COVID-19 and world health: Interview with virologist Christian Drosten and World Health Summit President Detlev Ganten

Detlev Ganten (right) and Christian Drosten (left)/ Copyright Photo: World Health Summit/S.Kugler

Prof. Drosten, Prof. Ganten, what was the biggest surprise for you regarding COVID-19?

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Christian Drosten:
I never expected that this virus would be so easily transmitted. It was clear to me very quickly that this is a SARS virus, namely the species, the same type of virus that I have known for 17 years. But I never thought that this one would behave so completely differently. This is due to a tiny detail in the surface protein of the virus, by the way.

Detlev Ganten:
For me, the biggest surprise was right at the beginning, when the virus was still far away. Suddenly, the rapid spread of the virus began – these were not individual cases but clusters. I would never have thought that the virus spread so quickly and that the systems were so overwhelmed with all the catastrophic consequences. After all, we had seen severe waves of influenza, but they were all controllable.

What is the most important thing in the fight against COVID 19?

Detlev Ganten:
Very clearly: transparency, cooperation, communication and: education! It is crucial that the population is well and clearly informed so that precautionary measures are understood and followed, and no myths are spread. „Education is the best vaccination“ – education is the best vaccination. An educated society is better able to deal with such things, even with false reports. The fact that the educational infrastructure in Germany is so poorly modern is, in my opinion, a huge disaster. Even worse than the fact that health authorities have been neglected in the past.

Christian Drosten:
Things have to change in science, too: In Germany, for example, medical research is very cancer oriented. And infectious diseases are extremely important in medicine, and we are noticing that not only now. We need much more research in this area. Antibiotic resistance is the next big issue. This also affects us in high-performance medicine. We can see how it takes its revenge if we neglect fields of activity that apparently do not concern us. But only apparently.

How can we get COVID-19 under control in the countries of the global South?

Christian Drosten:
From our Western perspective, one would say that we need a vaccination. But that is not so easy when you think of the global South. The clock is ticking. The spread in such countries is not slow. And we have no idea how many people are infected there.
However, it seems that there are relatively few deaths in African countries. There may be obvious reasons for that. One is the age profile: the population is simply younger. And for another, the immune system is used to many infections. Worm infections, for example, are universally spread there. They affect the immune system. Although we do not know the exact effect on this particular COVID-19 viral disease, it could be an explanation.

Germany currently holds the EU Presidency – what role can Germany and Europe play in the global fight against the pandemic?

Detlev Ganten:
In the current situation, in an increasingly bipolar world with the US and China blocks, Europe has a crucial role to play. The most important is international, multilateral cooperation, especially with countries that have not always been cooperative in the past.

So, what is the key to improving global health care?

Detlev Ganten:
Viruses and other health threats to people know no national borders. Therefore: international structures must be strengthened. We can only act together – with courage, good ideas and across all borders. That also applies to science.

How can we ensure that everyone in the world has access to a vaccine?

Christian Drosten:
You have to use existing structures: There are international organisations and programmes that are experienced in providing services to countries of the global South.

Detlev Ganten:
And the WHO must be strengthened. Europe and Germany are doing this in an exemplary manner. And there is another thing I consider important: international, moral pressure from science. The academies of science, which advise their respective governments and are heard in public, are particularly good at this. If individual countries do not join in, they will not be able to resist the public pressure in the end.

Do you think that science will be listened to more in the future?

Christian Drosten:
The credibility of science is currently high, but that can change quickly. At the moment, nobody knows exactly how the epidemic will continue. There is a possibility that, despite scientific explanation, the whole thing is no longer so easy to control and that science has simply been too slow with the availability of vaccines, for example. We will only know in the end how science has fared. After all, this pandemic is not a scientific phenomenon, it is a natural disaster.

Detlev Ganten:
Science is asked if it is credible. It must therefore take a holistic view of the whole event, i.e. the big picture, and also take an interdisciplinary view: that means not only the virological aspects, but also the economic, social and political aspects of a pandemic, for example. No one can predict with precision what will happen. Science must take a critical and self-critical approach to problems. And then communicate it in the same way. Christian Drosten is exemplary in this.

What is the most important lesson we can learn for the future?

Christian Drosten:
The pandemic will only really start now. For us too. We can only speak of lessons from the first wave in Europe. There are huge differences there alone. But what can be said in any case is that it is relatively important to provide the population with good and comprehensive information. It can do great harm if politicians use the dynamics of a pandemic for political messages. That is very difficult – the virus immediately serves the bill. You can see what it does in the USA. In Germany, too, we can see the consequences.

Detlev Ganten:
The message for me is very clear: health is the most important thing for the individual and it is the basis for a functioning society. The economy, culture and all that just does not work anymore if what we consider guaranteed is no longer there. I am not sure whether this is really so clear to everyone.

Christian Drosten:
I don’t think so.

If you had free wishes – what would they be?

Christian Drosten:
We have to change things to control the situation in the coming months. We need pragmatic decisions. There are already celebratory speeches being made about German success, but it is not quite clear where it came from. That success came simply because we reacted about four weeks earlier than other countries. We reacted with exactly the same means as others. We did nothing particularly well. We just did it earlier. That is why we were successful. We were not successful because our health authorities were better than the French, or because our hospitals are better equipped than the Italian ones. If you carry this over into the autumn, you must of course realise that we continue to do nothing better than others.

What does that mean?


Christian Drosten:

In Argentina, for example, the spread is very difficult to control despite measures – it is winter there. In Germany, we should take a much more differentiated and precise look abroad. We must stop talking about things like football stadiums. That really is completely misleading.

Detlev Ganten:
Of course, I would like to see an effective therapy and a vaccine.
But I also think it is very important that it finally becomes really clear how vital international and multilateral cooperation is. And I repeat: education, education, education. An educated society understands necessary measures, behaves rationally and does not run into the arms of rat catchers.

When can we say we have done it and shake hands again?

Christian Drosten:
What does „one has done it“ mean? Probably when the spread has broken through following an epidemic pattern. That is, when there is no longer a free wave of infection running through the population, but only localised outbreaks that can be controlled. This situation will be reached in different countries at different times. In countries of the global south, this could be the case earlier because the age structure is different. In our case, of course, it depends on when there are enough vaccines for the risk groups.

 So, priority to risk groups?

Christian Drosten:
Yes, then we do not need 50 million vaccine doses in Germany. Apart from the expected competition for distribution, it is not so easy to bottle up that many vaccine doses and then vaccinate them. Even if the vaccine is there. Even if one or two approved vaccines are available in January, the whole thing has to be bottled and vaccinated.

Detlev Ganten:
A vaccine and an effective therapy would indeed be a huge step forward. But one thing must not be forgotten: the other diseases are still there, the many preventable deaths, for example in cardiovascular diseases or infectious diseases, which cannot be controlled if antibiotics are no longer effective. I hope that the lesson to be learned from this Covid-19 pandemic is that we will be better prepared for challenges of this kind in the future. Prevention may cost money – but not being prepared can have dramatic consequences.

Source: World Health Summit

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