"Omicron is the so-called zombie variant of the virus, and I really couldn't predict it. Unlike all the other coronavirus strains, it seems to have been simmering for a year in a single person in South Africa, whose immune system was compromised by immunosuppression due to, e.g. cancer or AIDS. In that person, the virus had the opportunity to improve, and this is why it has so many mutations. Omicron is a precedent, such a case has previously been unknown – a virus strain that is so easily transmitted that it has infected so many people," Professor Janko Nikolić Žugić, immunologist and gerontologist of the University of Arizona's College of Medicine, the 2021 Arizona Bioscience Researcher of the Year, and born in Belgrade, said in his interview with Kurir.

Omicron developed in one person, who then infected the entire planet?

"That person had received some therapy against the coronavirus and, if they'd had a healthy immune system, it would have successfully removed the virus. However, since they did not, the virus was simmering there. The sequences resembling Omicron hadn't existed at all a little over a year before it appeared – it was as if it had come out of nowhere, out of the blue. So this is why the only possible scenario is that it was slowly improving, most likely in a single person. There's even the possibility that the subvariants BA.1 and BA.2 developed in that very person – two strains mutated independent of each other in the same human being."

What can we expect from the coronavirus in the fall?

"It's very hard to say how the virus will behave and whether it will be a danger to the population or something more similar to the flu – getting worse one season, requiring an additional vaccine to refresh our immune systems."

We virtually have not had the flu for two years because the coronavirus has been stronger. Now that the coronavirus is weaker, will the flu get stronger, or will the world be overwhelmed by the dangerous flurona – the combination of the flu and corona?

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"The predictions say that we will have a stronger flu season, and I hope that those predictions regarding the nasty interaction of the two viruses won't come true. Those who haven't taken either the coronavirus vaccine or the flu vaccine are gambling with their lives. And I mean everyone, not just the vulnerable groups. The flu itself is capable of making everyone unwell, even a strong and vital person. If this person isn't vaccinated against the coronavirus, with Omicron sufficiently potent to put life at jeopardy, an unacceptable risk arises."

But people don't trust the vaccines at all anymore – only 1.5 percent of the population took the fourth dose.

"The human mind doesn't want to be concerned with viruses anymore, but when we gamble and play with viruses, that can only be to our detriment. By ignoring viruses, we certainly won't get sick less or die less."

SCIENCE WORK WORTH USD 100 MILLION

You have published over 200 academic papers and handled over 100 million US dollars' worth of grants in your scientific work. What is it like to be handling over 100 million dollars?

"The long-Covid project that I am running now will end up being worth about 29 million. However, this includes 40 researchers in Arizona and an additional army of people. It felt nice to receive my first bigger grant – about 10 million for a period of five years, i.e. app. two million a year – so my children, when they heard, jumped with joy around the house because we 'were rich.' They didn't understand that us, i.e. I only get a smaller part of my salary from that money. The reward there really lies in the fact that you have the funds to engage in good team science at a high level."

The latest bivalent vaccines, containing the original, Wuhan strain, as well as Omicron, which is now prevalent across the world, are being approved globally. Are you against the Wuhan strain in this vaccine?

"If someone has taken three doses of 'Wuhan' (at zero, one, and six months), only that person is considered fully vaccinated, as is the case with many vaccines administered in the childhood. It's only then that you can talk about a booster vaccine. But if a dose contains 'Wuhan', which stopped circulating back in the fall of 2020, there's a chance that the immune system gets overly stimulated in the wrong direction. When a vaccine is administered, we have an army of white blood cells which kill the virus in the infected cell, and lymphocytes which produce antibodies. They divide up each time, the first time to a great extent, so a single cell produces 100,000 cells identical to itself. So, an army is created from a fairly small band of soldiers defending you, which is highly attuned to that strain, i.e. the microorganism that you included in your vaccine. With every new dose, you stimulate it to divide up and bump up its numbers. And now this army is required to recognize Omicron. If the Omicron vaccine also has 'Wuhan' in it, we're overcrowding the penalty area and weakening our attack against Omicron. For those unvaccinated, it's ideal to take what is actually the trivalent vaccine (it contains 'Wuhan', BA.4, and BA.5). For the vaccinated, it would be better to only have BA.4+BA.5, but it's still much better to take the bivalent one ('Wuhan' + Omicron) than be without protection against Omicron."

So what should the vulnerable groups in Serbia do – take the fourth 'Wuhan' dose or wait for the new vaccine?

"Whoever is in the high-risk group ought to take the fourth dose, because it does provide protection. And if an Omicron vaccine appears in the next three months, they should take that too."

When we spoke in early 2021, you said that you would be surprised if the coronavirus immunity didn't last for decades, absent some mutations. There are mutations, but the immunity lasts only three months.

"It isn't immunity that lasts three months, but the protection against Delta and Omicron – which have changed too much compared to 'Wuhan' – after taking the 'Wuhan' vaccine. If we'd had a vaccine against Delta, Omicron wouldn't have spread to such an extent at all. We've kept this basic vaccine against the Wuhan strain for too long. What is also important is the location of infection. When, for example, you have the flu that causes pneumonia, the virus doesn't replicate in the mouth or the nose, but in the lungs, so the vaccines administered intermuscularly (like the Covid vaccine) provide very good protection. At any rate, the 'Wuhan' vaccines still provide good protection of the lungs against a severe form of illness and death caused with the Omicron strain too. However, in order to able to protect someone from any infection, you have to have antibodies in high titer in the oral cavity and the mucous membrane, and with the coronavirus, you have them app. three months after the vaccine because it is not mucous."

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You are talking about the nasal spray vaccine?

"Yes, it is being developed in both China and the US, and it will have good results."

The hybrid immunity (three vaccine doses – with the RNA ones being the best – and an Omicron infection) is the best protection. You have this immunity and claim that now you are protected for as long as three or perhaps four years. How could it be so long?

"I've sequenced my genome, so I know that I've had BA.12, which is in the antigen group with BA.4 and BA.5 Omicron subvariants, which have perfected avoiding immunity to the highest degree. Also, compared to the summer of 2020, most people have some serious level of immunity (they have either had the disease, or taken a few vaccine doses, or both), so, from an immunological standpoint, we're no longer a naïve population. This is why, in a technical sense, this is the end of the pandemic. But the virus hasn't disappeared."

So when will the pandemic be officially declared over?

"I don't know when the WHO will declare its end, but we're no longer in the pandemic phase, but in the phase of living with corona."

VACCINE REDUCES SYMPTOMS IN 60 PERCENT OF CASES

What we have ahead of us now is the fight against long Covid. Are the vaccinated affected less by it?

"The studies looking into human subjects with long Covid who were then administered a Covid vaccine reveal that the vaccine managed to reduce the symptoms of long Covid in 60 percent of the cases, with 20 percent without any effect, and causing worse effects in the remaining 20 percent. As regards the 20 percent with worsened effects post-vaccination, we think that the vaccine, which contains very powerful activators of natural immunity – the modified virus RNA – stimulated autoimmunity. In people with an already existing predisposition to autoimmunity, it only exacerbates it. This suggests that app. 20 percent of long Covid is probably based on autoimmunity, especially in women, because they are more likely to have an autoimmune illness than men. There are other mechanisms of long Covid as well, one of them being that virus fragments remain in the body, so the organism thinks it is under attack again. This then leads to the hyperactivation of the immune system, which damages certain tissues and organs."

Kurir.rs/Jelena S. Spasić