Marta Cohen in Buenos Aires: “This pandemic could have been prevented”

As a good pediatric pathologist, Marta Cohen brought out during the COVID pandemic what she does best: go behind the track of diseases. That is why, at the children's hospital in Sheffield in the United Kingdom, where she has been working and residing for 20 years, and where she currently holds the position of clinical director of Pharmacy, Diagnostics and Genetics, she was nicknamed Sherlock Holmes, for her constant and obsessive scientific attitude to research. Thus, on the door of his office they hung a design poster with the name of the detective created by Arthur Conan Doyle.

On March 3, 2020, Cohen understood - before most mortals and above all before the great international conclaves of science and health - aboard a British Airways flight to the United Kingdom; surrounded by dozens of British passengers covered in masks returning from Hong Kong, that something strange and new was happening. A week later, on March 11, the World Health Organization (WHO) formally declared a global emergency at the start of a pandemic due to a virus so far unknown: SARS-COV-2, from the coronavirus family.

More than 24 months later, and under Cohen's robust analysis, considering all the variables of emergence of the new virus, it becomes clear that large global health agencies such as WHO acted late; and that scientific inconsistencies are overcoming about what happened to the manipulation of that virus which was studied in laboratories around Wuhan. The current conclusion is that no evidence was collected indicating that it was an accident or escape or an act of bioterrorism. “Until now, I have to go with the evidence and say that it would have arisen in the Wuhan market,” Cohen added.

The speed with which events rushed and faced so much misinformation and uncertainty due to a virus that nobody knew and that only piled up dead people in northern Italy and climbed in the rest of Europe, made Marta Cohen make a very clear and early decision: in the coming time she was going to play a role, her best version: communicate. And his antidote would be his outstanding professional skills and the privilege of accessing first-hand scientific information while at the center of the world. His biggest obsession besides his own was to help his beloved Argentina. “Providing effective and timely evidence-based information, I found that this was going to be the best way to combat the infodemic and fake news of the pandemic,” Cohen told Infobae.

“I almost unwittingly became a global media phenomenon,” he explained to Infobae. “On July 20, 2020, amid severe restrictions on movement and isolation in Argentina, before retiring from my office, I saw an article that had just been published in the scientific journal The Lancet - of which Cohen is a member of the panel of reviewers - an article that reported on the promising results of Phase II of the development of the Oxford-AstraZeneca vaccine. Without hesitation, I recorded a short message to explain the extent of the good news at a stage of the pandemic without vaccines, and to greet friends and family in Argentina - many in their beloved and native Trenque Lauquen. A few hours later, the video went viral with millions of views around the world. That's where it all started.

In line with his detective work, Cohen recovers the debate about the origin of the pandemic and takes up, among others, the work of biochemist Jesse Bloom — from the Fred Hutchinson Research Center , in Seattle, USA — who pointed out that some genomic sequences of the first cases of COVID in the Chinese city of Wuhan had disappeared from an international database - the GISAID platform where all genomic sequencing, including that of SARS-COV-2, which was decisive for science and research, are publicly uploaded to the service of science and research advance with the creation and production of vaccines and treatments against COVID.

Bloom managed to recover the deleted files and claims until today that the “deleted information” he recovered reaffirms that the virus was already circulating in Wuhan before the December 2019 outbreak.

The pathologist Marta Cohen shoots to deepen the analysis that allows the passage of time today - 24 months after the start of the pandemic - and added to Infobae: Why are the most recognized organizations in the world of science and health - considered the major transnational scientific leagues - such as WHO or the the GAVI initiative - created to distribute vaccines in countries with problems of access and poverty - failed at two levels: first, faced with the possibility of containing the pandemic and second in the development of equitable global health management?

“Neither the different governments of the world, nor the big science and health institutions such as WHO and GAVI reacted in time. Precious time was lost that should have served to curb the pandemic and not spread so brutally. While many governments around the world were taking the pandemic situation incredibly lightly,” the expert told Infobae.

“WHO could have done much more to stop the pandemic. It is true that WHO then made a mea culpa - especially so that it does not happen again - through the formation of the Independent Panel for Pandemic Response Preparedness,” Cohen emphasized.

The panel of experts was co-chaired by two brilliant women, former New Zealand Prime Minister Helen Clark and former Liberian President Ellen Johnson Sirleaf. After serving as prime minister, Clark went on to head the United Nations Development Programme; while Ellen Johnson Sirleaf received the Nobel Peace Prize in 2011.

The boost of Cohen's visit to Argentina this time - the second since the outbreak of the pandemic - is the advance of his latest book A World in a Pandemic, (Editorial Marea), which he will formally and publicly present at the upcoming 2022 Book Fair.

Cohen, in addition to having proved to be an exemplifying scientist, is also a forensic physician. And in that field she made a very important contribution in the United Kingdom that earned her, in the midst of the maelstrom of the COVID pandemic, on October 9, 2020, the recognition of Queen Elizabeth of England by granting her the Order of the British Empire (OBE) with the rank of Officer for her work in the investigation of the sudden death of the infant. Cohen received the distinction - created in 1917 - from Prince Charles. “I dream of bringing this research to my country, as it changed the paradigm of the approach to sudden infant death in the United Kingdom. There was a 360-degree turn in how to treat sudden death in infants, he left the forensic field to go to the hospital, because it is a non-suspicious death. And my obsession now is to turn it into a state policy in Argentina. I discussed it with Minister Carla Vizzotti when she was in England.”

In the interview with Infobae, Cohen wore the same suit as when he received the OBE from the Prince of Wales: “I chose this outfit because it is my way of paying tribute to journalists and the media who worked responsibly, and because it allowed me to strengthen a relationship of trust with all the Argentine people”, Marta told Infobae. She has a special son, Emiliano, whom she cares for with great love and dedication along with her husband and two professional female daughters. “I'm a very resilient person who always tries to see what's in the glass, and not what's missing.”

— Marta, let's take up the idea that the pandemic has not gone away. Where are we at the crossroads of the bridge that will take us from the pandemic to the endemic: What is next?

— I'm going to bring another phrase coined by someone I read and that was very interesting to me. The pandemic will not end until we decide. I mean, it's up to us to decide when it ends. That means that 75% of the world has to be vaccinated. Due to issues of vaccine nationalism, as Pope Francis calls it, inequity was generated, we have countries that are in the fourth dose, and other countries like many in Africa that have less than 10% of their population vaccinated.

The Delta variant that was terrible, came from an unvaccinated India. The Ómicron variant arose from an unvaccinated sub-Saharan Africa. That is, we are fine today, we are vaccinated. In the UK there were 2,000 deaths a day and now we have 1950 per week. We're better. But the person who dies is 100%. So in reality the pandemic didn't end.

And if we continue to vaccinate young people with a fourth dose, I mean those under 60 years of age, without immune disorders, we are not only somehow wasting vaccines, but also favoring inequity. Because that population of Africa that is not vaccinated or that has less than 10% of its population vaccinated - a 70-year-old who is infected in Africa has a 1 in 8 chance of dying - generates not only the persistence of the virus from person to person, but also generates such a high viral load in that high replication that generate failures. And those failures are mutations and so new variants can be created. And we start over

It already happens in the United Kingdom with the XE variant, which is a recombination of BA.1 and BA.2 (Omicron subvariants), a person becomes infected with two viruses, two subvariants at the same time and the same cells change, intermingle, exchange genetic material of the two variants and a new one emerges that is 10% more contagious.

— Back there is the idea that whoever can save himself in science does not work...

- Exactly. And the pandemic came to bring this to the fore. One issue that makes me very sad is the failure of the GAVI Organization, which together with the World Bank, Oxford University and WHO wanted to manage vaccines to ensure and distribute 2 billion doses in an equitable manner, first to older people, to go down the scale, and then to the vulnerable and health personnel. But that was not done, there were countries that received everything, countries that even paid for the vaccine more than the vaccine was worth, and other countries received nothing.

These globally recognized bodies failed because of selfishness. Mistakes have to be used to learn. And there is the virtue of making mistakes, reviewing, learning and correcting. Fortunately, the World Health Organization did so and in May 2021 it released the document where it talks about all its mistakes and concludes that the pandemic could have been avoided.

The pandemic would have been avoided because it was only on December 31, 2019 that China declared cases of atypical pneumonia in excess, of unknown cause. And only did global health authorities meet around January 20. Those lost days were crucial.

— January and February 2020 were the crucial months where the course of things could have changed...

— That's right. The first meetings between the world's agencies were in February. There I like to separate the staff and the global health system that did everything right, including mistakes. Like saying that ivermectin works and then saying no, clinical trials showed that it doesn't work. That's going after the evidence.

But on the contrary, politics failed in a momentous way. And within that is the World Health Organization that was lost in several bureaucracies a full month. I would say two months, he missed January and February. If the epidemic had been contained and had not turned into a pandemic. We now know that one of the things we need to reorganize is how epidemiological surveys are done to capture when there are new viruses, new variants, in different parts of the world.

Cohen lashes out on uncomfortable but necessary issues to study and debate about the pandemic: “While there is no evidence that the emergence of this pandemic had to do with a bioterrorist attack from China, it must also be said that science only said that there is no evidence, it did not say No!” .

— January and February 2020 were the crucial months where the course of things could have changed...

— That's right. The first meetings between the world's agencies were in February. There I like to separate the staff and the global health system that did everything right, including mistakes. Like saying that ivermectin works and then saying no, clinical trials showed that it doesn't work. That's going after the evidence.

But on the contrary, politics failed in a momentous way. And within that is the World Health Organization that was lost in several bureaucracies a full month. I would say two months, he missed January and February. If the epidemic had been contained and had not turned into a pandemic. We now know that one of the things we need to reorganize is how epidemiological surveys are done to capture when there are new viruses, new variants, in different parts of the world.

Cohen lashes out on uncomfortable but necessary issues to study and debate about the pandemic: “While there is no evidence that the emergence of this pandemic had to do with a bioterrorist attack from China, it must also be said that science only said that there is no evidence, it did not say No!” .

— To follow this revisionist reasoning about the pandemic, where do you place the origin of the virus, in that market in Wuhan?

— A lot happened around that time in the laboratories of Wuhan: in September 2019 in that laboratory in Wuhan where the SARS-COV-2 virus was being analyzed (and manipulated) he had to move, he changed buildings. Then there could have been an accident, an escape.

(Virologist Jesse) Bloom realizes that there is a first genomic analysis of China that had been erased. It had gone up and spelled it out. He was able to reconstruct it with the platform cloud and published it in a fantastic scientific article where he concludes that this genomic analysis was much more similar to the Wuhan variant, than what was later reported by the CDC laboratories in China. “It seems likely that the sequences were removed to hide their existence,” Cohen quoted researcher Bloom. The current conclusion is that there is no evidence to indicate that it was an accident or escape or an act of bioterrorism. And it's very interesting because they indicate that there is no evidence. It doesn't mean no, just that there is no evidence.

So the current acceptance is that the new SARS-COV-2 coronavirus has more than 99% similarity to the bat coronavirus, it is not the first coronavirus that humans have, as a pathologist I have been in contact with the respiratory coronavirus that produces colds, but it is not this. It is not known whether it was directly due to the handling of live animals that were sold in the Wuhan market that included these bats, rats, frogs, etc., or if it came about through an intermediary that is a Chinese anteater called pangolin. So until now, I have to go with the evidence and say that it would have arisen in the Wuhan market.

Cohen brings to the table some information on the production of antivirals against COVID, both disturbing and auspicious: “Argentina in 2017, exactly in December 2017, signed an agreement with an international patent agency based in Geneva and which is around from 120 countries, obviously middle- and low-income countries, which make it possible to make generic drugs. That agency also signed agreements with the laboratories producing Molnupiravir (MSD-Merck) and Paxlovid (Pfizer), to make these generic antivirals. In other words, theoretically we could explore doing them in Argentina.”

“No one is safe, until everyone is safe,” you wrote in your book. What will that process look like until we can remember the SARS-COV-2 virus as a bad time?

— The issue is that the new variants are not more lethal and the issue is that a new virus does not emerge, for example, if two different viruses that are infecting the same patient are recombined and we are unlucky that genetic material is combined in the same cellular system.

That is, if the situation remains the same, that more contagious variants appear, but that the vaccine continues to have the same efficacy... the vaccine protects against severe infection and death, in general with high efficiency, does not protect so much for re-infection, and immunity that obviously decreases after six months.

That's for humoral immunity, antibodies, but we don't yet know what happens to immune memory cells (cellular immunity) because in many people that memory remains valid and that is what would allow people not to have to be vaccinated so much.

By vaccinating a lot by giving fourth dose, fifth dose, we are also provoking the immune system, we are hyper-stimulating it. And we can without realizing it make viruses that are more resistant to vaccines thrive. Then be careful, let's vaccinate with doses when they are needed.

We need to invest more in air circulation technologies rather than recirculation, monitoring. It seems to me that it is very important that governments do not take any more tests now, even in the United Kingdom. Testing centers were dismantled almost everywhere in the world. The circulation of the virus must continue to be monitored and that is a task that the State must take on as a public health policy. If there are new variants, where and how they circulate...

- Otherwise we will be blind again, we will lose track...

— Of course, we will lose track and return to bureaucracy and waste valuable time. If we don't have a new, more lethal virus or a new combination, a new variant that is more resistant to vaccines, I think we are in the final part of this pandemic. But the pandemic will not end until 2023, when 75% of the world will be vaccinated. Then it will become an endemic virus, it will become the fourth or fifth endemic coronavirus that will have seasonal outbreaks, where we will get the flu vaccine, those over 60 years old, health personnel and people with vulnerabilities and chronic situations; coronavirus vaccine, on the same day and in different arms.

PHOTOS: Nicolás Stulberg - VIDEO EDITION: Nicolás Spalek

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