Source | China News Network

Head image | Public account “杨 兰 说”

A few days ago, Professor Walter Ian Lipkin, director of the Center for Infection and Immunity, Columbia University School of Public Health and infectious disease expert, known as the world’s best-known “virus hunter”, accepted a well-known chair at Columbia University An exclusive interview with Yang Lan answered questions about the epidemic of new crown pneumonia.

The following is a transcript of the interview:

Zhong Nanshan was focused and keen, and I was assigned a specific task

As early as 2003, Professor Lipkin was invited to Beijing to help China fight against SARS and donated 10,000 test kits to China. He and Academician Zhong Nanshan also met and became friends. On January 28 this year, Professor Lipkin was again invited to China to discuss the epidemic with senior government officials and experts. Due to time constraints, he and his old friend Academician Zhong Nanshan could only meet briefly at the airport.

Yang Lan (hereinafter referred to as Y): (at the airport) what kind of mentality did you find (Zhong Nanshan)? What is the communication between you?

Lipkin (hereinafter referred to as L): I have known Zhong Nanshan since 2003, and there is a picture of us sitting together at the time. Almost 20 years later, there was another photo of us at the airport. Obviously, we have all changed, but our friendship is still the same, and we are still intellectually (at the time).

Zhong Nanshan is a very focused and keen person, even when he is 84 years old. He is fluent in English, which makes it very easy for me to communicate with him.

Y: How does he comment on the situation of this epidemic?Estimated? You have experienced SARS together. How serious is the situation this time?

L: He’s realistic and practical. We discussed various approaches that may be used to treat severe cases, whether it is drug therapy or plasma therapy.

He is very strict in his search for methods to arrive at accurate diagnoses, which can guide specific practices. One thing is to be able to find the exact location of the virus in the environment, and then search the environment and find out how long the virus can survive on the surface of the object, such as subway handrails, railings, door handles, etc. These are what we need to know thing. If the virus is not transmitted by coughing or sneezing, you can find a way to reduce the risk of transmission.

We are still working. It should be said that he (Zhong Nanshan) is still working to determine how long a person is contagious, when is it contagious, who is the most contagious, and whether the virus still has various variability to prevent more Of people are at high risk of spreading the disease.

Also, why are some people suffering from serious illness when exposed to the same environment, while others have no symptoms at all? I discussed all these aspects with him and some of the shortcomings, and of course there are other issues.

Y: Have you been in contact during your isolation? (In early February, after returning from China to the United States, Professor Lipkin conducted 14 days of self-isolation. During this time, his work site was transferred to his basement.)

L: No. You know, I’ve been assigned a specific task, and I haven’t finished it yet. When I have done what he promised to do, I will contact him again. He is very busy now, in addition to trying to deal with the outbreak, but also communicating with WHO, government officials and others, so I do not want to increase his burden.

There is no evidence that the new crown virus is artificial, and the South China seafood market may be a secondary transmission

Y: How would you describe your mission?

L: My mission is to do what we are best at and have been doing for decades. It is trying to find clues and get “viral intelligence”, such as where the virus comes from, how it causes disease, etc. Wait.

Y: So, what is your reasoning for this virus?

L: If you want to know where the virus came from, look at its genetic sequence and see how similar it is to other known viruses. This virus is related to theOne virus found by the Chinese Virus Research Institute is most similar, and may be a bat virus in terms of percent identity to the bat virus.

This virus has differences in important regions of its genetic structure, suggesting that it had adapted to humans or human-like species and was allowed to move in this way before it could achieve effective human-to-human transmission. Therefore, we believe that this virus exists in bats, may be in contact with animals, may be in the wildlife market, or may be infected humans.

The virus adapts to other species as it grows. When it becomes capable of human transmission, the next link in the chain of transmission occurs, and it completes the jump from bat to human. It is now a human virus, not a bat virus.

My colleagues and I believe that there is no evidence that the virus was made in Wuhan Virus Research Institute or that it was accidentally released. We think it originated in nature.

Y: You mean, when we found this virus in the South China Seafood Market in Wuhan, it had already adapted to humans.

L: It is very likely that the virus has spread in Wuhan and even Hubei, and the connection with the seafood market is not so direct. Maybe a secondary transmission occurred in the Wuhan South China Seafood Market. It has already begun to spread.

New crown virus may coexist with humans, but it is still under control

Y: What do you think of (the epidemic situation) in the future? Some people say that perhaps after several rounds of transmission from person to person, the virus’s virulence is decreasing. Therefore, it will become another less threatening seasonal flu. Will this be the way forward?

L: It’s hard to know what happens when the virus first appears. It has a lifestyle like humans. But I think if there isn’t some kind of vaccine, it will most likely be with us every year like the flu.

Y: Will the virus die out slowly as the temperature rises, or is it seasonal?

L: I think this is also possible. Because the indoor environment is relatively closed, the breathing between people is closer, and the air is relatively dirty, and there are more floating objects that the virus can attach to. As the temperature rises, people begin to reduce the time spent indoors, reducing the chance of cross-transmission, and the spread of the virus will not be too far away, so IWe will see a decline in infectivity.

But as transmission rates decrease in some areas, transmission rates may increase in others. Just like we have the flu season, it may recur.

Y: So it might come back next winter?

L: I can imagine it might come back again.

I strongly support vaccine investment as a way to reduce morbidity and mortality. We have no reason to think that this is a virus that is difficult to develop because it doesn’t look so unstable and is still within our control. The difference in HIV is huge, and it is difficult to develop its vaccine. The flu changes significantly every year, but the virus seems to be more stable than both. So I think we should be able to develop a vaccine, although this is not something that can be done quickly because we have to do safety tests.

Y: I know this is hard to predict, but can you tell me what is the time span (of the vaccine)? Two months or three months?

L: Traditionally for vaccine research and development, not based on “month”, but on “year”. The question is can we shorten this time? I think we can, but it depends on many factors.

Unfortunately, there are too many people trying to develop vaccines at the same time, and we may waste a lot of resources. So I think we should choose some and invest heavily in them, and I think this will be what will happen.

More sensitive detection reagents will be tested in Wuhan and Beijing

As a pioneer and genetic hunter for infectious diseases, Professor Lipkin has discovered and identified more than 800 viruses related to human, wildlife or domestic animal diseases. His visit to China in early February also allowed him to understand the development and prevention of the epidemic situation as comprehensively as possible. After returning from China, Professor Lipkin led the team to quickly develop a new coronavirus detection reagent.

Y: We know that many people have been quarantined, and some false negatives have appeared. And you have been working to develop a diagnostic test method that is more sensitive than existing test methods.

L: The term false negative is used accurately. So, the question is, can you find a more accurate, sensitive, and specific test method? You know, the first test method when the disease is born is often not the final test method.

This is one thing we are asked to do, and another thing we are trying. We will try to profitWith the transfer of this sequence and capture technique, the benefits of doing so are to make the test more sensitive, cheaper, and less processing time. In the end, there is a test method that allows us to track how the virus evolved or did not evolve, and then became more likely to cause disease or spread more easily. These are my tasks.

Y: The accuracy of the initial nucleic acid test is relatively low. So how do you evaluate the accuracy of this new test you are developing?

L: I hope it will be better, and I think it will be better, but its effect will not be known until we have tested it on patients.

Our testing will be carried out in Guangzhou and Beijing. We will test people with existing nucleic acids and new types of nucleic acids, and compare them fairly. The data will tell us the facts, and then we will track these people. So, now I don’t want to guess, but want to see how it turns out.

Y: But I can see that you are confident in improving accuracy.

L: I am cautiously optimistic, otherwise I would not do it.

The epidemic is an unprecedented challenge to the world. Viruses are the greatest risk to humans.

Y: Through epidemics such as SARS and MERS (Middle East Respiratory Syndrome), we have learned a lot. They are basically considered as coronaviruses, but why does the speed and scale of this (new crown virus) spread make people feel So surprised. Why is this so?

L: This virus seems to be much more infectious, and it is undoubtedly more severe than MERS. MERS is a virus that spreads from bats to camels and then to humans.

There are very few cases of human-to-human transmission. SARS is transmitted from person to person, but it is not as easy as this virus. This is truly an unprecedented challenge for humankind, and this will not be the last.

Starting with HIV, we encountered SARS, NIPHA (Nipah virus), and MERS, as well as this new crown virus, dengue fever, and Zika virus. All these emerging infectious diseases basically come from wild animals, enter the human body to adapt to human beings, and then become able to spread directly or indirectly from person to person.

Thus, these are the issues we need to solve in the future, and we must do something to prevent this from happening repeatedly, such as closing the wildlife market. Today I heard (China) has made a closure of the wildlife marketThe decision, which is awesome, is exactly what is urgently needed now.

Another thing we need to do is share data. There is no such thing as the New York virus or the Wuhan virus. The virus is the common enemy of humankind, and we need to unite and respond globally. This also means that we must bypass some intellectual property and sovereignty issues, as well as greed, and all other factors that prevent the normal spread of information that is necessary to control viruses that threaten the entire world.

Y: The global epidemic situation is very serious. In addition to China, Italy, South Korea, Japan, Iran and other countries have many confirmed cases and deaths, as well as the United States.

L: As you can see, these countries are trying to adopt the same approach (coping) as China, but this is very difficult. This is one of the reasons why I discussed this topic with Zhong Nanshan.

Like I said, I can help you and provide you with a tool so that you can at least determine who is at risk and who is not. So we are trying to do this now, using these tools to get some clues and can help.

Y: The WHO Director-General said that the window to this global crisis is actually closing. Bill Gates also said that in the future, epidemics will be a greater threat than nuclear weapons. So what should humans do in the battle against this invisible enemy?

L: Actually, for the first time, I heard people say that the virus is the last enemy on earth. It is the late Nobel Laureate in Economics Joshua Lederberg. He uses the specific phrase we call “virus”, which is the greatest risk to humans on earth.

Another thing we can be sure of is that as we gradually tackle this particular problem, the threat will continue, and the epidemic will have more. We must form a global partnership to work together to strengthen containment of these (epidemics).

Therefore, the International Health Regulations were introduced in 2005. As mentioned above, every country must have the ability to diagnose diseases in its own territory, and more than 180 countries have signed this agreement. But as far as sharing this information transparently, it is clear that it has not yet reached that point.

At present, China has established infrastructure to enable it to detect the infection and gradually control its characteristics. But many developing countries in the world do not have such infrastructure. So one thing my colleagues and I are working hard to do is build this project, a global epidemiology network of infectious diseases, providing them with the sequencing and development diagnostic tools, and the infrastructure needed for kits. All informationWill be published to a central cloud-based database that everyone can access to get the information they want to reference. Everyone can then help solve the problem, contain it, and discover these small sparks before they become a fire.

Y: Therefore, we also need to establish a more effective global cooperation mechanism to meet global challenges.

L: I think that’s all we need.

Y: Xenophobia is a by-product of infectious diseases, such as the outbreak of the new crown virus virus. When people are afraid, it will cause irrational or even harmful behaviors, such as from a certain area or a People in the country are stigmatized. What’s your opinion?

Y: Yes, but this is nothing new.

I mean, this is human nature, because people do n’t really recognize the challenge, and this is exactly what people really need to do. It ’s a pity.

People from the affected areas need to be isolated, but this has nothing to do with whether you are white or Chinese, Asian or African. The virus knows no borders, it’s the same for everyone, and xenophobia is inappropriate because it sets up obstacles before it finds a real solution to a real problem.