Wednesday, August 4

Salim Abdool Karim: ‘None of us are safe from Covid if one of us is not. We have a mutual interdependence ‘| Coronavirus

The epidemiologist Salim Abdool Karim could be considered Anthony Fauci from South Africa. As co-chair of the South African Ministerial Advisory Committee on Covid-19, he is the government’s top adviser on the pandemic and has become the face of the country of science Covid-19. He is also part of the Africa Task Force for the New Coronavirus, overseeing the continent’s response to the global crisis.

Karim, who runs the Durban-based company Center for AIDS Research Program in South Africa and a professor at Columbia University’s Mailman School of Public Health, he has long advocated for science and for speaking truth to power. For three decades, together with his wife and scientific collaborator, Quarraisha Abdool Karim, he has been at the forefront of the fight against the major HIV and tuberculosis epidemics in South Africa and, in the early 2000s, he was one of the scientists who spoke out against the government’s AIDS. denialism.

Karim and Fauci, America’s leading infectious disease expert, recently jointly received the award John Maddox Award 2020 for “defending science during the coronavirus pandemic.” The award is given by the UK charity. Sense of science and the diary Nature.

South African President Cyril Ramaphosa, recently announced new blocking measures after the coup of the country 1 million coronavirus cases, the first African nation to reach that total, and a new variant, 501.V2, emerging there it was found to be spreading rapidly. How worried are you?
I am deeply concerned that this is now the dominant variant in South Africa and is driving our second wave. We have gone from a situation where we had a fairly stable virus to one suddenly with almost 20 mutations, three of which are the most important part: the receptor-binding domain that attaches itself to the human cell. And while we haven’t found it to be more or less severe than the previous strain, it appears that it can infect people more easily. We don’t know how it came about it is quite different from the UK variant, although they share a mutation [the N501Y mutation in the receptor binding domain] – and we need studies to tell us. But right now, our priority is to turn the second wave.

There are concerns that the vaccines currently being implemented might not work against the newly identified South African variant. How effective should we expect our vaccines to be against new strains?
By vaccinating, you put pressure on the virus to mutate. Strains not susceptible to vaccines come to dominate. So we will have to change vaccines and we will have to figure out how. It’s not going to be a case of, “Oh, we will vaccinate our population and then we will all be fine and we can go back to the way we were before.” We are going to have to maintain surveillance and we are going to have to revaccinate.

Africa as a whole has seen comparatively lower Covid-19 death rates than Europe or the US Why?
The number of cases and the number of deaths are not reported in most of Africa. But I’m sure, based on the fact that we didn’t find as many admissions for acute respiratory distress, that we’ve still had a much less severe impact since our first wave than most of the rest of the world. We are probably second only to Southeast Asia, where the impact has been even less.

We do not fully understand the reasons. Our young population plays an important role, and the early closures contributed a lot. The hypothesis that there is some pre-existing immunity [from other circulating coronaviruses] – My opinion is that the evidence is weak. They are present all over the world. I don’t think there is something special that we have in Africa that protects us.

The John Maddox Award recognizes the “exceptional communication” that you and Dr. Fauci have made of the science behind Covid-19 to legislators and the public. What has been more complicated?
There is a high degree of uncertainty. You should provide guidance, but in a way that takes into account what we don’t know. Next, you must face people who are guided by ideology but who use science to reinforce their ideological position. They interpret science in a completely different way. So you have to tackle fake news and conspiracy theories. I’ve spent a lot of time debunking hydroxychloroquine and ivermectin, for example. For me, it is a moral obligation.

Has the South African government listened well to scientists about Covid-19?
Yes. Unlike HIV, where the government took an antiscientific position, the first thing it did was bring scientists together. Then in the nine months or so [since March 2020] I’ve been giving scientific advice on Covid-19, the vast majority has been taken. In fact, I think it is important that the government not only takes all of our advice: they are the decision makers and must also take into account economic and social advice.

Dr. Anthony Fauci with Salim Abdool Karim at the 21st International AIDS Conference in Durban, July 2016.
Dr. Anthony Fauci with Salim Abdool Karim at the 21st International AIDS Conference in Durban, July 2016. Photograph: Rajesh Jantilal / AFP / Getty Images

South Africa is scheduled to receive some doses of the vaccine through Covax, the global procurement initiative to distribute Covid-19 vaccines fairly around the world, in the second quarter of 2021. I guess it can’t come soon…
We have chosen to follow the Covax route and through it we will obtain doses for the first 10% of our population. That will cover our healthcare workers and the elderly. On the other hand, we have an open line of communication with various pharmaceutical companies that make vaccines, and we will follow up with them when their results are available and when we have assessed whether they meet our criteria. Unlike other countries (US, UK, Canada) we have not made any commitments in advance. We don’t have the money to buy 10 million doses and then not use it if it’s inappropriate.

Are you concerned that low- and middle-income countries are not getting enough vaccines?
Vaccine nationalism is cause for concern. There are countries, like the United States, that believe they will be safe while the rest of the world will not. It is a fundamental fallacy. None of us are safe if one of us is not. We have a mutual interdependence. We need the whole world to be a part of Covax – all pharmaceutical companies should have committed all their doses of vaccine to Covax, which could then provide the vaccine fairly so that all healthcare workers can get vaccinated. It would be terrible if the United States vaccinated low-risk youth while we in Africa cannot vaccinate healthcare workers.

President-elect Joe Biden has appointed a task force of experts: the Covid-19 Transition Advisory Board – to advise you on the pandemic. What would you most like to see changed in the US approach? takes office?
If you listen to your workgroup, you are on a roll! They are smart people. They know infectious diseases. Many of them have been at the forefront of the fight against HIV.

I would like the severity of the disease to be highlighted. The United States plays an influential role in the world. So when a US president talks about injecting people with bleach and nonsense, he trivializes the seriousness. Covid-19 is a serious debilitating disease. Even if you don’t die, you can suffer a lot from Covid.

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