Björn Olsen on coronavirus: “We need smart strategies”

Björn Olsen is professor of infectious medicine and one of Sweden’s leading experts in infectious diseases and pandemics.

Photograph: Mikael Wallerstedt

COVID-19 , the new coronavirus, will affect older and sick people for a long time to come – perhaps up to a year. More research is needed, both to prevent more viruses from attacking us and to reduce the effects of the infection that is now spreading, says Björn Olsen, professor of infectious medicine at Uppsala University.

Björn Olsen is one of Sweden’s leading experts in infectious diseases and pandemics. Hugely in demand from the media recently, he has been closely following the course of events both as a researcher and as a doctor at the Section of Infectious Diseases, Department of Medical Sciences, Uppsala University Hospital.

Is there something you, as a researcher, have found lacking in the media debate about this novel coronavirus?

“What was extremely interesting from the start, but isn’t discussed so much now, is why we humans can get this virus at all. It’s a matter of human expansion. We’ve become too numerous, and take up too much space. We humans exploit animals and nature. So we get not only meat and milk, but also strange viruses. This ought to be given more attention,” Olsen says.

Scientists call this interdisciplinary way of looking at health “One Health”. Since many infectious agents circulate between animals and humans in nature, doctors, veterinarians and ecologists are collaborating in their quest to understand how various pathogens spread and how new infections arise.

Infection passed from animals to people

Uppsala University has a Zoonosis Science Center for research on zoonoses – that is, diseases transmitted from animals to humans.

“Here, some research is being done to characterise coronaviruses and see where they occur in the natural environment, and in which animals. For the past couple of years, Johan Lennerstrand has been investigating which substances could be used to stop the virus.”

When the virus penetrates the cell, it takes over cell function and multiplies through replication – making copies of the viral DNA.

“More knowledge of what the virus looks like at molecular level is needed, and a great number of substances need to be tested to see if we can stop the virus entering the cell, or the viral replication. This is the type of research we’re doing here in Uppsala.”

But research in medicine and microbiology is not all that is needed, Olsen emphasises.

“To understand this type of disease, we have to work in an interdisciplinary way – jointly with ecologists and social scientists, for instance. How can we make sure more viruses don’t appear?”

Too late to stop the spread

The window for global containment of COVID-19, the virus that is currently infecting more and more people worldwide, has now closed.

“We know it’s going to infect a colossal number, and presumably it’ll keep going for a long time. Until early autumn, at least, or perhaps for a year.”

One frequent comment is that the novel virus is no worse than ordinary influenza, but Olsen can refute this assertion.

“It doesn’t resemble ordinary flu in any way. It’s going to hit the oldest and weakest people immensely hard, and we live in a society that seeks to protect these groups. In the debate you sometimes hear ‘It only affects the old and sick, after all,’ but that statement holds enormous cynicism. If that’s how we think, we may just as well close down the Swedish health services.”

As a researcher, he thinks there is a great deal to be learnt from the ongoing spread of infection and its consequences in society. He would therefore like to see a sharper focus on research in this area.

“This is one of the big challenges for the future. We’ve come an incredibly long way in oncology and cardiac diseases, and we’re succeeding in research on antibiotic resistance, but we mustn’t forget that viral infections kill more of the population than antibiotic-resistant bacteria do.”

Good preparedness for a pandemic

What, then, can we do to reduce the impact of the infection spreading? For the individual, following the current recommendations is essential. From society’s point of view, it is a matter of being well prepared for a pandemic, Olsen thinks.

“It’s crucially important to do research on our state of preparedness. What quantity of resources should we devote to sampling, and to caring for the severely ill? The question is both how much upscaling has to be done, and when. We need new, smart strategies.”

At the Section for Infectious Diseases in Uppsala, for example, a large yellow tent has been erected to improve sampling efficiency by enabling more people can be tested at the same time.

“We proposed that five weeks ago, but then there was a lot of discussion about GDPR and confidentiality. We’re in an extraordinary situation, but there’s a kind of anxiety about being unconventional and unorthodox. Why is that?”

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