"We will be massively vaccinated in the middle of next year"

Adolfo García-Sastre (Burgos, 56 years old) sees the medium term with some optimism from New York, where he is head of emerging pathogens at Hospital Monte Sinaí and professor in Medicine and Microbiology.

Although in June it said that we were still at the beginning of the pandemic, the advance in vaccines now places us in another scenario.

Question.

Where are we now?

Reply.

It all depends on when we have a vaccine.

Without it, we are still at the beginning of the pandemic.

We are not like before, but as long as there are people who have not had the disease, who have not been infected and are not immune, this does not end there.

But now there is a great diagnostic capacity and it is possible to try to stop it using measures that, without being entirely effective, have slowed down the advance of the virus.

On the other hand, now I believe that we are closer to a vaccine and that means that we are not at the beginning.

Q.

There are nine in phase 3. Are you optimistic that we may have one effective soon?

A.

Yes, I believe that most of them are going to be effective.

What will vary is how quickly and what doses are available in a short period of time.

There will also be differences in effectiveness, but that will be very difficult to tell at first.

I think that most of the ones that are going to be approved are going to lead to some effectiveness and I also hope that they don't cause many adverse effects.

Although anyone will have them, the key is that there is less risk in putting it on than in becoming infected with the virus.

Once we have it, another thing we don't know is how long the immunization will last.

Spain's problem is a combination of many factors, including a random one that is very difficult to control

Q. Have you been surprised by the stoppage of the Oxford vaccine?

Do you think it will delay it a lot?

A.

No, I'm not surprised.

It is part of the way, I don't think it will be too late.

And that rehearsals have been halted is actually good news, it means they are not taking shortcuts.

Q.

Will this or the other allow us to return to the old normality next year?

R.

The most optimistic predictions say that we will all get vaccinated before the end of the year.

I do not think that's possible.

Barring disaster, the most normal thing is that people begin to be vaccinated en masse in the middle of next year.

This does not mean that no one has been vaccinated before.

Immunizing certain groups at the beginning will help to better control the pandemic little by little.

P.

What has gone wrong in Spain in this second wave for us to be with such a large incidence of cases?

A.

That is not known, because it is a combination of many factors, including a random one that is very difficult to control.

The number of contacts in Spain with respect to other countries may have contributed.

I can compare how it is being done here, in New York, and I think that even Spain is doing better diagnosis and contact tracing.

The three pillars that exist right now for containing outbreaks or possible new waves are rapid diagnosis, contact tracing and isolation and personal responsibility to reduce them.

The fewer contacts, the smaller the groups, the fewer closed spaces we frequent, the better.

There are three pillars to stop the virus: the diagnosis drawn up and that of contacts and personal responsibility

P.

In Spain there were far fewer trackers than there.

A.

Yes, but in New York the average diagnosis takes a week.

So no matter how many trackers you have, if seven days have passed, the tracking is no longer of much use.

Q.

Why does it take so long?

R.

There has been some complacency in thinking: "Well, we don't know yet if this is going to be a very big problem."

And because of that complacency, no more drastic measures have been used, which cost money.

P.

Many experts point out that this has also happened in Spain.

Didn't we learn from the first wave?

A.

Yes, but the so-called second wave is not yet like the first.

It is not a matter of saying we have not learned anything, because in that case we would be right now as before, or even worse.

Something is being done, but it is not enough.

The point is to increase the three pillars: diagnosis, contact tracing and personal responsibility.

We don't know which of them is failing the most.

And therefore, you have to try them all.

P.

How do you see the situation in Spain?

Do you think we are entering a plateau after the strong rise of the summer?

A.

I think a plateau is fine, but you have to make an even greater effort to lower the plateau, because you can be shot at any time.

With measures such as the opening of schools, the cases will rise, but the three pillars can also be raised to contain it.

Also with limitations such as closures, social restrictions, but they have more personal impact.

Q.

What are the great unknowns that we still have to know about the virus?

R.

How can the disease be stopped once it has high severity.

At that time, the presence of the virus is no longer very great, so that if antivirals are used they have less impact than when they take early, before having very severe symptoms.

And we don't know exactly how to fight the virus at the time.

Information about the coronavirus

- Here you can follow the last hour on the evolution of the pandemic

- This is how the coronavirus curve evolves in Spain and in each autonomy

- Download the tracking application for Spain

- Search engine: The new normal by municipalities

- Guide to action against the disease