SHARE
COPY LINK

HEALTH

WHO interview: ‘If our behaviour returns to normal Europe risks new waves of Covid-19’

The Local sat down with the man at the forefront of the World Health Organisation's quest for a coronavirus treatment to ask whether reopening our societies will create a second wave and what happens when populism meets science.

WHO interview: 'If our behaviour returns to normal Europe risks new waves of Covid-19'
"Social distancing is not very social" . AFP

In the world of science, John-Arne Røttingen is somewhat of an international superstar. 

In 2015, the Norwegian epidemiologist led the steering group of the groundbreaking study that helped produce a vaccine for Ebola at record speed.

If the stakes were high back then, they are even higher now.

Røttingen, who heads the Norwegian Research Council, is directing the WHO's international study into Covid-19 treatments and an eventual vaccine.

The study, Solidarity, is a clinical trial in multiple countries to achieve a treatment for Covid-19 as rapidly as possible.

Four different drugs – hydroxychloroquine, remdesivir (previously used to treat Ebola), lopinavir/ritonavir (a licensed treatment for HIV) and and lopinavir/ritonavir + interferon – are being tested on 3,500 hospitalised patients in 17 countries simultaneously. 

It is a massive international effort to try and compress years of work into months, to find a solution to the highly contagious virus Covid-19 which has killed nearly 400,000 people worldwide, pushing countries into an economic turmoil that could have long-lasting and devastating impact.

The Local: European countries are easing restrictions on social distancing, reopening societies slowly. Are we risking new waves of infection?

Røttingen: We are very vulnerable to new rounds of infection. To achieve herd immunity, at least 50 percent of the population in a country needs to have had the virus. No European country has those levels yet.

The “R” (virus reproduction rate) is important. If we manage to keep it below 1, we will avoid a resurgence. 

The Local: We’ve seen European countries taking different measures to contain the virus. Sweden kept things largely as normal, while southern European countries like France, Italy and Spain imposed strict nationwide lockdowns. What’s the best option?

Røttingen: It's a misunderstanding that Sweden did nothing to limit the spread of the virus. The population followed a lot of health precautions even if they didn't go into lockdown.

But our societies need to be prepared to impose restrictive measures earlier than they did last time. 

It would be better to begin with the measures that are less harmful for the economy and the society at large. We know that closing schools is very expensive, but probably not very efficient in reducing the spread of the virus. 

The Local: It seems like we here in the south of Europe are struggling more than people further north to keep up with these social distancing rules. 

Røttingen: Yes, in Nordic countries we sometimes joke that, when they told us that we can stop having to keep two metres between each other, we said “phew, finally, we can go back to our usual five metres”.

In France, the doctor Didier Raoult (on the picture) has been distributing hydroxychloroquine as a coronavirus treatment to patients in his hospital in the French southern city Marseille. Photo: AFP

The Local: What are the most efficient steps countries can take to stem the spread of the virus?

Røttingen: Social distancing. Reducing use of public transport and avoiding large gatherings. 

If our behaviours return to normal I believe that we will see new waves and will need new rounds of restrictions. It's an important balance to strike between resuming social life and taking health precautions.

The Local: So basically we can keep working and going to school but we have to stop everything that’s fun?

Røttingen: Yes, social distancing is not very social is it.

This is why testing is so crucial. We need to continue our efforts to develop a vaccine, continue testing and contact tracing, and we need to keep up social distancing and general hygienic measures. 

The Local: Will we ever get a vaccine and, if so, when?

Røttingen: There is a big, global race to get a coronavirus vaccine going on with more than 100 drugs being tested right now.

In a best-case scenario, we get a vaccine approved early 2021. Then we need to produce the quantity to begin to vaccinate people, which means we are quickly moving into late 2021, early 2022. 

But all this depends on decisions that are being made right now.

The Local: What kind of decisions?

Røttingen: You might have seen the initiative by the WHO together with French President Emmanuel Macron, German Chancellor Angela Merkel and other state leaders, which works to set up a large-scale development, production and distribution of vaccines.

If we manage to set this up now, we will be able to begin to vaccinate earlier than we usually would.

The Local: What kind of vaccine are we talking about? Will it be a one-time vaccine that will make you immune against the coronavirus for years, or a short-term vaccine that we’ll need to take again and again?

Røttingen: That’s difficult to say because how long an immunity lasts depends depends partly on how quickly and how much the virus is changing and partly on the properties of the vaccine.

Chances are we will see new outbreaks, perhaps not every year, but every two-three years. But right now it's too early to say.

 

Head of Norwegian Research Council John-Arne Røttingen is directing the WHO's international study into Covid-19 treatments and an eventual vaccine.. Photo: WHO

 
The Local: Tell us about the WHO study into possible treatments. What kind of results are you seeing?

Røttingen: We ourselves are not allowed to check the results. There is an independent committee overseeing the process, and analysing the results in intervals as they come.

We will stop the study as soon as we know that a drug is efficient – or as soon as we see that it is either not having the wanted effect or that other, unwanted side effects emerge. 

The Local: Hydroxychloroquine, one of the drugs you are testing, has been hailed as a miracle cure by some, while others claim its proponents are charlatans.

Røttingen: We have seen that several leaders including US president Donald Trump and Brazil’s President Jair Bolsonaro, have spoken out in favour of hydroxychloroquine. 

One big question about hydroxychloroquine has been whether it has serious side effects or not.

A study in The Lancet, (which concluded that hydroxychloroquine had dangerous side effects, before doubt was cast on it) had some methodological weaknesses and potential failures in their dataset. 

We were very unsure whether we should stop the branch of hydroxychloroquine or not, but we decided to put the brakes on it until we had analysed our data. We have now made the decision to resume the hydroxychloroquine arm of the study after our independent data and safety committee advised continuing.

The Local: Is it dangerous that populism is interfering with science?

Røttingen: Yes. It’s a shame that these kind of scientific questions become political.

In South America patients are often being offered the drug as a treatment even though it isn’t approved as an efficient treatment for Covid-19 yet. This complicates things for us because we can’t include patients who have already been taking one of the treatments into our study. 

The Local: What role does WHO play in all this?

Røttingen: The WHO plays a crucial role as a neutral and normative actor, which always stands on the shoulders of science. All its guidance are based on neutrality and independent data. 

But we know that the WHO is suffering from political pressure, and member states use the institution to push their own agendas. I have argued for separating science from politics in the WHO, to protect its scientific role. 

The pandemic shows us how much we need this kind of scientific, global institution. 

 

Member comments

  1. Brought to you by the same guys who said on January 14th that there was no sign of human-to-human transmission, praised the Chinese for their transparency, and touted the Imperial College Model used to justify the lockdown. If there are no big spikes in America this week, then all bets are off as far as the experts are concerned.

Log in here to leave a comment.
Become a Member to leave a comment.

SPORT

Swedish study finds footballers more likely to get dementia

Top level Swedish football players -- except for goalkeepers -- were significantly more likely to develop dementia than the general public over the last century, according to a large Swedish study published on Friday.

Swedish study finds footballers more likely to get dementia

Experts said the study added to “convincing evidence” linking the world’s most popular sport to a higher risk of degenerative brain disorders, and comes as head injury controversies rumble throughout other codes such as rugby and the NFL.

While traumatic brain injuries like concussions may be less common in football than those sports, the repeated heading of the ball by footballers has previously been associated with dementia.

The new study, published in The Lancet Public Health journal, analysed the medical records of more than 6,000 male footballers in Sweden’s top division from 1924 to 2019.

The researchers compared their rates of a range of degenerative brain disorders to 56,000 similarly aged Swedish men. The footballers were 1.5 times more likely to get Alzheimer’s disease and other dementias than the control group, the study suggested.

An exception was goalkeepers, who rarely need to head the ball and did not show any increased likelihood of degenerative brain disorders.

“This finding lends support to the hypothesis that heading the ball might explain this association,” the study’s lead author Peter Ueda of Sweden’s Karolinska Institutet told AFP.

Ueda said it was the largest research conducted on the subject since a 2019 Scottish study which suggested that footballers were 3.5 times more likely than to get degenerative brain disorders.

‘Protect people’s heads’

The Swedish study also found that footballers lived slightly longer than similarly aged men, which Ueda said could be related to the higher levels of exercise and socioeconomic status that come with being an elite footballer.

The study found no increased risk of motor neuron diseases such as ALS among the footballers, and a even slightly lower risk for Parkinson’s disease.

Ueda cautioned that the observational study was not able to show that playing football directly caused the dementia, and its findings could not be extended to female, amateur or youth football.

Because there is so much time between people playing football and the development of these brain disorders, many of the players covered by the study were active during the mid-20th century.

This means that better equipment, knowledge and training could have since made the game safer for modern professional players, Ueda said.

“But you can also speculate that contemporary players today are exposed to intense football from a very young age, so maybe the risk would even be higher among them,” he added.

Gill Livingston, professor in psychiatry of older people at University College London, said the “high-quality paper” added to “convincing evidence” that footballers whose heads come in contact with the ball were at a higher risk of dementia.

“We need to act to protect people’s heads and brains and keep playing sport,” said Livingston, who was not involved in the research.

Research into head injuries in sport, and post-career side-effects, has recently exploded, notably in rugby union and rugby league.

Last year research indicated former international rugby players are 15 times more likely to develop motor neurone disease. A group of former rugby union players is suing various governing bodies for allegedly failing to protect them from permanent injury.

SHOW COMMENTS