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Future of the COVID pandemic: Scientists say there is still a lot to learn

SACHA PFEIFFER, HOST:

Three years after the World Health Organization declared a pandemic, scientists say there is still a lot to learn about COVID-19. Akiko Iwasaki is a professor and researcher of immunobiology and molecular, cellular and developmental biology at Yale, who three years ago dedicated her lab to studying COVID. And she joins us now. Good morning, Professor.

AKIKO IWASAKI: Good morning.

PFEIFFER: What do you consider the biggest breakthrough to date in our understanding of COVID?

IWASAKI: I think the biggest breakthrough in our understanding of COVID is really how the immune response is occurring after viral infection and how that could actually either help you or harm you. And we and others have found that there's misfiring of the immune response happening in the severe COVID patients that lead to pathology and lethality.

PFEIFFER: Oh, that's interesting. So some people react differently to it and it becomes more protective. For others, it becomes counterproductive.

IWASAKI: Exactly. So it really matters how the immune system reacts to the virus in the beginning. And that kind of dictates the course of disease.

PFEIFFER: Do we individually have any control over that in terms of our level of health and nutrition? Or is it totally about our genes and it's out of our control?

IWASAKI: Oh, we can certainly control some of this. Obviously, you know, having vaccines and boosters will help you create that immune response that is protective against the virus.

PFEIFFER: Oh, interesting. So it's quite a message about the importance of vaccines still?

IWASAKI: Yeah, absolutely. Having preexisting immunity will absolutely help you fight against this virus disease.

PFEIFFER: Long COVID. You are leading multiple studies into Long COVID. What do scientists currently know or suspect about why, for some people, symptoms can linger for months and even years?

IWASAKI: Yeah, so we're still at the early phase of that understanding. But what we're learning is that, again, the immune response to the virus in the early phase might dictate how a person might develop long COVID or recover from the infection. And in particular, there are hypotheses about persistent virus that could be driving this disease. So if you can clear the virus early at the site of infection, it's likely that you will not develop long COVID.

PFEIFFER: And same question that I asked last time - do we individually have any control over whether, if we get COVID, it becomes long COVID? Or is that largely out of our control other than vaccines?

IWASAKI: Right. So there is, again, some insights that are being - developing right now as to who might, you know, be more at risk of acquiring long COVID. And people who even get mild COVID infection can develop long COVID. And this group tends to be women of ages around 30 to 50, whereas people who get severe COVID and then develop long COVID, these tend to be older patients.

PFEIFFER: And anything we could be doing when we're in recovery that might minimize our chances of developing long COVID?

IWASAKI: Right. So again, that's developing knowledge right now. But potentially - so anything to kind of remove the virus quickly as possible, such as the use of Paxlovid or other antivirals, might help a person recover quicker than if you didn't have that antiviral.

PFEIFFER: You know, as we talk, it's very clear there's so much still to be known. What do you personally most want to know about COVID that is not known yet?

IWASAKI: Oh, there are so many things that I - you know, my team would love to know about COVID, particularly how a person might develop long COVID and how we can prevent that because right now, even though millions of people are suffering from this disease, there really isn't a great therapy out there. And if we can understand the disease mechanisms better, then we can provide better treatment.

PFEIFFER: What do you think people's fear level of COVID should be now?

IWASAKI: Well, myself studying long COVID, I'm still very much fearful of, you know, catching the virus and potentially developing this since I'm in that demographic group for risk - high risk. So I'm still - yeah.

PFEIFFER: That people should still have a healthy fear, but there are things we can do that we didn't know about three years ago that could be more helpful in fighting it now?

IWASAKI: Right. But I would still keep maintaining preventative measures like mask-wearing and making sure ventilation is happening in buildings because, you know, not getting COVID is your way to avoiding long COVID.

PFEIFFER: Right. That is Akiko Iwasaki. She is a professor and researcher studying COVID. Thank you very much.

IWASAKI: Thank you. Transcript provided by NPR, Copyright NPR.

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