Luis Enjuanes: "The work of health workers who do not want to be vaccinated should be restricted"

With Aragonese roots (from Alcampel, on the paternal side) and Valencian (on the maternal side), Luis Enjuanes, head of the Coronavirus laboratory of the National Center for Biotechnology, is the father of one of the Spanish vaccines, which will reach the market at the end of the next year.

-What are we doing wrong so that contagions rise again?

-As always, there is the concern of the economy. We do the usual and we have already done it twice, which is the openings too fast. It is an error, because when one manages to lower, as we have done twice, the number of cases to less than 50 per one hundred thousand inhabitants, then monitoring is very easy to prevent it from spreading and also, the patients who enter hospitals have all the medical equipment at their disposal and are treated much better. Reopening too quickly what it generates is to reactivate the virus again, because viruses do not think, what they do is that they work with large numbers and any opportunity they have to spread they do so. And maintaining good health with 40 patients per 100,000 inhabitants is not the same as having 400 or 800 as we have had on other occasions.

-When are we going to learn to live with this virus?

-Probably soon, at least in Spain, in the sense that the number of vaccinated, which is now over 85%. By starting to administer doses to children, which can be done within weeks and taking into account that children are 14%, we could raise the percentage of vaccination above 90%; And that's the best way to control the spread of the virus.

-And omicron appears in these.

-We still cannot assess omicron with the data we have, we have to wait a couple of weeks because you have aspects that are still statistically insecure. Many of the infected people have been asymptomatic, but with the numbers we have we cannot say anything. The other data is that it has accumulated 32 mutations in sites that have accumulated other variants that have led the way, but we have to wait at least at least 2 more weeks, better three, to be able to compare all the data.

-Do you understand the closing of borders to prevent omicron from entering Europe or have they been closed because it comes from Africa?

-It is something that is not very clear because as it is being demonstrated, when the health services of all the countries have been intervened, what has been seen is that at least the virus had already been circulating for two weeks. All precautions are good and whenever you close a part of the world, you avoid dissemination, but maybe you have to think about it more carefully. And maybe have to correct it.

-Are you in favor of the covid passport, which is being established in almost all of Spain?

- I see that it can have advantages. There are many people who would not be vaccinated, who have not been vaccinated in fact, but when they have found out that if they do not get vaccinated they will not have the covid passport and they will not be able to go to certain cafeterias or they will not be able to do certain travel, has been vaccinated. In that sense, it is obvious that the passport has very positive aspects.

"To be able to assess omicron, we will have to wait another two weeks, even three"

-It has been shown that when it has been needed for the covid passport, the population has gone en masse to be vaccinated.

-So, do you see how the passport is worth it? This is not a matter of culture, it is a matter of the heart and things of the heart are sometimes difficult to understand. It is clear that for most people, vaccination is beneficial and protects you against even death, but despite everything, some do not want to be vaccinated. The problem is that not only do they put themselves at risk, but they put their children, their parents and their family and the rest of society at risk. We need the media to help us in this task.

-He said a few days ago that the unvaccinated should pay for their treatment. It has earned you a lot of criticism, but part of society agrees with you.

- What I want to say is that the first thing we have to do is talk to them, use our intelligence thoroughly, to be able to attract them to vaccination; explain the disadvantages of not being vaccinated, explain that not only are they putting themselves in danger, but also their children and their parents: that they go to an ICU, please, to observe how the patients who have been infected are doing. This infection, as some want to say, is not a hoax, it is a worldwide reality. You can see it in the press of all the countries of the world. It is impossible to deny it with a little common sense. Let's see if they reconsider and can make the decision to get vaccinated, for the good of themselves and their families, if only for that, it is enough.

-Are you then in favor of compulsory vaccination in general or in some sectors such as health workers or nursing home workers? Do you understand that a toilet does not want to be immunized?

-I think that due to legal impediments, establishing compulsory vaccination is possibly not possible unless it directly affects the safety of society in general. But what can be done are measures that affect different sites. How are you going to put a doctor to treat patients if he has not been vaccinated and is in contact every day and almost all day, with people who are shedding viruses? That would not make sense, we would have to restrict the work of health workers who do not want to be vaccinated. This is happening in many countries, in France, in Austria, and so on. They cannot force them to get vaccinated, but they can force them to restrict what they can do.

-How many variants will arrive in Spain before the Spanish vaccine is in operation?

-Many, because when a virus infects a cell all the viruses that grow in that cell are different. Therefore, by the nature of a virus RNA variants constantly emerge. No two viruses have the same RNA genome. Now, within these, viruses that are more dangerous than the current ones are always a constant. The flu virus continues to change constantly and there are some that from time to time produce an epidemic, and this will also happen with coronaviruses because they mutate a lot genetically and, of course, when they find a country or a continent like Africa where they can spread very easily because there are very few people vaccinated, that's where they have more space to create variants. Therefore, it is not only ethical to provide vaccines to Africa, but it is the smart thing we have to do to prevent new variants from being created there, as has happened for example in India, where there are very few people vaccinated and the virus you can try until you find a variant that is prevalent and that is more pathogenic.

-They say that the vaccine of the group that leads is the best, the most effective, but do you think it will be late?

-When a thing is valued, it can be valued from many points of view. Ours has aspects that are very promising, such as that it expresses different antigens, that it is self-amplifying, it can induce a sterilizing immunity. This is all positive and makes it promising. It has other aspects that go against it; and it is more complete and therefore needs more controls, its design is slower because many more checks have to be done. There is the good and the bad. This itself is slowing it down more, but current vaccines must be improved, because although we are very grateful for all the good they have done to humanity, we must also recognize that a vaccine that after two immunizations still allows you to multiply the virus, well that's not ideal.

How often will we have to get vaccinated?

It will probably become like the case of the flu in a seasonal vaccination. The luck that we could have is that the virus evolved, spreading every day and becoming more attenuated and that the time would come for it to occur with the first four human coronaviruses that have been discovered, which today are attenuated and infect all adults but as Much what we need is paracetamol and we have no excuse not to go to work.

-Give me a positive message. What do we have or don't we have to do this Bridge and this Christmas?

-We don't have to lower our guard. The numbers are blatantly climbing again. We are over 200 infected per one hundred thousand inhabitants. That's when we've been 50, it makes you want to cry. It is a pity. We must apply everything that is within our reach, the third dose, be whenever we can in open spaces, keep our distances, ventilate the rooms when we anoint ourselves with relatives, use a mask whenever we can; you have to take advantage of all the resources. We have to have a little patience and I would say a lot of responsibility.


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