Philadelphia hospital director: This winter will tell all” about COVID19

In an interview with Radio Free Europe, Offit expresses his belief that the future will bring more mildly ill people and fewer seriously ill ones.

However, he adds, the most real situation will be seen in winter, the season when infections usually take off.

Offit says people under 70 who are healthy don’t need a fourth dose of the vaccine.

Speaking about the possible post-pandemic period, he says that “this virus will circulate for decades, if not centuries”.

“We’re not going to get rid of this virus,” says Offit, who was also a member of a US panel that recommended the use of the Pfizer/BioNTech vaccine.

Radio Free Europe: Doctor Offit, the number of cases of COVID-19 is increasing worldwide. What is behind this growth?

Paul Offit: It is about the so-called subvariants of Omicron, which are immuno-invasive. So even if you are vaccinated, even if you have received the booster dose [të vaksinës], you can get a mild infection. This is also what we are seeing. Here in the US, too. We see an increase in cases mainly with BA.4 and BA.5. These subvariants of Omicron now account for about 50 percent of cases. But we do not see an increase in the number of deaths. We see only a small increase in hospitalizations. This is what I think will be the future with this virus – more mildly ill and less severely ill.

Radio Free Europe: Do you think this trend of low hospitalization and death rates will continue?

Paul Offit: I think this winter will tell everything. We know that the last two winters, in November, December and January, there was an increase in hospitalizations and deaths. But, this winter, compared to the previous ones, we will have a higher level of immunity in the population.

People who have been infected or immunized with vaccines make up maybe 80-90 percent of the population… So, let’s see. But I think the future will mean a lot of mild illness and a lot less serious illness.

Radio Free Europe: You say that vaccination, high infection rates have contributed to this situation…

Paul Offit: Exactly. I think vaccination, or natural infection, or both protect against getting seriously ill. There are many such cases now. I am vaccinated and have been infected. So are most of my friends. I think we have something called hybrid immunity, which means we are very likely to be protected, for years, against getting seriously ill. But let’s see. This virus always surprises. So, let’s see how it goes.

Radio Free Europe: You in the US have approved the fourth dose of the vaccine. But, for example, in some European countries it is not approved. Do you think the rest of the world should also adopt it?

Paul Offit: I think three doses will protect you against severe disease if you are otherwise healthy. Older people, meaning those over 70, or people who have other health problems, may be at risk of becoming seriously ill and may benefit from a fourth dose. But I think people under that age, who are healthy, don’t need the fourth dose.

Radio Free Europe: Is there any chance that Omicron will produce other variants?

Paul Offit: Yes, of course, this is the trend. Omicron was the BA.1 variant and now we have BA.4 and BA.5. These are viruses that have learned to evade our immune system – in the sense of protecting against mild illness. But, again, if you are vaccinated, or naturally infected, or both, you are – most likely – protected against severe disease, even with these sub-variants of Omicron.

Radio Free Europe: Yes, what if the new variants that emerge are more transmissible, more severe and avoid the vaccine?

Paul Offit: All of these variants, such as BA.5, BA.4, BA.2, etc., are able to evade your immune system and cause you mild or moderate illness, but not severe illness. It may be that a variant emerges that produces greater resistance to protection. This has not happened yet, but when it does, then a variant-specific vaccine is needed. I think, at present, there is no need for one.

Radio Free Europe: But we have been repeatedly told that vaccines with mRNA technology [Pfizer apo Moderna] can be easily adapted, depending on the variants that arise. However, we don’t have boosters – let’s say – for the BA.1 variant. Why?

Paul Offit: I’m on the Food and Drug Administration’s Vaccine Advisory Committee [të SHBA-së]. We considered a booster that would include Omicron, a two-component vaccine.

But if we look at the data — the people who got three doses of the current vaccine — the so-called original prescription vaccine — and then they got the fourth dose of the same vaccine, and the people who got three doses of the current vaccine and the dose the fourth received the Omicron booster – there is no significant clinically significant difference.

The difference was 1.5-2 times greater in terms of neutralizing antibodies against Omicron. I don’t think this is a clinically significant difference. I don’t think we need a very specific vaccine. But I think that the World Health Organization is pushing for such a thing. Our committee has voted with 19 votes for and two against for its approval. I have cast one vote against. Let’s see how it goes.

Radio Free Europe: In the Czech Republic, where I live, there are no restrictive measures, for two or three months now. Was this the right thing to do?

Paul Offit: I think we are reaching the point where we will have a new normal. Even if 100% of the world’s population is vaccinated, this virus will continue to circulate and cause mild illness because it has a short incubation period.

Even if you are vaccinated and have the booster dose, even if you are vaccinated, have the booster dose and have had the natural infection, over time, you will still be vulnerable to getting sick easily. We will have to get used to this because this will be the way of life over time, even if everyone in the world is vaccinated.

Radio Free Europe: Thinking ahead, should we do something different this winter?

Paul Offit: No, I think this winter will teach us a lot. Right now in the United States, most areas of the country are acting like there is no pandemic. The definition of a pandemic is that it changes the way you live, work or play.

I’m in Avalon, New Jersey, and if you go to a grocery store, you see that nobody wears masks. For the people here, the pandemic is over. On the other hand, if you go to Philadelphia, a lot of people there wear masks. So they continue to think that there is still a pandemic there. I think the way we move forward with this pandemic is going to evolve slowly and sort of adaptively.

Radio Free Europe: So, how do we judge what is safe and responsible?

Paul Offit: Again, people will get sick easily even if they are vaccinated. However, for the most part, they will be protected against serious diseases. But if you really want to be completely protected from this disease, then you should not leave your house.

Radio Free Europe: So, we are far from being “post-pandemic”…

Paul Offit: I think this virus will be around for decades, if not centuries. We will not get rid of this virus. There are four types of coronaviruses in humans. Two of them have been with us since the late 1700s and 1800s. This virus will be a part of our lives, for the rest of my life, my children’s lives, and their children’s lives.

I think we have to do the best we can to make sure we have a population that is immunized by vaccination, but also understand that this virus will circulate and continue to cause mild illness. And, to some extent, in immunocompromised people or people who are elderly, it will cause more severe disease. Those people may benefit from a booster dose of the vaccine before winter.

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