"As was the case with all previous coronaviruses, Covid-19 will eventually become a childhood infectious disease that people will recover from, like the common cold. Until we reach a point when SARS-CoV-2 behaves in this way, the pandemic won't end. When this will happen, I cannot say – I'm no soothsayer," Professor Vladimir Petrović, epidemiologist, Director of the Vojvodina Public Health Institute, and member of the Task Force, said in his interview with Kurir.

Is there an end to the fourth wave at least? It's been going on for too long.

"We've been having large numbers of new infections for six or seven weeks now, which is considerably longer than in previous waves. This is because we went into this wave early on, in September."

While the weather was nice, and we were outdoors?

"Yes, and now we're entering an unfavourable period, being in closed spaces, when people are typically closer to one another, and the likelihood of virus transmission is higher. We expect to continue to have higher numbers of infections and to have to deal with this virus throughout winter."

The fourth wave until the very end of winter?

"I wouldn't want to make predictions, but we will certainly have people falling ill throughout winter. How high the wave is will depend solely on the vaccination rates, enforcing general measures, and controlling compliance with them"

Will the fourth wave be enough for us to reach herd immunity then?

"No one will hide from the virus. Either the virus or the vaccine – that's the choice we have when an epidemic is so widespread in the population. Sooner or later, the unvaccinated will come into contact with the virus. I wish for them to reach immunity without any symptoms, but the majority won't – the disease will be clinically manifest, and there will be more patients with severe forms of the disease and more deaths. The vaccinated mostly get mild forms of the disease and are far less likely to get severe symptoms than the unvaccinated."

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Zorana Jevtić 

Will we be taking the fourth dose as well in four to five months?

"If new variants keep appearing, we can expect seasonal vaccination. Each new variant that reduces the effectiveness of the vaccines means that the manufacturers will need a new 'prescription', i.e. the new strain or the RNA, based on which a corresponding vaccine will be made, as is the case with the flu. We will take as many vaccines as needed to stay protected. But the third dose, taken after 16 weeks, is enough to protect us from the Delta strain. If Lambda or yet another strain appears, then we will have to see. Getting the jab every four months certainly won't harm us. To the best of my knowledge, after administering three and a half billion doses, no deaths caused by the vaccine have been recorded. That says something."

ONLY ONE OUT OF NINE ILL CHILDREN HAD COVID

Is the common cold around at all, or is it just the coronavirus?

"When school starts in September, there is always an epidemic of acute respiratory infections in children. This year was no exception. In September and October, out of every nine children that saw their GPs in Novi Sad – and we tested all of them – only one had Covid, and eight had something else – either the respiratory syncytial virus, or the common cold rhinoviruses and adenoviruses, which were going around. Of the bacteria, Streptococcus pneumoniae was recorded, as well as some rare viruses like metapneumovirus. For two of the children, other causes were at play, but we were unable to establish what they were. They were evidently mild in effect, however, with the clinical presentations of the common cold. We also had beta-haemolytic streptococcus, i.e. pharyngitis.

Other than testing, is there a way to distinguish between a cold and Covid?

"There isn't, unfortunately. All these acute respiratory infections have very similar symptoms, only the flu comes on suddenly, resulting in severe weakness and a high fever. With Covid, a cough appears first, alongside other symptoms, and the fever appears later. Unfortunately, though, this is characteristic of other viruses and bacteria too, so it's next to impossible to distinguish between them without lab diagnostics."

How do we increase the vaccination rates? Covid passes aren't stringent at all at the moment.

"As a solution that protects the society at large, Covid passes ought to be enforced 24/7. I'm not in favour of closing venues and facilities, as it would be very difficult to do that here, and because of other negative effects, e.g. people gathering at places we cannot control. Covid passes should ensure safe use of all services and going back to normal life, while minimizing risk and indirectly bringing the situation under control, in terms of infection rates. The key effect of Covid passes should be ramping up vaccination rates, because it's easier for everyone to take the jab than to get tested all the time."

Nothing else besides Covid passes?

"Our government has secured everything in a timely fashion – different vaccines, choosing the vaccine that you wish to take, not to mention that vaccination is paid for. It has provided protective gear and medical equipment. I do not know what else the government must do. Most people have had someone in their family who's died of or with Covid. Isn't that reason enough for everyone to get vaccinated? I don't think there's a better motivation than that."

You are not in favour of schools going online?

"Schools shouldn't be closed if hospitality venues are open. Closing schools is the easy thing to do, but then the question is – what do we do with the children? Where would they go? They'd go to shopping malls and gather in large masses in hospitality venues, where there's a greater risk of infection. On the other hand, we have a higher rate of infection in children than in the previous waves, due to the Delta strain, which is more transmissible. The percentage of those over 60 who have taken the vaccine is high, and the percentage of vaccinated adults is on the uptick, so the virus is shifting towards more vulnerable populations, where it can survive. That's children now. Currently, of 500 new infections, one ends up in a ventilator bed, while in children the ratio is 1 to 1,000. Therefore, the risk of a severe form of the disease in children is still lower, and they are far more likely to have mild clinical presentations. We assume that children are more likely to have an asymptomatic form of the disease – they get infected, develop immunity, and don't become ill."

THE MINISTER CAN DECLARE MANDATORY VACCINATION

Why isn’t there mandatory vaccination?

"Mandatory vaccination comes under the jurisdiction of the minister of health, who has a remit over declaring it under Article 33 of the Law on Protecting the Population from Infectious Diseases. The government has opted for recommended vaccination. I'm in favour of mandatory vaccination of health workers, teachers, the armed forces, the police, and the state administration. This should ensure the functioning of the society, particularly those who are at a greater risk."

But there are children in ventilator beds, they die, and can get vaccinated if they are over 12. The US has just approved the Pfizer vaccine for children over five.

"For the time being, that's the only vaccine that's been approved for children. I'd like to see others get approved as well, especially the Chinese vaccine, as it is inactivated, using the technology made for children."

What does that mean?

"The inactivated polio vaccine, for example, was made using this technology and is found in current pentavalent and hexavalent vaccines, which are given to infants. It's a safe and tested technology. Extensive pharmacovigilance, i.e. monitoring of side effects, is necessary for the other technologies. However, as we have seen, the United Kingdom and the US have found that the benefits far outweigh the risks of any reaction to the Pfizer vaccine."

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Zorana Jevtić 

The Chinese have announced that their vaccine is safe for children over three.

"They have indeed, but I've been unable to find that study, so until it appears in a serious world-class science journal, I cannot agree to it being used routinely. But I don’t matter, the Medicines and Medical Devices Agency, which needs to approve it, does."

Now we have more deaths of pregnant women and women who have given birth.

"That means that the virus is looking for a population in which it can spread unhindered. The Alpha and Beta strains didn't have such a potential for causing death or very severe clinical presentations in pregnant women. The Delta strain obviously does. Pregnant women dying is the worst possible situation as we lose two lives there. On the other hand, in and of themselves, pregnant women have a naturally better immunity than women who aren't expecting, as nature has made sure that they protect both the foetus and themselves. When a virus can get through that immune barrier, it means it's very aggressive. Vaccinating pregnant women is a priority."

(Kurir.rs/Jelena S. Spasić)

ADULTS INFECT MORE THAN CHILDREN

Who infects whom more – adults children or the other way around?

"Adults infect children much more frequently and to a greater extent than children infect other children and adults. It's a fact that's been confirmed in many countries. It's not impossible for a child to infect an adult, but it's much rarer than the other way around."

Why is that?

"Adults generate larger amounts of the virus, cough more deeply, and get more of the virus further afield. It's the opposite with the flu, where children drive the epidemics and infect adults more often."

Will there be flu this year?

"I sincerely hope not. The Southern Hemisphere has seen practically no flu season, and in Europe, only two countries have recorded flu cases – Croatia and Kyrgyzstan."

But Croatia is around the corner.

"It's not impossible that the flu appears here as well."