Eliana Galarza
05/13/2020 - 11:11
- Clarín.com
- Live
From Rosario, Santa Fe, to Wolfenbüttel, Germany, Carlos Alberto Guzmán toured a lot of academic life. Clinics, universities and laboratories in various countries. Today, at 61 years old, he is a world leader in vaccines. But nothing gives him more satisfaction than seeing his daughters, aged 26 and 25, "excited and hooked on Architecture and Law, the careers they chose."
“The path of the vocation is a mystery. They freely decided: I never tried to influence them in what they wanted to do. I just told them that it was important to me that they could work in something they loved, because you can only be really good when you love what you do, ”says Guzmán, who received a medical degree in 1981 with a diploma of honor (the highest average for her litter) at the National University of Rosario.
Then he had the international clean and jerk. He won a scholarship to specialize in microbiology and bacteriology in Genoa, Italy; he obtained doctorates and specializations in that country and in others ; and in 1994 he moved to Germany, where he is now head of Vaccine Research at the Helmholz Center for Infectious Disease Studies. A place of excellence.
Carlos A. Guzmán is part of the select Council of 100 of Vaccine magazine.
The pandemic found him working on several projects, including a Chagas vaccine, which affects 1.5 million people in Argentina. Like everyone, it adapted to the times and demands of the new coronavirus . "Sometimes I have video conferences with more than 30 people to start new research projects," he says.
We will have to live with the idea that not all Covid-19 patients can be saved.
Like a Transformer , the Helmholz became a focal place in Covid-19. He, for example, is engaged in what are known as "proof of concept studies" (intended to know whether the type of vaccine being tested will be effective ) of an intranasal compound against Covid-19.
Guzmán published more than 260 articles in international journals , is a co-inventor of numerous international patents and is part of the select group of the Council of 100 , which brings together the top experts in vaccines of the Vaccine magazine . In short, you know.
This is how we work in the Vaccines area of the Helmholz Center for Infectious Disease Studies, where Guzmán is head.
Based on your experience, which of the vaccines currently underway has the best chance of working?
It is very difficult to bet on a particular vaccine or technology. Obviously the first one to successfully complete its clinical development and be approved is going to have a substantial advantage. Normal clinical development times are 10 years , but in an emergency or pandemic, it is possible to think of shorter paths. So those that have started with the first clinical trials could have news in 18 or 24 months. However, no regulatory agency would approve a vaccine that does not fit within the logical requirements for safety and efficacy.
Those called messenger RNAs (based on ribonucleic acid) are the most disruptive. Is it possible that they will become the first to be ready?
All systems have advantages and disadvantages. Inactivated, attenuated and subunit vaccines are the most traditional and perhaps sound less disruptive, but are generated by robust and well-established processes . Its pros and cons are well known, there is a track record in millions of vaccinates that make it clear to us what kind of immune responses we can expect. Regarding RNA vaccines, considering their simplicity and speed of production, they could be really attractive in the context of pandemics. But so far none of them have been approved for use in humans in the field of infection. New technologies have to be subjected to tighter control processes to verify that they are safe and effective: it is not known how they could work under conditions of mass vaccination.
Does this virus pose extra challenges in finding a suitable vaccine?
First: we are facing a pandemic from a new virus. Coronaviruses are known, they cause diseases in animals and humans. They have the potential to cross the species barrier. Knowing that helps, however there is great variability in the characteristics of each virus in terms of its transmission, virulence and severity . The development of veterinary vaccines (for example in birds and pigs) has taught us that it is not so easy to develop vaccines against coronaviruses. And in this one, in particular, we lack information about the immune response against Covid-19. For example, what percentage of infected (symptomatic or not) develops a response against the virus, how long will that response last, what type of immune memory is stimulated, what correlation / association can there be between protection and immune response parameters, how can they contribute to the protection of pre-existing antibodies against other coronaviruses, know if it will cause less severe forms of infection over time , if it will mutate and become resistant to existing defense mechanisms or will be replaced by another coronavirus.
The development of veterinary vaccines (for example in birds and pigs) has taught us that it is not so easy to develop vaccines against coronaviruses.
In the meantime, do the measures being taken help?
I am not an epidemiologist or public health expert. What I can say is that acting vigorously and decisively against a new infectious agent that is spreading globally and causing severe clinical conditions is the right thing to do. Of course, each measure that is implemented is inevitably associated with positive and negative consequences. The balance at cost / benefit level has to be weighed by experts and dynamically integrated according to the evolution of the pandemic . And you must act on those changes. For example now, in Argentina, which is heading towards winter, the situation could worsen if the virus spreads in areas of precarious housing where the population lives in overcrowding. We must evaluate and act. Regarding the effects of the decisions, we now see surgical operations that are postponed, medical treatments that are not carried out properly, patients of other illnesses who do not come to the clinic for fear of contagion, increased violence and abuse at the family level , increased consumption of alcoholic beverages (31% in the United Kingdom) , suicides, unemployment (more than 22 million in the United States), economic crisis and bankruptcies, famines to come, couple crisis due to forced permanent coexistence, future reduction of resources for the treasury for obvious reduction in tax collection, etc. etc. It is essential that the balance is positive to keep certain measures in place and that the situation does not lead to an unacceptable increase in infections.
We are like this, and also without therapy and without a vaccine.
It is a time to rethink the future. Governments have to redesign their investment policies in health structures in the medium and long term. The risk of an emergency for infectious agents and a pandemic is not new, but most countries were not really prepared for this situation . On the other hand, while there are no therapies or vaccines, we will have to accept and live with the idea that not everyone can be saved. Because of my training, I think that a doctor, above all, should not cause greater harm to his patients than his own illness. At a certain point, the doctor has to help them decide how and where they want to die with dignity and allow, if they wish, to reasonably say goodbye to their loved ones.