Coronavirus: is mandatory mask-wearing coming back in Hungary?

Mask-wearing could be made mandatory again

Rusvai also drew attention to the fact that vaccination against the flu may be very necessary this year, as a serious epidemic is looming, commercial broadcaster ATV reported on Monday.

Virologist Miklós Rusvai said on ATV's Start programme that the upsurge in autumn illnesses since the arrival of Covid is not surprising, and that this could be caused by several viruses. 

According to him, the flu vaccine "does not harm anyone", but he fears that people will return to the mindset of the pre-Covid days, meaning that a large part of the available amount will remain unused by the end of the season. 

A total of 6,097 deaths could have been prevented in Hungary in the fourth wave (delta variant) of the coronavirus pandemic last autumn and during the January surge of the fifth wave (omicron) if those unvaccinated people that died of coronavirus-related diseases had been vaccinated fully, i.e. with booster shot(s), according to a joint study by seven experts.

Rusvai said that

it may be necessary to reintroduce the wearing of masks on public transport or in public institutions,

but it does not harm anyone and people can wear them now. It was also said that new mutations of the coronavirus are now better at evading the immunity induced by the vaccine, which is why there are more and more variants.

A 'Nightmare' Covid variant

While the BQ.1 and BQ.1.1 COVID subvariants have gained traction across the U.S. in recent days, another new strain is responsible for a surge in cases in Singapore, NBC Chicago has reported recently.

Referred to as the "nightmare" variant in some reports, XBB is the combination of two omicron subvariants - BA.2.10.1 and BA.2.10.75 - and is said to have a "significant growth advantage," said Dr. Maria Van Kerkhove, an infectious disease specialist and the technical lead for COVID-19 response at the World Health Organization (WHO).

Coronavirus sub-variants. Source: Covariants.org (Nextstrain.org) (XBB is the recombinant not yet marked in the figure above, a combination of two sub-variants of omicron).

Van Kerkhove explained data about the latest strain remains limited, but said the one study that was conducted with XBB shows "significant immune invasion." However, is it really any different than any of the other omicron strains that also appear to be more immune-invasive?

"We do know this recombinant has a significant growth advantage. All of the subvariants of omicron are showing increased transmissibility and properties of immune escape," Van Kerkhove said.

"With this XBB recombinant we have one study based on a pseudo virus, so not a live virus, that is analyzing antibody escape and it's showing significant immune evasion. And this is of concern for us because we need to ensure that the vaccines that are in use worldwide will remain effective at preventing severe disease and death."

US Centers for Disease Control and Prevention (CDC) data showed as of the week ending 22 October, BQ.1 made up 9.4% of recent cases, while BQ1.1 was said to be behind 7.2% of new cases. The numbers marked a notable increase from the week prior when each made up 5.7% of recent cases. BF.7 remained behind the other strains during both week-long periods, the data revealed. BF.7 accounted for 5.4% of cases the week ending 15 Oct. and 6.7% of cases for the week ending 22 October.

Van Kerkhove said there have been no signs of increased severity in the XBB, BQ.1.1 and BQ.1 variants, "but it's very early, and we have very little data to assess this."

Because XBB, BQ.1.1 and BQ.1 all have characteristics of omicron, the vaccine and treatments for the strain should be effective, at least to some degree, said Dr. Allison Arwady, commissioner of the Chicago Department of Public Health.

If a variant without any relation to omicron were to emerge, that could be particularly troubling.

"The way COVID, like any other virus, mutates, creates new variants is by spreading," she previously said. "Every time there's a new COVID infection, there is an opportunity for the virus to mutate just a little bit in the genetics of it. And when we start to see more COVID infections happening, we also start to see more variants. That's just how it works. So the fact that we're heading into colder weather, it doesn't surprise me at all that we would see more mutations."

Local warnings

Rusvai is not the first expert to speak out on the prospects of the epidemic and urge caution.

According to Beatrix Oroszi, an epidemiologist at Semmelweis University, the registered case numbers do not sufficiently reflect the risk: seven times more people are found infected, even though only a quarter as many are tested as a year ago. (Local authorities have not been publishing test numbers since mid-May, which makes it impossible to calculate the positivity rate, a key indicator of the severity of the pandemic in previous waves.)

According to Széchenyi Prize-winning immunologist András Falus, the omicron variants that are now spreading are fortunately associated with significantly milder symptoms. However, we cannot rule out that the virus could run wild again.

Virologist Ferenc Jakab has recently pointed out that it is currently very difficult to distinguish between the current omicron variant of the coronavirus and the symptoms of the flu, as patients show very similar symptoms.

He warned that the importance of the flu vaccine is much greater than it has been in recent years because of the erosion of immunity. Therefore, he recommends getting a flu shot as a matter of urgency.

Biologist Gábor Kemenesi wrote recently that there will be an autumn Covid wave, with several variants of the coronavirus spreading in parallel around the world, and in the meantime, it is worth preparing for the start of the flu season.

Kemenesi warned that it is impossible to predict anything about the coronavirus.

We have reached the stage in the pandemic where several variants are spreading in parallel around the world and mutating in very similar directions (what researchers call convergent evolution).

"This broadly suggests that the virus is having very similar effects everywhere, probably due to the fact that most of the world already has some form of acquired immunity - either vaccinated, or encountered the virus, or both," he explained. Kemenesi added that the process is now moving towards the practical possibility of catching the virus again. According to him, the virus is spreading in the world more than would be optimal for us, which is why newer and newer adapted vaccines are arriving.

The biologist urges to take a look at Western Europe for useful experience. The smarter countries are already embarking on a major booster vaccination campaign on the eve of the epidemic wave. On the other hand, he cites the example of Germany, where the reintroduction of mandatory mask wearing in confined spaces is already a serious issue. All this is linked to adaptive, situational defence.

All reasonable virologists and epidemiologists are of the same opinion, with a wealth of scientific data showing the effective spread of the virus indoors

Gábor Kemenesi argues in favour of mask-wearing, adding that the return of influenza is slowly becoming a certainty.

He also said that the main places where the coronavirus can be caught are in enclosed and poorly ventilated spaces, including public transport (buses, subways, etc.). This is where mask-wearing should be seriously considered as a precautionary measure. He stressed that rapid tests, available from pharmacies, are excellent for detecting the most infectious phase.

The virus can affect not just the time of infection, but the rest of our lives. We are unnecessarily exposing our bodies to the unpredictable risk of a viral infection,

wrote Gábor Kemenesi, who also provides concrete studies and evidence. For example, a study of data from more than 250,000 people has clearly shown that repeated COVID infections increase the prevalence of post-Covid complications. If that were not enough, it is also clear that long-term adverse cardiovascular diseases can result from infection, the prevalence of which has increased at a well-documented rate as a result of the COVID pandemic," he said.

Cover photo: MTI/Csaba Krizsán