Is the second COVID-19 infection coming? Make good drug reserves! Zhang Wenhong's latest statement

According to CCTV News, as of April 18, at least 33 countries or regions around the world have reported 3,647 XBB.1.16 variants, mainly from India (63.4%), the United States (10.9%) and Singapore (6.9%). Since March, the proportion of XBB.1.16 in the sequences reported by India has increased rapidly, and it has now become the main prevalent strain in India. Among the variants currently prevalent in the United States, XBB.1.5 is still the main one, but the proportions of XBB.1.16 and XBB.1.9.1 have both increased recently.

According to the latest data from the China Centers for Disease Control, from December 1, 2022 to April 13, 2023, a total of 31,434 local cases of novel coronavirus genome sequences were reported nationwide, all of which were Omicron variants, covering 106 evolutionary branches. Among them, a total of 328 local variants of concern were monitored, including the recently highly-watched XBB.1.16, also known as "Arcturus". This new variant is considered to be the most contagious strain, and there have been reports of symptoms such as conjunctivitis.

In response to recent social concerns about the new coronavirus XBB.1.16, the National Disease Control and Prevention stated on April 21 that the level of XBB.1.16 among domestic cases in my country remains extremely low and has not formed a transmission advantage.

On the afternoon of April 20, at the "Infection Immunity Summit Forum (2023)" co-organized by the Shanghai Immunology Society and Frontiers China, Professor Dong Chen, an academician of the Chinese Academy of Sciences and Shanghai Jiaotong University School of Medicine, asked Professor Zhang Wenhong, director of the National Center for Infectious Diseases (Shanghai) and director of the Department of Infectious Diseases at Huashan Hospital Affiliated to Fudan University, "What vaccine should we get now to prevent secondary infection with the new coronavirus?"

Zhang Wenhong: It is recommended that vulnerable groups receive the new crown vaccine again

Zhang Wenhong replied: "I am here to appeal that vulnerable groups should be vaccinated again after 6 months, but both bivalent and monovalent vaccines are OK. China's bivalent vaccine is slowly coming out, and you can also get the bivalent vaccine. It is slightly more effective against Omicron, but this data is only from clinical trials."

At the forum, Zhang Wenhong gave a speech titled "New Crown Secondary Infection". He introduced that data showed that if the new coronavirus mutates, secondary infection will slowly appear after 6 months, generally on a small scale, but if the next wave of virus mutations effectively breaks through the immune barrier formed by the human body to fight the previous wave of viruses, the second wave will form an infection peak. He said that in response to the new crown secondary infection, it is necessary to pay attention to vulnerable groups, continuously monitor and warn, make good drug reserves, and respond quickly to the arrival of any mutant strains.

COVID-19 changes

Two waves of the COVID-19 epidemic have occurred in many countries and regions around the world (including Taiwan, Japan, Singapore, the United States, and the United Kingdom).

Zhang Wenhong explained that there are two main situations of secondary infection:

First, the immunity of people who were infected in the first wave of the epidemic gradually weakened.

Second, people who were not infected in the first wave of the epidemic were infected in the second wave.

According to monitoring data, many people infected with the new coronavirus in China are in the latter situation.

Academician Dong Chen asked a question after Zhang Wenhong's speech:

Why different countries

Does the peak of secondary infection have high or low values?

Zhang Wenhong quoted Fauci, an American infectious disease expert, as saying, "The new coronavirus will find everyone. When the barrier of herd immunity is established, the new coronavirus will look for people who have not yet established an immune barrier. Therefore, countries that have better control over the first wave of infection will have a higher peak in the second wave of infection."

"At present, the several new coronavirus variants in China are mainly BA.5, BF.7, and XBB. XBB accounts for 90% of the strains prevalent in the United States and 50% in Hong Kong, China. The proportion in mainland China will gradually increase in the future. It will shorten the protection time of effective neutralizing antibodies from 6 months to 4-5 months. However, neutralizing antibodies still have a protective effect. Six months after infection, the protection rate of neutralization antibodies is still 50%." Zhang Wenhong said.

Regarding the future trend of the new coronavirus, Academician Dong Chen raised another question

Will the new coronavirus become like the flu?

Zhang Wenhong said that influenza has many subtypes every year, with genetic recombination, more variants and greater volatility; while the subtypes of the new coronavirus are replacement-type, with the latter replacing the former, and there is no genetic recombination. If nothing special happens, it will become more and more like the existing coronavirus and will always exist, but its presence will not be as strong. Whether it will eventually become influenza depends on the characteristics of its later mutations.

In the face of secondary infection, we need to pay attention to vulnerable groups

In the face of secondary infection, we still need to pay attention to key groups

Zhang Wenhong reminded that both international and domestic data show that people who were not infected in the first wave of the COVID-19 epidemic are at higher risk of infection when the second wave of infection comes. As for secondary infection, people aged 60 and above and those who have not been vaccinated are at higher risk of infection.

In addition, there is still a need to stockpile small molecule antiviral drugs. At the same time, a very important measure is to establish a model that can provide early treatment within 48 hours, so that citizens can go to the nearest community health center to test antibodies or antigens and receive corresponding drugs.

"I believe that by constantly monitoring, issuing early warnings, making good drug reserves, and responding quickly to the arrival of any mutant strains, we will definitely be able to get ahead of the next wave of the epidemic," said Zhang Wenhong.

(Source: CCTV News, The Paper)