Will Azerbaijan go through next coronavirus phase or monkeypox outbreak? Azerbaijani microbiologist answers explains for Caliber.Az

Azerbaijan has achieved success in the fight against the COVID-19 pandemic. Both international organisations and citizens see and highly appreciate the outcomes of the government’s efforts. However, the situation with COVID-19 is still unstable in the world. The virus is still capable of appearing anywhere. The situation is unpleasant in China, the hotbed of COVID-19. There is an increase in the number of COVID-19 cases and death toll; lockdowns are seen in cities such as Shanghai. Meanwhile, a BA.4 Omicron sub-variant of the SARS-CoV-2 coronavirus was recorded in Sweden. The virus is currently dominant in South Africa. In general, we see an increase in COVID-19 cases in Africa and Southeast Asia, but no coronavirus cases are observed in many European countries as it was on a surge before. Some 5-8 new COVID-19 cases in Azerbaijan per day are insignificant for the 10 million population. Azerbaijan has achieved success in the fight against the COVID-19 pandemic. Both international organisations and citizens see and highly appreciate the outcomes of the government’s efforts.

However, doctors are warning and even scaring us, talking about the new COVID-19 variants. According to the doctors’ opinion, COVID-19 has not disappeared on a global scale. We will face new COVID-19 variants in summer and especially in autumn. After two exhausting years of the COVID-19 pandemic, people do not want to believe in these scenarios, however, we should be prepared for any developments. Azerbaijani microbiologist, Esmira Mammadova, who has been analyzing the situation with the COVID-19 for a long time, disclosed some details in an interview with Caliber.Az.

- During a recent meeting with the Head of the World Health Organisation (WHO) Country Office in Azerbaijan, Hande Harmanci, Azerbaijani Health Minister Teymur Musayev noted that Azerbaijan has recently seen a sharp decrease in the number of COVID-19 cases. Azerbaijan is among the countries that have achieved significant progress in the fight against the new type of coronavirus. What stands behind Azerbaijan’s success?

- Azerbaijan has achieved a lot, although it was very difficult at the initial stage. Each of us can be proud of this success, and the difficulties we have overcome. Let's remember that it was hard to force the entire population to wear masks because it was new to everyone, unusual and uncomfortable. Many people did not believe in coronavirus at all, they joked about it. Then the situation changed and everyone began to wear masks, actively use disinfectants, wash their hands more often, avoid crowded places, etc. Presently, we see more positive trends despite the mandatory requirement for wearing masks indoors having been cancelled. Many people themselves put on masks in shops, subways, buses, and other crowded places, continue washing their hands more often, etc. That is, success was achieved thanks to the universal measures applied by the government and citizens’ comprehensive support for these measures, and the higher consciousness of the people.

- This success has already resulted in a sharp decrease in the number of infected people. What does it mean in the longer term?

- In case of recurrences of the COVID-19 pandemic, which we have been recently scared of, given the outbreak of COVID-19 in China, it will not take much time for the Azerbaijani population to be fully ready for combating the disease. People know everything about the rules of hygiene, social distance and masks. That is, in case of the return of the pandemic to previous levels, a new wave of the disease will be milder for us. It will cause no anxiety. Of course, nobody wants this, however, a new phase of the pandemic is real, rather than hypothetical. Presently, there is temporary tranquillity.

- In this case, when can a new phase of the pandemic occur - in autumn or in the summer?

- When the temperature of the air decreases, the number of acute respiratory infections, common cold, inflammatory processes increase, and influenza intensively spreads during cold weather. However, infectious diseases easily spread even in summer, moreover, many viruses spread more intensively when the temperature rises. It is obvious that coronavirus may spread in any season.  An outbreak can be also observed in summer. The past two years, when one of the big phases of coronavirus occurred in summer, testified to this. So, the outbreak can revive both in summer and in autumn.

To be honest, there is an important point. Human immunity is usually higher in summer than in autumn, which is facilitated by good nutrition (fruits), sunbathing, vitamin D, and a general hardening of the body. Of course, viral infections and colds weaken the body in autumn, and a weak body is especially susceptible to illness.

- The disputes around the closure of Azerbaijan’s land borders, which have been closed since 2020, are still in place. Thus, a member of the Azerbaijani parliament (MP), Vugar Bayramov, has recently said that the current epidemiological situation allows the opening of borders as the number of infected people is very small. This will help to sharply boost Azerbaijan’s tourism sector and provide the country with more foreign currency. Another Azerbaijani MP, Musa Guliyev, said that the Operational Headquarters under the Cabinet of Ministers planned to open land borders in late May or early June 2022.

- At the time, the coronavirus impact on Azerbaijan has greatly mitigated thanks to the border closure. If the borders were open, the contagion in the country would be much higher. In general, a quarantine regime, and closing borders is a long-standing traditional methods in medicine and state policy. The coronavirus is spreading in phases that are interconnected as if by one network. If there is an increase in the number of infected people in any region, then in a while we will see it spill over into neighbouring regions. When the number of infected people was rapidly growing in Georgia, we saw a similar situation in Azerbaijan before long. It is difficult to be completely isolated. The number of infected people has recently increased in North Korea.

So, the closure of borders is not a panacea, but this was a big positive factor. Is it observed now? I think that the number of infected people may rapidly increase as a result of opening the borders. How significant is it? It is necessary to consider the situation in connection with each specific country. For example, if the epidemiological situation in Georgia is stable, the borders with Georgia may be opened. There are the Georgian Azerbaijanis who have been unable to leave Baku for Georgia to see their relatives for two years. As for Russia, Iran, Turkiye, it is also necessary to consider the situation with those countries. It is important to remember that the coronavirus has not disappeared, it is hidden. Therefore, in case of opening borders, we should always be ready to close them rapidly if necessary.

- Many say that we should realise that we will always live with the coronavirus, we are scared by new strains that always appear. Thus, German Health Minister Karl Lauterbach does not exclude the possibility of a new phase of the dangerous delta variant of coronavirus. Do you think the new variants will be more dangerous in terms of infection and fatal cases or will COVID-19 turn into seasonal flu?

- Antibodies appear in the human body after each infectious disease. We have seen that coronavirus is a different disease. Both those who have been ill and those who have even received several vaccines, but could not prevent contracting the virus. This [vaccines] is not a guarantee against illness, we ourselves have seen it. The virus may be mild or severe …

What does it depend on? First of all, it depends on immunity. I am sure that people should strengthen it. During coronavirus or other infectious diseases, people immediately begin to take numerous antibiotics. However, people do not take into account that antibiotics greatly weaken immunity, and the body cannot resist the disease, which results in recurrent diseases, and severe consequences …

Therefore, it is impossible to say now that after a certain period this variant of coronavirus will appear, while another variant will pop up in six months. No one will be able to predict this. No one will be able to describe a possible pandemic. Of course, new variants may be observed and COVID-19 may turn into the seasonal flu. What kind of virus will it be? Coronavirus did not appear in 2019, we studied it at the university. People saw the “Spanish flu” in 1918-1920, “chicken flu” in the early 2000s, “swine flu”, and COVID-19 … “Goat flu”, “pigeon flu”, etc. may appear in the future.

- Why can't doctors, gaining knowledge and experience as a result of two year-pandemic, accurately predict the emergence of new variants of coronavirus for society to be able to prepare for them?

- The issue is the flexibility, insidiousness of the coronavirus, and its ability to quickly mutate and adapt to changing environmental conditions. The coronavirus is not a new virus, but it changed and became deadly to humans in 2019. We, humanity, do not know the reason. No matter how ridiculous it may sound, the coronavirus seems to be smarter than us, it knows more, it is always a step ahead, it always attacks, and we are forced to adapt to it, being unaware of when it will attack, we defend ourselves, we are looking for something that can oppose it. The coronavirus has an initiative, we are only defending ourselves, while this is a passive policy - we solve problems with COVID-19 only when they appear.

The virus destroys the outer layer of the cell, after which it destroys the nucleus, and changes DNA. That is why coronavirus is so dangerous. 

- New vaccines should be prepared against new mutations, as the old ones are ineffective against new variants. That is, the fifth, sixth or seventh dose of the vaccine may be required in the future. What do you think about it?

- I have always been against current vaccination and I make this statement on my own behalf for three main reasons. Firstly, all vaccines must be transported and stored at a certain temperature, which is not always observed, and this greatly affects the effectiveness of vaccines. Secondly, everyone, especially children, reacts to vaccines differently and it is impossible to predict the consequences. Thirdly, no vaccine guarantees full protection against coronavirus or severe treatment of the disease. Every vaccine is a stress for the body. It was obvious that those who received several doses of vaccine were also infected with the coronavirus.

There is another very important point that almost no one pays attention to. Before vaccination, a thorough check-up of the patient is required, a patient must pass comprehensive tests that will accurately determine his/her state of health, it is necessary to check the sugar level in the blood, pass thyroid function, cholesterol tests, etc. Has anyone done this? Almost no one passed this procedure. A patient comes for vaccination, sits down, injection is made, that’s all, see you! Those who have low immunity should not be vaccinated at all - they can provoke an exacerbation of those diseases that have so far been in the body in a latent form.

I would like to emphasize again that this is my personal opinion, based on years of observation and medical practice. I do not force anyone, if people want to be vaccinated, they may do it.

- In this case, what should we do to protect from the coronavirus?

- The best way is to boost immunity. It is necessary to eat high-quality and healthy products, we should not overeat. People should move a lot and be physically active. It is necessary to start with nutrition and sports. There are a lot of obese people, in other words, people with weak immune systems! A healthy mind in a healthy body! Such a lifestyle will help protect not only from coronavirus but also from other diseases. A person should care about their body and health. For example, many doctors, who treat contagious patients, are not infected due to very high immunity.

- There were many conspiracy theories about the artificial origin of COVID-19 at the beginning of the pandemic. Two and a half years have passed. What do doctors think about this?

- I support the version related to the natural origin of the coronavirus. I reiterate that it existed until 2019, but then it mutated and became dangerous. I hope for the humanity of mankind and do not want to think that it is artificial. Although, on the other hand, namely people as a biological species tend to kill each other massively, a tendency that is not seen among animals.

- I should ask this question which disturbs many - is it reasonable to demand a COVID passport before attending weddings, entering shopping centres, or catering facilities, given that everybody walks there without masks?

- From a medical point of view, there is absolutely no sense. There are big crowds in the subway, markets, and buses. Why is not a COVID passport required there? It is just one of the ways to encourage the population to get vaccinated, there is no practical benefit from it in terms of reducing the incidence rate.

- WHO is convening an emergency meeting of experts to discuss the outbreak of monkeypox. How do you assess this new danger? Is the Azerbaijani healthcare system ready for it?

- The Azerbaijani Health Ministry has already issued a statement, saying currently there is no monkeypox virus in Azerbaijan, and sufficient measures are being taken to prevent its spread. Of course, the danger should not be underestimated. This tropical viral disease is actively spreading in Africa, where the health system is not strong enough. The disease is usually mild, patients may recover within 2-3 weeks. The mortality in those countries where it has spread is minimal. The most important thing is that the effectiveness of the chickenpox vaccine has already been proven to protect against monkeypox. Most people have received this vaccine in Azerbaijan or had chickenpox in childhood. In any case, it is necessary to remain vigilant and carefully follow the developments.

- All pandemics end sooner or later. As for COVID-19, can we hope for this?

- Of course, it will end. History clearly proves this. However, over time, some viral diseases will be replaced by others, perhaps even more dangerous ones. I reiterate that after the stress we experienced, after more than two years of the pandemic, people (both societies as a whole and each person individually) are more prepared for it. Everybody is more aware of the ways of transmitting viruses, and the need to wear masks, wash hands, and maintain social distance. Therefore, we hope that we will be able to go through a further pandemic if it happens. We will be able to experience it easier and of course, this is a great merit of people who helped the doctors as much as they could. We, the doctors, should remain vigilant and be ready to prevent any increase in the incidence of coronavirus, no matter when it occurs in summer, autumn or winter.