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May 30: Warning of the tightrope walk ahead as governments battle the coronavirus crisis, Nobel laureate Peter Charles Doherty has expressed concern about densely populated countries such as India relaxing lockdown norms while also describing a complete shutdown as “an economic and social impossibility”.

The Australian immunologist, who cautioned that the number of COVID-19 cases will rise in the coming days, said the earliest time frame for an effective vaccine “going into large numbers of people” is nine to 12 months.

"If all goes well with testing, we could know if some of the candidate vaccines are both safe and effective as early as September/October. Then, rolling a vaccine out will depend on the type of product and how quickly it can be made, put in vials and so forth," Doherty told PTI in an email interview from Melbourne.

The novel coronavirus, he added, does not change fast like influenza and, from what is known so far, “the same vaccine should work everywhere”.

Doherty, who is with the Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, won the Nobel Prize for Medicine in 1996 for his discovery of how the body’s immune system distinguishes virus-infected cells from normal ones.

Discussing the lockdown, he said, "If it was purely a matter of hard science, everywhere should stay locked down. But that’s pretty much an economic and social impossibility.”

The expectation, he said, is the numbers will rise and limiting spread will depend on people acting responsibly and the capacity for rapid response and extensive contact testing.

“And in a densely populated country like India I think that it will be very difficult," the scientist said.

Several countries, including India, began relaxing lockdown norms in mid-May despite the WHO’s warning about a second wave. India’s lockdown began on March 25 and has since been extended. The fourth phase ends on Sunday.

Asked whether there are any alternatives to a lockdown, the 79-year-old said, "There is no other option other than closing borders. South Korea, for example, conducted massive, intensive testing and contact tracing in a wealthy country with a very disciplined population. Otherwise, not till we have effective vaccines."

He added that he personally doesn’t see the point of closing borders for people coming in if there’s already a high incidence of disease in the community, “unless it’s to avoid the need to care for them and use scarce hospital beds".

According to Doherty, the coronavirus "is a new virus which has come straight out of nature".

“It (the virus) has moved so rapidly across the world because of people travelling on international planes as well as tourist ships," he added.

The immunologist also warned against the use of hydroxychloroquine to treat COVID-19, and said current and planned trials of the anti-malaria drug should be stopped.

“My understanding is that the use of the drug in severe disease is definitely contra-indicated, but it’s not yet clear whether, if taken under medical supervision, it could have some useful effect if taken early on, or as a preventive. Those trials just haven’t been done properly," Doherty noted.

The Indian Council of Medical Research (ICMR) has backed the use of hydroxychloroquine as a preventive against COVID-19 even after the WHO suspended clinical trials of the drug citing safety concerns.

Asked whether plasma therapy can be an effective treatment for COVID-19, Doherty said, "We lack good properly controlled trials but, especially if the plasma has been tested for antibody levels and there’s evidence of good activity, it could be helpful. If I had the disease and was offered plasma therapy I would certainly accept, but I would not take hydroxychloroquine."

Doherty is also very optimistic about herd immunity developing against the SARS-CoV-2 infection.

"We think that (herd immunity) will cut in and have an obvious effect when, say, 60 per cent of people have been infected. Best hope is to boost herd immunity with a vaccine," he stated.

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections.

The number of COVID-19 cases have crossed 5.9 million and the fatalities 3,65,000, according to the Johns Hopkins University on Saturday. 

In India, the death toll has risen to 4,971 and the number of cases to 1,73,763, according to the Union Health Ministry on Saturday.

Several states, including Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand and Chhattisgarh, have reported a rise in number since lockdown norms were relaxed in early May and migrant workers reached home.

In Uttar Pradesh, for instance, the number of infections rose from around 3,000 on May 4 to 6,532 on May 26. Similarly, Bihar’s numbers increased from around 500 to over 2,700 in the period.

Global coronavirus infections passed 14 million on Friday, according to a Reuters tally, marking the first time there has been a surge of 1 million cases in under 100 hours.

The first case was reported in China in early January and it took three months to reach 1 million cases. It has taken just four days to climb to 14 million cases from 13 millionrecorded on July 13.

The United States, with more than 3.6 million confirmed cases, is still seeing huge daily jumps in its first wave of Covid-19 infections. The United States reported a daily global record of more than 77,000 new infections on Thursday, while Sweden has reported 77,281 total cases since the pandemic began.

Despite the surging cases, a cultural divide is growing in the country over wearing masks to slow the spread of the virus, a precaution routinely taken in many other nations.

U.S. President Donald Trump and his followers have resisted a full-throated endorsement of masks and have been calling for a return to normal economic activity and reopening schools despite the surging cases.

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Other hard-hit countries have “flattened the curve” and are easing lockdowns put in place to slow the spread of the novel virus while others, such as the cities of Barcelona and Melbourne, are implementing a second round of local shutdowns.

The number of cases globally is around triple that of severe influenza illnesses recorded annually, according to the World Health Organization.

The pandemic has now killed more than 590,000 people in almost seven months, edging towards the upper range of yearly influenza deaths reported worldwide. The first death was reported on Jan. 10 in Wuhan, China before infections and fatalities then surged in Europe and later in the United States.

The Reuters tally, which is based on government reports, shows the disease is accelerating the fastest in the Americas, which account for more than half the world’s infections and half its deaths.
In Brazil, more than 2 million people have tested positive including President Jair Bolsonaro, and more than 76,000 people have died.

India, the only other country with more than 1 millioncases, has been grappling with an average of almost 30,000 new infections each day for the last week.

Those countries were the main drivers behind the World Health Organization on Friday reporting a record one-day increase in global coronavirus cases of 237,743.

In countries with limited testing capacity, case numbers reflect only a proportion of total infections. Experts say official data likely under-represents both infections and deaths.