In autumn, there is a recurring growth in the novel coronavirus disease. This is, as experts put it, another wave of COVID-19. Olga Sokolova is Associate Professor in the Department of Infectious Diseases, Epidemiology and Dermatovenereology at St Petersburg University and Head of the Clinic at the Botkin Hospital. She explained: what the chances are for vaccination to help reduce the consequences that this rise might lead to; whether you could get infected if you have high antibody titres; and what complications after COVID-19 are most common in medical practice.

Doctor Sokolova, is it really necessary to get vaccinated against COVID-19?

Yet, it is! Getting vaccinated means that the risk of serious disease in COVID-10 cases decreases. This is what we are witnessing in the hospital.

In Israel, almost 70% of the population is vaccinated, but the rates of coronavirus infection are still growing. The research has shown that you may get infected and admitted to hospital even if you are vaccinated. Yet, as the comparative study has shown, the difference between how the disease progresses in vaccinated and not vaccinated patients is enormous. If you are not vaccinated, the risk of serious disease is three times higher. This difference increases significantly for people over 50. In this age group, severe cases in unvaccinated people develop 23 times more often compared to those who have been vaccinated.

Have you worked in the red zone? How difficult is it for a doctor?

I was working in the red zone from April to September in 2020. This was in the wake of an outbreak of the coronavirus pandemic. We had no idea how to treat it. It was difficult. It was not clear why patients were getting worse and what to do about it. Although we are experts in infectious diseases, having to work in personal protective equipment is not what we encounter every day. So it was difficult. Yet we, as specialists, were ready.

Today, the rates are increasing once again.

Yes, the epidemic trajectories resemble waves. Now, according to official statistics, there is a sharp increase in the cases. We are witnessing a severe course of how COVID-19 progresses in patients admitted to hospitals, with a high death rate that is 2.5 times higher than in 2020. There is a shortage of places in hospitals, with new sites being open. This is partly due to the fact that in autumn people returned from vacations, and the infection began to spread among schoolchildren, their parents, in families, and among unvaccinated people. This is quite predictable.

Many of us who reject COVID vaccine fear side effects.  Is there any reason behind these fears relating to how serious these side effects might be?

Having worked in the red zone when the first wave started to decline and the Clinic at the Botkin Hospital reopened, I was deeply concerned by the patients who had complications the COVID-19 had caused. There are few, if any, post-vaccination complications. In January 2021, we started to vaccinate, and the number of those who got vaccinated is already over 10,000 people. Among the side effects that are observed in almost 100% cases are fever that can be accompanied by chills and malaise. This is a normal response to the viral infection and indicates that the body develops immunity to the virus. This is how the vaccines work.

A serious side effect that can be expected is cases of anaphylaxis after administration, reactions to the components of a vaccine, but we have not had such cases. For people who are at risk of allergic reactions, we recommend to take anti-allergic drugs three days before receiving the COVID-19 vaccine. In most difficult cases, we can simultaneously inject hormones. Yet there have been no serious autoimmune reactions in our practice.

Many theorise that booster vaccinations may further increase the risk of autoimmune diseases. There is no confirmed data, these risks are possible but not probable. The risk of coronavirus infection and its severe course seem much more real. Revaccination is necessary.

When can you get your Covid revaccination?

According to the order of the Ministry of Health, the dose must be given at least six months after a second administration of the vaccine or six months after you had COVID-19.

Is there any data on whether antibodies persist for a long time? How to make sure you are protected? Do you have to have an IgG antibody test in the laboratory to make sure you are protected?

We are continuing to study COVID-19 as a novel disease. Now there is a lot of conflicting data. Some people do not get sick without having antibodies, and, conversely, some get sick with a high antibody titre. So antibodies in this case are not an unambiguous indicator of whether you can get sick or whether you are protected.

Obviously, how our immune system responses to coronavirus disease is not the way it usually does to other infections. Scientists have not yet discovered this pattern. Contemplating about the risks by the presence or absence of antibodies is meaningless. You are not even recommended to take an antibody test during revaccination. You just need to get revaccinated against coronavirus every six months.

Today, experts talk a lot about long COVID, i.e. post-Covid syndrome. What are the most common consequences of the disease you encounter as a doctor?

There is a diverse range of consequences of COVID-19. The virus can affect any organ or body system. There is a lot of data about diseases of: the cardiovascular system; myocarditis; increased blood pressure; the effect on blood vessels; exacerbation of autoimmune diseases; neurological problems; dysfunction of the gastrointestinal tract; and fibrosing processes in the lungs after pneumonia. What we know is far from being systematised. We treat pathogenetically, symptomatically, and advise them to consult relevant specialists.

Is there anything you can do while you are suffering from or after you have suffered from the disease to alleviate the effects of COVID-19?

The key is to take proper medication: to monitor your condition, to agree to be admitted to hospital if necessary. There is no universal advice, everything is individual. For various pathologies, if different organs and systems are affected, there are different drugs that need to be taken to alleviate the consequences and, primarily, prevent death.

Even though the pandemic hasn't ended, seasonal illnesses are still with us.

During the pandemic, the incidence of SARS and intestinal infections has significantly decreased. This is due to wearing masks and washing hands more often. Yet this year people are more likely to neglect preventive measures, for example, wear less masks, there might be an increase in the flu rates. Seasonal vaccinations can help prevent severe flu. Now you can get vaccinated against flu, too.

Read more about influenza vaccination in an interview with Dmitrii Lioznov, Director of the Smorodintsev Research Institute of Influenza, and Daria Danilenko, Deputy Director and graduate of St Petersburg University.

How to boost your immune system for autumn?

In any autumn, you need to regularly go in for sports, walk at least five kilometres a day, have a balanced diet, be outdoors more often, follow a balanced daily routine: sleep at night and stay awake during the day. These are the best ways to boost your immune system. As always, in November, you can take multivitamins containing vitamin D and other vital supplements.

Is it possible now to summarise the interim results of the pandemic and give a forecast for how long the world will live with SARS-CoV-2?

This is another infectious disease. In this case it is a viral infection that has produced an enormous impact on Earth, on the whole world, on people, and on the economies of states. It is too early to make any predictions. Probably, this is the disease that will always be with us. We are very unlikely to get rid of it. Over time, perhaps we will learn how to be routinely vaccinated against the coronavirus, or maybe the virus will develop into some new forms.