In the fight against the pandemic caused by the emergence of coronavirus, which is a major issue in our daily lives, spreading misinformation and clickbait headlines through media and social networks is inevitable. Although this social behavior is seemingly negligible in relation to the severity of the pandemic, those same information can cause irresponsible and risky behavior of individuals that could lead to a fatal outcome in the fight against coronavirus. In order to prevent such outcome, STEM Games organization has decided to provide you with responses from experts who experienced development of the coronavirus situation firsthand.
We present you a discussion where their own experiences, thoughts and comments shared with us two esteemed scientists who are directly confronted with some of the problems related with the appearance of coronavirus: Ivan Đikić, this year's STEM Games ambassador, and Wolfgang Bock as the mentor of the mathematics arena.
Ivan Đikić is a Professor of Biochemistry at Goethe University in Frankfurt. Currently, he is part of a research group at the Buchmann Institute for Molecular Sciences where he is exploring the impact of coronavirus on replication in human cells, innate immunity, and blocking the replication of virus in the body.
Wolfgang Bock is a Professor of Mathematics and Engineering at Kaiserslautern Technical University. He is currently working with epidemiologists to model the spread of COVID-19 within the MOCOS (Modeling Corona Spread) group using stochastic and complex systems.
Some of the topics touched on were different approaches in the fight against pandemic, mathematical modelling of the spread of coronavirus, the role of mathematicians and molecular biologists in the fight against the virus, ways how the current measures influence the spread of the infection and the impact of the media on society. They also commented on issues of great concern to the general public, such as the impact of temperature on the spread of the infection, the seasonal appearance of coronavirus, the effect of alleged coronavirus cures, and the development of vaccines. You can find out all the details in the video interview conducted by Vladimir Šimović, lecturer at the Zagreb University of Applied Sciences.
You can watch the full interview here and you can find the transcript below the video.
Vladimir: Hello everyone, my name is Vladimir Šimović. I am a teacher at the Zagreb University of Applied Sciences, and I'm here to host the STEM Games interview with Mr. Wolfgang Bock and Ivan Đikić.
So now I'm going to ask them to introduce themselves a bit. Mr. Bock can you tell us something about yourself?
prof. Bock: Yes, my name is Wolfgang Bock, I'm 37, and I'm a lecturer at TU Kaiserslautern. It's where I'm actually lecturing engineering and mathematics. Also I was involved in the Mathematics Arena in STEM Games for this year. Right now, as my research, I'm doing epidemiology and stochastic systems, complex systems and I'm at the moment in the modeling crew for COVID-19.
Together with some friends from Poland we formed the MOCOS group (Corona spread group). Since this week I'm also somehow part of the research group in the German epidemiology society group for COVID modeling.
Vladimir: Ok, thank you. Mr. Đikić?
prof. Đikić: Hello, my name is Ivan Đikić, at the at the moment, I'm a professor of biochemistry at the Goethe University Medical School. I'm also leading the Institute for biochemistry as well as a part of the BMLS Institute where we are doing quite a bit of coronavirus research at the moment.
Our university is officially shut down on a very cold programme such that there is no activities. Students are at home, we do quite a bit of online work with them, but critical research on coronavirus has been approved forseveral groups. And in this current situation, part of my lab is really focused on understanding how coronavirus too affects the replication within the human cells, the innate immunity of humans as well as what are the damages and what inhibitors we can use to block normal replication of the virus inside ourselves.
Vladimir: I would like to ask you a question about different approaches to battle this epidemic. So, we've seen some countries have opted to enforce drastic measures to slow the spread as much as possible, while other countries are hoping to immunize the population as quickly as possible or "ride the wave."
Could you perhaps explain the motivation behind different approaches of fighting this and maybe comment on them?
prof. Bock: So, there are different approaches as you said in principle, with strong measures, we can talk about suppression and mitigation.
Well, mitigation actually is what you said- you try not to extinct the disease. You keep it in a critical phase, but such that you don't threaten too much the health system to build up herd immunity and, that you get a
protected against the 2nd wave.
With suppression, someone needs to take very strong measures to let the disease somehow run out in a certain time period also without threatening your health system, but really in a short time until you don't have herd immunity.
And there are also other measures like backtracking measures and testing or something, I could talk a bit about that. Our group has now recently published a preprint where we think that herd immunity and mitigation is very hard to reach in this corona spread.
Because, we had a very small interval of contacts you can have out of the household where such a mitigation strategy [could work] such that you are not exploding exponentially and threatening your health system, but you somehow keep the disease under control in such a way in critical phases.
This margin is very, very thin. It means if you are... It's not very robust. So, if some small amount of people is not somehow following these measures you immediately go to a very critical epidemic. And that's why we think, with our group that it's maybe better to do a suppression method here and also to couple this with some strong household quarantine and backtracking measures.
I mean there are different approaches of course. Maybe Ivan can say
something about that.
prof. Đikić: Yes, so I would follow on Wolfgang's comment, there are different approaches we have seen that different countries have been taking different measures but also having different success. This is something which is a negative aspect of the fight against the pandemic virus spread.
We have learned from history, from the time of Spanish flu in 1918 from 50s, 60s bird and swine flu, SARS - the global approach to fighting this type of viruses is the only way forward. And the knowledge and the facts that we can collect.
This has been quite poorly done in this current situation. The world was apparently totally unprepared and this you can see by the measures. Every country was having internal measures, there was the closing of borders when the virus has been already spread throughout Europe. The measures were very chaotic, a lot of panic, a lot of media exaggeration of the things has been happening and, unfortunately, most of the governments around the world have not understood seriously that they should have worked behind the scene behind the media and prepare the system.
The system should have been prepared in two layers - one is public health and the second one is the hospital system where we should have had much more capacity to accept the urgent cases of patients who were coming.
All of this we could have seen and learned from China because we had an experiment ongoing in front of our eyes. Unfortunately, as you see today in America which is a now the center of the pandemic, you have the same problems like in any other country in the world; whether you are very developed or not.
In the absence of proper testing, in the absence of the drugs against the virus and in the absence of the vaccination, we are left only with very rigid epidemiological measures and the public health procedures.
Some countries have done it well, we can discuss about the reasons and the way is how they did it, other countries did it weaker. Those who did it well, successfully did only one thing - they introduced measures on time and secondly they had the discipline of their public.
Discipline of the public is very critical because, when you're doing something to block and prevent the spread and circulation of units of the virus in population, if you start having holes in this, the virus will get out, it will get to a new population and you're going to have a problem continuing from one continent to another, from one country to another.
That's where we are currently at the moment. Unfortunately the countries which are not yet in the heat of the virus spread are not yet understanding how critical is that they start with certain measures of prevention early, as early as possible.
Vladimir: My follow-up question was actually about one of the topics you actually touched on, let's say a lack of coordination between countries or even continents. How much is that a problem? Like when you see a hotspot has developed in one part of one country... how much of a problem is that some countries take a different type of approach globally?
prof. Đikić: I'll just follow up on my previous question. I said it is deadly it is dangerous and it is unacceptable in 21st century that we behave like "me first", "my country first" "my city first". [That we] don't show the signs of solidarity, don't show signs of knowledge that we can fight a global pandemic only with global measures. In that aspect you know, there is no solo play, we should have all been unified behind the data, we should at least have followed the collection of the data by the World Health Organization and tried to work together. Particularly in the European Union, we should and could have done significantly better.
prof. Bock: I mean, especially in the EU, at the beginning of the crisis it was somehow also that you could travel freely. There you have to have a European data system. You would have to have European measures really on the on European side, because you're actually dealing more like one country in the epidemiologic sense.
So, Ivan is completely correct; you need to somehow combine everything. Now it's like if you had a puzzle of small countries taking measures - one is taking stricter measures, the other taking the other measures. This will, of course, lead to different times when this, the whole crisis is over. So I ask myself, for example, what is with these countries; can you, for example, as a country which is through the whole thing open your borders to a country where somebody is fighting against the whole situation. This is the situation right now. So, you are threatening you or your own population with that.
You can help them, of course, but it's very hard to somehow open the borders to countries that have different measures than yours. You have a different timelines inside of the whole of the whole of European Union and in the whole world. This can be a very big problem later on, but at the moment we are dealing with fighting the crisis right now and I think it's it's getting a bit better. Especially because scientists are talking to each other right now.
So we have some data exchange, but it would be better if we had this right from the start, already in January or February.
prof. Đikić: Also one can follow up on this one, and ask the question - even we go via this very very critical peak and then it goes down, how can we behave after the first wave is over? Because, if we don't unify our behavior like China has unified [where] you have one point four billion people now with zero cases of virus appearance... it is impossible to imagine that two months ago you had the virus spreading through the entire country. If we don't take this... and this was all because they took the proper measures - they are giving instructions to people, people know what they can do in public, people know how to behave, how to distance and testing is very critical.
So, if we don't come to those measures around the globe, around the world around Europe, it will be impossible to contain the virus.
Vladimir: Ok, Mr. Đikić I want to ask you since you are a Croatian citizen living in Germany, could you comment on the differences of approaches? I think Germany is, let's say, considered sort of a success story for now.
prof. Đikić: There is no success story in any of the situation. I actually always avoid comparing the countries. Every part of any country that is affected badly [will] have a very high death toll. Today's count in Germany is 931 and this is a large number, [the number] in Italy is outrageously high and in Croatia as well. I would like to send the messages that we can learn from others and this needs to be as fast as possible and we need to adjust.
Sometimes, countries go with weaker measures, but then they need to apply what South Korea has done well - that's what Germany has done tremendously well. They have been testing and testing and testing and they've been knowing. Also Wolfgang and people who are on power of predictions and also our colleague professor Mezić from California. These people can predict what numbers are going to be happening in one or two weeks and based on this, they can adjust the measures. I think that's the power of science and the science being heard by politicians is today absolutely on the top. We see that in Croatia very well, we see that in Germany and many other countries. The scientists and professionals are actually taking the lead in providing the public with the right conditions.
Vladimir: I would like to come back to this topic because I find very interesting the differences of the starting point between Europe as a whole and the United States because, let's say, it is a collection of states but there's like, a really different access to public health and stuff like that which
just makes the starting point for them.
prof. Bock: In Germany we have a federal system and you can see that if you are talking to the different states, especially at the beginning, in federal states we had really problems with data. So we always have some time lag in the
Robert Koch Institute to collect the data. This is something which is coming from the federal system and you also have a different health structure. This is known in the cities, let's say, University clinics and smaller towns in the countryside. It's maybe not so drastic as in USA because the distances are not so large. You don't have to fly to another state or something like that. I think it's the same in Croatia. It should be, if you are either in Zagreb or you are in Zadar it's different.
Vladimir: Yeah but the thing is, I think... I'm not an expert, but personally I think they're handling it very well. It's already been a week, I think, since we banned all traffic between cities unless you have an e-permit for work or something like that. So let's say I cannot go to different city now so I think that's actually good.
prof. Bock: I'm living 105 kilometres from where I work and I could go every day if I wanted but we decided that we can do a lot of things online more less like Ivan said. At the moment, the lectures period is stopped so we start with the new semester in two weeks. We are preparing everything for online courses and this will work for some months and it's okay. You can work right well from home. Of course you have to be at the university at some point. I have to reset my servers and stuff like that, because if my server is somehow switched off, somebody has pressed the button, therefore I have to go there. But other than that, we try not to be at the university.
Vladimir: This would be a question for Mr. Bock: could you talk a bit about the challenges you face while modeling this outbreak?
prof. Bock: Well we had at the beginning quite an easy model where we just modeled in-the-household context and the out-of-household context. And [in] the out of household context we put a more or less free parameter, so that we know how much we can shrink it. So the the in-household context...There, at the moment it's okay, because you can use a clique structure. These are models which are well known and you can read this up.
Of course, we have some problems with clinical data. Because...we have to use data from Wuhan and from South Korea which are quite good. There's a lot of data there, especially about when people get infected, when they get symptoms, how long they are usually, on average in the hospital and these are the things we are trying to estimate with distributions. For that, it's always important to have a lot of data. Now we are starting to do backtracking modeling. That means we try to model infection chains, and for that we would need patient data, individual data and this is very hard to get. So there of course we are lacking some data.
We are talking right now with Robert Koch Institute to get something there. In Poland we are one step further, we have already some infection chains at least. What we haven't modeled yet, for example is the geo-localized data that means how people are traveling right now in Germany. There are some data about that however you cannot usually use the traditional models anymore because everything is quite dilute now. You have public transport going on a very low level, not everybody is going somewhere, you have some certain amount of home office. This is for example hard to model and the other thing is the number of infections you don't know [about], so the detection rate. The detection rate is this something you can somehow estimate, and also if you ask, every scientist will give you a different number. We are trying to estimate it now but there are a lot of uncertainties.
Vladimir: So, if I understood correctly you're currently modeling the
outbreak in Germany or on your scale?
prof. Bock: No, so we are modeling... so with the MOCOS group we are modeling the outbreak in Poland and in Germany, and actually we check how much quarantine measures and backtracking and somehow testing also can influence the whole thing so we're doing more of an easy model and trying to put effectiveness of measures somewhere to get an idea.
Now we also started to model the Philippines because I'm doing a project with the Filipino University and Mindanao and they asked us too if we could help them to estimate their ICU unit needs. They are a very early stage at this island so the island is as big Hungary but they have this region that has certain cases right now and it's starting to grow. Also one has to say that they haven't tested that many people and of course the tests are not so available there.
But right now they are trying to prepare themselves and they asked us if we could help them in estimating how many ICU beds they'll need under lockdown and without lockdown. This is for example also something that we do. Every country you can get microcensus status of - our model is based on micro census data - we can somehow simulate we can simulate. We started with, as I now said Germany, we had Poland, Philippines we're starting with Nigeria I think and Sri Lanka.
Vladimir: So, for our viewers, I'm guessing, when you ask yourselves why you fill out those census forms this is one of the things where we need that data.
Is there any meta-analysis of modelling done yet? Is there cooperation between teams from different countries, different parts of the world?
prof. Bock: Yeah, as I said, so we're working with Poland, you have a group in Sri Lanka, a group in Philippines which we are working with and there are different, many many different models. So we are working on that what you call micro simulation models really, then you have contact models where you try to mimic the contacts on a sample of the whole population and there you can, with a certain depth of detail you can somehow try to mimic the measures.
Say, what happens if you, for example, quarantine everybody who is older than 65m or households with people who are older than 65, and you can check how this somehow relates to the spread of the disease without these measures and things like that this. This is for example, a typical micro structure model we are doing.
There are a lot of differential equation models. These are standard models from epidemiology, and I would say there are different classes - from very easy models which are quite fast to very sophisticated models where you put different types of compartments inside. Like one small box for people who are asymptomatic one with critical and then you would quarantine inside. So it goes from very easy to very developed. Every area of these models is somehow important because some are faster, ours need some more time. Certainly, if you are going to write detailed models you need more time, of course. So for quick predictions, for example, you can also use a differential equation model but just to some certain extent. You cannot expect very detailed information from a very core model. This is somewhat clear.
Vladimir: People generally have no idea what to expect in the future considering the measures that we're taking. The most common question is when this will stop. So let's start a bit before that - what would be the ultimate goal of the measures currently in place?
prof. Đikić: Thank you. Expectations are very difficult to say, because they depend on two things - the way how we approach the problem, the virus and second whether the virus can change with time. Both of the variables are not 100% certain, therefore it gives us a lot of problems even when we do predictions like Wolfgang was saying. You can do quite a bit with smaller scale communities, cities, even countries, but it's very difficult to predict exactly what is going to happen in the months to come.
Based on the data we currently have and particularly what we have learned from China or South Korea, we could predict certain stuff - if and this is a big if, if we behave and if we prevent the uncontrolled spread of the
virus, expectation are that within a month, or two or three months this could come under the first wave control and then comes the second step and this is changing our behavior and very many measures which are going to prevent reappearance of the virus.
I'm speaking about this based on the facts which we know - if anyone gets in contact with the virus now, it will take 20, 25, 28 days until virus goes through the body, creates symptoms or doesn't, but makes the person infectious. If we would manage, from now on, to control the spread of the virus by isolating people, everybody should come, within three to four weeks through this process and virus is not going to have any more people to infect. Those who are not infected will be clean, so by the isolation we are going to naturally prevent the virus to find new hosts and in that case our epidemiologic measures are working.
So, this requires discipline and the discipline in the real world is not same and it's not possible to have it 100%. And we can tolerate 10-15 % of non-obeying, but every, every percent is a higher chance that virus is gonna leak and that we're gonna have a much longer reappearance of the virus in smaller populations.
Vladimir: So, if I understand correctly, the idea is to let's say localize the virus potentially and isolate people and hopefully write it out.
prof. Bock: So what you would do for example is as Ivan said, you isolate for a certain amount of time and then you see that the number of new infections is going down and then you would start to to test again and with aggressive testing and then household quarantine you can really somehow get everything under control.
That's for example what China did. And also in South Korea they did a lot of massive testing. They know exactly who has the virus. And also Singapore, they know a lot about who has it and then you can take measures against this. So it's important to make social distancing or let's say an isolation. And in combination with strong, aggressive testing and a household quarantine.And then you get it under control. Also without vaccine for example.
So, there's been a lot of talk about the effect of temperature. Is it something we're hoping to help us?
prof. Đikić: The hopes are not helpful with virus. I mean on a serious side, I think the virus spreads based on its ability to spread among the people. If the people are in the high temperature, it's going to spread there. If it is in a cold temperature it's gonna spread there.
What we have observed is that when the high temperature is outside and when there is high humidity and when there is high contamination of the air - which happened in China, which happened in Milan - these are the factors from environment which are helping that the virus spreads faster or - slower, sorry, with the temperature and humidity.
But with the contamination, it happens they'll have much higher symptoms with the people simply because people have respiratory tract which is more amenable for the viral infection. So these are the factors which we know, but these are only, I would say, correlative factors which provide plus or minus on a relatively small scale compared to the virus spread. So, to hope that this is gonna help us - it's not gonna happen.
If we make all the proper measures, we're gonna do it despite the warmer weather coming on and that's what is expected from us as a society.
Vladimir: What are the chances of this becoming a seasonal sickness like the common flu? Like is COVID-19 gonna be a permanent part of our lives from now on?
prof. Đikić: Maybe from the medical side I may comment and Wolfgang is going to come out from more predictive power.
Right, so we need to learn from past. And when you see for the influenza - influenza is a serious disease. We as a society feel that's unacceptable to lose half a million people approximately every year from that serious disease because it became seasonal and we accepted it and we have vaccinations so we don't have this incredible fear.
Our medical professionals are protected, therefore they can respond to the disease quite without fear. However, influenza has also appeared as a pandemic influenza in 1850s and 60s. This was pandemic and at that time the behavior of the virus has been different than a seasonal.
In the case of coronavirus we already had SARS, we had MERS and we had now SARS-2 - 19 and 20. And unfortunately we have not invested enough of the money to prepare scientists to come out with a better understanding, better knowledge of vaccines which could be used like against influenza. We reuse vaccines from the past and past and help us to verify the antigens of those viruses.
So this is what I would like to kind of put forward for the discussions: What can we do to prevent that this virus doesn't stay too long among us? And then if it happens to become seasonal, how can we be certain that in public there will be no this incredible fear around the globe and block of the movement, block of the economy? These are all very serious consequences of our fear and non-understanding or lack of knowledge.
Maybe Wolfgang can comment as well because I think this is an important topic.
How can we you know, what can we do to make certain type of numbers to predict from the historical knowledge and from the behavior of SARS-1 and MERS that just came up and disappeared very rapidly because they were so lethal .
And it is much easier to deal with a disease that has high lethality because the spread is on a smaller scope. With the virus like SARS-2 - coronavirus 2 - you have an invisible enemy that spreads among the people so rapidly that suddenly you have it on all continents.
And then it's very difficult. This virus can stay among us much much much longer and then become the virus that reappears from here and there
throughout the year without seasons.
prof. Bock: So, what I can what I can say from the predictive point of view, what I'd say the mathematical point of view behind all of it is, I mean if you have some certain amount of immunity inside of the population then the whole thing will definitely... the second wave will be less severe.
And that's what also Ivan said we need to find measures to do that and vaccination is one of the measures. So if we would find a vaccine as we do it with influenza where we vaccinate a large part of the population, at least in Central Europe, you get these things under control. And this would be the same.
Of course right now with SARS CoV-2 we don't know... We don't have that much data as for influenza. So for influenza you have time series going back to really hundreds of years... hundred years. So you can somehow build up there a historical model based on that one, but I think that I'm completely on the side that we need to to also think about investing money into vaccines here. And learn from the other coronavirus types also.
Vladimir: We are constantly talking about vaccines. The thing that comes to my mind is like the crisis of authority and pseudo-information about vaccines in general. For example like the influenza vaccine, at least in Croatia, but I think mostly in Europe, isn't something you must do, it's something you can do. You can take every year. So I'm thinking - will the crisis of authority and pertinent information here be a problem in the future when hopefully we have a vaccine for this? And talk to people to use it actually.
prof. Đikić: It's a good point. I think it's a general problem in society that there are a lot of groups, particularly social media groups, who are completely denying the effect of vaccination. So my hope as a scientist is that community is going to learn that without the vaccines we are incapable, despite all the money and all the technology power we have, we are incapable to fight the new very very small viruses.
And this is now becoming a situation that people will, if the vaccine comes it's gonna be clearly a lot more interest for people to be protected.
I personally am vaccinated every year against influenza. I understand that by getting a small shot in my arm here, for one or two days having a little bit of pain, I am creating my own immunity, my own antibodies that prevent me from the combination of antigens that might be coming in the seasonal manner with influenza.
And this is something which we also do for most of our medical personnel in our hospitals. And in that case we already are in a leading position because we have people who can stand against the influenza virus. And in population, I don't know the numbers in every country, but relatively large number gets vaccinated and we are creating this common immunity, collective immunity in our society. Therefore, we are responding to influenza virus with significantly lesser losses.
If that would not happen, without vaccination we would have very similar problems like with the corona virus now because influenza is actually giving even stronger disease symptoms. It's - based on medical terms - it is more dangerous disease, but because of the measures we control it. To support the vaccination is THE measure including polio, including morbilli (measels). Morbilli is also becoming reappearing serious disease in public simply because our vaccination goes below 90, 80 % and then disease appears again.
Vladimir: I want to just drop in for a second. You mentioned social media and you mentioned the comparison between seasonal flu and COVID and how one is more dangerous than the other, but because of the measures we're currently taking it's actually for now... the death toll, the number of effected people are less for covid and for influenza.
I mentioned this because also the same problem exists with the vaccines as with the let's say denial of facts when compared to as I said you mentioned social media.
I'm guessing it's much more easier to just share a Facebook post about saying how influenza kills a lot more people than COVID and why are we making such a fuss, than read about it. I'm asking is there any way... how we can combat this? "Read more" isn't as sexy as an advice as "share this post".
prof. Bock: I mean we're doing this interview. I think we are going in the right direction. I mean it's I think from scientists' point of view it's also important to make your statements and also make them public right now.
I also speak a bit against this fake news and very nonsense which is partially published in social media like Facebook, WhatsApp and whatever.
But that's more or less the only thing we can do. I think this is the first epidemic where you actually have a very very important role of social media. So we never had it that way and that's also something that would be an interesting fact to investigate after this whole thing. How the influence of the social media somehow influenced the behavior what Ivan was talking already about many many times.
That means you have to behave! To stay inside!
And how social media is triggering this would be a very interesting topic to investigate. Especially when you somehow say that the amount of posts we just done and in which direction they are going how are they influencing the the behaviour of the people.
And I think in future you will have to cope with this much, much more than than right now. I mean this is just the beginning, this is something like the first crisis where the social media is really playing a crucial role, in my opinion.
prof. Đikić: I think I will just follow up on Wolgang's comment and also you have a question - I think it's a very relevant question not only to monitor it now, and try to work with public. We as scientists, we need to be vocal, we need to be precise, and we need to be with numbers correct. And without interpretation too much and promises too much, because it is not always easy to do. But what will be important is to understand why we as a societies behave like that.
I was having a nice discussion at home with my family and with kids and we were trying to elaborate what has been the new happening in a social context that sometimes very, very clear facts and something as 1+1 is 2, some people don't want to accept. They will claim 1+1 is 4.
And it is very difficult for media, very difficult for scientists to actually correct that. Because, we have created social groups in which the truth that the social groups have is the ultimate truth. So, you can have a social group in which the title is the Earth is flat. And under these conditions, everybody who is a part of that group believes in that 100%.
There will be very few people who are gonna take a plane and fly with these people around the world to demonstrate that this is not correct. But you will not change them.
And this is what we are facing at the moment that what Wolfgang was very nicely saying there will be, and there should be many more studies in the future how do we impact with the social networks to the behaviour of society during the crisis. Do we create better or actually a more vulnerable society?
And that will be something to follow up, but I do feel that there is a difficulty at the moment to penetrate with the correct information against the enormous number of theories, enormous number of so called fake news. Even though I would not call them fake fake, they are created for the purpose of the social network, and in those they believe and they spread it as much actively because they are believers in that.
Vladimir: To backtrack a bit, while I was researching for this interview, I actually found that in October of 2019 the Global Health Security Index was released and it examined whether countries across the world are prepared to deal with an epidemic or pandemic.
They made a list: the first two places were USA and UK as the most prepared for pandemic. The next ones were Australia, the Netherlands and Canada. I want to ask the two of you in which moments did the situation develop contrary to your personal expectation and what were you surprised by?
prof. Đikić: I think the numbers that you are referring are talking about the capacity of health system, and about technologies, and about educated work force, and about possibilities that our hospitals have to treat the emerging danger.
However, in the current situation we can easily see if the political leadership at the moment does not do right steps at the right time, even with the strongest hospitals in the world, with the highest technology you might have you don't score so high.
And America is... I really am sad to see how... how sad the situation and how dangerous situation is at the moment and how many people are daily dying there, despite the strongest medical system.
So, I would just make it like very simple with the pandemic and epidemiological problems, the world has not been prepared, there was a lot of articles, a lot of people were talking about that, there was the Time magazine with the front page saying "Danger, we are not ready
for new pandemic."
And there were a lot of data showing how many more viruses have come out of animals to men and they spread further on, the numbers have been skyrocketing every every 5 to 10 years, and the WHO have given the 10 most dangerous for the world, 9 of them were viruses.
And despite all of this, the leadership in the world has been very much ignoring it. We as scientists have gotten so little money to research on the viruses which have been coming a potential danger, including SARS or MERS which are number 4 on that list.
So there is a consequence of this of the situation where you have certain measures which are made only based on a human eye, but not on the nature. And the nature comes out with surprises and then you see who listens, who is ready, who has a good health system and I have to say Croatia has done very well because of the history of public health with Andrija Štampar and schools. I was studying medicine in Zagreb and I participated in the measures which are today as good as they were in 80s when I was studying.
So, you know, the knowledge and the preparedness comes out from the real knowledge that we have, not only technologies.
The fact that we were so unprepared was actually also something which was, at least, irritating me at the beginning a bit. Especially because, as Ivan said already in the beginning of the interview, you had a blue print with China in front of you.
So, it's actually... with some time delay you could also try to predict the time delay when it would come to Europe. And we were not prepared at all for it and this was this was something which was really... I didn't expect it in that severeness I have to say.
Vladimir: Talking about the disease itself a bit. Is there any biological or statistical information supporting the idea that a part of population might be naturally immune? From the current data we have seen, meaning sequencing first viruses which appeared in China and now moving through Europe, the US and growing around the globe. The virus is unique, is natural, it happened as a very new one, so there was no presence of this type of virus in a population of the world, so there was no immunity.
Because none of us... those who have been, now, in contact with virus, they have immunity, but none of us who were not in contact, we could not have it because it is a completely new virus, so there is nothing that somebody who had the SARS-1 or MERS and has probably antibodies during that time, these people are not immune on the COVID, on the coronavirus-2.
So, in that case, there is no evidence that there is an immunity present until we normally now get when we get in a contact, we get more people infected, immunity grows up and this will also be important in the future.
Because, you imagine that this type of virus might happen to become seasonal. So we will become partially more or less immune to the next appearance of the similar type of virus within a similar antigens and our antibodies Therefore today I would also like to stress the serological tests, not only genetic tests to identify the virus, but serological tests which take my blood and do antibody testing.
Say you have IgM that means you are in the early phase of infection. You have IgG antibodies against this virus, you are in the later phase and now you're becoming immune and this is gonna last sometimes lasts for decades. So, let's get this test done.
It is also disappointing that we have not had a genetic test on time, we don't have yet... the entire world doesn't have serological tests that are
This will be, this puts a lot of attention: vaccinations are number one, serological tests is number two to bring to the market. That we can be more powerful, than we know about the virus, who is immune. So if I am immune, I'll be the first one going to hospital and work because I am protected.
That knowledge is so crucial now for the future fight.
Vladimir: I think it's definitely very ungrateful to talk about timelines. But what will be the possible timeline of developing a vaccine and, or, a serologic test?
I'm not talking about now but let's say, if you had all the money in the world. Are there any time limitations that you have that create problems for fast development of, say, a vaccine or a test.
prof. Đikić: I'll go very fast because I have really studied that very much in details now. There is no vaccine that will be done within 12 months. Not because we don't have technologies and not because we don't have antigens already known.
Because we need to do precise, correct and safe testing. We are not allowed to give anything to millions of people around the world, without being hundred percent sure that this vaccine is not damaging. And then secondary, the vaccine needs to protect.
These are the two measures and therefore it takes time. If you just create a vaccine, There are people who have made vaccines within a record time. A month or two. But the vaccines now are starting in America, China and Europe. Each of the vaccine trials are going with five hundred, three hundred patients who are normal human beings, who are coming out as a first test to see whether the vaccine has any side effects.
Therefore it's 12 months. And the public has been informed about this. All the professionals have been saying the same prediction, and therefore I feel we need to accept that now and then only in the future, by having this type of a new vaccine for coronavirus-2 we might do it better because and faster because we have it already and we can adjust few antigens the next stage will be better.
So if we had already had a vaccine against SARS-1 and MERS. You can imagine how much faster we could have been in this crisis as well.
Vladimir: When talking about testing, I want to ask Mr. Bock, How do you model for false positives? How do you model for the uncertainty of the test itself? Also, how do you account for recovered individuals, where recovery
isn't required to report.
prof. Bock: For the false positive testing, I mean this is... This is just normal statistical modeling so you have, in principle, probability distribution that the test is not working, so you test and then you take a certain amount of people out.
This is actually quite easy to do, we just have rates and just adjust the rate such that it fits. That's its principle statistics, I think second year or third year. You can you can do that.
About this, the number of unreported cases - it is very hard, so we try to fit curves on... So one thing you can do for example is - you have certain countries which close the borders so with some certain time lag you can you can check what was it before what was behind the measurements and you can somehow detect the death rate. And say okay if you know that the number of death is somehow... Okay so you know that there is a Corona death then you can estimate something.
But it's very difficult so you can you cannot really predict this very accurately and you can just give a quite broad span of that and that's why serologic tests are very important - because we would like to know how many people are immune, because immune people are slowing down the disease spread. Of course, and and we can just do predictions on reported cases right now and and say: "Okay what happens if we have a detection rate of this and this and this amount", and try to see the outcome and fit it to the curves.
Yeah? Or then we can say okay we have this amount of immune stand and fit it to the curves. But other than that you cannot do much right now.
Vladimir: How involved are mathematicians in the process of decision making regarding nationwide and local measures?
prof. Bock: Okay so mathematicians, in Germany we have, in epidemiology you have an... Epidemiological group some people with mathematical background. We have in in our group mainly mathematicians, we have people from medicine form university of Warsaw, and also from biotechnology are there, which can help us a bit up with this these medical questions and help us there also in modeling.
But if you just talk about prediction, and things like this it's more like mathematicians and partially physicists. The workgroup leader in in Poland is a mathematical physicist, I would say. He did a hybrid application in physics but I think he came for the mathematics, so they are around to somehow simulate, write algorithms speed up the algorithms do the mathematical modeling in such a way that you get the proper answers, also do the statistics behind the whole stuff.
There you actually need the mathematicians.
Vladimir: How how computer intensive are your current models? Like do you have to use the cluster network, or a local university network?
prof. Bock: So I use a 32 core server with 750 gigabyte of RAM, and in Poland we have something like 120 cores. Let's say it's not recommendable to run our model for Germany on your private laptop.
Vladimir: I was guessing that. So one of the questions we had for you specifically Mr. Đikić is that we would like to know your comments and thoughts on current biomedical research that's going on throughout the past 2 months regarding COVID.
Are we any smarter regarding treatment options and epidemiology measures?
prof. Đikić: Scientific progress in the last three months has been enormous. It is absolutely unbelievable how much data has been collected, and how much good data has been shared among the scientists from Asia, Europe, America, Australia, all around the world.
And they have helped us to know more and to also start doing all of these small clinical trials with different repurposing of a different already existing drugs. And therefore you have this combination of chloroquine together with azithromycin or with other antibiotics. You have Ebola drugs with HIV drugs that have been created for those viruses, but are now repurposed for treatment of the patients in hospitals.
But I always like to stress for the public is that these drugs are only to be used in hospitals - not to be used by the people at home. Because the politicians take the pre, um, you know predetermined data from scientific community and then spread into a media. Then you have the events like - in the U.S. one man died and his wife was very very sick because they used an enormous doze of chloroquine without understanding why and how. So knowledge of what we did with science has been great, we have been improving tremendously but this should not be communicated badly.
And second of all public also needs to understand most of the drugs we have at the moment are dealing with them symptoms of the disease, they are not yet preventing the spread of the virus. Therefore epidemiology is THE response to the virus, and not expecting that they will give us drugs that we can drink at home and then prevent the infection.
Vladimir: We are seeing like the need... The people have a need to let's say do something to help themselves, to boost their immune system, and we're seeing some efforts to try to get some over-the-counter drugs and pharmacies that they think will help because they read somewhere again with the Facebook posts or or even maybe some early research that is not very conclusive right now - but everyone seems to be jumping at the possibility of helping themselves in a way and it seems to be hurting other people who actually need the medicine.
prof. Đikić: This was very very good question. Particularly your point about, whether the data at the moment are conclusive. And this is what many scientists are saying. These are first preliminary data, we observed that and this.
Then when this, non conclusive data comes to the general public then you have these issues of also hurting, not intentionally, but hurting others. Like with the rush of the all the people to hospitals to be tested that blocks cancer patients or blocks the heart failure patients to be better treated while the virus is in the hospital.
That has indirect effect on the rest of the population and the lethality of those cases we don't know yet.
The second point of your question was also well taken -
why do people now rush to pharmacies and keep buying everything that they can read on internet. Like the zinc. The zinc ions are gonna save you against the coronavirus. Evidences for that one are non-existent, while the people still believe in that, they buy.
You go and buy the vitamins, all the different supplements. Whatever people read, somehow they believe in that. And this is kind of boring for me, because we know now that normal life, being in isolation, avoiding the contacts, not hugging and then kissing everyone around. These are the measures which are more efficient than if you take ten times dose of vitamin D, vitamin C, all groups of vitamin B.
The normal food intake and healthy food of course with the groups of the people that have normal nutrition, not those who are like poor. Those people should not overdo it, like the people who are socially endangered. Those who are on the streets. Who have had a very poor nutrition. Those need to be provided with the basic foods, such that their immune system goes up and they are not becoming the real endangered people around us.
So, this is common logic, common knowledge. Let's behave as the people who will, with the information we have, most efficiently fight the virus. Don't go every day out to pharmacies for no reason and so on and so on.
Vladimir: I think there is a there is a common factor to these types of decisions I think it's the same need when thinking about alternative medicine. Not only talking about COVID, but and different disease. It's the idea of "it can't hurt" to try this. But in this case, as we talked about, it actually can hurt. There can be a deficit of medicine for the people who actually need it, etc.
prof. Đikić: Your point of hurting is well taken because everything we take in our body has a positive side when it's in the right dose and might have the negative side when it's in a low dose or a very high dose.
You know that the most dangerous population are the elderly. They are very often under several combination of the drugs against the hypertension,
against cancer for example.
And these people, when you start now introducing some some additional factors, their drugs can be affected. In one nice example, which is public now, you know today that receptor on a human cells that lets the virus to enter is called ACE2.
It's the angiotensin converting enzyme. And the angiotensin is known to regulate the blood pressure. So there are drugs which given in the high blood pressure people, which blocked the activation of that enzyme.
And in that case blood pressure goes down. But response is that you have more and more of these ACE2. So these people are gonna be more amenable
and more infectible. Simply because they have more receptors, more doors to which virus is connected to themselves.
So this correlation and this knowledge is very important because we now need to pay special attention to the patients who have a high blood pressure and who are actually treated with inhibitors against ACE2.
Vladimir: How has this epidemic affected your daily life personally? For example, I teach, so I do a lot of online classes now. Is that the case for you, and in Germany? What would be the changes?
prof. Đikić: Everybody's life has changed dramatically. I think you can see that for all professionals. Just the inability to communicate the way how we were used to. Particularly contact with the students, teaching, practicum.
All of this has been put online now. We are working very hard to create more efficient and better ways of, not only transferring the knowledge, but also checking what students are doing.
This is just one aspect. My personal life is being very much affected by family. We need to stay at home. We have three kids. It's not always very easy. We are playing chess every day, but you cannot do also chess playing every day to be exciting. Even if you want to lose to your kids to more excited about winning.
But this is the part of the family. And the professional side is... We have started to work on the coronavirus two months back and we have been selected as one of the crisis labs in our university. There are only few of them because the rest of th university is closed and research is completely down.
So in my lab there are six people who have been now in the coronavirus 2 team and we are researching on studying the enzymes of coronavirus, which are called proteases, which are required to process polypeptides of virus to make them small proteins. And then these small proteins are going to create the virus at the end. And then these these enzymes we would like to block because, in that way, we are going to decrease the replication and the spread of the virus.
At the moment, I have to say, in a very short time six people have been amazingly productive and very very successful in the research. We have also crystals, we have also structures, we have new inhibitors and we are communicating on Twitter on LinkedIn with our colleagues around the world. We share the reagents, we are getting the reagents around the world, not what we are asking but what people have in their freezers including lysates, antibodies, cDNAs.
We even didn't ask that but they sent us all. That tells that when you have something this is important the world of science is totally united. This gives great hope and this gives us encouragement that in this profession that we do there are many people around the world who are as dedicated and even if they cannot work at the moment they want to share and they want to help those that work.
I believe every University has teams which are working on this. In Frankfurt we are lucky - Frankfurt was the center of German virology during the SARS crisis so we have the viruses since the 2002, we now have several strains from China, US, Italy, Germany and all these strains are isolated. We have them in labs and we can use them to test on the primary human cells and we see in reality how the primary virus effects, damages and how fast it multiplies in different cell types and the different treatments, different inhibitors. So the amount of the information is amazing.
Vladimir: I also wanted to ask you this type of change in behaviour - what would be, let's say, what would be our guess about the long-term effect on the let's say the attitudes of people towards science, even personal hygiene after this is all someday done for example I'm giving an example like my generation from Croatia was one of the I'm part of the generation that actually remembers the war and like for example I can say the most immediate effect on me was that I abhor violence and for example I cannot think why would someone have a let's say a gun in their house.
I'm thinking will this crisis maybe finally put more importance on education certain parts of science and yeah and some changes in the human behavior like human contact,hygiene etc.
prof. Đikić: We talked about those already I think it's our hope that the science is going to be put in more focus, particularly science on those dangerous diseases which are potentially happening in the near or distant future. Then, the fact that the professionals can be now more in the focus of the public.
The public has also learned that this is a different type of people than those we normally see in media, politicians - people who do not really provide much of the information but there is the language which has been always more declarative without facts and without things and there were always certain measures which were hidden by som higher interest.
So now the professionals spoke and public has really responded well. There is an authority which has been built up, which has been trusted inside the societies, inside these countries and the politicians have been actually pushed a little bit backwards.
You can see that in every country - small one, big one, including the US with with all the power that president of the US has and he says he's gonna reopen the country by Easter - he backed up immediately when the professionals came out with the facts and were very strong - saying: this is our prediction, these are our facts, please consider them.
Then, out of fear for their positions and the public, they back down that's a good aspect.
Third aspect concerning our community, the STEM people is that technology is very important. We need to be able to build up technology that can respond faster. It is unacceptable that after, three months, four months of the virus being present among us we still do not have rapid trustable tests in the countries which have the most developed technologies.
So the question is why. And this is what we need to reflect on and we need to reflect on how do we can do better in that aspect.
And the fourth point is social networks and social sharing of the information. We need to learn from them, what went good and what went bad and how can we, in moments of crisis, control that this also does not do damage to the democratic liberty and all the things which we want to have, but we should not endanger others based on irresponsible individuals.
Vladimir: So, we rejoined with Mr. Bock at the end of the interview just to say any
closing remarks for us.
prof. Bock: You should be staying at home, really listen to that what the government is saying, try to keep social distancing and try to stay healthy.
Vladimir: I would only maybe add to the STEM community members that it's unfortunate that we had to delay or postpone our our planned Games or your planned Games, but wishes are that with the time things will get better and we will meet all together.
During that time, as we just heard we need to stay safe, stay healthy and fight together because only when we are united and together our chances to remove the virus from our environment faster increase. So good luck to everyone and I hope you have enjoyed this conversation.
Vladimir: We've come to the end of the interview. I'm thanking our guests that have listened to this and that have talked to us. I'm thanking STEM Games that have made this possible I'm also hoping that our viewers got some valuable information from this
Thank you all, stay safe, stay away from each other for now and good bye!