As children headed for school after months of online teaching, triggering worry and fear; as Covid-19 cases multiply in schools and debate rages on as to whether children should be vaccinated or not and whether this is the end of our woes with Covid, many questions surrounding Covid-19 remain unanswered. Dr Sunil Gunness accepts to give his views based on months of research in the area.

The first time you talked to us about Covid-19, you told us that the virus would weaken at some point and go away. Has that point arrived, according to you?

Yes, I am very happy to say that this is exactly what is happening right now. There are many very positive results around the world. It started in South Africa with Omicron, a highly contagious virus but a less aggressive one. I am also in a position to say that in the future, even the mutations in the Omicron like BA.1 and BA.2 are less severe. This is the way this pandemic will go away. It will become endemic.

Some countries have already realised that, haven’t they?

Yes, Spain for example, has removed all the barriers and life is back to normal. The UK and Sweden have gone that way too and France and Switzerland are easing out. Even in the US, some states like New Jersey are easing out. So we will also head that way and Covid will become like the flu. It won’t kill more people than the flu. We started with a novel Coronavirus. That means it was the first time this virus had affected our body and we used many scientific ways to deal with it.

Without a lot of success?

I must say that in spite of the ups and downs, the scientific community did things right. If you compare Coronavirus with the Spanish flu in 1918-1919, you are comparing 50 million fatalities with about 5 million due to Covid-19. Also, it took three years to eradicate the Spanish flu. For Coronavirus, it took us only two years.

Helped by the media, you must concede…

Yes, the role the media played was essential. However, in some situations, they created a lot of panic. When you take scientific information and translate it for the layman, it is at times not well translated and, in some cases, this aggravated an already bad situation.

The media did help make everyone aware of the precautions to take, the dos and don’ts etc., didn’t they?

Yes, that was great but take the example of vaccination. If you are jabbing about 3 billion people, something is bound to go wrong in some very few, exceptional cases. The media blew that out of proportion and created a situation of panic: you get 10 cases of blood clots and that becomes main news. With any medication, you are bound to have some complications and the vaccine is no exception.

You must also admit that the vaccine did not end the pandemic in the end. It was Omicron that did.

 I agree with you 100 per cent but the vaccine limited the mortality rate while waiting for the virus to weaken. Without the vaccine, there would have been more deaths, our hospitals would have been flooded and we wouldn’t have been able to treat the other diseases. I think that vaccination and the sanitary measures have helped us control the virus. We have used these two elements judiciously.

Is there any evidence today that the vaccine did substantially reduce the number of casualties?

Oh, yes! The first big study done was in France and it involved 22 million people. It clearly showed that the number of deaths and hospitalisations was reduced in the vaccinated group. There was another study in Israel that went in the same direction. Over all, with the vaccination, we were able to counterattack this virus better. But it is important to understand that the sanitary measures go hand in hand with the vaccination and are as important. We need to remember that the viral load is very important. The sanitary measures helped us reduce the viral load.

What is the situation in Mauritius today?

I think that the situation is very good.

Is the virus gone?

Yes, the Delta virus is gone.

Forever?

Forever!

So what we are left with is a mild form of the virus which is not likely to cause a great deal of harm to anyone, is that so?

Exactly!

So why are we queuing up for a booster dose?

When we started doing the booster dose, it was six months after the second dose. The explanation is very scientific: scientists saw that after six months, the antibodies started going down.

Why does that matter if the virus is gone?

At that time, the virus we were dealing with was Delta.

How about today? Would you go for a booster now if you hadn’t done one?

Yes I still would. We all say that Omicron is believed to be mild but again it depends on the viral load and the health conditions you may have and which you may not even be aware of. Even with Omicron, there are fatalities.

“I think a fourth dose is too much. I am against the fourth dose. It is scientifically proven that the third dose will be effective for a whole year. Let’s wait for a year and see what happens.”

Very few as I understand…

Very few but we want to avoid even these few.

But you can’t avoid them even with the vaccine, can you?

We will get less casualties with a booster dose.

But when is this going to stop? In some countries, they have started a fourth dose.

I think a fourth dose is too much. I am against the fourth dose. It is scientifically proven that the third dose will be effective for a whole year. Let’s wait for a year and see what happens.

In the meantime, we are in the middle of vaccinating children and there is talk of vaccinating kids as small as five year old. Is that reasonable, particularly with the mild variant we are dealing with?

That is a big, big debate between us doctors. Fifty per cent are for and the other 50 are against.

In which 50 per cent are you?

Frankly, I don’t think it is necessary to get kids vaccinated. It has well been proven that when children get Covid, they stay by and large asymptomatic. Those who are for vaccinating children argue that the children can secrete large amounts of the virus if they are not vaccinated. In my opinion, since we are all vaccinated, it doesn’t matter how much viral load children secrete. I am not for vaccinating children. This is my personal opinion.

“You will get the virus even if you lock yourself up in the most secure safe of the biggest bank. Better get the virus vaccinated and while respecting sanitary measures.”

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Have you shared that opinion with the authorities?

No I haven’t had the opportunity to do that. But if we had a debate among doctors, that would be my stand.

In the meantime, some kids are being denied access to school because they are not vaccinated. Do you think it’s fair?

Honestly, I think it’s unfair. But I hope that will change in light of the recent developments. I hope that what we will see in the coming weeks will help change that decision and that children are allowed to go to school even if they are not vaccinated.

It might be too late as they will have lost a lot of time.

You know, I have given you my opinion. I am not the one who takes the decisions but worldwide, medical opinion is divided when it comes to vaccinating children. Even imposing masks on children is tough. I find it unfair. Is it worthwhile? I think there will be a tough time when everyone will get the virus but then we will become immune to it and better times will come.

Do you think time has come for us to lead normal lives again?

I think yes and this will come in Mauritius very soon. However, in spite of the easing out, as a doctor, I would recommend that people are careful for a couple of months more and keep the sanitary measures. Even if the laws are eased out, I would still recommend that. Let the virus ease out slowly instead of exposing ourselves to large loads of it. We need to be more careful for a little longer.

How careful can you be if you are meeting people, eating out etc.?

If you can’t, you can’t. But my opinion is that we should go back to normal life slowly.  My feeling is that we will get more and more viruses. We must learn to start changing our lifestyle and respecting our environment. Even human interactions must be done differently. Keeping some sanitary measures costs nothing and can prevent the transmission of viruses.

What is your opinion of the role the World Health Organization played throughout the pandemic?

I am very sad that there were a lot of arguments between some of the biggest scientists in the world. I thought the WHO would be bold enough to bring all these factions around a table and give the world a common language and give the world one common message. Leaving that to the media created a lot of chaos and the poor population didn’t know what to believe. Wear a mask or not wear one? Get vaccinated or not get vaccinated? The WHO failed to shine by bringing scientists together and giving the world population more confidence in the organisation. I was sad as a doctor to see America fighting with France…People didn’t know what to do. Very sad.

Up until now, the scientific community hasn’t come up with a vaccination that works 100 per cent and still less medication that works against Covid. Isn’t that a failure on the part of scientists?

You are 100 per cent right. In epidemiology, when a vaccine works 60 per cent, we say it’s OK. All these vaccines worked above 60 per cent, not only in vitro but also in vivo. What saddens me is that there was no oral vaccine invented as in the case of Polio. I was very optimistic that we would get one against Coronavirus. If we had, it would have been distributed around the world very quickly as in the case for Polio which has virtually been exterminated.

So the best brains in the world got together but couldn’t produce a vaccine that works 100 per cent, let alone the oral vaccine you are talking about nor could they produce any medication. So what did they do?

They did a lot. You know the mRNA vaccine is a real breakthrough because if there is a new variant tomorrow, the vaccine can easily get adjusted to deal with it. It will also be used in the future in some cancers like the cervical cancer in the female gender and in some heart conditions.

But still no medication. Is it a failure?

I don’t think so. There is a big difference between chronic and acute diseases. With chronic diseases, you have time to do research. Coronavirus is an acute disease. Within 15 days, you are back on your feet.

Or gone…

Yes, or gone. So you don’t have time to do research. This is a big drawback about infectious diseases. We have learnt something though. We initially thought that the virus was dangerous. It’s not the virus that is dangerous but our body’s reaction to it. And we adjusted our treatment to that like replacing intubation with high flow oxygen, which was more effective at least for the first few days of the disease. So next time we get a pandemic, we will know how to deal with it.

Are you expecting another pandemic soon?

I fear it will happen sooner than later because of the way we are destroying the environment, nature and the way we are developing the world. I think we have destroyed the world too much.

How?

I will give you a simple example: normally, when you get a chest infection, you are prescribed an antibiotic type 1. Today, some strong antibiotics called type 5 are available. So pushed by pharmacies, society etc., more and more doctors are prescribing type 5 when type 1 could have worked. Take another example: look at your mobile. It’s still working but there are all types of incentives given and there is a lot of pressure for you to throw it away and get a new one. Think of how much energy and environment destruction are involved in producing a mobile. These are things we should be thinking about in a more scientific way.

Other than the death toll, what has been the cost of Covid to the living?

Definitely, heart disease has gone up. There are many explanations to that: during the lockdown, people were stressed and couldn’t exercise, move around etc. Also, the cost of living has gone up and people have become poorer. The other aspect is that both the virus and the vaccine cause clots. Naturally, the virus causes a lot more clots than the vaccine. I also think that many people have had the virus without knowing and it has caused inflammation in their organs.

What is the rate of the increase of heart disease in Mauritius in particular?

At least 30% over the last two years! We are flooded with patients. We work seven days a week and there are many emergencies – angiography, angioplasty, cardiac surgery…

Isn’t it because you were not fully operational during the lockdown?

We were!  At the Cardiac Centre, we have never stopped doing cardiac surgery, even during the lockdown. We were taking care of emergencies – one or two cases a day in very challenging conditions. We had to adjust to the fact that visits were not allowed so we installed WIFI everywhere and gave free phones to patients so they could talk to their relatives and keep the human touch. This is a lesson. We can do this in the future to reduce the number of visits.

If there was a 30 per cent increase in heart disease because of stress, what do you think the mental health services must be experiencing?

From my own experience, many people come to visit me because they have so much chest pain that they think they have a heart condition. In fact, it’s stress. So I can imagine that there must have been a huge increase in the workload of the mental health services. People are extremely stressed because of the reasons I mentioned above and they also worry that they might get the virus. I tell them, ‘you will get the virus even if you lock yourself up in the most secure safe of the biggest bank. Better get the virus vaccinated and while respecting sanitary measures’.

Is it better for us to go out of our way to get the virus?

I wouldn’t say it’s better but if you get it, don’t worry.

I mean since we will catch the virus, isn’t it better for people to go out there and catch it now that the booster dose is still fresh in their bodies than wait and catch it when its effect has waned?

Scientifically, you are right since the immunity you get from the virus is better and stronger than the immunity you get from the vaccine. However, it boils down to the same thing: let’s say we all remove our masks and start competing to get the virus, the health system will be flooded and the risk of mortality will increase.  

What you are saying is: ‘the virus is gone but...’

…but let us be careful for a few more weeks. Things are going very quickly. We will be over this soon.