Omicron not the final solution to fight the pandemic - Hungarian-developed spray and vaccine on the way, says virologist

Omicron will not end the pandemic

Amidst sharp spiking daily new COVID-19 cases due to the rapid spread of the Omicron variant (B.1.1.529) we have asked Jakab about the vaccination protocol regarding the fourth (second booster) dose, and occasional remarks by some that this could be the last wave in the coronavirus pandemic.

Referring to the uncertainty if we need to get used to living with COVID-19 that would spread in less and less severe waves and would eventually become similar to the common flu, he said that based on currently available information there are various open questions we have no answers to just yet.

I think it is out of the question that the Omicron variant will bring an end to the pandemic.

“It is conceivable that due to its rapid spread the virus will infect the whole population and give everyone some level of immunity, but on the one hand this immunity will wear off very quickly. On the other hand, it is also worth bearing in mind that

if a more virulent variant than Omicron hits, which is also very powerful in attacking the lungs and also causes severe symptoms, we are back at square one.

The immunity acquired against Omicron, which is already waning for this autumn-winter season, will not provide the desired level of immunity needed to fight off such a variant. So, I do not think that Omicron is the ultimate solution to combat the pandemic. What the next season will bring, no one can say at this stage. I think that

unfortunately, there will certainly be waves of outbreaks with greater or lesser amplitudes,

but it's too early to predict that. What is certain is that this virus will become part of our upper respiratory tract infection palette, and in the long term we must expect that it will certainly cause epidemics, if not on this scale, then smaller or larger infections.

Vaccination and booster doses

When asked if we should be prepared to get booster doses regularly, Jakab replied that

Excessive regular vaccination is not good. Our experience so far,

it is not recommended to vaccinate every four months,

because it is not a common thing, and we don't know how the immune system will react.

Whether we need to give a booster shot on an annual basis, we'll see next season. But I think there will be significant advances in therapeutic and antiviral drug development.

At the moment, of course, vaccination is our only effective weapon, but I don't think that will always be the case.

These drugs can also help in symptomatic treatment, but if we can develop a drug that reduces the ability of the virus to replicate within the cell, then that could be a targeted therapy. Both have relevance, both are being researched, both will eventually have results, he added.

Nasal spray against coronavirus

An international research was started last year by the Virological Research Group of the University of Pécs into the potential use of a nasal spray widely available in Hungary for lowering the risk of being infected by SARS-CoV-2.

The substance that the research group has examined is called azelastine, which is an anti-histamine. “Azelastine, an histamine receptor-blocker, was predicted in multiple screens, and based on its attractive safety profile and availability in nasal formulation, was selected for experimental testing,” said the research group in their study.

When asked about the effectiveness of the nasal spray against Omicron and subsequent variants, Jakab said the nasal spray is not variant dependent.

The exact mechanism of how it works within cells is being investigated, but it certainly works against omicron. Trials are ongoing, there is both laboratory and clinical experience that this could be an effective method of protection.

The clinical trials are being conducted with Austrian and German partners, he noted, adding that "the first results were highly reassuring."

Herd immunity

Herd immunity matters when it is developed against a disease that gives lifelong protection. When it comes to a disease where immunity is reduced or even disappears in a few months, it is completely pointless to talk about herd immunity.

Jakab reminded that we can get the traditional cold and flu viruses year after year, because we do not develop long-term immunity against them. As with SARS-2, this immunity is short-lived and not lifelong. In this respect

I don't think it's worth talking about herd immunity.

Multi-layered defence

When asked about multi-layered protection against the spread of coronavirus, i.e. the simultaneous deployment of vaccines, face masks, measures to lower the number of contacts, Jakab stressed that "this is the only thing that makes sense. We have always said

vaccination is a great thing, it can clearly mitigate the pandemic, but it is not enough on its own.

Vaccination will suffice only if the three fundamental epidemiological measures, mask-wearing, disinfecting hands, nad keeping distance, are in place and adhered to. Vaccination makes sense only in that case, he added.

Vaccinated people may also transmit the virus therefore they must also mitigate risks by wearing a mask.

Jakab also stressed that third (booster) doses provide greater immunity than just two shots.

When asked about Omicron-specific vaccines, the virologist said it would be important, but that is not the long-term solution.

The solution will be to create a multivalent vaccine that protects against all [existing] and future coronavirus variants.

Several laboratories, including the one he heads in Pécs, are working on this, Jakab said, but did not wish to go into details.

New projects in progress

In many cases, we are already in the animal testing phase, which are now dominating, said Jakab, highlighting three projects:

• the very first Covid project that has been launched in the country: the ELTE-Richter-ImmunoGenes-PTE consortium, led by Professor Imre Kacskovics. (This is a protein-based drug development, it is also well into the animal testing phase.);
• the Hungarian nasal spray (note that the azelastine nasal spray mentioned earlier is an existing drug);
• two vaccine development projects, one with a company residing in Pécs, and another one with biotechnology firm Cebina. These are also in the animal testing phase.

As regards the nasal spray, they are currently looking at, for example, how many hours the antibody applied to the nasal mucosa provides protection. The plan is that before going into an enclosed community or space, you spray it into your nose and even if enhaling viruses, enough should be killed to avoid infection completely or get over the disease with mild symptoms.

Jakab reminded that if the viral dose input is smaller the chances of transmitting the infection are also smaller.

Vision

When the BSL-4 laboratory was inaugurated in Pécs in 2017, residents and even experts did not understand why Hungary needed such a lab, feeling it was superfluous. Unfortunately, it became highly necessary very soon.

Biosafety level 4 (BSL-4) is the highest level of biosafety precautions, and is appropriate for work with agents that could easily be aerosol-transmitted within the laboratory and cause severe to fatal disease in humans for which there are no available vaccines or treatments. BSL-4 laboratories are generally set up to be either cabinet laboratories or protective-suit laboratories. Source: Wikipedia

Jakab said there could be further developments but they physically cannot expand.

"Now we have to take advantage of what we have," he said.

Perhaps the only personal goal I would still like to achieve is to create a school.

"If anything happens to me, I want to leave behind a school that will take virology research in Pécs forward. I now consider the training of young people and the education of the next generation to be a very important task."

He did complain, however, that "it's very difficult to recruit young people, it's a huge problem."

Social media vs. science

Asked about the omnipresent anti-vaxxers and the possible reasons behind vaccine scepticism in the face of the breath-taking results achieved with vaccines in record time, Jakab did not have an answer, but said social media greatly worsens the situation.

"A researcher should be able to say that we don't know. If he does not say so, he is not a researcher. Research is looking for answers to open questions.

Anyone who says he knows all the answers is lying.

"I think the situation is made a lot worse by social media, by the immesurable amount of knowledge that we're flooding people with. Now everybody knows everything, everybody has become a virologist, a vaccinologist and an epidemiologist in this country.

The problem is that it is easier to read a three-line Facebook post and believe it than to listen to the expert.

"Many people do not believe that we here in Pécs, for example, work because it is our job, we love it and we want to help. There are very few people who follow up a Facebook post after reading it.

"The other thing is that our society is built on mutual trust. [...] If I want blonde hair, I go to the hairdresser, she puts something on my hair and I leave blonde. If I want to buy a house on mortgage, the lawyer draws up a 20-page contract, sorts things out, I sign it, and I leave happy. Because I trust him.

Then why don't we trust the researchers? Why don't we believe that they have studied and worked and chosen this profession to help us and ensure we live happy, healthy lives?

The problem is that this mutual trust has been shaken in people because they suspect ulterior motives in everything, and that is not good. There is no trust and it is visible on a global level.

Cover photo: University of Pécs