Dr Omar Khorshid - First case of COVID-19 reinfection; vaccine development

Subject: First case of COVID-19 reinfection; vaccine development

BASIL ZEMPILAS: Dr Omar Khorshid is the AMA President, and he joins us on the line now. Dr Khorshid, how interesting has this news been to you and your fellow members of the medical profession?

OMAR KHORSHID: Well, it does appear to be the first properly documented case of someone getting the coronavirus twice. As you mentioned, we have had other reports and probably what that was is people who never cleared the virus - so they had a positive test, then they had a negative test which was probably false, then they had a positive test again. Whereas this chap, by the sounds of it - if they've done their science right, and they got it published - it sounds like he has had it twice.

And rather than it being a mutating virus, what they're actually thinking is perhaps the immunity that you get from having had it once, maybe it wanes a little. And that's really one of the big questions. One of the many things we don't know about this virus is once you've had it, how long is it before you lose that immunity.

BASIL ZEMPILAS: So, the argument that there's a different strain of the virus in different parts of the world, does that hold up?

OMAR KHORSHID: Well, it is mutating but only a very small amount, and at this stage, from what I understand, they're pretty confident that if you can get a vaccine against the main part of the virus then it's likely to be effective for the different strains. It's not mutating anything like the flu does, for instance - not as fast and not as much, and that's good news in terms of vaccine development.

And I think one of the messages from this paper is that we can't necessarily rely on the viruses going through the community and infecting everybody and then everyone gets immune. That may not work for this virus, like it doesn't work for the common cold, and we probably do need to look at a vaccine. But again, the big trick with the vaccine is making sure it lasts for years and not months, and that's still unknown at this stage.

STEVE MILLS: Sure. And whether you'll need boosters, et cetera. How key is this person in scientific studies going forward - the fact that he has had it twice?

OMAR KHORSHID: Well, I think one thing to remember is there's something like 22 million people that have had this virus and there's one guy's who's got it twice. So he might just be unlucky, so we really shouldn't read too much into it at this stage.

I think there's a lot of research going on, and immunity is an incredibly complex topic, and our understanding of how our immune system works keeps evolving over time. And I guess, though, the good news is that we've got the smartest people all over the world working as hard as they possibly can to get us out of this crisis with a vaccine. And I think we can be pretty confident they'll get there, but we just don't know when, and we don't know once the vaccines are available, just how long are they going to last for.

BASIL ZEMPILAS: So it's impossible to predict what our life will be like even with a vaccine. I mean, can you imagine us returning to life as it was in 2019?

OMAR KHORSHID: Look, my general thoughts- and this is just me looking into the crystal ball - is that we'll either get a vaccine relatively quickly - you know, within a year, maybe a year and a half - that'll be effective, or you might even get several vaccines. And yes, I think life would go back to pretty much normal if you got a safe and effective vaccine.

BASIL ZEMPILAS: Right.

OMAR KHORSHID: But the alternative is I think that we don't get one, and then I think our population's tolerance for all these restrictions would actually start to wane, and I think our governments will have to start rethinking their policies. But when you look at the two options, gee, the vaccine option comes out way, way, way ahead.

BASIL ZEMPILAS: Sure. Dr Omar, just a third option. Is there any chance - and we know that history tells us that this sort of thing has happened - but can the body sort itself out anyway? So can the body find a way to get on top of the virus? Or that would take a lot longer than that?

OMAR KHORSHID: Yeah, if you're talking about us mutating to be immune to the virus, I mean that'll take an awfully long time [indistinct]…

BASIL ZEMPILAS: [Interrupts] Yeah. No, but our tolerance level to it? Or our ability to sort of handle the virus - not to get particularly ill, not to be suddenly susceptible to death as, you know, many people have been?

OMAR KHORSHID: Yeah. Yeah. Well, I think you'd have to say that for the majority of people, they're already in that situation…

BASIL ZEMPILAS:   Right. Yeah.

OMAR KHORSHID: … but for the majority of people to catch this virus is actually fairly trivial and some don't get any symptoms at all - so that is your immune system, that is immunity. And one of the things it could be is that you've already had a coronavirus, just a different one. Maybe you had a common cold coronavirus that's giving you some partial immunity. And I think the good news about this chap was that he had a pretty bad bout of the virus the first time, but the second time he didn't get sick…

BASIL ZEMPILAS: He didn't even know.

OMAR KHORSHID: …and that might mean that he still had some immunity going on.

BASIL ZEMPILAS: That's true. And one person doesn't make the whole thing. How far away are we, or have we got it, where we can actually test whether we've had the virus?

OMAR KHORSHID: There are tests already available to do that, just looking at the antibodies in your bloodstream, and there's lots of science being done at the moment on how reliable those these are. They give you a result very, very quickly, but are they actually going to give you a reliable result? And I think as we go forward, testing people's immunity, whether they've had it or whether they need the vaccine, will be part of our community response. But at the moment that's still being investigated.

STEVE MILLS: Right.

BASIL ZEMPILAS:   Dr Omar, just before you go. You mentioned the two scenarios that you put forward, and you said the first one is getting the vaccine and reasonably quickly - a year, a year-and-a half. Right now, that doesn't seem reasonably quickly, does it?

OMAR KHORSHID: It doesn't seem quickly, but in terms of vaccine development that's really fast. And although we're hearing a lot of thoughts that maybe we could get one by the end of this year, the quicker we get a vaccine the less it's being tested.

So, I think we heard from the UK that the Oxford vaccine, which is the one Australia signed up for, the UK Chief Medical Officer said that he thinks that, at the earliest, it'll be at the end of next year. That was reported in the media yesterday.

STEVE MILLS: Yeah. Indeed.

OMAR KHORSHID: So I think we do need to take a little dose of reality. This is complex stuff but we’ve got to get it right, and I think once a vaccine does become available, the good news is we can be confident that it's been properly tested and something that we can all sign up for straight away once it's available.

STEVE MILLS: And if you're not patient enough, you can move to China or Russia who don't seem to care too much. We appreciate your time this morning. Dr Omar Khorshid there, the AMA President.

25 August 2020

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