INTERVIEW | 'COVID-19 is the Disease X we experts worried about'

Dr Rajeev Fernando, a top infectious diseases specialist in the US, says a vaccine is a must to stop COVID-19 now, but warns it might not be very successful in the coming seasons
Dr Rajeev Fernando, infectious diseases specialist at the Stony Brook Southampton Hospital in New York.
Dr Rajeev Fernando, infectious diseases specialist at the Stony Brook Southampton Hospital in New York.
  • This is Disease X that infectious diseases experts always worried about. We expect to see something like this once every century. Humanity is being hammered. It is not about patients alone, it is about economies...
  • One thing to understand is the sensitivity of the testing, even in the US, is poor. The tests till recently only had a 65 per cent accuracy rate.
  • At this stage, it is very important to understand the concept of life versus livelihood. What we need to do to keep life going is sacrifice our livelihood.
  • It is important to understand that this is going to be our life for a few months — at least for two-three months.

All these observations about the pandemic ravaging the globe are made by Dr Rajeev Fernando, infectious diseases specialist at Stony Brook Southampton Hospital in New York.

A Chennai boy at the epicentre of the COVID- 19 battle in New York, he said the world was “clearly unprepared for this kind of pandemic”.

In an interview with The New Indian Express, Dr Fernando stressed that a vaccine is a must now to stop the “aggressive spread of this disease”, but warned vaccines could have a flawed success rate in the coming seasons.

The doctor, who did his MBBS at the Rajah Muthiah Medical College, explained this by saying the current strains are all essentially similar with really tiny changes — “point mutations”, as doctors call it. 

“At the moment, the mode of transmission is perfect. It affects a group of people and they pass it on to many more. So, the virus has little reason to mutate. It is when the coronavirus is not effectively transmitting to human beings that it could say, ‘Wait a minute, we are not being as successful as we were, let us do a big mutation’. This could lead to its molecular structure changing and that could have consequences”.

He drew upon the example of the flu vaccine to build his point.

“Ask yourself why the flu vaccine is given every year. That’s because the virus mutates. And the success rate of the flu vaccine is pretty lousy — 30-40%,” he said, adding that it is certainly possible the novel coronavirus vaccine too could end up mirroring this trend later.

But he went on to stress that “at this point, there is no mutation and in order to halt this crisis, the vaccine is a must”.

Dr Fernando said he expected a vaccine to be out by the end of the year.

He also threw a note of caution for the young, observing that those between 18-50 years accounted for 50% of the hospitalisation. With many cases being asymptomatic and 80- 85% just developing a minor cough, it was imperative for the young, even if they had a minor symptom, to stay at home and not pass on the disease to the elderly, whom it could kill.

Asked about India, he said while he has not had the time to follow developments in the country keenly, his initial thoughts were that though there has been “under-reporting”, the weather seems to be obstructing the transmission of the virus.

“Early studies (not universally acknowledged by experts) say the virus transmits best in the 37 degrees Fahrenheit (2.78 degree Celsius) to 62 degrees Fahrenheit (16.7 degree Celsius) range. It doesn’t like heat at all. We feel if we put something with the virus in the microwave, it will probably die in the heat,” Dr Fernando observed.

Then came the caveat.

India remains high-risk. If the virus gets into the villages and to packed cities like Mumbai and social distancing is not enforced, it could wreak havoc.

“Social distancing is tough, but these are outrageous times and they call for outrageous measures. There is no other way out,” he emphasised. “Unless someone is an essential worker, they should be staying at home. I want India to be cautious.”

Dr Fernando ended on a note of optimism. “My message to people is that we will overcome this. This is not going to go on for years. Science will  come through.”

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The New Indian Express