Prof Francois Balloux is Director of the University College London Genetics Institute. His work focuses on rebuilding disease outbreaks and epidemics. With her colleague, Dr. Lucy van Dorp, she led the first large-scale sequencing project of the Sars-CoV2 genome. During the pandemic, he has become a prominent scientist on Twitter, where describes himself as a “militant centrist crown.”
Would you say that a new variant of concern remains the main threat to our exit from this pandemic?
We haven’t had one in a while. The four variants of concern they all emerged in the second half of 2020, and it’s important to note that viruses evolve all the time at a fairly regular rate.
However, with Alpha something unexpected happened: there was a sudden accumulation of mutations. A reasonable hypothesis is that Alpha arose from an infection from an immunosuppressed person or someone who was infected for a very long period. The other three variants of interest (Beta, Gamma, Delta) arose through the gradual accumulation of mutations.
So it’s not always predictable?
It is extraordinarily difficult to predict an impact like that of the Alpha variant. What is easy to predict is that mutations will continue to appear and the virus will progressively drift, and vaccines will be less effective over time.
There was a suggestion in a wise paper that a very lethal variant could emerge, while other scientists suggest that the virus has reached its “maximum setting”, that if it continues to evolve it will lose the ability to coexist with its human hosts.
It is important to balance the fear of predictions with their probability. The likelihood of a 50 times more deadly lineage emerging is remarkably unlikely. I say that because we have 200 respiratory viruses circulating and most of us get infected regularly. We have never seen that kind of sudden change in mortality. I’m not saying it’s impossible, but you may have a better chance of winning the lottery jackpot many times over.
Where do the alpha and delta variants appear on your jackpot winning measure?
That is such a difficult question. It is comparable to asking what the chances are that someone will win the jackpot, without having any idea how many numbers are on the lottery ticket.
The Alpha and Delta variants emerged, and they were obviously winning combinations of mutations for the virus, although we also know that no other comparably transmissible viral lineage has emerged so far, despite millions of infections and a constant influx of mutations.
Another concern is a mutation that allows the virus to “escape” from vaccines …
More than two million viral samples have been sequenced and we have probably already seen all the mutations that are technically possible. From our observations, we know that the vaccine leak will not appear after one or two mutations; it will require an accumulation that results in the correct combination. We will not go from one day everyone is protected to everyone being vulnerable the next day. We will have time to update the vaccines.
Also, while an escape variant of the vaccine could infect vaccinated people much more easily, it would not negate the protection against severe disease and death provided by the vaccine and previous infection.
What do you think about vaccinating adolescents?
This is the mother of all questions. There are very passionate people on both sides. Given the available data, and not many teens have been immunized, I think the JCVI You have probably been right to err on the side of caution in recommending the vaccine first for healthy people over 18 years of age and, as more data becomes available, for healthy people over 16 years old. There is a problem with Inflammation of the heart in younger men who received mRNA vaccines.. One possible solution might be to give teens just one dose; most of the side effects have been recorded after the second dose. However, a single dose regimen has not yet been tested or approved.
You said a “non-trivial” long Covid number the cases are psychosomatic.
We know that infections like Covid lead to post-viral syndromes. At the risk of being numb, I would be surprised if there was no link between severity of illness and severity of follow-up symptoms. Like tuberculosis or influenza, people who have a severe case must wait a long time to fully recover. And sometimes the recovery is never complete.
The situation is more complicated with a mild infection. Post-viral symptoms can occur, but I find it relatively unlikely that this happens very often. In all likelihood, some cases are psychosomatic, although this does not make the suffering any less real for those affected or reduce the cost to society. All disease is real, regardless of its root cause.
There is a mental component to health and illness. Just the fear of something bad happening to us can make us feel bad. A striking example of this process can be seen in the way that more than 30% of the people who were enrolled in the control group of the Pfizer vaccine trial reported headaches and fatigue, despite not having been injected with a vaccine.
You had a bad fight with Covid, does this inform your opinion?
I try to dismiss my own experience when thinking about public health issues. That being said, they would probably include me as a long Covid because six months later I have not fully recovered my sense of smell or taste. I think we need a meaningful definition that captures whether you have regained your full physical form. I’d like to emphasize: if you have a severe infection, don’t necessarily expect to be fully fit again in three months.
Your Twitter bio says you are a “militant centrist crown ”. WhWhat do you mean with that?
From the beginning, the pandemic has been polarized. Some people thought we should “let it rip” or “take it on the chin” and others thought we should fight to remove it everywhere. These fields have been fighting for 16 months and it is quite toxic. They are both quite extreme and unrealistic. I always thought that very careful mitigation could keep the pandemic under control until the vaccines arrived. Some countries have come close, like Singapore, Norway and Denmark.
The scientist is supposed to review his conclusions as the evidence evolves. Do you think scientists on both sides of the Has the debate clung to your views despite the evidence?
It’s selfish to say “they don’t change their mind, I do”, even though I didn’t. Our brains work in a Bayesian way: we have antecedents that influence how we consider new information. As a scientist, it is very important not to have an overwhelmingly strong background; You must be open to surprises and let your background update with new information. It is important to commit to new evidence. Being dogmatic is problematic.
This problem is amplified when, as now, scientists are speaking directly to the public …
Before the pandemic, scientists were rarely asked a question, or listened to in a polite and somewhat boring way. But now people are holding on to the words of scientists, which can make it harder for them to change their minds. Few scientists have changed their views on Covid, but when they do, it is often not well received: There is an element of groupthink and, for the most media-savvy scientists, an expectation from the adoring crowd is that they are not meant to do that.
Neil Ferguson has been criticized for his predictions of 100,000 cases one day following the easing of restrictions on July 19.
I know Neil, he was my boss for five years. His predictions were pretty pessimistic, but he tends to be pessimistic, which is not a criticism. If you are in a position of authority giving advice to the government, you really want to err on the side of caution.
Can you explain what you mean by “scientific populism”?
As the pandemic has progressed, the public mood has grown darker and more fearful and this has created a market for sadness and doom. It’s just as bad as the effects of super optimism at first – stay home for two weeks, it’s mild illness, or wear a mask and it will go away. So I captured the market for coronacentrism, not to be systematically optimistic or pessimistic and to make it clear that there are huge uncertainties. And this is empowering, because understanding things is.
He has often said that the pandemic will end in mid until the end of 2021. Do you accept this?
It depends on how you quantify it. I would say that the pandemic is over when Covid-19 does not cause significantly higher mortality than other circulating respiratory viruses. This will happen first in places like the UK that have had the privilege of getting vaccine coverage; hopefully no later than early next year.
George is Digismak’s reported cum editor with 13 years of experience in Journalism