not protected.
Yes, it is better than nothing.
Suppose there is a vaccine by early next year, would you say that for those who are getting vaccinated then is like participating in a phase 3 trial?
Yes! When you give a vaccine next year, it is like the continuation of a phase 3 trial, or a phase 4 trial.
Anybody taking the vaccine even after a phase 3 trial is a volunteer, according to me. Their data will be recorded and there will be follow ups too. It is good.
If 50,000 got vaccinated and if it is considered safe, you can give to more people. Only then we will know the efficacy.
Would you say that there is some danger involved when you take the vaccine the moment it comes out?
Yes, there is. See they had to stop the Oxford vaccine in between because a volunteer fell sick. It is a good sign that the system is alert.
Imagine if the vaccine is dangerous for certain people with certain sickness. These things will become apparent only when the number is very large. If you are testing only 10,000 to 20,000 people, you may not get all the variants.
That's why the real trial will continue for a long time, and only after that, we will get the full data.
The advice that you hear now is that you have to learn to live with the virus. How do we live with the virus?
Have discipline, wear a mask, travel less and maintain social distancing.
In short, we have to reduce the chance of getting infected, and also not infecting others unknowingly if you are infected.
This is living with the virus!
How long will this new normal continue?
At least for a year or so, we have to follow this new normal.
While people without any health issues are safe, those with co-morbidities and elderly people will have to be careful.
We will have marriage parties with very few people.
We will travel less.
That is the new normal. Yes, a lot of adjustments have to be made.
We have to chase the virus so that it will not come to you.
Does that mean 2021 also will be like 2020?
Maybe there will be less panic in society as we know how to live with the virus!
When we understand the virus, we will be able to avoid the spread of the virus, unlike in 2020.