Alexander Myasnikov, chief physician of the Moscow Zhadkevich City Clinical Hospital. Photo: Alexander Shcherbak / TASS
In the virtual studio of the radio station “Komsomolskaya Pravda” we talked with a famous doctor, TV presenter, head physician of the Moscow City Clinical Hospital named after M. Ye. Zhadkevich Alexander Myasnikov.
WHEN AND FOR WHAT ANTIBODY TESTS REALLY NEEDED
– Alexander Leonidovich, our people are now so actively passing tests for antibodies that in Moscow recently there were even interruptions in the supply of reagents in commercial medical laboratories. Do you really need to test for antibodies? If so, which ones and when?
– If you look at the European and American recommendations, then you do not need to take antibody tests to make a decision on vaccination. Such tests may be needed by doctors to determine the phase of the disease. Acute phase – IgM antibodies are present. If a person has IgG antibodies, the disease has already been in the past. If both are elevated, we understand that the patient is going to recover.
In our country, people often do tests for the purpose of diagnostics: have I been ill with covid? Previously, it was important to understand whether you have protection or not. Because up to 30% of people suffered from the disease on their feet, or even asymptomatic. But in the era of mass vaccination, there is no longer any logic to such testing. Even if you have antibodies, the vaccine provides additional protection against new mutations in the virus. If so, why spend money doing antibody tests and delaying the necessary vaccinations?
HOW OFTEN WE WILL GET INTO A
– In Russia, it is now starting, and in Moscow, the re-vaccination of those who were vaccinated more than six months ago, and the vaccination of those who have recovered are already in full swing. With the latter, everything is more or less clear. We know that WHO and many foreign medical associations recommend vaccinated patients after six months, or even faster. But to be re-vaccinated earlier than a year later, there are still no official recommendations abroad. Why do you think?
– The problem is that we are still walking along an unknown road, laying a ski track on virgin soil. Nobody has gone there yet. But we understand that the concentration of antibodies decreases over time, and memory immune cells also begin to lose their functions in about six months. Covid flows in waves. Reactivation of vaccination gives protection only after one and a half to two months. There will be another outbreak in October-November. To be ready for it, you need to revaccinate now.
In general, initially, when the question arose about the vaccine, many doctors said that at least once a year they would have to be vaccinated. I even wrote that there will probably be some kind of vaccine against coronavirus together with influenza in one syringe. During the time covid has arrived, we see outbreaks occur twice a year. It looks like this will continue. Three months outbreak, three months interval. Will it always be necessary to vaccinate every six months? No one knows. Probably, after all, once a year.
WHY WE HAVE SO MANY FALSE TESTS FOR COVID
– If a person has a PCR test positive for coronavirus, should it be rechecked?
– No, it’s not worth double-checking. Because a false positive PCR test is casuistry. But a negative one does not mean anything (that is, it is far from always a guarantee that a person does not have a coronavirus – Ed.). The PCR test is an extremely sensitive reaction. False negative happens, for example, when a cotton swab was poked somewhere near your ear, anointed, moved side by side and simply did not receive enough material. If you are somewhere abroad, there they thrust this thing right into your brain, at the right angle, at the right depth, this is very important. And it’s not that safe. There is a certain percentage of cases of severe bleeding after the test. And how we take it – there is nothing to be surprised that we have a lot of false negative tests. Often, poor-quality material fence, this is all too often.
COVID-19 vaccination station in Gostiny Dvor.
Photo: Ivan MAKEEV
VACCINATION OF CHILDREN AND PREGNANT WOMEN NEEDS A SPECIAL APPROACH
– Clinical studies of Sputnik in adolescents have begun in Moscow. What do you think: children will need to be vaccinated in the future?
– If we talk about vaccination of children and pregnant women, then I would have a different approach. I would vaccinate pregnant women with risk factors – those who, with covid disease, can die or get serious complications. If not, I would abstain. It’s my personal opinion.
– The Ministry of Health also decided so – in the recent recommendations it is said that it is the expectant mothers from risk groups that need to be vaccinated. What about the children?
– As for the vaccination of children, I would also think ten times what kind of children. If a child is sickly, weak, that is one thing. If a normal growing child, I would wait for the results of vaccine studies on children, this is happening not only in our country, but all over the world.
“COLLECTIVE IMMUNITY REMINDS ME A SNOW MAN”
– With the help of vaccination, we not only try to protect the vaccinated themselves, but also to protect others from infection. At the same time, it is known that in clinical trials, say, Sputnik, the effectiveness of the vaccine was tested precisely to prevent a severe form of the disease. And to what extent the vaccinated are protected from the asymptomatic form, but at the same time contagious to others, it seems to be unknown …
– Yes, this is a serious question. The words about herd immunity actually remind me of talking about Bigfoot. Everyone is talking about him, but no one has seen him. Personally, I don’t really believe in the achievement of herd immunity in covid. In the sense that herd immunity will interrupt the procession of the coronavirus across the planet. Will not interrupt. Covid will stay.
And Western companies, and Pfizer, and AstraZeneca, scientists unanimously say: we do not know if vaccination interrupts the transmission from an asymptomatic person to others. The Americans wrote about this six months ago. Europeans write about this. And we began to write. Still no one can say how effective vaccination is in this regard. Yes, it protects against serious illnesses, deaths – statistics show this. Also, vaccination reduces the viral load in the nasopharynx. But whether this interrupts the chain of infection from an asymptomatic person to others who are not vaccinated – we do not know.
Based on this, the CDC (the American analogue of Rospotrebnadzor) and the WHO say: vaccinated people must wear masks under certain conditions. It is protecting others from you.
Herd immunity is needed by the unvaccinated. If we achieve it, their risks will decrease. But since this is still a vague thing, let’s everyone take care of themselves personally. Let’s get personal immunity – get vaccinated.
TO THIS TOPIC
“Coronavirus is not a bug, it does not stick into the hands”
– When do you think we will be allowed not to wear gloves and will stop taking fines for their absence?
– Sorry for being straightforward, this is idiocy from the very beginning. No country in the world has a requirement for gloves. Okay, at first we didn’t know exactly how the covid was transmitted. But from the first day it was clear that the coronavirus is not a tick, not a bug, it does not stick into hands. And the glove itself is a source of infection. If you don’t take them off, everything sticks to them. Gloves become a colossal source of infection, worse than leather. Because the skin has a bactericidal effect of its own cells.
I’ve been talking about this for more than a year now. Why make people angry with nonsense? I have no explanation.
“Because of the QR code, the son cannot get into the Moscow public catering”
– QR codes have been introduced in Moscow for visiting restaurants. And in the subway we are like herring in a barrel. What’s the point?
– I don’t see the logic. In a stuffy room, in the subway, no matter how they ventilate, why bend your heart – the risks of getting infected are high. Hence the recommendation – if you need to get somewhere, if possible, walk, get on a bike, take a taxi (in the latter case, be sure to open the windows to ventilate – there could be infected passengers in front of you). Once again, I would not recommend going down the metro today during rush hours. Transport is generally an infectious threat. In Europe, more than twenty people will simply not be allowed on the bus. You are sitting alone in a row.
As for QR codes, in principle this is a good thing if everything was done smartly. I ran into problems from personal experience. My son came to see me, he is a medical student in France. Vaccinated with Pfizer vaccine. We do not recognize it, we do not give a QR code. He went and took a nasal swab for PCR. Gave a QR code that should work. But he is not allowed into any restaurant with this code. It lights up red. There is a QR code, but it must be registered with the State Services. When that doesn’t work, it causes legitimate annoyance. And we are not alone, I know a lot of such cases.
What awaits us next
– Now the delta strain is raging. Because of him, a new wave in Russia, with new anti-mortality records. What will save us this time? The virus is more contagious, everyone is tired and relaxed, so far only a small part of the population is vaccinated …
– The virus mutates and will mutate. And any mutation will go in the direction of contagion. Due to the fact that the mass vaccination did not happen immediately, the strongest variants of the virus survive. We cultivate it ourselves.
As for vaccines, I said a year ago: 90% effectiveness is on healthy young volunteers. When the vaccine goes to the masses, the effectiveness of any vaccine drops to about 50-60%. Moreover, new strains appear that partially escape from immunity.
And there will be more new strains. With the flu, we encounter new mutations every year. Nothing unnatural happens. Our business is to get vaccinated. This is the only thing we can do.
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