for the greek alphabet runs out of letters. what's an interesting question? we don't look with any virus infection, the spreading, you will get changes, you'll get mutations that has been happening all the while. and of course, these mutations all sort of selected for those that are going to be more infectious or data are able to evade part of our immune system. so with this all the time, the only way to quote this actually is to get people vaccinated actually, to spread the virus. so sadly, of these viruses are popping up all the time. many of us who get infected will be infected with more than one variant. anyway, and it's just a bit of a game in terms of chasing the genetics of the virus and trying to suppress these changes by dampening transmission. and the way you do that is by vaccination. so i hope we get to a phase where we don't have to exhaust the whole of the greek alphabet, but i only have 9 letters left. so given the, in the speed of the mutations, it looks like this may be the case and i read the the other day that it will, how we're going to zation is already contemplating naming you variance after the

star constellation. so there's really unlimited potential there. and i know you said before that we will have to get used to leaving this virus and we will have to adapt to it. but how do you think it will continue being such and such an imposing constraint on the predictability of our lives? yeah, i think, i think we're, you know, we're learning about this all the time and i think it's going to take some time before it's settled. what we're saying, essentially in real world, illusory times, if you like, it's worth adapting to us. we've never seen anything like this before. buyers adapting johnson rather than adopting to the virus. well, bob was going to say how of human behavior does have to be taken into account to. so it is a 2 way street, and it's going to take some time for us to settle into a home of endemic invention. that's one of the fixture becomes more predictable, more seasonable, more manageable. and way, when you go to pandemic, you know,

you can't think about an infection becoming endemic, a more controllable, and you grasp it worldwide. we'll see what we've learned from on record which we, we should have realized. anyway, of course we did was it was, it's important for governments to control and to cool off to what's going on in their own countries, unless you will. so a keep them on what's going on elsewhere in the world. you'll never get a handle on this and this what we heard all the time is mantra, if you like it, you know, we're all in this together when nobody safe until everybody is safe. and the whole issue of vaccine democracy, if you like, an equity is so important. now you mentioned already that every new variance seems to be more dairy than the last. but i think only really looks like the special holy they seem collection of some old mutation here plus some new ones that have we seen anything like this? is this the sort of be this the scariest so far?

is the scariest, because many of us hold the delta would be the sort of p i did, i thought, well, you know, going to get a car. surely, any more transmissible than delta and what's happened? you got something which has popped up with more than 30 changes in that spite protein that we're all interested in. it's accumulated, all the mutations we've seen in different areas, only one virus. and that raises the very interesting issues about, you know, where did it come from? in the 1st place, is it possible to get even more mutations and what's going to happen in terms of disease severity and vaccine protection is suggesting that, you know, the virus has still got some way to go and we'll throw some more surprises. nothing . i'm wondering how consistent is our understanding of the wires from one bear in to the next? i mean, i you personally, how often do you have to revise what you have taken for granted about it? yeah, well, you know, we go, i think monday, which is

a wonderful thing so that we can actually read the genome. great. and we can understand what some of these changes mean. so we know mechanics of keys accumulated changes that we know are associated with increased info, activity or transmitter ability. and indeed with the ability to evade certain elements of the immune system. learning about this all the time. you know, we can, we can predict the structure of this part protein and how interact with cell. so we already knew that there would be increased infective, 80 simply by the way that this fight proteins changes the shape. and so that's about now going out to be true of course of both in both in real life as well as in laboratory studies in the same way we just heard over the last 24 hours. the, there is a significant degree of immune evasion in terms of antibody responses. so we can predict, we can predict up to a point, but obviously we're only looking at one bit of the virus. it's important to stress

that all the focus on want to be the virus is important, because this is how the virus gets into cells. and this is how the vaccines are working at the moment. but there are also things we need to be doing to increase the chances of better management to this virus by, by targeting other bits of the virus gene are not just despite protein. now you mentioned that this last baron has been able to have you put it in a certain element of the immune system and in plain english as far as i can tell, it would be, it would mean that it can actually reach it back in unity and some doctors in south africa have already reported that they have quite a number of patients vaccinated patients who have contract expires. they have also noticed that the, the number of children and young adults was denied is increasing. is, is that what you would normally expect from a virus? let's say we, he, so i rightly, me, years after it, it has originated,

easy, supposed to be gaining in strengths at this point. what is it all depends, what you mean by gaining strength? because what we're seeing here is a virus that is more infectious and because it has some degree of capacity to build around the immune system, it's infecting people who either previously be infected and other variant or indeed have been fully vaccinated. a lot of people, so the coming out however, are suggesting and is only suggestion that a lot of this infection is model disease and it's possible. but what we're seeing with this overcome variant is a virus that is gaining infectiousness, but as a consequence of vaccination, etc. is losing some of its strengths in terms of inducing disease, virulence. one of the things we hoped originally by analogy with some of the viruses that might happen, although it's controversial, is as a virus adapt to up what is it becomes more infectious?

it may become less harmful. now whether this is the case or not, we don't recall, we don't know, but it certainly much more infectious. and a lot of the early ripples suggesting that even with full boosted vaccination, you can still get mild disease or perhaps not severe disease. it may be a totally ignorant question on my part, but with an age on virus like common 19, is there any difference between boxing induced immunity? let's say you indicated the latter one doesn't really matter which there in your body has, has now before you come across a micron. yeah, this could have been a day to actually including some reason day to the suggest that if you've been previously infected with whatever variant and you then get vaccinated, you have a better immune response. that's not surprising because depending on the vaccine, most of these vaccines have a little bit of the, of the virus, they just have the spite protein. of course, there are some vaccines that all using the whole virus. and of course,

you can understand is quite easy. the if your body see the whole virus is seeing other bits, not just, no, just the spice of the, but his immune system responds to a much broader array of different bits of the virus. and some of these are, some of these bits are more conserved, the less changed, for instance, in the, on the chrome varian, the nuclear protein. another protein that's in the, in the virus is, has only 4 full changes, not 30 changes. so one of the things is quite interesting about all of this is we understand more about the immune response more about how the vaccines are working. if you think about incorporating some of these other bits of the virus in these vaccines, and that's why there's a lot of talk at the moment about adapting, rapidly adapting the m r. renee vaccines not only to cope with the spike changes in all the comp apps to include other bits of arista on change this much speaking about the way there is work. i understand that it's too early to same as relying on

your professional and intuition. i know that there were vaccines are approved in south africa and are in a one t a non replicating bio vector once. and in an activated one who decides is do you think i am a crown would be more likely to reach 1st? that's a very, very difficult question. as i said earlier, i think i think attenuated vaccines may give a, make it better protection. but i think what we've learned, we've known for years about vaccines is mixing and matching vaccines works really well. so, so called heterozygous vaccination. so if you, for instance, had one of the attenuated vaccines followed by an m r a vaccine, you're lucky to get a much better immune response. at the moment it's really difficult because what we tried to do is almost do experiments in the real well, we know these vaccines a safe and have been approved and work. and the most important thing of all of calls is to protect against avidity, disease. today's a very important day for the u. k. the world because today marks one year since the

vaccine was the 1st use of an approved vaccine was injected actually somebody locally in the hospital where i work in coincidence in coventry in the u. k. moment keena was given the 1st dose a year ago today, and of course the hope there and it was, it was that we can protect against severe disease, and that's what we've seen or all around the world. so the most important thing obviously, is that we are ahead of the game a year into the, into, into vaccination. and it was a bit of a risk. we didn't know that vaccines would work. we just didn't know that that would be able to protect, but be able to protect against severe disease is really important. and i think what we're going to see, what the pandemic has fast tracked, if you like, is the development of new approaches to vaccines that you can develop these in a way that is rapid, but also more effective. now the new variance was 1st attacked in a south african before making

a crossing in the northern hemisphere. how much you, geography, and the sort of host population, immunological status matter in terms of producing the new variance. i'm asking because despite the relax reluctance to associate the new there, is it any given country b, china k, brazil, india. we have quite a few areas which originated in specific countries. and there's not a single one that originated in russia. not that i'm calling for it, but that's a, that's an interesting question to ponder. why some countries do get the same invitations and others don't. yeah. anybody in fact he's generating musicians. this has been studied in the context of cove is really people who are in a compromise. so we know there are 2 things going on here. this partly to do with the proportion of your population that's vaccinated,

mostly in south africa. and that those countries in south africa regards to the low levels of vaccine coverage. but also where we, where this has been looked at in detail aware mutations similar to the mutations we're seeing, a number call other brightness have been demonstrated in a, in a person is actually in people who are in a compromise. these individuals have sometimes very prolonged infections. so normally we clear an infection like crone of ours, within a week or so it clears from our bodies. we call 10 days. sometimes these people are in a compromise, will have an infection for more than a 100 days. and they become a breeding ground for variance to develop. and that's where you see some of these more severe barrett's if they spread into a pot. if these viruses spread into a population that's fully vaccinate to the company called go much further, even on recon, actually might have been more restrict it if the population in south africa was mostly vaccinated, i think is a complex mix. actually,

of the mean competence of an individual and the mean protection of population. ok, well dr. young, we have to take a very short break right now, but we will be back in just a moment. thank you. ah ah a a a ah

ah, is it on you? no, no, no, no, no, but they just did a valuable mapping by middle no, i own my head up my laptop that has a knuckle. i love that you didn't thought, no, well, i'm going up there to be a well, i mean a relationship with ah

welcome back to wells, of course with lawrence young to have a religious at the university of boring to young. many of your colleagues are in favor of st. border control measures in the, in an effort to stand this brad of been you varian. but i've also heard alternative hypothesis that amik fonts, contagious nature may actually be a blessing in disguise because it is allowed to spread widely and rapidly it may forestall the development of the new mutations. is that reasonable, or is it too big of a risk to task? this to position in real life and with real lives on a tuesday. so to answer really, what is the border control? we know it's very difficult when you've got a virus particularly infectious off your it takes a while to do the genome analysis. once you identify new there, it's usually it's,

it's, it's spread beyond the original country and that's the nature of infectious disease and the nature of these days of international travel. so what's the, what's the purpose down? no or severely restricting, like you and from south africa as in most countries around the world. and i'm not sure there's any value in doing that. now to be frank, i think it really straight because as countries like australia or i know i've got friends in hong kong where quarantine is so straight and testing is so straight that you just, you know, that that's the way they control. it's very hard to do that in other countries. so i think this is questionable. i think it's really important that we support south africa. we don't cut off south africa, them having done such great work and sequencing the virus, etc. they need support. as for the spread of this, of course it looks like it will come compete out delta. we're seeing that already in the u. k, we predict it will overtake delta if and it's a big if, if this variance is associated with more more disease in fully vaccinated

individuals, then that could be a good thing. the worry we have, of course, is that always be a small number of the population, either unvaccinated, or whose response to vaccines are not great, and they will get poorly and, and that, and the small proportion of a large population of effect individuals could put enormous burden on health care systems and what we're all concerned about is, you know, protecting our health care assistance from being overwhelmed at the moment. that isn't the case in south africa. if you look at the number of people who are hospitalized at school up, but people tend to be staying in the hospital for a short period. and what's really interesting is if you compare the data at the same time in terms of the number of cases when they had the delta wave in south africa, they had formal men far more people in intensive care at that stage than they do now. so this all goes well, but we will be all the courses because we're looking at the data that comes in. the hope is that this will result in more mild disease. i think that's the case. then

you can say, well, actually, perhaps it's not cops, it's not such a bad thing. i've read some reports that trying to identify the special sort of south version of omics on the one that cannot be detected by a standard ccr test, which could only be sam the through genetic testing. if that's the case, is there a possibility? all the other forms, are there a variance of the fires that are spreading around on detect and because many countries are now trying to detect ami on but usually standard ccr just doesn't it . yeah. so, so you know that this almost becomes an issue of semantics on what you, what, what you call a variance variance. because all the while these, these are a sublet ages, are there were changes all the while and you can map all of these. and it, so how do you define when, when all these changes become another variance?

so the loss of variance circulating all the walk. also, we just have to be concerned about the ones that are more transmissible. and that's why you know, make surveillance is so important. i agree with you that it's possible to actually quite rapidly modify the pcl test if you want to take to particular variance. it's also really important that you have high levels of genomics of amos around the world. some countries don't do that to the south africa doing really well with other countries in the develop. well, do that well, but you know, let's, we're going to handle this elsewhere. i think that's going to be really important again. so another reason why the, what the more develop, well, it should be supporting genomics of violence in other countries because this is an important way to keep a handle on what's going on to make sure that if any nasty various popping up, we identify them early. well, you know, the surveillance and intelligence usually come together and even the level of tensions, international tensions in the world. you know, between russians and west are between china and the united states in china and

india as a host of other countries. i, i can't imagine that there could be some use in santa one or incentive against sharing certain information with other countries, especially in those countries or identify openly as an adversary from your vantage point. how free is common response and surveillance that you've been such and such an advocate for how free it is from or bad old politics? yeah, i don't know if you know, because we've seen this, certainly with the global rollout of explanation. as i said earlier, you can understand the government wants to protect their own people, but we do have a responsibility. the rest of the world politics is always going to get in the way . have you said that you know, the world health organization that are really good job in supporting other countries? as far as i'm aware, most countries been very open,

around sharing data. what we don't want to do as we see in the last week or so, is penalize a country like south africa being very open about the data that they provide. and what we hope promote, we anticipate is that other countries are going to be just as open when they get data that demonstrates new variance popping up. and i think on the whole, your data sharing has been from the beginning. this has been a real testimony to the global interaction, and so the responsibility that we will have across the world to work together to combat in china 1st, ready to sequence very well. you know, that was, that was the, that was the starting gun to being able to develop a vaccine without that. we've been in a lot of trouble. so i think that has been open, but i also oversee politics solving. inevitably gets in the way occasionally. well one area where politics getting to waive very prominently is of course the

introduction and the recognition of vaccinations. if you can, if you were to come to moscow or i were to go to london, we would be treated as a major how i think we just do you see that as a problem or is there perhaps some unknown silver lining there as well as you know, i think there's a real issue here about the requirements for approval of drugs and approval of vaccines and the data that is needed to support that and what type of rigorous are approaches. we have to make sure that when we are approving vaccines, they're recognized in different countries. so we don't end up with this. and i were facing at the moment. and a lot of that i think is how the different agencies around the world are working. and again, i come back to the fact that it will hold health organization is really important, trying to pull it all together. so we might have all these different regulatory requirements in different countries, but we need to unify more. i think this is going to be one of the, there are many,

many lessons are going to come out of this pandemic. i'm going to help us prepare the next for the next time. and i think one of these is how do we unite so that we can work together internationally. we can approve developments vaccines, test internationally. perhaps that hasn't worked as well this time. and it's something we need to fix. now there's one question that's been bothering me from the beginning of the malays and it is very intense. there are specific focus on anti comment protection b vaccination or mask wearing social distancing, et cetera. as opposed to 4 to find your by overall immunity being conscious, being disciplined about your daily health choices. maybe my on like a logical defense and you know, they decided to have some semblance of control over the virus. but i was wondering,

in your personal, you, in your professional, your how much does 11, lifestyle influence he's or her chances of contracting in combating that? yeah, he was a lot about that. we've learned a lot about the differences in relation to disease outcomes in different populations. i. e ethnic differences in the way people responded and how that might have led to some problems with the way different communities have been supported and managed and indeed messaged the messaging is very important to populations. we've learned a lot about what we knew for years, which is the impact of co morbidities. so not only about social deprivation, but also about things like obesity and diabetes. and this is into sharp focus. the need for not only individual responsibility, but governments to support the development of more preventative measures and more information to allow people to understand the personal responsibility that you just mentioned about our own health and how we need to control that. and i think perhaps

if people didn't realize before, they certainly realize now that the other factors in their life of the lifestyle factors are really influencing the way you respond to this infection. and again, it's another i keep mentioning the same thing is another wake up call actually for taking personal responsibility for your health. but also for the government, i think messaging and supporting better individuals who are in situations where they are economically or socially deprived. we've known about these health inequality for many years, and sadly, a pandemic, a lot of this shines a big a lot on those inequalities. let's see, i'm very quickly. i mean, you mentioned the importance of messaging and from the very beginning of the spend down a fascination and community for harold it as the, the main weapons against the virus. and that also produced a certain push back, not only in terms of faxing has it is asking certain countries including russia now dealing with a full blown that's in rejection,

and it only gets stronger. i'm concerned that the, the army on darien ability to breach some of that back in and use community may actually yeah, you know, provide some more arguments to the anti back community that they're going to, you know, feel a little bit emboldened and spreading the message. yeah. i see, i think that is an issue because there are 2 groups of people that are very sort of hauled line, anti faxes, and whatever you do, you'll never persuade them of the enormous benefit of vaccines for more than you needed 200 years. we've seen the enormous benefits, but i think those people are never going to be persuaded. then there was a very seen hesitant. i see what we've seen. and we're particularly seeing in central and eastern european countries is a very, very high level of vaccine hesitancy. and this often comes from a mistrust in the government, and i think this is a big problem. it's having confidence in your government and in the messaging from your government about about the need to be vaccinated, the need to,

to adopt certain behavioral changes in it. again, it demonstrates how, how important that sort of social contract is with governments. and it's a very difficult thing to fix. my view is rather than co, while the sort of coerced by mandating vaccination with eric about this now in certain european countries like austria that you really do need to bring people along with you and but you, if you try and force people to do things that can be counter productive, but i think a lot of this is about how clear the message has been and how clear the evidence that you produce is and how to adjustable. that is to your population. but they have to have trust in the government, but they don't have that. then this will not well, maybe they also have something to do with the notion of personal responsibility. and if no messaging is working, maybe a government should allow nations take its course as cruel as it may sound. but i think people rarely learn from somebody else's mistakes. they only come to their

senses when they encounter danger. and, and i need your life, we have more time to discuss that any more. thank you very much for being with us today. thank you very much to thank you for watching put this year. yeah. next week . when will depart, ah ah ah, better by the survival guide is like wont stored safely at the federal reserve issue. it's still there or you don't forget it? oh no, it's

a recreation game. we get the right to 7 years. so with this, every year i've tried to report yeah, we just of she is a, she is not better. we video don't. michelle kraus, of pretty much be with the with can sure the coordinator, a greater blue your skin bomb. yeah. but a just stick with the boy vigilant uniforms. a going away from the lead on most that as we said that the gamma out will, you will like you. but what would you like? somebody isn't that your mutual ways figured out those they might not spanish videos yet because the long term with

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